Adult Acne — How Does Dermatology Treatment Actually Proceed?

What to know before searching for "the best place" — causes, order and duration

People who come in with adult acne have typed almost the same words into the search bar: treatment cost, whether insurance covers it, how long it takes, the best place. Here is how I answer, in that order.

Adult acne is not teenage acne

If teenage acne can be explained by sebum alone, adult acne is tangled up with hormonal shifts, stress and a compromised skin barrier. So extracting and applying medication alone does not control it well, and the weight shifts toward preventing recurrence. Without barrier care alongside, it comes back after treatment ends.

In what order does treatment proceed?

ReYeonK's acne treatment is planned as once a week, 14 sessions in total. Treatment — care — treatment — care alternate week by week, seven of each. On the first visit we photograph the skin with a diagnostic imaging system (Mark-Vu) and begin with a 20- to 30-minute consultation with the doctor.

Early on we clear what disappears in a session or two (blemishes, moles, flat warts), and for severe acne we recommend Gold PTT together with oral medication — both work by shrinking the sebaceous glands. Around the third session we tackle the substantial issues like scars and pores; around the fifth we refine texture with gentler treatments; and at the seventh we finish precisely what remains.

If you ask why we do not do it all at once — it is because the same doctor watches the skin change every week and sets the direction. Acne is tied to the skin cycle (about 28 days), so change usually shows from session 3 or 4, and it takes 3 to 6 months of continued care to stabilise.

Is extraction really necessary?

Yes. Extraction — clearing sebum and dead cells from blocked pores — is the foundation of acne treatment. Squeezing forcefully at home leaves scars and pigmentation. There may be slight redness right after extraction, but it settles within a day or two, and most treatments allow a return to daily life the same day. Treatments that need anaesthetic cream are done after the pain is reduced.

Cystic acne is treated differently

Red, swollen, pus-filled cystic acne is not something to squeeze out. The inflammation must be calmed first. When patients come in with it, we usually do Gold PTT once or twice + oral medication + anti-inflammatory injections all together. Squeezing forcefully leaves scars.

When choosing "the best place"

Acne is not the kind of condition that improves from one-off treatments here and there. It improves substantially when one person takes responsibility for treating it for three months or more. That is why I say to look not for a place that promises to do everything at once, but for one that looks at your face every week and adjusts the direction. And while acne is active, we treat the acne before the marks and scars — reverse the order and the marks keep forming.