I've only ever referred 3 people for roaccutane or medical intervention treatment in my entire career.
The vicious circle. It usually occurs via two paths.
Vicious Circle One:
You had acne as a teenager and are now 28/34/47 and continue to treat your skin as if it is acnaic - even though your skin moved on when you were 19/20 and is actually normal - underneath that redness and sensitivity that was caused by years of using products for oily/combination skin - which dries it out and 'mattifies' (*cries*) it - which causes it to over-produce oil, give you angry red spots, burning cheeks and lead you to think that you are still an oily/combo skin and that your skin hates you. And usually makes you hate your skin and despair.
Vicious Circle Two:
You once had a few breakouts and went to a beauty counter/had a facial where you were told you had an oily/combination skin because your sales assistant/therapist has been trained in no way other than spots = acne = oily/combination = foaming = mattifying. Your skin was actually pretty normal. Now it's oily because it's dried out and is desperately trying to replenish itself so you are oily by 12/3pm and keep thinking that you have an 'oily' skin. You thus think you're doing everything wrong and your skin hates you. And usually makes you hate your skin and despair.
Below are pictures of one of my clients with a true 'acne' breakout. (used with their permission obviously)
I'm simply suggesting that we overuse the word 'acne' across the industry and don't train our people well enough to detect the difference between acne and hormonal breakouts/food intolerance spots or product reactions for example...
The majority of the people I see with breakouts have a normal/slightly dehydrated or sensitised skin with spots. That is very very different to acne. It can happen to anyone for any reason.
As a matter of interest the same client is pictured below after treatment:
So please, please. The next time you have breakouts - even if they are multiple - in different areas of the face - at different time of the month. They are spots. Don't treat your entire face as if you have an acne/combination skin.
Think about what it could be. What have you done differently? have you ever had intolerance tests for food?Is your period due? Have you been on a 3 day bender?? Are you using an SLS shampoo in the shower and letting it run all over your face?
Treat the spots, take care of the skin. It is not your enemy. Don't treat it like it is.
Spots and acne are two very different things.