As soon as Shamban sees my face, she calls me out, saying I’ve neglected my skin. I’m embarrassed, and I can feel my face turning red — which probably makes my acne look even worse. And in that moment, I feel like an ugly, hormonal teenager again. What’s wrong with me? Why am I still dealing with this problem? But she’s right. By only using cleanser, I have been lazy with my skin.

Shamban tells me my acne is mainly hormonal. She calls it “red and active” acne, with a lot of indented scars beneath the fresh acne. Usually oral acne medication combined with birth control helps keep hormonal acne under control, Shamban says. But when I tell her I’ve already tried that, she puts me on an extensive four-step treatment plan, which includes everything from topical creams to laser treatments.