Acne is often seen as a surface issue, but it is more accurately understood as a chronic inflammatory skin condition involving several biological mechanisms: excess sebum, altered keratinisation, microbial imbalance, inflammation and barrier disruption. Acne can present as comedones, papules, pustules, oily skin and post-inflammatory marks, and it can persist beyond adolescence into adulthood.
This is why supporting acne-prone skin requires more than suppressing visible breakouts. A clearer, more resilient complexion depends on addressing the conditions that allow inflammation, congestion and recurrence to persist.
At AWvi, we approach skin health from the inside out and the outside in. The goal is not only to calm what is visible, but to support the biological environment in which skin can rebalance, defend itself and recover.
A case study supervised by Dr Rachna Murthy
This AWvi case study was conducted under the supervision of Dr Rachna Murthy, FRCOphth, Oculoplastic, Aesthetic and Reconstructive Surgeon. The protocol involved daily oral intake of The Skin Biotic, combined with twice-daily use of The Gentle Cleanser and The Active Cream over eight weeks.
The before and after images show one individual case, with photographs taken at baseline and at week eight. In this case, the follow-up image suggests visible improvement in the appearance of inflammatory blemishes, redness and overall skin clarity after the combined protocol.
This should not be read as a guaranteed result. Acne is multifactorial and should be assessed by a qualified healthcare professional, particularly when it is persistent, painful, scarring or associated with hormonal or medical factors.
Expert insight
“Acne is a chronic inflammatory skin disorder with multiple contributing factors: microbial dysbiosis, sebaceous gland hyperactivity, altered keratinisation, and immune imbalance.
It is not limited to adolescence; in many cases, it persists into adulthood, reflecting its complex biological roots.
Management goes beyond suppressing visible lesions. It requires addressing the underlying mechanisms that sustain inflammation and disrupt skin homeostasis.
Effective care involves rebalancing the microbiome, regulating sebum, supporting epidermal renewal, and strengthening the skin barrier, ideally through a combined systemic and topical approach that supports and works in harmony with skin physiology.”
Dr Rachna Murthy, FRCOphth
Oculoplastic, Aesthetic and Reconstructive Surgeon
Dr Murthy is an award-winning Consultant Ophthalmologist and Oculoplastic & Reconstructive Surgeon. Maison Restorative describes her as internationally recognised for work in aesthetic and functional periocular surgery, with experience across NHS and private practice, while TFOS describes her as co-founder of FaceRestoration and Maison Restorative, with expertise spanning ocular surface health, thyroid eye disease, regenerative aesthetics and microbiome-related topics.
Why acne-prone skin needs a systemic and topical approach
Acne develops through several interconnected pathways. Excess sebum can contribute to follicular congestion. Altered keratinisation can interfere with normal cell turnover. Microbial imbalance can contribute to inflammation. Barrier disruption can make the skin more reactive and less resilient. Current dermatology references describe acne as a chronic inflammatory disorder of the pilosebaceous unit, with treatment often requiring a combination approach depending on severity.
The gut-skin axis adds another layer to this picture. Reviews on acne and the microbiome describe acne as multifactorial, with both skin and gut microbiota implicated in its pathogenesis. More broadly, gut-skin axis research describes bidirectional communication between gut microbiome balance, inflammation, immune regulation and skin health.
For AWvi, this supports a simple principle: acne-prone skin should not be addressed only at the surface. It should be supported as part of a wider biological system.
The AWvi protocol used in this case study
Step 1: The Skin Biotic
The Skin Biotic formed the inside-out layer of the protocol.
In this case study, The Skin Biotic was used daily to support the gut-skin axis, microbiome balance and immune regulation from within. The objective was to help create a more balanced internal environment for skin prone to inflammation, congestion and recurrence.
This inside-out approach matters because acne-prone skin is not only shaped by what happens on the surface. It can also be influenced by systemic inflammation, microbial balance, nutrition, stress and the body’s wider regulatory mechanisms.
Step 2: The Gentle Cleanser
The Gentle Cleanser was used twice daily as the first topical step.
For acne-prone skin, cleansing must remove excess sebum, impurities and environmental residues without stripping the barrier or disturbing the skin’s microbial balance. Over-cleansing, harsh surfactants and aggressive products can aggravate sensitivity and compromise the skin’s resilience.
In this protocol, The Gentle Cleanser was used to support surface balance while helping preserve the skin barrier and microbiome.
Step 3: The Active Cream
The Active Cream completed the outside-in layer of the protocol.
In acne-prone skin, hydration and barrier support are often overlooked. Yet a weakened barrier can intensify discomfort, reactivity and post-inflammatory visible marks. The Active Cream was used to support barrier integrity, calm visible signs of stress and reinforce skin resilience through biomimetic topical support.
The objective was not to overload the skin, but to create a stable environment that supports recovery and tolerance over time.
From visible lesions to biological balance
This case study illustrates AWvi’s broader view of skin health: clarity is not only the absence of blemishes. It is the result of a more balanced skin environment.
A purely surface-led approach may temporarily address visible lesions. A biology-led approach considers the mechanisms that allow those lesions to recur: microbial imbalance, barrier fragility, inflammation, sebum irregularity and altered renewal.
By combining The Skin Biotic, The Gentle Cleanser and The Active Cream, the protocol worked across both internal and external pathways: supporting the gut-skin axis from within, while helping the skin surface remain cleansed, protected and reinforced.
A longer-term view of acne-prone skin
Acne-prone skin often requires consistency. Progress is rarely immediate, and the skin’s rhythm needs time to normalise. A supportive home protocol can help bridge the gap between professional assessment and everyday care.
For AWvi, this is where long-term skin health begins: not with aggressive correction, but with intelligent support for the body’s own systems of balance, defence and repair.
Acne-prone skin is not just about breakouts. It is about imbalance. And where imbalance is understood, clarity can begin.
Sources:
Dr Rachna Murthy’s FaceRestoration profile
Dr Rachna Murthy’s Maison Restorative profile
Maison Restorative’s About page
Managing Gut Health to Enhance Skin Quality
Dr Rachna Murthy’s PHIN profile
TFOS Ambassador profile: Rachna Murthy
BOPSS speaker profile: Miss Rachna Murthy
Aesthetic Clinical Training Academy: About Us
AWvi: The Future of Skin Health, Bridging Science and Biology
How You Can Fortify Your Microbial Mantle™?
Skin and Soul: How to Balance Complexion, Gut and Mind
Deep Clean: Simple Steps to Detoxification, Inside and Out
