Why Do I Get Breakouts?

Acne and breakouts are a medical condition — not a skincare failure. Whether you’re dealing with persistent adult acne, hormonal breakouts, painful cystic acne or early scarring, we get it. Our team of dermatologists have the skillset and understanding of how to clear skin safely and protect it for the future.

Here is our advice on why we get breakouts, and how to treat acne:

Why do I get acne and breakouts?

Firstly, you’re not alone. Acne is a very common skin condition. Most people experience it at some point — often during their teens, but it can persist into adulthood or start later in life.

Acne develops when several things happen at once:

• The skin’s oil glands (sebaceous glands) become overactive. These glands are influenced by hormones and, in people prone to acne, are particularly sensitive — even when hormone levels are normal. This is why drying medications and lasers such as Aviclear can help – they target these glands to dry them out.

• Dead skin cells build up and block pores.

• Oil and dead skin combine to form blackheads and whiteheads.

• Naturally occurring skin bacteria multiply inside blocked pores, triggering inflammation. This leads to red, sore spots, pustules, nodules or cysts.

Hormonal changes can play a major role. Acne can flare with puberty, menstrual cycles, pregnancy, and conditions such as polycystic ovary syndrome (PCOS). Certain medications, including some hormonal contraceptives, and steroids, can also worsen acne. Oily skincare or hair products, and picking at the skin, may aggravate it further.

There is no single cause — acne usually develops due to a combination of hormonal, genetic, and lifestyle factors which is why seeking expert treatment can be the only way to resolve breakouts.

What type of acne and breakouts do I have?

Acne varies in severity, and understanding the type you have helps guide treatment.

Mild acne

• Blackheads and whiteheads

• Occasional small red spots

Moderate acne

• More frequent inflamed spots and pustules

• Often affects the face, chest or back

Severe acne

• Deep, painful lumps (nodules) or cysts

• Higher risk of scarring and long-term marks

Acne can also leave behind pigmentation or scars — either raised, indented, or areas of darker or lighter skin. Severe or persistent acne should always be assessed by a dermatologist early to reduce the risk of permanent scarring.

What treatments will clear my acne?

There is no single “cure” for acne, but treatments are very effective at controlling it, preventing new breakouts, and reducing scarring. Understanding why we are getting these breakouts is the first step, and dermatologists can help you understand this. In the meantime, the following may help your skin:

At home topical treatments (applied to the skin)

These are usually the first step for mild to moderate acne and include:

• Benzoyl peroxide (most of which are available over the counter at your pharmacy)

• Azelaic acid

• Topical retinoids (such as adapalene or tretinoin)

• Nicotinamide (niacinamide)

They are applied to the whole affected area — not just individual spots — and typically take 8–12 weeks to show improvement. Some treatments can cause temporary dryness or irritation at first, and acne may briefly worsen before it improves. If you need support with products then give us a call as everyone’s skin varies. Our dermatologist’s favourite products from the pharamacy are:

• Cleansers: Cetaphil Gentle Cleanser, CeraVe Hydrating Cleanser, or CeraVe Blemish Control. If you have dry skin go for the more hydrating cleansers… more oily, go for the Blemish Control.
• Moisturiser: Effaclar Duo+M. Don’t skip the moisturiser, even with oily skin as your skin may try and over-compensate.
• Targeted treatment: Acnecide (benzoyl peroxide gel), or if you want to spend a bit more, think about a retinol like Alpharet by Skinbetter (which we can help you get with a prescription if needed).
• SPF: Heliocare 360 Oil-Free Gel SPF – love this. And also like the mineral tolerance fluid if you have sensitive skin.
• Cover-up Make-Up: Oxygenetix do a great range of camouflage make-up that won’t clog your pores.

Oral treatments (prescribed)

For moderate to severe acne, or acne not responding to topical treatment:

• Oral antibiotics (usually for a limited course)

• Hormonal treatments for women, including certain contraceptive pills or medications that dermatologists can prescribe

• Strong redinoids for severe, scarring or treatment-resistant acne. These medications need specialist supervision by a dermatologist.

Procedural treatments (see recommended treatments at the bottom of this page)

Light, laser and other procedures may help selected cases or acne scarring, but they are not a replacement for medical diagnosis and treatment and work best as part of a wider dermatology-led plan.

What can I do at home to clear breakouts?

Good daily habits support treatment and protect your skin long-term:

• Cleanse gently twice daily and after exercising with a mild, non-comedogenic cleanser (see above recommendations)

• Avoid scrubbing or over-cleansing — acne is not caused by poor hygiene

• Do not pick or squeeze spots; this increases inflammation and scarring

• Use a light, non-comedogenic moisturiser to support the skin barrier

• Wear sunscreen daily, especially when using acne treatments. Opt for an oil-free version.

Acne can affect confidence and mental wellbeing. If your skin is impacting how you feel, it’s important to talk to someone — and to seek professional support early. One of the reasons this clinic was founded is because seeking support for acne felt overwhelming. Read our founder’s story here. 

When should I see a dermatologist?

You should book a dermatology consultation if:

• Your acne is moderate, severe, painful or persistent

• Over-the-counter treatments haven’t worked

• You are developing scarring or pigmentation

• Acne is affecting your confidence or mental health

• You suspect a hormonal cause, such as adult-onset acne or PCOS

Early, evidence-based treatment makes a real difference. Acne doesn’t need to be “lived with” — it can be controlled safely, effectively and with a plan that fits your life.

At No. 23 Skin, acne care is medical, joined-up and personal. We don’t chase quick fixes or trends. We diagnose properly, treat with evidence-based dermatology, and support your skin long-term.

Our ambition is to clear your skin and get you out the door without having to layer on the concealer or hide away. Talk to us via our contact form, via phone on 02039411815 or book online for a consultation to start your journey to clear skin.

Helen & Dr Cherry
CoFounders x

NB: any recommendations made in this post are for information purposes only and should not be used instead of professional medical advice. Please book with one of our dermatologists for medical advice and treatment.