Case Clinic: The Bumps That Won’t Budge 🔍✨

A 27-year-old client comes in frustrated about “tiny bumps that just won’t go away.”
She’s been exfoliating daily with a scrub and chemical peel pads she bought online, but nothing has improved, and her skin now feels tight and easily irritated.

In the treatment room, you notice:

• Small, uniform, flesh-colored bumps across the forehead and upper cheeks

• Slight flaking around the nose and chin

• A shiny-but-dehydrated appearance

• Mild sensitivity when you begin cleansing

• No visible inflammation or pustules

• Barrier looks compromised from over-exfoliation

• Makeup tends to pill or sit on top of these areas

• She uses a fragranced, heavy moisturizer and wears the same workout headband daily

And here’s the twist:
She’s convinced it’s “acne,” but something about the pattern and her routine suggests it might be something else.

Your Turn:

How would you approach this client’s skin?

• What’s your first step in the treatment room?

• Would you exfoliate? If so, how?

• What conditions are you considering: closed comedones, milia, cosmetic congestion, fungal folliculitis, or something else?

• What ingredients would you prioritize to rebuild the barrier and improve texture?

• How would you guide her home care routine to prevent over-exfoliation?

Share your professional perspective below, there’s no one right answer, and your approach might be exactly what another therapist needs to see.