Mikayla Miller Esthetics

Before & After One Liquid Microneedling 👀

Her fine lines have dramatically reduced and I couldn’t be happier! The power of spicules is unmatched.

If you’ve ever started an acne journey and felt like your skin was getting worse, this post is for you.

When most people look at these photos, they immediately focus on the increased inflammation and the amount of visible congestion in the photo on the right. More red bumps. More visible breakouts. More acne.

But as an acne specialist, that’s not what I see.

What I see in the before photo is a significant amount of congestion sitting deep beneath the surface of the skin. Much of it wasn’t immediately obvious when looking at her skin at rest. In fact, a lot of the congestion could only really be seen when the skin was stretched or pulled taut. The blockages were there, they were just hiding beneath the surface.

Fast forward to the photo on the right.

Now we’re seeing more visible inflammation. To someone unfamiliar with the acne-clearing process, it might look like her skin is getting worse.

But what’s actually happening is that the congestion is moving.

Acne cannot clear if it stays trapped deep within the pore. Those blockages have to work their way up and out of the skin. As treatments begin increasing cell turnover and clearing the pathway for healthier skin, that hidden congestion often becomes more visible before it resolves.

Think of it like cleaning out a cluttered closet. Before it gets organized, everything has to come out into the open.

Is every breakout a sign of progress? No.

But when I see deep congestion beginning to surface like this, I know the skin is actively working through what has likely been building up for months.

This is why patience is so important when treating acne. We are not just treating the blemishes you can see. We are treating the congestion you can’t see yet.

The goal isn’t a quick fix. The goal is truly clear skin. Long lasting clear skin.

Sometimes, that means trusting the process when it doesn’t look pretty and this client has been an absolute trooper because dealing with this congestion has been years in the making with NOTHING moving it.

Acne is one of the most misunderstood skin conditions I see and honestly my favorite to treat.

It’s not because you’re dirty or you ate one piece of chocolate. Acne starts inside the pore long before you see a breakout on the surface. Understanding what’s actually happening beneath the skin is the first step toward clearing it.

If you’ve been trying product after product with little success, there may be a reason.

My lovely client 🤍

She came into my treatment room feeling like her skin was dull + dry so we gave her skin some TLC.

She left absolutely glowing ✨

If your skin suddenly starts acting completely different in the summer…you’re not imagining it ☀️

Heat + humidity can be brutal for acne-prone skin.

More oil production.
Sweat getting trapped.
More inflammation.
A weakened skin barrier.

It’s the perfect recipe for angry breakouts. One of the biggest mistakes I see is assuming your skincare routine should stay the same year-round. What worked beautifully in winter may not be what your skin needs in the middle of summer.

Your skin is constantly responding to your environment, hormones, stress, and lifestyle. Acne correction requires adjusting with it, not fighting against it.

My own personal before and after!

It’s been a few years, but it’s good to look back at how far I’ve come. When I promise you I’ve been where you’ve been, I mean it.