Most acne education stops at the surface: cleanse harder, exfoliate more, dry it out. Alex Lee thinks that advice is why so many patients never get clear. In the first episode of The Practice Lab, the DermaRoom Collective's clinical trainer walks through the biology underneath acne — the pilosebaceous unit and the four drivers that feed it — and makes the case that barrier repair, not stripping, is what actually breaks the cycle. She also shares a cystic acne case that improved roughly 75% before she performed a single treatment.

In this episode:

The gap between graduating and facing your first real acne patient, and why Alex built a course to close it
The pilosebaceous unit, and the four pillars of acne: follicular hyperkeratinization, excess sebum, Cutibacterium acnes, and inflammation
Why over-cleansing and over-exfoliating make acne worse, and what barrier-first treatment looks like instead
Reading the pattern: cyclical jawline breakouts versus uniform, itchy presentations, and why one patient often has several types at once
A severe cystic acne case: two weeks of stopping everything, then a simple routine, then mapped microneedling
Where Alex stands on microneedling over active acne, including her extraction and antimicrobial protocol
Three things a practitioner can change the day after finishing the course

As Alex puts it: "The key to healthy skin is a healthy microbiome." Or, on why sequence matters more than product choice: "You need to have a healthy foundation in order to use those ingredients and to use them properly."

About the guest: Alex Lee, CBAM, is a medical aesthetician practicing at Beauty Mark Medical Aesthetics in Prince Edward Island, and clinical trainer for The DermaRoom Collective. She is Course Director of Understanding Acne: From Pathophysiology to Practice.