Why there’s no one-size-fits-all acne treatment, according to a dermatologist

If you were to Google “how to treat acne,” you’d be greeted by pages upon pages with zillions of products that all promise to rid your face of your unwanted visitor. While a good chunk of these are serums, topicals, and face masks you can buy on beauty shelves at any old beauty shop or drug store, there’s also a sliver of treatments that cross into Rx territory.

This is where the great divide happens—while some people can get by with over-the-counter options and self-treatment, others still face acne after trying a number of things, so they turn to the professionals (i.e. dermatologists). I fall into this camp, and so do 71 percent of the 700-plus women Well+Good surveyed about acne.

When it comes to Rx options, there are topicals—like uber-strong retin-A—and there are oral medications, which include everything from birth control pills to hormone regulators (like Spironolactone), and what seems to be the last resort: Accutane.

Of course, you may wonder why it’s such a diverse mix, and why some people can get by with spot treatments while others have to take stronger pills. Turns out it all comes down to the many causes behind the skin condition, along with the skin you were born with.

“Everyone’s genetic makeup is a little bit different, which helps explain why people develop different types of acne, and people are susceptible to break out from different aggravating factors,” says Joshua Zeichner, MD, a New York-based dermatologist. “Genetics may also explain why certain treatments are more effective on one person than another.”

Hence why your BFF can quash zits with tea tree oil while your other friend needs to be on a pill to clear things up. Everyone’s different.

“While we understand the basics of why acne happens, there’s so much that we have yet to learn,” says Dr. Zeichner. “As we understand better the genetic factors that cause acne—and the difference in genetic factors in different types of patients—we will better be able to treat acne.”

In the meantime? Think of your trials and tribulations with treatments as a mere way of research as you get your healthiest skin ever.

And yes, there’s a connection between acne and mental health. Stress and acne are intertwined as well.