I’ve Tried Everything for My Acne. What Now? when you’ve tried the products, treatments and advice — and your skin still isn’t where you want it to be

“I’ve tried everything.”

I hear some version of this from acne clients all the time, and usually, when we actually go through their history, they really have tried a lot. Different cleansers, acids, retinoids, supplements, facials, skin needling, prescription treatments, TikTok recommendations, expensive skincare, cutting out foods, putting foods back in, changing clinics. Sometimes something worked for a while and then stopped. Sometimes their skin became worse. Sometimes they aren't even sure whether something helped because they changed three other things at the same time.

By the time they sit down with us, they're often not just frustrated with their acne. They're exhausted by the process of trying to understand it. And that's the first thing I want someone in that position to know: if you've tried what feels like everything, my immediate response isn't necessarily to find you another thing to try.

Usually, I want to go backwards.

I want to understand what happened, what you've used, how long you used it for, what your skin was like at the time, what changed, what helped, what didn't and whether we've actually been treating the same problem throughout the entire journey.

Because sometimes the missing piece isn't another product. It's finally having someone look at the whole picture.

“Trying everything” can make it harder to know what actually works

The skincare industry gives us an enormous number of options, which sounds like a good thing until you're the person trying to decide between all of them.

If you have acne, you can find convincing arguments for salicylic acid, benzoyl peroxide, Vitamin A, azelaic acid, niacinamide, exfoliating acids, prescription treatments, supplements, dietary changes, professional treatments and dozens of other approaches. Some of those have strong evidence behind them. Some have more limited or emerging evidence. Some might be useful for one person and completely unnecessary for another.

The problem isn't always that the things you've tried were wrong.

Sometimes they were never given enough time. Sometimes they weren't appropriate for the type or severity of acne you had. Sometimes several useful ingredients were combined in a way your skin couldn't tolerate. Sometimes the treatment improved one part of the acne but another contributing factor wasn't being addressed. And sometimes the acne genuinely required medical management rather than another cosmetic product or treatment.

This is why one of the most useful things we can do in consultation is create a timeline. What did your skin look like before this started? What happened next? What did you introduce? How did the skin respond? How long did you continue? Why did you stop? Once we start putting those pieces in order, the story often becomes much clearer.

Before we decide what to do next, we need to work out what we're actually treating

Acne isn't one identical presentation.

Someone can have predominantly non-inflammatory congestion and closed comedones. Someone else may have significant inflammatory lesions. Another client may have acne alongside considerable sensitivity, dehydration and irritation from years of aggressive treatment. Someone may actually be most bothered by the redness or pigmentation left behind after their acne rather than a large amount of active acne itself.

Those differences matter because the plan should change accordingly.

When I assess acne, I'm thinking about what's happening within the follicle — keratinisation, sebum, C. acnes and inflammation — but I'm also looking at the condition of the surrounding skin. Is it reactive? Dehydrated? Inflamed? Is the barrier struggling? Is the client doing far too much, or are they barely treating the acne at all?

Then there is the history around it.

Does the acne fluctuate with the menstrual cycle? Did it begin after stopping hormonal contraception? Has something changed medically? What treatments have already been prescribed? Are there other symptoms that make medical investigation worth discussing?

The breakout is where we can see the problem. The consultation is where we start understanding it.

Sometimes you haven’t failed the treatment — you simply haven’t had enough time

This is probably one of the least satisfying answers in skincare, but acne treatment takes time.

If you've used something for two or three weeks, become frustrated that you're still breaking out and moved onto something else, you may never have given the original plan enough time to show you what it could do. Depending on the treatment, meaningful assessment often happens over a period of weeks to months rather than days, and current acne guidance commonly evaluates treatment response over approximately 12-week periods.

That doesn't mean you should continue indefinitely with something that's causing a significant adverse reaction, nor does it mean every treatment deserves three months simply because you started it. It means we need realistic expectations about how quickly biological change happens.

I often compare it to the gym. If you changed your entire training program every fortnight because your body hadn't transformed yet, you'd never really know which program worked.

Skin can be similar. Time + consistency = results.

Not because consistency magically makes an inappropriate treatment effective, but because an appropriate plan needs enough consistency for us to properly evaluate it.

And sometimes the treatment really isn't the right treatment

The opposite matters just as much. “Give it more time” should never become the answer to everything.

If acne is persistent despite appropriate treatment, is severe, is beginning to scar or is having a significant psychological impact, there are circumstances where medical review or dermatologist involvement becomes important. Current Australian guidance recognises escalation for persistent or treatment-resistant acne, particularly where there is scarring or significant impact.

This is something I feel strongly about because I don't believe good skin care means trying to keep every client inside our clinic. Sometimes the best thing I can do for someone's skin is say, “I think we need another practitioner involved here.”

That might mean a GP or dermatologist for medical acne management. If there are other relevant health concerns, it may mean discussing those with the appropriately qualified practitioner too.

Referral doesn't mean we've run out of ideas. It means we're recognising where someone else's expertise may give you a better result.

If your skin has become angry, adding more acne treatment may not be our first move

This is another pattern we see regularly in clients who feel like they've tried everything.

