Korean Skincare Acne Treatment Not Working? Test the Bacteria First

Why does Korean skincare acne treatment stop working?

Hello, I'm Dr. Won Woo Choi, a board-certified dermatologist and Chief Director at WELLS Clinic in Apgujeong, Seoul. I trained at Seoul National University Hospital, hold a Ph.D. in dermatology from Seoul National University, and am CEO of CutisBio. This article is based on my YouTube video from December 2024 above, where a junior colleague from Seoul National University and I talk about why Korean skincare acne treatment and repeat prescriptions so often fail; English auto-translated captions are available on YouTube.

My answer: a good routine and standard medicine calm acne for many people, but when inflamed breakouts keep returning, the missing step is usually diagnosis. If you don't know which microbes are driving the inflammation, you are guessing at the medicine. At WELLS we look for that cause with an acne-bacteria test.

How is acne usually diagnosed and treated?

My colleague saw long-standing acne that had not responded well to treatment while he worked at Seoul National University Hospital. As he explains in the video, diagnosis mostly relies on what the doctor can see and feel, such as small bumps under the skin.

• For very severe inflammation, an injection into the spot is sometimes used, but it is not a long-term treatment.
• For the longer term, the usual choices are oral antibiotics or a prescription medicine that reduces oil production.
• Those are essentially the same medicines I was using 20 to 30 years ago.

A patient recently told me exactly what that feels like: every clinic gave the same medicine, the acne was better while taking it and came back when it stopped, and the doctor only looked before prescribing. That stung, and it is why we started doing something different.

What does an acne-bacteria test show?

The test is simple for you. A cotton swab is rubbed on the skin, and the very small amount of microbial DNA it picks up is analyzed, so we can see the whole community of bacteria living on your skin rather than one suspect. WELLS developed this test with CutisBio; university hospitals were not yet offering it when I recorded the video.

When we tested people with severe acne, the results often differed from the textbook:

• With very strong inflammation, you would expect lots of the usual acne bacterium (Cutibacterium). Instead we often found Staphylococcus, sometimes Staphylococcus aureus. Once we knew that, a different antibiotic, one internists use more than dermatologists, cleared one patient's skin within about three days.
• In another patient whose skin looked the same, the test picked up large numbers of gram-negative bacteria. Gram-negative folliculitis is a known problem after long antibiotic use, but without a test it can only be guessed from the patient's history.

The point is to find the cause and prescribe the antibiotic that matches it, instead of repeating the same two medicines.

Is a bacteria test the right Korean skincare acne treatment step for you?

Not everyone needs it. Mild or occasional breakouts usually respond to good skincare and standard treatment. The test is worth asking about if:

• You have seen several clinics and been given much the same medicine each time.
• Your skin improves while you take medicine and flares again when you stop.
• Inflamed, recurring breakouts have lasted a long time, or you have used antibiotics for a long stretch.

A test result is not a diagnosis on its own. The dermatologist who examines you reads it together with your skin and history, then decides the treatment. For a wider look at routines versus clinic care, see Korean acne treatment: skincare vs clinic.

What does WELLS do once the cause is known?

Medicine matched to the result settles the active inflammation. To work on the source of the oil, our personalized acne treatment is chosen by acne type:

• Gold PTT: a gold nanoparticle ampoule activated by laser to shut down the sebaceous gland, weekly for 3–5 sessions, with little disruption to daily life.
• 1450 nm acne toning: heats the sebaceous gland; WELLS has ten years of clinical data with this laser.
• Blue PDT: no photosensitizer, so you can go out straight afterwards.
• Aladdin and FCR peels: exfoliate and stimulate collagen, also for back and chest acne.

The price is confirmed at consultation, once the dermatologist has seen your skin and recommended a plan.

How do you plan an acne visit to Seoul?

Bring the names of the medicines you have used and roughly how long you took them; that history matters when we read a bacteria result. Send a clear photo of your skin and your travel dates on WhatsApp first, so we can tell you what fits your stay. Gold PTT is weekly, so it suits a longer stay or return visits.

If you want to understand skin-microbiome testing more broadly, see my video article on skin analysis in Seoul. WELLS is about five minutes on foot from Apgujeong Station (Line 3), Exit 3. Results vary from person to person.

This article explains general medical information from the video. It is not a diagnosis; results vary by person and are decided in consultation.