If you’re an acne sufferer, you’ve probably said some version of this sentence:
“I’ve tried everything to clear my acne and nothing works.”
I hear it all the time in my clinic and from young adults and adults online. You’ve tried different products, counter treatments, prescription medications, maybe even multiple rounds of Accutane. You’ve scrubbed harder, switched face wash every few weeks, gone on a “clean” diet, tried the latest TikTok-approved skincare products you saw on social media… and you still don’t have clear skin.
Here’s the good news: if your skin isn’t clear yet, you actually haven’t tried everything.
When I sit down with a new client and ask:
“Has anyone ever explained what acne really is, what type of acne you have, and given you a personalized treatment plan that’s adjusted every two weeks?”
the answer is almost always no.
That missing piece is usually why nothing has worked long term.
In this blog, I’ll walk you through:
- Why your case of acne hasn’t responded to what you’ve done so far
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The real causes of acne (and why poor hygiene is not one of them)
- Why the wrong products and “blanket cause of acne” advice keep you stuck
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The best way to approach acne treatment when you feel you’ve tried it all
- A simple game plan you can start today, even if you don’t live near an acne clinic
And yes, we’re going to talk about dead skin cells, oil glands, hormones, diet, mental health, and more—but in plain English.
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Why “nothing has worked” (yet)
The first question I always ask when someone tells me they’ve tried everything is:
“Have you ever worked with an acne specialist who sees you every two weeks for treatment and home care adjustments?” Almost every time, the answer is no.
They may have seen a board-certified dermatologist once every few months, picked up a few acne products, tried an acne medication or oral antibiotics for a while, or grabbed a new acne product from the drugstore shelf. But that is not the same as working with an acne specialist who:
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Analyzes your skin type and type of acne
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Builds a realistic skincare routine for you
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Adjusts that routine every couple of weeks based on how your skin responds
If you haven’t tried that, you truly have not tried everything. But before we get to different treatment options, you need to understand what acne really is.
If you’re totally new to this, I also recommend reading my blog: “What Really Causes Acne: The Genetic Story Behind Breakouts” – it goes deeper into the science behind acne.
What actually causes acne (and what’s just a trigger)
Acne is one of the most common skin conditions on the planet. The medical name is acne vulgaris. It usually starts in the teenage years—hello, high school—and often continues into your early 20s and beyond. Adult acne (especially in women in their 30s and 40s) is incredibly common.
There are two main ways someone ends up with acne:
1. Genetic acne (this is most people)
This is the big one. Somewhere in your family tree, you inherited the “acne gene.” That gene changes how your hair follicles behave.
Here’s what happens inside the pore:
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The lining of your hair follicle starts to hyper-shed dead skin cells.
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Those dead skin cells mix with excess oil from your sebaceous glands (your oil glands).
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That mixture forms a plug inside the follicle and blocks the pore.
Those plugs can:
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Stay non-inflamed (like blackheads and clogged bumps)
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Or become inflamed when acne-causing bacteria (also called acne bacteria) get involved
That’s when you see:
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Red inflamed pimples and acne breakouts
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Pustules
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Cystic acne
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Larger acne cysts and even an acne nodule that hangs around forever
You didn’t cause this with bad habits. Your skin is genetically acne-prone skin.
2. Acne imposters (much more rare)
Sometimes, something else entirely is going on—like:
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Certain steroid use
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An illness
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Parasites
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Unusual reactions to medications
These can create bumps that look like acne in someone who isn’t naturally acne-prone. In over 12 years of working with thousands of acne sufferers, I’ve only seen a true “acne imposter” a handful of times.
So for 80–90% of people, genetics are the root cause.
Hormones: the accelerator
Then we layer in:
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Changing hormone levels
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Androgen hormones (like testosterone)
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Hormonal fluctuations in your teenage years, young adults, pregnancy, and around the menstrual cycle
Hormones increase oil production, thicken the lining in the pore, and can turn a mild case of acne into more frequent, stubborn flares we call hormonal acne.
What doesn’t cause acne?
Two big myths:
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Poor hygiene – Scrubbing harder or washing your face five times a day won’t clear acne. Over-washing and harsh scrubs actually damage your skin barrier, irritate your skin, and can cause more issues.
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“You ate one bad food” – Food can be a trigger, but not the only way and not the only cause.
You are not dirty. You’re not lazy about the care of your skin. You just have the biology for acne.
