Acne

What is acne

Acne is a common inflammatory skin condition that develops when hair follicles become clogged with oil (sebum), skin cells, and microorganisms. While acne often begins during adolescence, many individuals experience persistent or adult-onset acne that can continue for years.

Acne is driven by several interacting processes including increased sebum production, abnormal skin cell turnover, microbial imbalance, and inflammation within the hair follicle. When these processes occur together, they can lead to clogged pores, blackheads, whiteheads, inflamed papules, and cystic lesions.

Because multiple biological factors contribute to acne development, effective treatment often requires addressing more than the visible skin symptoms alone.

Why acne develops

Acne reflects the interaction of several physiologic pathways within the skin.

Increased sebum production

Hormonal signals stimulate sebaceous glands to produce excess oil.

Follicular plugging

Skin cells accumulate within the hair follicle, contributing to clogged pores.

Microbial imbalance

Bacteria such as Cutibacterium acnes or Malassezia yeast can trigger inflammatory responses.

Inflammatory signaling

Immune pathways within the skin amplify redness, swelling, and acne lesions.

These processes can be influenced by hormonal changes, diet, stress, medications, and other systemic factors.

Common acne triggers

Common Factors That Can Contribute to Acne

Acne severity and persistence are often influenced by both internal and environmental triggers.

Common contributing factors include:

• hormonal fluctuations
• insulin resistance and metabolic signaling
• high glycemic diets
• dairy and whey protein in some individuals
• certain medications or supplements
• stress and sleep disruption
• cosmetics or pore-clogging skincare products
• gut microbiome imbalance

Identifying the individual drivers of acne can help guide a more targeted treatment strategy.

Our Approach to Acne Treatment

Dr. Larivee provides care for patients with persistent, hormonal, or treatment-resistant acne. Rather than focusing solely on suppressing breakouts, care focuses on identifying the biological factors that contribute to ongoing inflammation and follicular disruption.

Treatment plans are individualized based on acne severity, hormonal patterns, prior treatment history, and the patient’s overall health.

Approaches may include:

1.Clinical evaluation

Review of acne history, triggers, and previous treatments.

2.Skin barrier support

Strategies that maintain healthy skin function while treating acne.

3.Hormonal and metabolic considerations

Evaluation of endocrine and metabolic factors influencing sebum production.

4.Targeted therapies

Use of dermatologic medications, botanicals, or other therapies when appropriate.

5.Long-term skin stability

Focus on reducing recurrence and maintaining clear, resilient skin.

Who This Care Is Designed For

This care model may be appropriate for patients who:

• experience persistent or adult acne
• have hormonal or cystic acne
• have not achieved lasting improvement with conventional treatments
• want a physician-guided integrative dermatology approach
• are seeking a deeper understanding of what is driving their skin condition

This practice focuses on complex chronic skin conditions and may not be appropriate for urgent dermatologic care

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