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12 Reasons Why Acne Treatment Not Working

a woman trying different acne treatment

For many individuals, the struggle with acne extends far beyond the physical discomfort. It’s a constant battle that can deeply impact self-confidence and quality of life. Despite investing time, money, and emotional energy into acne treatments, it can be disheartening when the anticipated clear, vibrant skin remains elusive. This article delves into why acne treatments might not have the desired effect, shedding light on potential barriers to skin health and offering guidance on how to overcome them.

Understanding Acne

Acne is a prevalent skin condition that affects people all over the world. It is characterized by the appearance of spots, which mostly appear on the face, back, and chest. These spots can vary from surface-level blackheads and whiteheads, which are often mild, to deep, inflamed, pus-filled pustules and cysts that can be severe and long-lasting.

The overproduction of oil primarily causes acne, blocked hair follicles that don’t allow the oil to leave the pore, which may cause a clogged pore, and the growth of bacteria inside the hair follicles. Hormonal changes, such as those during puberty, can lead to the excessive production of oil, thereby increasing the likelihood of acne. 

Common acne triggers include hormonal changes, medications, diet, and stress. Each individual may have different triggers, so understanding and identifying these factors is crucial to managing acne effectively.

Common Acne Treatments

Acne treatments aim to reduce oil production, unclog pores and manage bacteria growth. 

Topical Medications

Topical medications are applied directly to the skin and come in gels, creams, and lotions. One such medication is Benzoyl peroxide, which reduces acne-causing bacteria and causes the skin to dry and peel, thus promoting the turnover of skin cells. Another class of topical acne medication is Retinoids, derived from Vitamin A, which prevent the formation of comedones (blocked pores).

Oral Medications

Oral medications are typically prescribed for more severe cases of acne. Antibiotics can reduce inflammation and bacteria on the skin, but they are often used in combination with topical treatments to maximise effectiveness. For women, hormonal therapy, such as the contraceptive pill, can be effective in treating acne by regulating the hormones that cause the skin to produce excessive oil.

Lifestyle and Skincare Changes

In addition to medication, lifestyle and skincare changes can significantly impact acne. Maintaining a consistent skincare routine, using products designed for your skin type and avoiding those that can clog pores (comedogenic) can make a substantial difference. Regular exercise, a balanced diet, and adequate hydration contribute to overall skin health. 

It’s important to remember that while diet does not directly cause acne, certain foods might trigger flare-ups in some individuals. Stress management is equally critical, as stress can exacerbate acne by stimulating the body’s production of hormones associated with oil production. 

Reasons for Acne Treatment Not Working

a person with worse acne pimple

1. Incorrect Diagnosis

One reason acne treatments may fail is due to incorrect diagnosis. Acne is not a one-size-fits-all condition; it comes in different forms, like comedonal, inflammatory, cystic, and hormonal acne, each requiring a unique approach. Misdiagnosis or misunderstanding can lead to inappropriate treatments. For example, using a cream for mild acne or cystic acne may not be effective. Consulting a dermatologist is crucial for accurate diagnosis and a personalized treatment plan.

2. Not Following Treatment Instructions

Acne treatments may fail because of inconsistent or incorrect use of prescribed medication or skincare products. Follow the recommended dosage and application instructions closely. Skipping doses, using more or less than advised, or not using the treatment long enough can affect results. Note that acne treatments may take weeks or months to show visible improvements. Patience and consistency are key for successful treatment.

3. Overuse or Misuse of Acne Products

Excessive or improper use of acne products can worsen the condition, leading to more skin problems. Acne treatments with active ingredients like benzoyl peroxide or salicylic acid can dry and irritate if overused. This can strip the skin’s natural oils, causing it to produce more oil, leading to clogged pores and more acne. Misusing products, like spot treatments such as full-face creams, can also dry out and irritate the skin. Combining multiple treatments without professional guidance can result in over-exfoliation, sensitivity, and skin damage. 

Follow product instructions carefully and consult a skincare professional if unsure to prevent inadvertently worsening acne.

4. Resistance

Antibiotic resistance is another reason for acne treatment failure, which occurs when antibiotics are used excessively or inappropriately. Propionibacterium acnes, the bacteria causing acne, can become resistant to antibiotics. Consequently, these medications lose their effectiveness, and acne reappears. 

Antibiotic resistance is a growing concern in acne treatment, making subsequent treatment more challenging. It’s crucial to use antibiotics and acne product judiciously and under the supervision of a healthcare professional. Moreover, combining antibiotics with other acne treatments, like retinoids or benzoyl peroxide, can reduce resistance development and enhance treatment effectiveness.

5. Hormonal Factors

Hormonal imbalances are a significant factor in persistent or recurrent acne, especially in adult women. Androgens, like testosterone, increase sebum production, leading to clogged pores and acne. Fluctuations in androgen levels during the menstrual cycle, pregnancy, or conditions like PCOS can cause regular breakouts. 