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Know your type of acne (so you can stop guessing) To clear acne, you first need to know what you’re dealing with. Different types of acne need different treatments. Some common patterns:
Sometimes, things like fungal folliculitis or even skin cancer can be mistaken for acne, especially when people search for their symptoms on social media. A board-certified dermatologist is especially important if:
For classic acne-prone skin, an acne specialist who lives and breathes acne can often create a more detailed, practical plan than a quick prescription visit alone. Why your current skincare routine isn’t working Let’s look at what’s lined up on your bathroom counter. A lot of acne sufferers are doing too much and not enough at the same time:
You might have:
You are trying to take care of your skin—but the wrong products, the wrong combinations, and hidden pore-cloggers can keep you stuck. Hidden pore-cloggers Many “non-comedogenic” skincare products and skin care products actually contain ingredients that clog pores over time. They might not cause an instant breakout, but they quietly create new breakouts under the surface. Harsh cleansing habits Scrubbing with harsh beads, using really hot water instead of gentle warm water, or cleansing five times a day strips the skin barrier, leads to irritation and sometimes more oil production as your skin tries to compensate. Not matching products to your skin type
If your type of acne and skin type don’t match your routine, your skin can end up red and irritated… but not clear. Jumping routines too fast If you switch from product to product every week, none of your topical treatments get enough months of treatment to work. Every new acne product just adds confusion and sometimes new breakouts. No wonder it feels like nothing works. The Pore-Clogging Watchlist (check this before anything touches your face) Because pore-clogging ingredients are such a big deal in a case of acne, I ask all my clients to run their products through our Skin+ Ingredients Checker at: https://skinplus.com/pages/ingredients-checker It’s a good idea to do a quick audit of your bathroom shelf. Here’s the Pore-Clogging Watchlist I use in my clinic. If you see these in your skincare products, makeup, hair products, or even “clean” wellness products, they may be working against your clear skin goals. Just know that if you’ve “tried everything” but your makeup and moisturizer still contain several of these, that alone can prevent you from getting clear skin. Food, hormones, and lifestyle: important, but not everything If genetics and dead skin cells in your follicles are the main actors, food and hormones are the supporting cast. Diet and high-glycemic foods High-glycemic foods are things that spike blood sugar quickly: sugary drinks, white bread, candy, lots of processed snacks. For some acne sufferers, these can make breakouts worse. A healthy diet with more whole foods, protein, and fiber is a better foundation. Food is rarely the only way to clear acne, but supporting your skin from the inside is almost never a bad idea. Here are a couple of blogs I wrote on this subject for a deeper dive: Does Dairy Really Cause Acne? The link between milk and Breakouts What's Up With Vitamin B and Acne? Does Protein Powder Cause Acne? Hormones and birth control Hormonal shifts in your teenage years, early 20s, and beyond can aggravate acne. Sometimes birth control pills help by adjusting hormone levels; other times they make acne worse, depending on how they affect androgen hormones. This is where working with a professional matters. Birth control should never be treated as a one-size-fits-all, blanket acne cure—there are pros, cons, and potential side effects. Check out these blogs for more information on hormones and acne: Hormonal Acne and Polycystic Ovary Syndrome (PCOS) The Truth About Birth Control For Acne Acne & Menopause: A Personal Guide From Your Skin Coach Stress and mental health Chronic stress can influence hormones, sleep, and inflammation. Constantly fighting your skin can also impact your mental health. You are absolutely allowed to want clearer skin for your own confidence. Treatment options that actually move the needle You’ve heard of most of these, but what matters is using the right combination for you. Topical treatments Common topical treatments for acne include:
There is no single magic product. The best way forward is a smart, layered approach built around your skin, your health history, and your comfort level with treatments and their side effects. Why coaching and consistency beat “just one product” Here’s the part nobody prints on the bottle: Most people don’t clear because they never stay on a strategic routine long enough—and they never have someone adjusting that routine as their skin changes. This is why you might:
Often, your skin just adapts. You might need different active ingredients, a stronger percentage, or a rotation of products. As a general rule of thumb, clearing acne requires:
Think of it like working with a trainer at the gym. The only way to get stronger is consistent, guided work—not one heroic workout. It’s the same for your skin. What to do if you feel like you’ve tried everything If you’re reading this thinking, “I’ve had acne since high school and I’m so over it,” here’s a concrete starting place. 1. Understand what acne is If you haven’t already, read my blog “What Really Causes Acne: The Genetic Story Behind Breakouts”. It goes deeper into acne genetics so you understand your skin isn’t dirty or broken—you just have acne-prone biology. 2. Download my Free Acne Clearing Checklist This is your roadmap. It walks you through good things to start and stop doing right away:
It’s the best way to stop guessing and start acting like a scientist with your own skin. 3. Audit your products Grab everything you use on your face and hair:
This one step alone can dramatically reduce new breakouts. 4. Simplify your at-home routine A good starting structure:
Don’t layer five actives at once. You’re playing the long game, not trying to annihilate your skin in one night. 5. Get support If you can, work with an acne specialist who can:
If anything about your skin seems “off” or doesn’t behave like typical acne, it’s always a good idea to also see a board-certified dermatologist to rule out skin cancer and other skin conditions. 6. Give it time (and compassion) Even with an excellent plan, most people need a few months of treatment before they feel truly skin blemish-free. You’ll usually see progress sooner—but consistency is everything. You are not a failure because your acne hasn’t cleared.
You likely have genetically acne-prone skin, plus a few triggers—and until now, no one has helped you address it systematically. Your next step If you feel like you’ve tried everything and you still don’t have clear skin, here’s what I want you to remember:
Start by:
From there, consider working with an acne specialist who can coach you through each step. Like any long-term transformation, your skin deserves more than a one-and-done product. You’re not alone. And even if this isn’t your first time trying to clear acne, it can be the last time you have to start over. If you haven’t worked with me yet, here is the link to book an appointment. I look forward to helping you. Book Your First Appointment |
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