Causes of Acne

Types of Acne

Acne can be classified into two categories: Adolescent Acne – which is common in teens who hit puberty, and Adult Acne – which can emerge after the age of 20.

Adolescent Acne

Adolescent acne is caused by over production of sebum in the sebaceous glands as a result of hormonal changes that occur during puberty. Therefore, adolescent acne most commonly appears on the T-zone (forehead, nose, and chin) where sebum production is excessive.

Adult Acne

In adults, acne can develop as a result of hormonal imbalance. These hormonal changes can be induced by stress, unhealthy lifestyle (such as poor nutrition, lack of exercise, and insufficient sleep), and condition in one's living environment (UV exposure, high humidity, and air pollution). All of these factors reduce the skin's natural rate of regeneration leading to dead skin cells mixing with sebum which then clogs the skin's pores. Adult acne commonly appears on U-zone (cheeks, chin, and around the mouth) where skin tends to be dry.

  Adolescent Acne Adult Acne
Cause Overproduction of Sebum Unhealthy Lifestyle・Poor Environment/Living Condition
Area T-zone (forehead, nose, and chin) Stress・Hormonal Imbalance
Skin Type Oily Any Type

How Does Acne Develop?

As sebum production is accelerated, your skin's turnover (shedding of the dead skin cells) becomes irregular, and hair follicles get clogged with oil and dead skin cells. Acne begins to develop when the clogged follicles become inflamed due to bacterial infection (Propionibacterium acne) thus we recommend medical treatment as soon as possible.

Stages of Acne Development

  • 1. Hair follicles become clogged with oil and dead skin cells.
  • 2. Sebum (excess oil) is trapped in the follicle and begins to form comedo.
  • 3. Bacteria on the skin surface invades clogged pores causing redness, inflammation, and suppuration.

BHA Peeling + Photo Facial + Vitamin C

Peeling improves acne by removing the old keratin that causes acne. Combined with Vitamin C and Photofacial Treatment that produces irradiation, this will sterilize and improve the state of the skin with acne further.

Salicylic Acid Peeling (BHA)

Salicylic Acid cleans out excess sebum and dead skin cells from the follicles. This action reduces inflammation and accelerates the skin's reproduction which improves and prevents further acne outbreaks. For best results, treatment every two weeks is recommended.

Treatment Process

  • Peeling
    Peeling will be performed to remove the old keratin, letting the new skin grow.
  • Photofacial
    The light from the photofacial is beneficial not only for treatment of acne but also for treatment of spots.
  • Vitamin C
    Vitamin C will be applied to the treated area to further improve the acne, scars, and spots from deep inside the skin.

Acne / Acne Scar Treatment Course Fee

BHA Peeling
Trial ¥8,250
BHA Peeling + Vitamin C + Photofacial
Trial ¥18,000
5 Times ¥165,000 (@¥33,000)

Hormonal Therapy for Severe Acne

Depending on the severity of the acne, Azabu Skin Clinic also offers to check the hormones which might be the cause of the problem. This is done through blood tests and prescription of appropriate medicines based on the result of the test.

※ Click here for more information on Hormones

Other Areas Affected by Acne / Acne Scar

Treatment of other Areas Affected by Acne / Acne Scar

These treatments are proven to be effective for addressing acne and acne scars: Peeling helps to improve acne condition and reveals fresh and healthy skin by cleansing clogged pores and removing trapped dead skin cells and excess oil; Topical and oral antibiotic medication helps to reduce inflammation, redness, and infection; and Photofacial and V-beam laser treatment uses heat energy to destroy the acne-causing bacteria, and in the process reduces redness and inflammation.

  • Oral medications, Topical medications (Depending on the condition, improvement can be seen after intake or application of meds)
  • hormone therapy
  • PDT (Photodynamic Therapy) Treatment
  • V-Beam Laser

Acne on the Back

As summer temperatures increase, sebum (oil) production in hair follicles increases. And acne begins to appear where sebaceous glands are most active – on the middle of the back and upper-middle chest. To prevent further development of acne and scarring, proper treatment is required. Salicylic Acid Peeling (BHA) is affective for treating body acne.

Treatment Process

  • Peeling
    When performed, peeling causes the skin to exfoliate and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin.
  • Photofacial
    Improves acne scars and redness of the skin gradually, resulting to a white and clear skin.
  • Vitamin C
    When applied, the active ingredients of Vitamin C penetrates deep into the skin and treats the cause of acne from deep within.

