| Blackheads & closed comedones |
Home salicylic acid or retinoid route; congestion facial or suitable superficial peel; careful extraction where appropriate. |
Barrier-safe home routine → congestion facial or peel → maintenance active after recovery. |
Blackheads are oxidised pore contents, not dirt. Aggressive squeezing and scrubbing can create inflammation and marks. |
| Active inflammatory acne |
Evidence-based acne skincare; pharmacist, GP or dermatology treatment where needed; gentle acne programme or selected peel for suitable stable skin. |
Control inflammation medically/home care → support the barrier → address residual marks or scars only after active acne is controlled. |
Do not microneedle through active inflamed or infected lesions. Deep, painful or scarring acne needs medical input. |
| Post-inflammatory dark or red marks |
Daily SPF; azelaic acid, vitamin C or retinoid as tolerated; selected peel; microneedling only for suitable stable skin. |
Control the original inflammation → daily pigment-support routine → cautious peel or needling route after review. |
A flat mark is not the same as an indented scar. Irritation can create more pigment, especially in deeper skin tones. |
| Indented acne scars |
Microneedling for suitable texture; subcision for tethered rolling scars; selected peel for shallow surface change. |
Scar-type assessment → subcision for tethering where indicated → separate microneedling/PRP remodelling after healing. |
Ice-pick, boxcar and rolling scars respond differently; one whole-face treatment rarely fits every scar. |
| Enlarged-looking pores & uneven texture |
Home BHA or retinoid; suitable peel; microneedling; oil and barrier management. |
Consistent home routine → peel or needling course → maintenance after the barrier has settled. |
Pores cannot be erased. Congestion, oil, sun damage and reduced structural support can all make them look larger. |
| Rosacea-prone redness |
Rosacea-Calm Facial; gentle cleanser, moisturiser and sunscreen; clinician-led azelaic or other rosacea medicine where appropriate. |
Trigger-aware home routine → no-heat calming facial when stable → GP/dermatology or vascular-light referral for persistent vessels/redness. |
Avoid heat, scrubs, strong acids and vigorous massage during a flare. Acne-like rosacea bumps are not ordinary acne. |
| Dry or dehydrated-feeling skin |
Humectant + emollient/occlusive routine; gentle hydration or barrier facial. |
Short barrier reset at home → hydration facial → reintroduce only the actives still needed, one at a time. |
Dry skin lacks lipids; dehydrated-looking skin lacks water. They overlap, and oily skin can still be dehydrated. |
| Sun spots & uneven pigmentation |
Daily broad-spectrum SPF; vitamin C, azelaic acid or retinoid as tolerated; suitable peel or cautious microneedling. |
Photoprotection and pigment routine → selected peel or needling after lesion and pigment-risk assessment. |
A new, changing, irregular, bleeding or suspicious mark is assessed medically, not treated cosmetically. |
| Melasma |
Tinted broad-spectrum SPF with iron oxides; gentle skincare; specialist topical pigment plan. |
Strict photoprotection → clinician-led topicals → conservative procedure only when suitable, with maintenance. |
Heat, light and irritation can worsen melasma. Procedures are not a cure and can sometimes rebound pigment. |
| Fine lines & crepey texture |
SPF and retinoid route; superficial peel; microneedling; PRP/PRF; skin booster or PDRN route. |
Home SPF/retinoid foundation → staged microneedling or skin-quality course → review before adding another mechanism. |
Dehydration lines, expression lines, collagen change and structural folds need different approaches. |
| Expression lines or deeper folds |
Skin-smoothing injections for selected movement lines; dermal filler for selected structural folds; skin-quality treatments for the surface. |
Movement assessment/treatment → review → structural or skin-quality route only if a separate need remains. |
Softening movement and replacing structure are different jobs. Natural expression and proportions remain part of the plan. |
| Mild skin laxity |
Microneedling; radiofrequency route where suitable; PLLA or CaHA biostimulator; selected thread or structural treatment. |
Skin-remodelling course → review → biostimulator or structural support if it addresses a remaining layer. |
Laxity, volume loss and a local fat pocket can look similar. More advanced laxity may not suit non-surgical treatment. |
| Stretch marks |
Microneedling; PRP adjunct where appropriate; home moisturising and sun protection. |
Staged microneedling course → optional PRP support → reassess colour and texture after remodelling time. |
Early red/purple and mature pale stretch marks behave differently. Improvement is realistic; complete removal is not. |
| Cellulite |
Massage/body therapy; radiofrequency or tissue-quality route where suitable; assessment of tethering, laxity and fat distribution. |
Tissue-quality or circulation-support course → review → a second mechanism only for a separate contributor. |
Cellulite is not simply “too much fat”. Fibrous bands, skin thickness and fat lobules contribute, so no route guarantees removal. |
| Localised pinchable fat |
Fat-dissolving injections for suitable small areas; body-contour assessment. |
Local fat-reduction course → allow swelling and tissue response to settle → assess skin quality or contour afterwards. |
Not a weight-loss treatment and not suitable for visceral fat. Loose skin and cellulite need a different plan. |