Discontinuing oral contraceptive pills can trigger or worsen acne if the underlying hormonal imbalance is not addressed. Treatments targeting bacteria or inflammation may be less effective in these cases, and a comprehensive hormonal evaluation is crucial for an effective treatment plan. Consulting a healthcare professional is essential.

6. Lifestyle and Diet

Lifestyle choices and diet greatly impact skin health and can affect acne treatments. Stress, for instance, triggers acne by increasing cortisol production, stimulating oil production and clogging pores. Managing stress through meditation, yoga, or exercise can help regulate cortisol levels and reduce acne. 

Diet also plays a role. While specific foods don’t directly cause acne, high-GI foods like white bread and sugary drinks can raise blood sugar levels, increasing insulin and sebum production. Dairy products, especially skimmed milk, are linked to acne due to hormones and growth factors. 

Understanding dietary triggers of acne problems can complement acne treatment. A balanced diet with fruits, vegetables, lean proteins, and whole grains supports overall health, including skin health.

7. Neglecting Skin Cleansing

A thorough skincare routine is vital for effective acne treatment. Refrain from compromising basic practices like cleansing and moisturising to undermine treatment benefits. Regular cleansing removes excess oil, dead skin cells, and impurities to prevent clogged pores and breakouts. Avoid harsh cleansers and excessive scrubbing to prevent skin irritation and dryness. 

A suitable moisturiser maintains the skin’s moisture barrier and prevents dryness associated with acne treatment. Choose ‘non-comedogenic’ products for acne-prone skin. Remember sunscreen, as acne treatments can increase sun sensitivity. Apply broad-spectrum sunscreen daily for skin protection. Keep your skincare routine simple, gentle, and tailored to your skin type and needs. It forms the foundation for optimal acne prevention and treatment.

8. Insufficient Moisturizing

a woman moisturizing her face to avoid things worse and lessen more bacteria to buiild up

Moisturising your skin is crucial for acne treatment. Insufficient moisturisation leads to increased sebum production, clogging pores and worsening acne. Some acne treatments can dry the skin, making proper moisturisation essential. Use a non-comedogenic moisturiser to keep skin hydrated without contributing to acne. Ultimately, proper moisturisation enhances skin health and the effectiveness of acne treatments.

9. Clogged Pores

Clogged pores contribute to acne formation and can hinder acne treatments. Pores get blocked when sebum mixes with dead skin cells and becomes trapped. This creates an environment for P. acnes bacteria to thrive, leading to inflammation and acne. 

Regular exfoliation helps prevent pore blockages by removing dead skin cells, reducing their chances of getting trapped. Using non-comedogenic skincare products is crucial to prevent clogged pores. These products are designed not to block pores, reducing the risk of blackheads, whiteheads, and acne. They are typically oil-free and may contain salicylic acid or benzoyl peroxide to clear pores. 

Remember to be gentle to avoid skin irritation and worsening acne. Choose gentle, non-comedogenic products suitable for your skin type and follow a consistent skincare routine for maximum benefit.

10. Using Non-Comedogenic Products

Choosing the right skincare and makeup products is crucial for managing acne. Many traditional products can worsen acne by clogging pores with oils and other ingredients. Non-comedogenic products, on the other hand, are designed to be pore-friendly, making them essential for acne management. 

These oil-free products, such as cleansers, moisturisers, sunscreens, and makeup, may contain beneficial ingredients like salicylic acid or benzoyl peroxide to clear pores. They offer desired skincare benefits without promoting blackheads and whiteheads. 

Preventing acne formation by avoiding pore-clogging is as important as treating existing acne. So, incorporating non-comedogenic products into a skincare routine is vital for acne patients.

11. Touching Your Face and Picking At Your Acne

Touching your face, especially picking at acne, can worsen the condition. Our hands come into contact with various surfaces throughout the day, collecting bacteria and dirt. When you touch your face, these bacteria transfer onto the skin, increasing the risk of infection and inflammation. For those prone to acne, this can lead to more frequent and severe breakouts. 

Picking at acne has even greater risks. It may provide temporary relief but can cause more inflammation, increased scarring, and spread acne to other areas. Instead, resist the temptation to touch or pick at your acne and let your skincare routine and treatments work their magic.

12. Expecting Immediate Results

Patience is crucial in acne treatment. Instantaneous results can lead to frustration and abandonment of effective treatment. Acne treatments take time, typically showing results after four to six weeks or months of consistent use. The biology of acne formation involves skin cell cycles that can’t be accelerated without harm. Inflammation takes time to resolve. Stick with a treatment regimen before assessing effectiveness.

