Dr Nadia Abuhussein NASkin

Acne can still come back, even after finishing a full course of treatment.

Why? Because acne is not simply a problem of excess sebum.

Treatments can reduce oil production, inflammation and breakouts, but if the underlying drivers have not changed, cystic acne can return.

From a functional dermatology perspective, I look beyond the skin itself and consider factors such as hormonal signalling, insulin resistance, gut health, inflammation, stress, sleep, nutrient status and the skin microbiome.

The goal is not just to suppress acne temporarily.

It is to understand why your skin is behaving this way in the first place, then address the contributing factors alongside appropriate topical treatment.

Clearer skin is not always about using something stronger. Sometimes it is about looking deeper.

Perioral dermatitis needs a controlled approach, looking at both what’s happening externally and what may be contributing internally.

Externally, I look at potential triggers such as overexfoliation, topical steroids, irritating skincare, heavy occlusive products, fragrance, cosmetics and disruption of the skin barrier and microbiome.

Internally, it can also be worth exploring factors such as hormonal changes, gut health, nutritional status, stress, medications and individual inflammatory triggers.

The goal isn’t to throw more products at the skin. It’s to remove potential triggers, calm inflammation, rebuild the barrier and investigate relevant internal contributors where appropriate.

A controlled, step by step approach often tells us far more than changing multiple things at once.

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Hair shedding is often a symptom, not the root problem.

Telogen effluvium happens when a larger than normal number of hairs are pushed into the resting phase of the hair cycle, usually after a physiological or emotional stressor. The shedding often starts around 2 to 3 months after the trigger, which is why the connection can easily be missed.

Common triggers include iron or nutrient deficiencies, thyroid dysfunction, significant illness, rapid weight loss, restrictive dieting, hormonal changes, medications, surgery, chronic stress and poor sleep.

From a functional medicine perspective, I look beyond the scalp and ask why the hair cycle has been disrupted in the first place. Depending on the history, this may include assessing iron and ferritin, thyroid function, vitamin D, B12, folate, zinc, protein intake, metabolic health, hormones, gut health and any recent physical or emotional stressors.

The aim is not simply to add a hair supplement. It is to identify and correct the factors affecting healthy hair growth.