What is the skincare routine for active acne?

Question

Hello doctor,

I want to know if my skincare routine is good or if I could do better. Just for your information, I have had acne since I was 16 and am turning 21 this year. My active acne is only on my forehead, between my eyebrows, and on my cheeks, and no other areas are affected.

And after years of trial and error with different skincare products, I have been left with significant post-inflammatory erythema in those same areas. I would love to hear any ideas on how to improve my current routine.

My morning routine is Naturie Hatomugi Skin Conditioner, Glad 2 Glow Centella (Allantoin) Soothing Gel Moisturizer, T3 Mycin 1.2 percent lotion every four days, and Azarine Calm My Acne Sunscreen Moisturizer. At night, I use Nature Hatomugi skin conditioner and oil-free ultra-moisturizing lotion, and on the same day, a pea-sized amount of 20% Azelaic acid cream.

I use Clindamycin in the morning and Adapalene 0.1 percent gel in a pea-sized amount, which I apply the night after Azelaic acid. I use the sandwich method to apply for active ingredients. My night routine is a 4-day cycle where I use Clindamycin and Azelaic acid, then Adapalene, then 2 days of skin reset where I just put on toner, moisturizer, and sunscreen in the morning. I also use a little bit of Benzoyl peroxide as a spot treatment for active breakouts.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I can tell you have really put a lot of thought into your acne, especially after five years of living with it. That trial-and-error phase can be exhausting, and developing post-inflammatory erythema (PIE) on top of active acne makes it even more frustrating. You are doing many things right already.

All of your standard treatment options, Adapalene 0.1%, Azelaic acid 20%, Benzoyl peroxide spot treatment, and sunscreen are evidence-based and appropriate for acne and PIE. Adapalene is very good for long-term comedonal control and prevention of new breakouts. Azelaic acid is particularly good for inflammation and redness. Also, the sandwich technique you’re doing is a good way to minimize irritation.

However, there is some room for optimization. The main area for improvement is the frequency of Adapalene. Using it only once every four days may limit its effectiveness. Retinoids work best when used consistently, ideally at least three to five nights per week, and eventually nightly if tolerated.

Increasing Adapalene gradually (while monitoring irritation) would likely improve both your forehead acne and persistent PIE over time. Instead of having two full “reset” days, you might consider reducing to one barrier-repair night and increasing retinoid frequency.

Regarding Clindamycin, topical antibiotics should ideally always be paired with Benzoyl peroxide to reduce bacterial resistance. If you are not applying Benzoyl peroxide on the same day as Clindamycin, I would recommend either using a Benzoyl peroxide wash in the morning on those days or applying a thin layer of Benzoyl peroxide before Clindamycin. We do not advise long-term standalone antibiotic use.

Your moisturizer and sunscreen choices appear appropriate, and strict daily use of sunscreen is essential for improving PIE, so please continue that consistently. The toner is not harmful, but it is not essential; if irritation ever develops, simplifying your routine by removing non-essential steps would be helpful.

Since your acne is localized to the forehead and between the eyebrows, consider possible contributing factors such as hair products, oily scalp, friction, or frequently touching the area. Small mechanical triggers can maintain chronic inflammation in that zone.

Your routine is well structured, but improving consistency with Adapalene and ensuring proper antibiotic pairing would likely give better results over the next few months. Acne at your age is still very common, and with steady, simplified, consistent treatment, it usually stabilizes significantly.

You are clearly committed to caring for your skin, and that dedication will pay off.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.