30's - acne jawline and post inflammation erythema and texture. How can I treat this? (Photos)

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi there — thank you for opening up about this. I know how defeating it can feel when breakouts and redness keep showing up, especially in your 30s when it seems like this should be “over.” You’re not alone in this, and what you’re describing is something I see often. There are effective ways to calm the acne, fade the red marks, and smooth out the texture.

Here’s what I want you to know:

1. Jawline acne in adults is extremely common.
This pattern often ties into hormonal fluctuations, stress, or even subtle triggers like diet, cycles, or underlying inflammation. It doesn’t mean you’re doing anything wrong, and it definitely doesn’t mean you’re “back in puberty.”

2. The red marks (post‑inflammatory erythema)
Those lingering red or pink spots after a breakout can be so frustrating. They’re not scars — they’re tiny dilated blood vessels and inflammation under the skin. They do fade, but they take time, and the right routine can speed that up.

3. Texture changes
Ongoing breakouts plus inflammation can leave uneven skin, but this is also something we can meaningfully improve with the right combination of treatments.

Here are the approaches that tend to work best together:

• A gentle, consistent acne‑focused skincare routine
– A salicylic acid or benzoyl peroxide wash
– A retinoid at night for texture, pores, and preventing new lesions
– Niacinamide for redness and barrier support

• Hormonal acne support
If your breakouts flare along the jawline or around cycles, options like spironolactone or certain birth control pills often help tremendously.

• Treating the red marks
These fade with:
– Retinoids
– Azelaic acid
– Light chemical exfoliation
– And for faster improvement, vascular‑targeted lasers like Vbeam

• Smoothing the texture
Retinoids, chemical peels, and light resurfacing treatments can help refine the skin and even things out gradually.

Most importantly, nothing about what you’re going through is hopeless — this is something that can get better. It just takes a plan that addresses both the acne and the inflammation it leaves behind. I’m here to guide you through it whenever you need clarification or support.

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic skin in Chicago. I’m really sorry you’re dealing with this — adult hormonal-pattern jawline acne + PIE (post-inflammatory erythema) + texture is one of the most frustrating combinations, and a lot of people in their 30s feel exactly like you do.
The good news is: this can get dramatically better, and the key is getting the right sequence of treatments, not just throwing products at it. Calm the breakouts (4–8 weeks)

Pick ONE of these as your main acne treatment (don’t start everything at once):
Option A: Topical tretinoin (0.025% to start). Helps: acne, texture, pores, PIE over time.
Pair with: gentle moisturizer to prevent irritation. Option B: Azelaic acid 15–20%. Helps: redness, PIE, acne, brightening.
Option C: Benzoyl peroxide 2.5% (AM only, 3–5x per week). Kills acne bacteria + prevents cystic flares. Most people with sensitive, PIE-prone skin do best with: Azelaic acid + gentle cleanser + moisturizer
Then add tretinoin later.

Step 2 — Address the jawline hormonal component
Jawline acne in adults is nearly always hormonal.
These are the treatments that make the biggest difference:
Spironolactone (oral medication) — the #1 for adult female jawline acne. Reduces hormonal breakouts dramatically. Safe long-term. Often life-changing for stubborn cysts. Works within 4–8 weeks If you prefer topical only: Clascoterone (Winlevi) is a topical hormonal acne treatment.
Slower than spironolactone but helps many people.



Best non-laser options:
Azelaic acid (one of the best). Niacinamide. Tretinoin (slow improvement). Sunscreen daily (crucial — redness worsens with UV). If you’re open to procedures:. Vascular laser (Vbeam) or IPL. Fastest and most dramatic improvement. 1–3 sessions. Minimal downtime. Safe for PIE specifically. If you tell me your budget, I’ll let you know if IPL or Vbeam is worth it for you.

Step 4 — Smooth the texture. Once active acne is controlled, texture is addressed with:

Best options:
Microneedling. Tretinoin (slow but steady). Superficial chemical peels (salicylic, lactic, glycolic)
DO NOT start texture procedures while you’re still breaking out a lot — it causes more irritation and more PIE.
THE BIGGEST MISTAKES PEOPLE MAKE (so you can avoid them). Starting too many active products at once → irritation → more redness → more breakouts. Not treating the hormonal component. Using harsh cleansers/toners thinking it will “dry it out”
Not moisturizing enough, Giving up too early (treatments take 6–12 weeks)
You’re not failing — the standard approach is just not intuitive.

Here is a simple, gentle routine to try starting now
AM: Gentle cleanser. Niacinamide serum (optional but helpful). Azelaic acid. Moisturizer. SPF 30–50 daily
PM: Gentle cleanser. Moisturizer. Tretinoin every 2–3 nights (or start later if sensitive)