They've spent so long trying to clear the acne that the skin surrounding it has become increasingly unhappy. There might be redness, flaking, tightness, dehydration, sensitivity and stinging alongside the original breakouts.

At that point, the temptation is usually to go harder because the acne is still there. I often want to do the opposite.

This doesn't mean we believe barrier repair is a cure for acne. It isn't. But if the skin is struggling to tolerate what you're currently doing, continually adding more stimulation can make the overall picture increasingly difficult to manage.

Sometimes our first phase is therefore surprisingly simple. We might change the cleanser, reduce unnecessary duplication, adjust active frequency, improve hydration or temporarily simplify the routine while we get the skin into a more comfortable position.

Then we reassess. We strengthen before we stimulate. Not because every acne client needs months of “barrier repair”, but because I want the skin to be in an appropriate position for whatever we're asking it to tolerate next.

You may not need a completely new skincare routine

This is something clients are often surprised by. Coming to a new clinic doesn't automatically mean everything in your bathroom cabinet needs to go in the bin.

If you're using something that is appropriate, well tolerated and serving a purpose within the plan, I'm perfectly happy for it to stay there. I'm much more interested in creating a routine that makes sense than creating a routine where every bottle has our preferred brand name printed on it.

Sometimes we'll change quite a lot. Sometimes we'll change one or two things. Sometimes the biggest change is simply teaching you how to use what you already own properly.

I think this matters particularly for someone who has “tried everything” because the last thing they need is another person handing them six new products without explaining why. You should know what each part of your routine is doing. You should understand what we're trying to achieve.

And you should know what we're looking for before we decide whether the next step is working.

What about hormones, gut health and finding the “root cause”?

This is often where someone ends up after topical skincare hasn't given them the result they wanted.

They begin wondering whether their acne is actually coming from their hormones, gut, diet, stress or something else happening internally. Those questions can absolutely be worth exploring in the right context, but I don't believe every persistent breakout proves there is one hidden internal problem we simply haven't discovered yet.

Adult female acne is multifactorial and can be persistent or relapsing. Hormonal factors can be relevant, but the overall picture is more complex than identifying one universal cause.

This is why I prefer to look for relevant clues rather than inventing a root cause.

If your history suggests something deserves medical investigation, we can recommend that. If there are other symptoms that need assessment, they should be assessed properly. But I don't want someone spending thousands of dollars investigating every system in their body simply because they've developed acne.

Sometimes there is an important internal piece. Sometimes acne itself is the condition we're treating. Both can be true.

Your previous treatments weren't necessarily a waste

I think this is really important emotionally as well. When you've spent hundreds or thousands of dollars trying to improve your skin, it's very easy to look back and feel embarrassed or angry about the things that didn't work.

I don't think that's particularly helpful. Every previous treatment gives us information. If something improved your acne temporarily, that's useful. If your skin became extremely irritated, that's useful. If you tolerated a particular active beautifully, that's useful. If your acne returned after stopping a treatment, that's useful too.

Even knowing that something did absolutely nothing can help us make the next decision.

This is why I want clients to bring their history with them rather than feeling like we're starting from zero. If you can remember product names, prescription treatments, approximate timelines or have old photographs, all of that can help us understand how your skin has behaved over time.

We're not judging what you've tried. We're using it.

Progress might need to be defined differently

When someone has struggled with acne for years, the goal is understandably usually “clear skin”. I don't want to take that goal away from anyone, but I do think we need more ways to recognise progress along the way.

Maybe you're still breaking out, but instead of ten inflammatory lesions you're getting three. Maybe your menstrual-cycle flare still happens, but it resolves faster. Maybe the acne is less painful. Maybe you're developing less post-inflammatory pigmentation. Maybe your skin can now tolerate a treatment it couldn't tolerate six months ago. Maybe you're finally able to leave the house without thinking about your skin every five minutes.

Those things matter.

Adult acne can be persistent and relapse is recognised within clinical guidance, so long-term management may sometimes involve maintenance rather than reaching one point where the skin can simply be forgotten forever.

I don't say that to make acne feel hopeless. I actually think understanding this can make it feel much less personal. A breakout isn't evidence that you've failed. It's information we use to decide what the skin needs next.

So, what do you do when you feel like you’ve tried everything?

Stop searching for the next thing for a moment. Instead, step back and look at the entire journey. What are you actually treating? What have you already tried? Were those treatments appropriate? Were they used consistently and for long enough? How did your skin respond? What is your skin doing now? Are there signs that something needs medical investigation? And does the plan you're following actually make sense to you?

This is exactly why our acne consultations are intentionally in-depth. I don't want to look at your skin for five minutes and tell you which serum to buy. I want to understand how you arrived here, because that history often tells us just as much as what's happening on your face today.

Then we build the plan from where your skin actually is.

Sometimes that means simplifying. Sometimes it means introducing targeted homecare. Sometimes it means progressing into professional treatment. Sometimes it means involving your GP or dermatologist. And sometimes it means telling you that you're actually on the right path and need to give it more time.

There isn't one answer for the person who has tried everything. That's the point.

Because if you've spent years collecting different solutions without ever having a clear plan, you may not need another thing to try. You might just need someone to finally help you make sense of everything you've already tried — and work out what should come next.

— Shae
Founder & Dermal Clinician
Curated Skin Aesthetics