Back Acne Treatment Course Fee

BHA Peeling
Trial ¥7,000
BHA Peeling + Vit C Introduction
5 Times ¥65,800 (@¥13,160)
8 Times ¥98,800 (@¥12,350)
BHA Peeling + Vit C Introduction + Photofacial
Trial ¥28,400
5 Times ¥141,800 (@¥28,360)

Fractional Resurfacing + Growth Factor

What is Fractional Resurfacing?

Fractional resurfacing is the latest and revolutionary system that delivers between 100 and 1000+ microscopic laser beams per square centimeter to the skin. Collagen remodeling is increased by the thermal energy delivered to the dermis and subsequent natural healing replaces coagulated tissue with new tissue.

This versatile new technique can achieve a rapid effect particularly good for improving wrinkles, sagginess, acne scars, and enlarged pores without any surgical methods.


Fractional Resurfacing laser creates 1000+ microscopic laser beams per 1cm² and are introduced into the skin. The coagulated tissue will be replaced with new ones by natural healing process as well as the collagen remodeling is increased by the thermal energy delivered to the dermis. The results are smoother, softer, brighter skin.

What is growth factor? (Cell growth factor – FGF and EGF)

Growth factor (cell growth factor) is a type of protein that controls all cell proliferation, including cells that produce collagen and elastin in our body. It slows down aging of the skin, activates the cells, and makes the collagen new among many others. Its main function is to make the skin youthful. Aside from this, it also repairs the skin tissue and improves pigmentation. The main types of growth factor are EGF (epidermal growth factor) and FGF (fibroblast growth factor).

Discovery of EGF – Awarded Nobel Prize in Medicine and Physiology

Dr. Stanley Cohen received the Nobel Prize in Medicine and Physiology in 1986 due to the discovery of EGF.

Function of EGF (Epidermal Growth Factor)

  • Delay cell aging
  • Promote the regeneration of new cells
  • Make new collagen, elastin, hyaluronic acid
  • Improvement of moisturizing ability and elasticity of skin
  • Improvement of pigmentation
  • Repair of skin tissue

Problems treated by Growth Factor (Cell growth factor-FGF · EGF)

Wrinkle · Sagging · Pigmentation · Stiffness · Gloss · Enlarged Pores · Acne · Acne scars · Pregnancy Marks · Stretch Marks

Acne Treatment Course Fee

Fractional Resurfacing + Growth Factor (Whole Face)
Trial ¥39,500
Fractional Resurfacing + Growth Factor (Cheek)
Trial ¥28,400

Microneedling Treatment

What is Microneedling?

Small needles are used to create micro channels in the skin. This stimulates the skin's natural ability to heal itself and in the process produces collagen and elastin. This repair process begins almost immediately and results in a thicker dermis and softened wrinkles or scars. The small channels in the epidermis close very quickly and the skin begins a healing response right away.

Microneedling Treatment Fee

4 times ¥130,300 (@¥32,575)
8 times ¥202,700 (@¥25,337)

Microneedling + Stem Cell

Microneedling + Stem Cell

For skin rejuvenation and whitening! A: Microneedling + Stem cell used for regeneration of beautiful skin, B: Microneedling + Whitening cocktails which penetrates deep into skin, promoting collagen production and skin rejuvenation!

With the holes made by the microneedling, the treatments are ensured to reach deep into the skin's layers. After treatment, these microscopic holes immediately closes and the skin starts its healing process. During this time, collagen and elastin are formed which brings firmness to the dermis and improves wrinkles and other superficial skin conditions.

Treatment Fees (Whole Face)

5 times
¥140,000(1 time at ¥ 28,000)
8 times
¥198,000(1 time at ¥ 24,750)

PDT Treatment (Photodynamic Treatment)

What is PDT Treatment (Photodynamic Treatment)?

PDT (Photodynamic therapy) potentiates the effect of light therapy (Photofacial / V beam laser) more efficiently by applying special medicine (Aminolevulinic acid) to enhance photosensitivity. Aminolevulinic acid is absorbed into the sebaceous gland and other cells selectively. Thus, it enhances the effect of light therapy for treated area. PDT is an effective treatment for certain conditions of skin, such as acne, acne scar, senile sebaceous hyperplasia, oily skin, reddish face, broken capillaries, solar keratoses, Bowen's disease, basal cell carcinoma and keratosis. It also helps rejuvenate the skin.

