Esty Protocols: The Treatment of Acne

Sponsored by: Face Reality Skincare

Acne 101

Through no fault of their own, estheticians coming out of esthetics school are unfortunately not equipped with the knowledge it takes to correct most skin conditions, let alone something as complex as acne. Acne is a hereditary disorder of the pores that takes dedicated time and training to fully understand and treat successfully. While there are many factors that exacerbate acne, it is caused by retention hyperkeratosis. This process is the excess buildup of dead skin cells that clump together by sebum, ultimately leading to the creation of the microcomedone. Thirty to 90 days later, you can see inflamed and/or noninflamed acne visible on the surface of the skin. There are also many lifestyle and diet factors to consider while treating acne clients, but we'll start with what it takes topically. 

Treatments & Contraindications

Being able to properly identify the acne type and severity that you’re working with is essential to curating the proper treatment protocol. You will also need to consider the client’s skin type, Fitzpatrick type, and any other skin conditions or concerns. Many times, clients will already come to us with an impaired barrier stemming from the different things they’ve tried, especially prescription options. It’s important to start slow, especially in these cases. Enzymes are a great option for clients who need a gentler option in the beginning because they provide quality, professional exfoliation without overwhelming the skin and creating new problems. In addition to an impaired barrier, you may also encounter clients who have picked at their skin. Sometimes, it is just one big lesion they couldn’t leave alone, but other times they may have an anxiety disorder that causes them to pick at lesions causing open wounds. If you encounter this in the treatment room, use your best judgement—you may be able to occlude picked areas with an occlusive like Vaseline, but in more severe cases, the client may not receive a treatment that day.  

Once your client’s barrier is healthy enough for stronger treatments, corrective peels are an excellent step up to not only target acne, but also the texture and post-inflammatory hyperpigmentation left behind once the acne has cleared. There are many different options when it comes to choosing corrective peels. Whatever brand or type you decide on, make sure there are customizable options. The best way to approach acne is by using a “low and slow” method. You can work clients up to stronger treatments over time so you never cause too much down time, which could inhibit them from performing their home care routine. While treatments are a great way to speed up the clearing process and correct other skin conditions, 80 percent of the clearing process is achieved at home with a consistent home-care routine. 

Home Care

Acne clients should have curated morning and evening skin care routines and they should be based on skin type, acne type and severity, and Fitzpatrick type. The supporting products in the routine, such as cleanser, toner, and moisturizer, will be chosen based on what the skin needs to remain healthy. The exfoliating acids should be chosen based on the acne type or acne imposters that may be present. Exfoliating acids, such as l-mandelic, l-lactic, and salicylic, help address what’s already seen on the surface of the skin. They can help soothe inflammation, reduce post-inflammatory hyperpigmentation, smooth texture, and more. There should also be a preventative step in the acne client’s routine, like the widely popular benzoyl peroxide. Benzoyl peroxide oxygenates the pore to kill acne causing bacteria and exfoliates dead skin cell build up. This ingredient can be controversial because many people rush into using it and cause excess dryness, irritation, etc. When used correctly, benzoyl peroxide can be used without issue and for long-term acne control.  

Face Reality Acne Peel for Face and Chest Procedure

Step 1: Cleanse

Using the Ultra Gentle Cleanser, cleanse the entire treatment area with a small amount of cleanser and rinse thoroughly with warm water.

Step 2: Tone

Moisten a cotton pad with the Glycolic Lactic Toner and wipe over the entire treatment area to degrease the skin.

Step 3: Peel

Take a 4 x 4 cotton esthetic wipe and fold it into quarters. Place the dry cotton pad directly on the open bottle of the Acne Peel #1 solution and invert the bottle, making a circle of solution on the pad. Move the bottle around the pad and repeat this five-times in a circle. Starting on the forehead, wipe the cotton pad evenly and apply the peel in panels to cover the entire face and upper neck. If your client is not sensitive, unfold the cotton wipe to reveal a clean side, and apply a second layer.

Step 4: Extractions

The skin is now prepped from the peel solution, and you may perform extractions. For noninflamed acne lesions, you may use the Custom Comedone Extractor in a size 0 or 00 or use gentle pressure with gauze wrapped fingers. For inflamed acne lesions, we recommend using the gauze wrapped finger method and applying a dab of the Sulfur Spot Treatment once extracted. Once finished, wipe the face thoroughly with Sal-C Toner to disinfect. For pregnant and nursing clients, use the Calming Toner.


Step 5: Optional

You may perform hi-frequency and/or LED light therapy for additional benefits.  

Step 6: Finishing Products

Gently apply the Daily SPF 30 Lotion during the day or gently apply the Cran-Peptide Cream at night.

Before and After


Alex Hernandez of Face Reality SkincarePresented by: Alex Hernandez, LE, Lead Educator at Face Reality Skincare

Alex Hernández, a Licensed Esthetician for over 6 years, first joined Face Reality’s Clinic as an Acne Specialist, then became Lead Esthetician, managed our clinic, and then assumed responsibility as Lead Educator. Alex oversees professional training, and develops Face Reality’s educational materials, protocols, and classes nationally. Alongside Laura Cooksey, owner and co-founder of Face Reality Skincare, she is an expert at educating both clients and professionals on the treatment of acne using Face Reality’s safe and effective personalized protocols. 

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