A New Era in Treating Adult Acne: What Really Works Today — Explained by Facial Specialist Anastasiia Haraieva

Adult acne remains one of the most common reasons women over 25 seek professional skincare help — and, importantly, approaches to its treatment are changing rapidly today.

Anastasiia Haraieva — Acne & Skin Health Expert, Licensed Esthetician (Florida), and author of scientific publications — has been studying adult acne for many years through the lens of evidence-based medicine. She notes that in recent years, markedly different approaches to skin care have emerged depending on the country and professional school.

The differences between European, Asian, and American models of working with adult acne have become especially noticeable — not at the level of terminology, but at the level of outcomes and long-term skin condition. We asked the expert to explain what exactly this difference is and which methods have already become this year’s breakthrough.

— Anastasiia, we constantly hear about a “revolution” in cosmetology. But what has truly changed in the treatment of adult acne — not at the level of marketing, but in real clinical practice?

– The most significant change is the shift from fighting only the external manifestations of acne to restoring the skin’s ecosystem. We have finally begun working with the microbiome not theoretically, but practically. Today, topical probiotic serums with live third-generation strains of Lactobacillus and Bifidobacterium have appeared. These are not just moisturizers with the word “probiotic” attached — they are live cultures stabilized in special capsules that activate upon contact with the skin.

Why is this important? Because a disrupted microbiome is the main reason adult acne becomes chronic. When protective microflora is impaired, the skin loses its ability to regulate sebum, control inflammation, and recover. Previously, we killed “bad” bacteria with antibiotics or acids. Now, we restore the balance of “good” bacteria.

— It is believed that the Asian market often outpaces the Western one by several years. Which innovations from there are already available but have not yet become mainstream in the US and Europe?

– Asia is currently leading in two areas: barrier function and fermentation. Korean and Japanese laboratories have developed next-generation pseudoceramides — synthetic analogs of ceramides that are structurally identical to natural ones but penetrate 40% deeper and work faster. This is critical for adult acne because most patients have a barrier damaged by years of aggressive care.

The second area is fermented ingredients. Fermentation breaks molecules down into smaller fragments, making them more bioavailable. Fermented niacinamide, for example, penetrates the skin three times more effectively than conventional niacinamide, while not causing redness or irritation. For sensitive, inflamed skin, this is fundamental.

Another trend is Centella asiatica in liposomal form. Asian formulations have learned to encapsulate active components into microcapsules that deliver them precisely to the required layers of the skin, bypassing surface irritation. This makes it possible to use high concentrations without side effects.

— What is happening in American cosmetology today?

– In the US, a real breakthrough has occurred in personalized diagnostics. In 2025, at-home skin microbiome tests became widely available. You take a swab with a cotton applicator, send it to a laboratory, and within a week receive a map of your microflora: which bacteria dominate, which are lacking, which ingredients suit you, and which will trigger inflammation.

This completely changes the logic of skincare selection. Previously, we worked by skin type — oily, dry, combination. Now we work based on the microbiome condition of a specific individual. Two women with identical adult acne symptoms may have completely different microflora imbalances and, accordingly, require different protocols.

The second direction is psychodermatology. In the US, an interdisciplinary approach is now actively developing: dermatologists and cosmetologists work in collaboration with psychologists. This is especially important for chronic adult acne because the connection between mental health and skin condition is scientifically proven.

— Anastasiia, what do you think will be the next step in adult acne therapy in the next couple of years?

– Without a doubt, we are moving toward personalized cosmetology. I am confident that the next major leap will occur where skincare stops being a “universal scheme” and becomes finely tuned to the biology of an individual’s skin. We already see the development of photobiomodulation, biomimetic formulas, and digital diagnostics, but this is only the beginning.

The focus is now justifiably shifting toward restoring the skin barrier function and working with the neuro-cutaneous connection — and it is precisely here that the most valuable discoveries await us.

Photos Courtesy of Anastasiia Haraieva

— If you could give three concrete actions to a woman who is tired of the endless fight with adult acne, what would they be?

– First — radically simplify your routine for two weeks. Leave only three things: gentle sulfate-free cleansing, basic hydration, and SPF. No acids, no active serums, no multi-step rituals. Just give your skin a break. In 60% of cases, this already leads to improvement because the skin finally gets the opportunity to restore its barrier.

Second — undergo microbiome testing. It is no longer expensive or complicated. The results will show which direction to move in — perhaps you do not need new acids, but restoration of microflora. Perhaps your skin simply does not tolerate certain ingredients that are present in all of your products.

Third — find a specialist who asks questions not only about your skin, but about your life. A good cosmetologist should ask about sleep, stress levels, the menstrual cycle, and lifestyle changes. Because adult acne is not a problem of isolated skin areas. It is a systemic condition that requires systemic understanding.

And the last thing I want to say: your skin is not working against you. It simply needs the right conditions and time to remember how to regulate itself.