Adult acne, signs of ageing, universal skincare must haves, is SPF really that important? A top dermatologist answers your questions.
As you know, I’ve been on a skincare journey of my own, trying to clear my hormonal acne with topical spironolactone, using products from Uncouth, which is a personalised, prescription skincare brand founded by a dermatology doctor.
Uncouth compound bespoke formulas using ingredients that you would only be able to get from a private dermatologist: like Tretinoin for anti-ageing, Hydroquinone for melasma, and of course, Spironolactone for hormonal breakouts.
I’ve been using their products for around 6 months now and I’m definitely seeing good results with my skin. It’s just so tricky to get hormonal acne completely under control! I’ve also tried a couple of their other active ingredient topical creams and I can safely say that they are definitely a power house!
I thought it would be a good idea to talk to one of the dermatologists at Uncouth (the lovely Emma) and get some answers on some of our important skincare concerns! Emma has been helping me with my treatments and is extremely knowledgeable, so I asked her some important questions that I think all of us want to know! I hope you all find this interview really useful. My questions are in bold, Emma’s answers are in plain text. Please do let me know if you have any questions as well!
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(Dermatologist Emma from Uncouth)
Lorna: What’s the most common skin complaint you encounter?
Emma: The most common concern I see is acne — and not just in teenagers. Adult acne, especially hormonal breakouts in women in their 30s, 40s and beyond, is incredibly common. I also see a lot of rosacea, melasma, pigmentation issues, and general concerns around ageing like fine lines, dullness, and skin texture.
That’s good to know! I’ve suffered from acne (mostly hormonal) since I was 14 years old. Do you have any useful tips for those of us struggling with acne?”
Absolutely — you’re not alone. Hormonal acne often flares around the jawline and chin, especially before periods, and can persist well into adulthood. A few key tips:
- Stick to a simple, consistent routine. Overloading your skin with too many actives can worsen inflammation.
- Ingredients like benzoyl peroxide, salicylic acid, and azelaic acid can be helpful for mild to moderate cases in the first instance.
- For hormonal or persistent acne, prescription treatments — such as topical retinoids or oral medications like spironolactone — often offer more lasting control.
Are there any specific products you recommend as a universal must-have?
Yes — SPF is the absolute non-negotiable. A broad-spectrum sunscreen (SPF 30 or higher), worn daily, is your best defence against pigmentation, premature ageing, and skin cancer.
If you’re prone to melasma or pigmentation, I often recommend tinted sunscreens. These contain iron oxides, which offer extra protection against visible light — an often-overlooked trigger for melasma.
I prefer gentle cleansers, particularly balm cleansers, which cleanse effectively without stripping the skin barrier.
For dry or eczema-prone areas, simple ointment-based moisturisers — even something basic from Boots — can be incredibly effective. They often contain fewer preservatives than creams and do a better job at sealing in moisture.
I had no idea about iron oxides! What’s your number one skincare rule or tip?
Consistency over complexity. You don’t need a complicated routine — just a few well-chosen products, used regularly and correctly, make the biggest difference.
If you’re using a prescription retinoid it’s important to find the strength that suits your skin. Not everyone needs (or tolerates) the highest dose — it’s better to settle into a level that gives you results without irritation.
And finally — don’t wait until skin problems get severe to seek help. Early, evidence-based intervention can save a lot of stress later on.
What would be your recommended routine for those of us worried about signs of ageing?
For ageing concerns, focus on products that protect, stimulate renewal, and support the skin barrier:
Morning:
- Gentle cleanse
- Antioxidant serum (like vitamin C)
- Moisturiser
- Broad-spectrum SPF 30+ — every single day
Evening:
- Cleanse (balm cleansers are great)
- Prescription retinoid or over-the-counter retinol (build up slowly) you can combine or add in extra skin brightening ingredients like arbutin to increase efficacy. I’m a fan of antioxidants like Niacinamide and ferrulic acid.
- Moisturiser to support the skin barrier
Hydration, consistent SPF, and a well-tolerated retinoid are your foundation.
Tretinoin seems to be a skincare ingredient that has gone viral too. Can you tell us more about this product and how it could be useful?
Tretinoin is a prescription-strength retinoid
That said, not everyone needs the highest strength — irritation is common when starting. I recommend starting with a lower strength, using it a few nights per week, and building up gradually. And always pair it with SPF and moisturiser.
At Uncouth we have different bases available to suit different skin types and we can combine tretinoin with a variety of ingredients to improve results, minimise side effects and simplify your routine.
That’s great to hear! Is diet really that important when it comes to skin health too? What about our water consumption?
Diet does play a role — but it’s not about perfection. For acne, there’s growing evidence that high-glycaemic diets and excess dairy, can trigger breakouts in some people. However this is likely to be more of a contributory factor.
As for water: hydration is important, but drinking loads of water alone won’t magically clear your skin. Think of it as piece of the puzzle, alongside sleep, stress, skincare, and hormones.
I can vouch for that as dairy does break me out, as well as oily, sugary foods. Is it ok to wear make-up every day, or do you recommend having days off?
It’s absolutely fine to wear make-up daily, as long as you’re removing it thoroughly at night and using non-comedogenic products (formulated not to clog pores). Skin doesn’t need a “break” from make-up — but it does need good cleansing habits to stay healthy underneath.
Great! I do love make-up! And finally, do we all need to be using retinols/retinoids and multi-step routines, or is a simple cleanse and moisturise ok too?
You don’t need a 10-step routine to have healthy skin. A basic routine — cleanser, moisturiser, and SPF — is perfectly fine. That said, if you have specific concerns like acne, pigmentation or signs of ageing, then retinoids, antioxidants, and targeted actives can offer real benefits.
But it’s not “all or nothing.” Start simple, and only add products if they serve your skin’s needs. Skin care should feel sustainable, not overwhelming.
Thank you so much! This has been super helpful!
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