Acne is often reduced to breakouts, oiliness or blocked pores. In reality, persistent acne-prone skin reflects a more complex biological disruption.
It involves inflammation within the pilosebaceous unit, microbial imbalance, immune activation, altered follicular keratinisation and excess sebum activity. In this case study, the focus was not only to suppress visible lesions, but to support the underlying conditions that influence recurrence, inflammation and skin clarity.
This is why AWvi approaches acne-prone skin from the inside out and the outside in: supporting the gut-skin axis, preserving the skin barrier, modulating surface imbalance and reinforcing the skin’s capacity to recover.
A case study supervised by Prof. Jonathan Roos
This AWvi case study was conducted under the supervision of Prof. Jonathan Roos, MB BChir MA PhD (Cantab), FRCOphth FEBO, Ophthalmologist, Oculoplastic and Reconstructive Surgeon.
The photographs were taken at baseline, T0, and after one week, T1. The protocol included daily oral intake of The Skin Biotic, combined with twice-daily application of The Gentle Cleanser and The Active Cream, alongside the use of Purifeyes, one Hydrafacial and one IPL session.
In this individual case, a visible reduction in long-standing acne was observed after one week. The supplied case-study text describes this rapid improvement as reflecting a synergistic modulation of inflammation, microbial balance and sebaceous activity.
This is an individual case and should not be interpreted as a guaranteed result. Persistent or severe acne should be assessed by a qualified healthcare professional.
Expert insight
'Acne is more than occasional eruptions on the skin; it is a manifestation of sustained follicular and sebaceous-unit inflammation, set in motion by an interplay of hormonal drive, microbial imbalance within the pilosebaceous unit and immune-system activation.
Treatment must shift from simply suppressing lesions towards re-establishing equilibrium in the skin’s ecosystem, regulating sebaceous output, normalising keratin-follicle behaviour, supporting barrier and microbial health, and integrating systemic lifestyle factors into the plan.
Only then does true clarity become possible.'
Prof. Jonathan Roos
MB BChir MA PhD (Cantab)
FRCOphth FEBO
Ophthalmologist, Oculoplastic, Reconstructive Surgeon
Why chronic acne requires a wider biological view
Chronic acne is rarely driven by one isolated factor. It is a complex inflammatory cascade involving gut and skin microbiome imbalance, immune dysregulation, follicular hyperkeratinisation and excess sebum activity.
The clinical focus was therefore structured around five priorities:
→ Rebalancing the gut-skin axis
→ Normalising keratinocyte turnover and follicular clearance
→ Regulating sebum production without barrier disruption
→ Reducing C. acnes activity and biofilm formation
→ Soothing inflammation and supporting immune homeostasis
This approach reflects a key AWvi principle: acne-prone skin should not be treated as impurity. It should be understood as imbalance.
The AWvi protocol used in this case study
Step 1: The Skin Biotic
The Skin Biotic formed the inside-out layer of the protocol.
The Skin Biotic targets the biological disruptions underlying acne by recalibrating the gut microbiome, modulating immune responses and supporting the skin’s natural barrier function from within.
This internal layer is central to AWvi’s approach. Acne-prone skin can be influenced by systemic inflammation, microbial balance, immune response and lifestyle factors. Supporting the gut-skin axis helps address acne-prone skin beyond the surface.
Step 2: The Gentle Cleanser
The Gentle Cleanser was applied twice daily.
For acne-prone skin, cleansing must be effective without being aggressive. Over-cleansing or harsh products can disrupt the skin barrier and increase reactivity. In this case study, The Gentle Cleanser is described as supporting acne-prone skin by eliminating excess oil and pore-clogging impurities, soothing inflammatory responses and helping rebalance the cutaneous microbiome while maintaining barrier strength and resilience.
The objective is controlled cleansing: removing what contributes to congestion without stripping the skin’s natural defences.
Step 3: The Active Cream
The Active Cream completed the topical AWvi layer.
The Active Cream reinforces barrier integrity, regulates sebum and lipid balance, alleviates inflammatory stress and strengthens resilience with biomimetic ingredients aligned with the skin’s physiology.
This is important because acne-prone skin is often treated too aggressively. Barrier support, lipid balance and hydration can be essential to helping the skin recover without provoking further irritation.
From suppression to equilibrium
Chronic acne should not be approached only by suppressing visible lesions. The objective is to help re-establish equilibrium within the skin ecosystem, supporting microbial health, barrier integrity, sebaceous regulation and systemic lifestyle factors.
For AWvi, this is where clarity begins. Not with harsh correction. Not with the idea that acne reflects impurity. But with a deeper understanding of disruption, and a protocol designed to support the skin’s natural biology.
Sources and further reading:
FaceRestoration: Our Team
PHIN: Dr Jonathan Roos profile
ESOPRS: Find Members, Dr Jonathan Roos
Top Doctors: Professor Jonathan Roos profile
Doctify: Professor Jonathan Roos profile
ResearchGate: Jonathan Roos research profile
