Before I learned how to treat my skin correctly, I’d wake up and spend 20 minutes on my skin care while my then-boyfriend slept in. At night while he relaxed, I applied more products to my face ― some, like sheet masks, rendering me incapable of doing much but lying there ― all in the name of having great skin. The joke was on me, though, because while I woke up in the morning to new breakouts and lingering scars, his skin was smooth and bright, never too oily or dry, and while I asked that he at least put on some sunscreen once in a while, hardly so much as a cleanser ever touched his face.
I’ve seen this replicated across real life friends and internet follows. But it’s not always a strict split between genders — there are some people who seem to be immune to acne or fine lines or flaky skin. While you can argue that those with something they want to “fix” on their skin are more likely to pick up skin care products in the first place, which came first? The pimple or the product?
“The more involved you are, the more likely you are to overuse products, not give them enough time or follow too many trends. That won’t happen if you’re doing little to nothing to affect your skin,” said Corey L. Hartman, board-certified dermatologist and founder of Skin Wellness Dermatology in Birmingham, Alabama.
Jennifer MacGregor, a board-certified dermatologist at UnionDerm in New York City, sees this phenomenon happening during most patient consultations. “Many people go for marketing and spend tons of money without realizing what ingredients will actually work for the skin they have,” she said.
It’s not just an issue for women, although it may appear that way. “I think stereotypically women are proactive and seek information and treatments for their skin,” MacGregor said. Which also means they may be more likely to try out products that may or may not work well for their skin type.
Female hormones fluctuate throughout the month, though, and in some cases, out-of-balance or changing hormones can play in how skin looks. “Hormones influence sebaceous glands, oil production, blood vessels and redness, and even our microbiome,” MacGregor said. Making it even more complicated, those hormones can change, as often happens during pregnancy or menopause, or while taking birth control.
For transgender patients undergoing hormone replacement therapy, new skin issues can crop up due to new hormones. MacGregor, who treats transgender patients, explained that while testosterone therapy can increase oil production and acne, trans women might develop drier skin and softening of facial contours, which can make skin appear looser. For these patients, being proactive can help. “I’m thrilled to see more families reaching out for virtual visits before hormonal therapy to get a plan in place,” MacGregor said.
Lifestyle can also undo skin treatments and trigger issues. Outside of obviously unhealthy habits ― such as excessive drinking or smoking, an unbalanced diet and lack of sleep ― less evident behaviors, such as consuming a high-glycemic diet, can trigger acne and rosacea.
Of course, some people naturally have less reactive, problem-prone skin than others, which is why it might appear effortless. “Genetics play a significant role in the skin care journeys of individual patients. This is why some people age well with little intervention while others require maximum effort to just maintain,” Hartman said.
Why your skin care routine might not be working
Beyond those internal factors, there’s a whole host of issues that can make it seem like your skin care routine isn’t working ― and mostly, the skin care products themselves are to blame.
The issues begin when the problem is misdiagnosed in the first place. “Even just plain acne can take many different forms,” MacGregor said. There’s acne vulgaris ― the typical “teenage” acne ― then there’s acne rosacea or hormonal acne, and even conditions that look like acne but aren’t. “All of these have different treatments,” MacGregor said.
But just because the right issue is targeted, it doesn’t mean you’re in the clear. The experts I spoke with named product overuse as one of the biggest problems they see in their clients.
“I can’t tell you how many patients will try any product that they see on TikTok and everything that worked for their friend only to bring the list to me and discover that some of the active ingredients are canceling each other out. A more complicated regimen is often a waste of time and money,” Hartman said.
“Many people purchase tons of products and find that no matter how many products they use, they aren’t happy with their skin,” said Annie Gonzalez, a board-certified dermatologist in Miami. Not only are people using the wrong products, she said, but they are also attempting to “fix” genetic components that are difficult to address, like the size of their pores or the oiliness of their skin, paving the way for disappointment.
Furthermore, some products aren’t meant to layer with others. “There are many ingredients that are good individually but when you combine multiple simultaneously it can cause more harm than good, especially for beginners,” Gonzalez said. One example is most retinoids and benzoyl peroxide ― two common ingredients used for acne treatment. When used together, the benzoyl peroxide actually deactivates the retinoid molecule, according to Gonzalez.
Over-exfoliation can create its own issues. Powerful ingredients like retinoids and acids are good choices for both acne and anti-aging, but when used incorrectly ― like using them too often or applying them at the same time ― they can be damaging. “Stimulation of too much cell turnover can cause redness, irritation, flaking and breakouts,” Hartman said.
How to build a skin care routine that actually works
When it comes to the solution, the advice is clear: Seek out a professional. “A visit to a board-certified dermatologist can really help to clarify what’s working, what’s not, what’s necessary and what’s overkill in the pursuit of clear skin,” Hartman said. And yes, that means an actual qualified expert. “I see people every day that waste a lot of time and money listening to the advice of those who lack the credentials to provide an expert opinion and advice on how to achieve skin care goals,” he said.
A dermatologist can give you prescription-strength products and advice, but if a doctor’s visit isn’t possible for you, MacGregor suggests trying proven over-the-counter products and sticking to one line based on your skin type and concern.
And remember to take your time with any new treatment. “People should be aware that any products used to combat acne or enhance the appearance of healthier skin can take eight to 12 weeks to show results,” Gonzalez said.
While there’s little you can do about your genetics, you can set your skin up for health by resisting temptation next time a friend raves about a product, or you see a TikTok about a new must-have ingredient. Remember to take a step back and evaluate what your skin actually needs ― it’s probably not another serum.