You've tried every face wash on the shelf. You've gone through two tubes of that cream your friend swore by. And still, every few weeks, the breakouts return. If this sounds familiar, you're not alone. Recurring acne is one of the most common complaints we see at Youthville Clinic, and the reason it keeps coming back almost always comes down to one thing: treating the symptoms, not the cause.

Why Acne Isn't Just a Skin Problem

Acne forms when hair follicles get blocked by a combination of excess oil (sebum), dead skin cells, and bacteria called Cutibacterium acnes. But what causes that excess oil in the first place? That's where most over-the-counter products fall short, they address the blockage but not the trigger.

The real causes are almost always internal:

1. Hormonal fluctuations

This is the most overlooked driver of adult acne, especially in women. Fluctuations around your menstrual cycle, PCOS, thyroid issues, or coming off birth control all cause androgen levels to spike, and androgens directly stimulate your oil glands. If your breakouts follow a monthly pattern, or cluster along your jawline and chin, hormones are almost certainly involved.

2. Insulin and diet

High-glycaemic foods, white rice, maida, sugar, sweetened drinks, cause rapid spikes in blood sugar and insulin. Insulin, in turn, increases androgens. It also triggers a protein called IGF-1 that ramps up sebum production. Studies from the Indian Journal of Dermatology confirm this link is particularly significant in Indian diets. Dairy can also be a trigger for some people.

3. The wrong skincare

Products that are too stripping actually make acne worse, your skin overcompensates by producing more oil. Many popular face washes contain sulphates and alcohol that strip the skin barrier, perpetuating the cycle.

4. Stress and cortisol

Stress doesn't cause acne directly, but it elevates cortisol levels, which trigger inflammation and oil production. This is why exams, work pressure, or big life events often coincide with a flare.

5. Incomplete treatment

Most topical treatments take 8–12 weeks to show meaningful results. Most people stop at 3–4 weeks when they don't see immediate change, or stop entirely once skin clears, allowing the underlying condition to resurface.

What a Dermatologist Does Differently

When you see a dermatologist for acne, the first step isn't prescribing a cream, it's diagnosis. We assess your acne type (inflammatory, comedonal, cystic, hormonal), severity, your skin type, your diet and hormonal history, and what you've already tried.

From there, treatment is personalised. For hormonal acne, this might include prescription-strength retinoids, oral medications, or hormonal regulation. For cystic acne, a combination of peels, LED therapy, and medical-grade topicals is typically needed. For post-acne marks, targeted treatments like microneedling or chemical peels help speed up healing without worsening pigmentation, which matters especially for Indian skin tones (Fitzpatrick III–V), where post-inflammatory hyperpigmentation is a real concern.

The difference isn't just in the products used, it's in the systematic, layered approach.

The Realistic Timeline

We tell every patient upfront: acne treatment is not instant. Here's what to expect:

• Weeks 1–2: Skin may temporarily worsen (purging), this is normal

• Weeks 4–6: Active breakouts begin to reduce

• Weeks 8–12: Significant improvement in most cases

• 3–6 months: For stubborn hormonal or cystic acne

Consistency, not intensity, is what clears acne and keeps it clear.

When to See a Dermatologist

Don't wait if:

• Your acne is painful, cystic, or leaving scars

• Over-the-counter products haven't worked after 3 months

• Your breakouts are hormonal (cycle-linked, jawline/chin pattern)

• You're developing dark marks alongside the acne

At Youthville Clinic, Andheri West, every acne consultation starts with a root cause diagnosis. Because clearing your skin for good means understanding why it's breaking out in the first place.