Solutions for Treatment-Resistant Acne

1. Consultation with Your Dermatologist

If you diligently follow an acne treatment regimen without desired results, it’s time to seek professional help. Dermatologists have expertise in skin health and can evaluate your condition comprehensively. They can identify factors contributing to persistent acne and prescribe specialised treatments. Dermatologists can also offer advanced therapies like light and laser treatments for resistant acne. They guide the management of the psychological impact of persistent acne. Remember, seeking professional advice is proactive towards achieving clearer, healthier skin.

2. Treatment Adjustments

a woman using the right treatment to achieve instant results

Dermatologists excel in personalizing acne treatments based on individual needs, which is crucial when standard treatments fall short. They consider acne, severity, skin type, and overall health. For example, if you have resistant cystic acne, they may prescribe stronger medications or suggest in-office procedures to reduce inflammation and prevent scarring. For sensitive skin, gentle formulations are recommended. Hormonal imbalances may require medication to regulate hormones. Dermatologists also manage side effects and adjust treatment plans to minimize irritation or dryness. They understand that acne has no one-size-fits-all solution and create customized plans that enhance effectiveness.

3. Patience and Realistic Expectations

Acne treatment requires patience and realistic expectations. Understand that acne doesn’t disappear overnight. It often takes weeks or months for significant improvements to show due to the natural cycle of skin cell growth and shedding. Consistently follow your prescribed regimen without faltering. Take your time with treatment, as it could mean missing an opportunity for clearer skin. Every step towards improvement, no matter how small, brings you closer to your goal. Be patient and maintain realistic expectations for a smoother journey to acne-free skin.

4. Addressing Underlying Health Conditions

Persistent acne may indicate underlying health issues like Polycystic Ovary Syndrome (PCOS), adrenal gland disorders, or certain digestive conditions. These conditions often involve hormonal imbalances or inflammation, affecting skin health. For instance, elevated androgen levels in PCOS can increase sebum production, leading to more frequent or severe acne breakouts. 

Digestive conditions like Irritable Bowel Syndrome (IBS) can also impact gut health, which is linked to skin conditions, including acne. If you’re struggling with stubborn acne despite treatment, it’s worth investigating potential underlying health conditions. A holistic healthcare practitioner or dermatologist can guide you through the diagnostic process and help manage any identified issues. 

Addressing these conditions improves the overall health of dry skin and effectively manages acne. Clear skin goes beyond topical treatments; it reflects your overall well-being.

5. Prevent Acne Scarring

While treating acne, taking steps to prevent acne scarring is equally important. Scarring is often a consequence of severe or improperly managed acne, but it can be minimised or even prevented with the right approach. Here are some tips to prevent and treat acne scarring:

  • Avoid Picking and Squeezing: It is essential to resist the urge to pick or squeeze acne. This can cause damage to the skin, lead to infections, and increase the likelihood of permanent scarring.

  • Follow Your Treatment Plan: Consistently adhering to your acne treatment regimen is key. This will help reduce inflammation and promote faster acne healing, thus reducing the risk of scar formation.

  • Use Gentle Skin Care Products: Aggravating the skin with harsh products can exacerbate acne and contribute to scarring. Using gentle, non-comedogenic products that don’t block pores is recommended.

  • Protect Your Skin From the Sun: Sun exposure can darken acne and acne scars, making them more noticeable. It can also inhibit the healing process, leading to persistent scars. Consider using a non-comedogenic sunscreen and wearing protective clothing whenever you’re outdoors.

  • Maintain a Healthy Diet: Nutritious, balanced eating can support skin health and speed up healing, reducing the probability of scars.

Why do I still get acne after treatment?

Persistent acne, even after treatment, can be discouraging. But understanding acne’s complexity and its underlying causes is crucial. 

Firstly, acne treatment is ongoing, not a one-time solution. Hormonal changes, stress, and diet can trigger new breakouts even after successful treatment. Maintain a consistent skincare routine and follow prescribed treatments to prevent future flare-ups.

Secondly, acne can be caused by underlying health conditions. Seek advice from a healthcare professional to address any potential contributors to persistent acne.

Lastly, some may need more aggressive treatment options, such as oral medications or advanced skincare procedures. Consult a dermatologist for personalized and comprehensive treatment plans.


Treating acne requires consistency, patience, and a multifaceted approach. Addressing underlying health conditions, like hormonal imbalances or digestive disorders, is important. Preventing acne scarring involves avoiding picking or squeezing acne, sticking to your treatment plan, using gentle skin care products, protecting your skin from the sun, and maintaining a healthy diet. 

Despite ongoing treatment, acne may persist due to factors like hormonal changes, stress, diet, lifestyle habits and health conditions. Seeking professional advice is valuable for personalized and aggressive treatment options. Understanding and managing acne can lead to clearer skin and improved overall health.


Medical Director

After graduating from the National University of Singapore, Dr Boey’s journey in aesthetics brought him to esteemed institutions such as Harvard Medical School, American Academy of Aesthetic Medicine and Queen Mary University of London in diverse cities like Seoul, London, Boston and New York.