Dear Diary: She Came to Me for Skincare. I Told Her Not to Buy Any.
Sometimes acne isn’t about needing another skincare product. Discover why understanding what changed in your health and skin can be more important than adding another product to your routine.
Emily Britten
9/15/20265 min read
I had a Skin Discovery Session last week that has stayed with me.
Not because it was an unusual client story. In fact, parts of it were very familiar. She had experienced acne as a teenager, but it had eventually cleared and her skin had been settled for years. Then, a few months ago, she experienced some digestive issues, and not long afterwards her acne returned.
When she came to see me, she naturally wanted to know what skincare she should be using to get rid of it. And I completely understood why.
If you have acne, you want to know what to put on it. You want to know which cleanser to use, which serum might help, whether you need a different moisturiser or whether there is a treatment that will finally get your skin back under control. Especially when you have come to see a skin specialist.
So she was probably expecting me to talk to her about skincare. I didn't.
The moment she realised I wasn't going to give her a shopping list
When I explained that, in her situation, skincare should actually be the last thing she needed to be thinking about right now, she looked genuinely shocked. Almost mortified. I could practically see the thought on her face.
But you're a skin specialist. Surely you're supposed to tell me what skincare to use?
And honestly, I don't blame her for thinking that.
We have been taught to think about acne as a skin problem that needs to be solved from the outside. If you have spots, you need a product for spots. If your skin is congested, you need something to unclog it. If your acne keeps returning, you need to find the right routine.
Sometimes that is appropriate.
But sometimes, before we start changing everything you are putting on your face, we need to stop and ask a much more important question.
What changed?
In her case, something had changed
This woman's acne had been gone for years. Then something changed with her digestion. A few months later, her acne returned. That doesn't mean I can say with certainty that one caused the other. I don't think acne is ever that simple. But the timing was information. And it was information I wasn't prepared to ignore simply because she had come to see me about her skin.
So I told her that, for now, I didn't want her attention going towards buying more skincare. I wanted her to focus on rebuilding the health of her digestive system and getting things functioning normally again. And then we could see what happened with her skin as that picture settled.
I actually said to her:
“Your acne has come back following a gut-related issue. Unless you plan on swallowing your skincare, skincare isn't where I'd put our attention right now.”
We both giggled. But there was a serious point behind it.
Sometimes the answer isn't on your bathroom shelf
This is one of the things I wish more women understood about persistent acne. I'm not anti-skincare. Far from it. I am a skin specialist, and skincare has an important place in the work I do. But I don't believe that every acne problem should automatically start with another product.
If your skin has suddenly changed, I want to know what else has changed. If your acne has returned after years of clear skin, I want to understand what was happening around the time it returned. If you have been struggling for years despite doing everything you have been told to do, I want to understand what you have already tried and what happened.
Because your skin doesn't exist separately from the rest of you. And sometimes the most useful information isn't sitting on your bathroom shelf.
This is why I ask so many questions
When someone comes to me, I don't just want to know what cleanser she is using. I want to know her history. I want to know when her acne started, whether it has changed over time and what she has already done to try to improve it. I want to understand the patterns in her skin and what was happening in her life when those patterns changed.
That doesn't mean I am looking for one magical cause. It means I am looking for the bigger picture. Because if I simply looked at her skin, saw acne and immediately recommended an acne skincare routine, I would be making a huge assumption. I'd be assuming that the most important thing to change was what she was putting on her face. And I wasn't convinced that was true for her.
This is the difference between treating the skin and understanding the person
I think there is a subtle but very important difference here.
You can look at acne and ask:
“What can I put on this?”
Or you can look at the person and ask:
“Why has this changed?”
Those questions can lead you in very different directions. And I know which question I would rather start with. Because I don't want to be the person who gives you a beautiful new skincare routine that makes you feel hopeful for a few weeks, only for you to be back where you started wondering what went wrong.
I want to understand the problem before deciding what needs to change. That is why education is such a big part of my approach. I want you to understand why I am asking the questions I am asking. I want you to understand why I am recommending certain things and not recommending others. And I want you to feel that there is a reason behind the plan rather than feeling as though you have simply been handed another list of instructions.
That is the thinking behind my HELP+ Method.
It is also why a Skin Discovery Session is about much more than looking at your skin and deciding which products you need.
So, should you stop using skincare?
No. That isn't the message. Skincare can absolutely be useful, and there are situations where it is an important part of an acne plan. The point is that skincare shouldn't automatically be the starting point simply because the problem is visible on your skin.
Sometimes we need to step back first. We need to understand what has changed. We need to understand the pattern. We need to understand the person. And then we can decide what actually deserves our attention.
For this particular client, that meant putting skincare further down the list for now and focusing on her digestive health first. That might sound like a strange thing for a skin specialist to say. But I'd rather tell you what I genuinely think you need to hear than recommend something simply because it is what you expected me to recommend. Because if you have trusted me enough to come and ask for my help, you deserve my honest opinion.
Even when that opinion is:
“Don't buy anything yet.”
Want to understand how I approach persistent acne?
I've created a free masterclass where I explain more about why I don't believe acne should always be treated as a skin problem in isolation, and how I approach the bigger picture.