In other words, what do you cleanse with: is it alkaline, acidic, do you exfoliate with rough scrubs, coarse cloths or salts and pumice? Are you overdoing it?

These can create irritation and damage the skin barrier leading to chronic inflammation. Most people use these way too frequently.

Long term use of retinoic acid (more than 12 weeks per year) increases blood flow to the skin, and is associated with chronic capillary redness, even rosacea.

Are you using products that have a balance of cholesterol, ceramides and fatty acids?  Do you know the best time to use them?

Even though they are great to eat, they are not suitable for everyone, especially acne prone skin. Many single oils can disrupt the barrier function of the skin over time, leading to irritation and accelerated aging.

Some cause rapid breakdown of collagen and elastin in the skin, hastening lines, and may make your skin more reactive in the long term. They may also be very necessary for your health, and your skin will need extra care.

Acne and rosacea are strongly associated with imbalances in the gut microbiome, and antibiotics can make it all worse, not just in your gut, but in your skin as well.

Drugs for autoimmune diseases can cause major problems with skin, especially dryness, slow healing, hyperpigmentation and sensitivity. Others can lead to massively oily skin, with blackheads and pustules.

When was the last time you washed those brushes? Have you checked the labels for pore clogging ingredients?

Ouch. Friction of any kind can cause micro-tears in the skin and lead to irritation. Heat and humidity that build up under a mask are classic triggers for both acne and rosacea.

Are you getting enough essential fats in your diet for healthy skin renewal? How about silica, calcium, sulfur, magnesium and vitamin C? Do you remember what you ate for breakfast? Was it nourishing or aging?