PDT for Treating Acne

This PDT therapy is especially suitable for patients with persistent acne. For those who have already tried other treatments such as chemical peeling, light therapy, topical and oral medication but found it ineffective. In this treatment, Aminolevulinic acid will be absorbed in the sebaceous gland of the skin and produce porphyrin. IPL (Photofacial) rays will react to the porphyrin and efficiently target the problematic area. Furthermore, the active acne bacteria in the treated area will absorb the aminolevulinic acid and increase porphyrin, and react to rays. As a result of the synergetic effect, the skin will become healthy and radiant due to the decrease in sebum secretion and elimination of the acne bacteria.

PDT Treatment Process

  • Consultation with the Doctor.
  • Application of Aminolevulinic acid in the entire face or specific spots. It will be left for about 1 to 2 hours to penetrate deeply into the skin.
  • 3. Irradiation will be done on the face or treated area.
  • Cooling of the treated area will be done.
  • Make-up can be worn immediately after treatment.
  • There will be redness and swelling for a few days after the treatment.
  • It is necessary to avoid sunlight and UV rays several days after treatment.

Treatment Fees

Course A (Made in Japan)
Whole Face
Trial ¥64,000
Trial ¥50,370
Course B (Made in USA)
Whole Face
Trial ¥64,000
Trial ¥50,370

The Medical Team


Dr. Kawashima graduated from Tokyo medical College in 1992,March,worked Tokyo Medical College hospital from 1992,and at various other dermatological clinics.She furthers her knowledge through attending and constantly engaging in both domestic and international conferences, especially those held by the American Academy of Dermatology (AAD), the American Society for Laser Medicine and Surgery (ASLMS), and the American Academy of Anti-Aging Medicine (A4M).furthers her knowledge through attending and constantly engaging in both domestic and international conferences, especially those held by the American Academy of Dermatology (AAD), the American Society for Laser Medicine and Surgery (ASLMS), and the American Academy of Anti-Aging Medicine (A4M).

Current Position:Owner and President ― Azabu Skin Clinic(2002 ― Present)

Associations and Affiliations:

  • ● Associate of American Society for Laser Medicine & Surgery, Inc. (ASLMS)
  • ● Member of the American Academy of Anti-Aging Medicine (A4M)
  • ● Member of the Japanese Dermatology Association
  • ● Member of the Society of Aesthetic Dermatology
  • ● Member of the Japanese Cosmetic Science Society
  • ● Member of the Japan Society of Aesthetic Plastic Surgery
  • ● Member of the Society of Anti-aging Medicine for Women
  • ● Member of the European College of Aesthetic Medicine and Surgery

Certifications and Accreditations:

  • ● Certified Trainer and Instructor for Hyaluronic Acid Filler Injection by Galderma (Switzerland)
  • ● Certified Specialist of Doublo Treatments
  • ● Certified Specialist of Thermage Treatments
  • ● Certified Specialist of Dr. Obagi's Cosmetics

Clinic Schedule:Wednesday-Sunday (Reservation required)


Associations and Affiliations

Dr Takahashi graduated from Tokyo university post graduate in 2011,March, started working at Tokyo University hospital,plastic surgery department from 2001,April.

  • ● Head of the Department of Plastic Surgery – Saitama Medical University Kawagoe Clinic
  • ● Board Certified Specialist of Japan Society of Plastic and Reconstructive Surgery
  • ● Board Certified Specialist of Japan Society of Aesthetic Plastic Surgery
  • ● Certified Physician of Association of Aesthetic Medicine
  • ● Board Certified Specialist of Japanese Society of Anti-Aging Medicine

Clinic Schedule:By appointment only


After graduating from Toyoma Medical and Pharmaceutical University, Dr. Hirabe became a member of the faculty of the Department of Dermatology at Kyushu University Hospital. Later on, she moved to the Fukuoka Hospital of the National Hospital Organization.

She has also accumulated vast experience working with the Federation of National Public Service and Affiliated Personnel Mutual Aid Association, Hamano-machi Hospital, and many other notable institutions. Dr. Hirabe has been with the Medical Team of Azabu Skin Clinic since 2008.

Clinic Schedule:Sundays from 10:00AM – 7:00PM (Reservation required)


6-F Prescious#18 Building
4-14-6 Minami azabu,Minato-ku,

6minute from Hiroo st
Tokyo Metro HIBIYA Line 1 gate
(Wednesday AM11:00-8:00)
self care practice

Clinic Free Dial
Free Dial0120-005-327
Consultation reservation