The Science of Getting Better.
10 Harley Street
London W1G 9PF
The breakout settles. Your skin begins to improve. For a while, you think you've finally found something that works.
And then the acne returns.
For some people, acne is a temporary problem during adolescence. For others, it continues well into adulthood, appears for the first time in their thirties or forties, or repeatedly returns despite treatment.
The frustration is not simply the spots themselves. It is the feeling that something keeps changing without a clear explanation.
At The Sona Method, a Harley Street clinic in London, persistent acne is considered within the wider context of a person's health.
Because sometimes the most useful question is not simply how to treat the next breakout.
It is why the breakouts keep happening.
Beyond the surface
Acne develops through a combination of increased sebum production, blocked hair follicles, inflammation, and the activity of skin bacteria.
Hormones, genetics, medications, and skincare products can all influence the condition.
But acne does not behave identically in everyone.
One person may experience breakouts around menstruation. Another may develop persistent acne after adolescence. Someone else may notice changes associated with medication, stress, or particular skincare products.
Recognising these differences matters because not every case requires the same approach.
The diagnosis may be the same. The contributing factors may not be.
Hormones & metabolic health
Androgens influence the production of sebum, one of the processes involved in acne.
This is why hormonal changes during puberty, menstruation, pregnancy, and perimenopause can affect the skin.
For some women, persistent acne may also occur alongside irregular periods, increased facial hair, scalp hair thinning, or other features associated with polycystic ovary syndrome (PCOS).
Insulin resistance and metabolic health may be relevant in certain cases, particularly when PCOS is present.
However, acne does not automatically indicate a hormonal imbalance, and not everyone with acne needs hormonal investigations.
The important question is whether the individual's history suggests that further assessment would be useful.
Hormones may be part of the picture. They should not automatically be assumed to be the explanation.
Gut, nutrition & inflammation
The relationship between diet, metabolic health, the gut microbiome, and acne continues to be investigated.
Some research suggests that high-glycaemic-load diets and certain dairy products may aggravate acne in susceptible individuals.
However, the evidence is not strong enough to suggest that all acne originates in the gut, or that eliminating particular foods will reliably resolve it.
When acne occurs alongside digestive symptoms, nutritional concerns, or other persistent health problems, it may be useful to consider these together.
The aim is to identify clinically relevant relationships without assuming that every symptom has a single underlying cause.
Looking at the whole person does not mean assuming everything is connected. It means being willing to investigate when the history suggests it might be.
Finding your pattern
Two people can have similar-looking acne for very different reasons.
One may have predominantly inflammatory acne. Another may experience comedonal acne, with blocked pores and relatively little inflammation.
For others, the timing, distribution, severity, and associated symptoms may offer useful clues.
At The Sona Method, the assessment begins with the history.
When did the acne start? Has it changed over time? What treatments have helped? Are there menstrual changes, medication changes, or other symptoms worth considering?
Depending on the individual, the wider assessment may include hormonal history, metabolic health, nutrition, digestive symptoms, medication use, sleep, and lifestyle.
The purpose is not to search for a hidden cause in every case.
It is to understand what is relevant to this particular person.
The pattern matters because it helps determine what deserves attention.
Working alongside conventional care
Effective acne treatment may include topical retinoids, benzoyl peroxide, antibiotics, hormonal treatments, or isotretinoin, depending on the type and severity of the condition.
These treatments can be important for controlling inflammation and preventing permanent scarring.
A wider health assessment does not replace appropriate dermatological treatment.
Instead, it considers whether additional factors warrant attention alongside established care.
Severe, painful, nodular, or scarring acne should be assessed promptly by an appropriately qualified medical professional.
Good care is not about choosing between treating the skin and understanding the person. Both can matter.
Your skin tells part of the story. The rest deserves to be understood.
Acne Support on Harley Street, London
Sona Parmar works with people experiencing persistent and complex health concerns from her Harley Street practice in London.
The Sona Method may be particularly appropriate for adults with recurrent acne, acne accompanied by possible hormonal or metabolic symptoms, or skin concerns occurring alongside other unexplained health problems.
Each assessment considers the individual's history, existing diagnoses, previous investigations, and current treatment.
Where skin symptoms form part of a wider pattern, assessment may also involve hormone health, digestion, and the principles of functional medicine.
Your skin tells part of the story. The rest deserves to be understood.
If persistent or recurrent acne is affecting your life and you would like to explore whether The Sona Method is appropriate for you, get in touch to arrange a consultation.