I have bad break outs on my neck and back. I used dermalmd blemish serum twice a day on clean skin. After the first two or three days, my skin had an increase in breakouts BUT after about a week with the product, my skin is smoother and much clearer! I am very happy with this product! I have always heard that breakouts will get worse once a regimen has begun but will eventually clear up. I recommend dermalmd blemish serum!