Acne is a common skin problem that affects men and women of all ages. From genetics, stress, and air pollution to hormone fluctuations, medications and more, several factors can contribute to the onset and ongoing aggravation of acne.
When suffering from unwanted skin concerns, it's easy to feel like you're struggling alone. Yet, did you know that 9.4% of the world's population is believed to have acne? In fact, acne affects 85% of Australians aged 15-24 years old.
Whether you're religiously treating your acne and seeing little to no results, or you're overwhelmed by research and unsure where to start, this is the perfect beginner's guide to understanding your skin, the different types of acne, and the many treatment options available.
As always, we recommend using the following information merely as a guide to help educate you and help build your ideal skincare routine. When paired with quality medical advice, you can begin to take proactive steps towards improving and nourishing your body's largest organ.
What is acne?
Acne is a skin condition that eventuates when one's hair follicles are plugged with oil and dead skin cells. Let's take a closer look at exactly what occurs beneath the skin's surface…
With healthy skin, the sebaceous glands — also known as the oil glands — produce sebum, which is excreted by the pores (i.e., the opening in the follicle) onto the skin's surface. This process helps to lubricate the hair and skin to reduce dryness. As the body sheds skin cells, keratinocytes — a type of skin cell that lines the follicle — elevate to the skin's surface.
However, for acne-prone skin, this process looks a little different. Opposite to the above, when someone has acne, the sebum, hair, and keratinocytes get stuck together inside the pore, usually due to excess oil production, which plugs the follicles.
This encourages harmless bacteria on the skin to contaminate the clogged follicles, causing inflammation marked by swelling, redness, and pain. The end result? Pimples.
What are the different types of acne?
Like with most skin conditions, there isn't a one-size-fits-all approach to acne, nor is there a simple miracle cure that'll eradicate all types. Yet, understanding the different types of acne and which one you're experiencing is key when understanding what is required to help treat it.
Type of acne: |
Acne characteristics: |
Whiteheads |
A closed comedone presents as a bump that develops underneath the skin's surface. This form of acne is covered by a thin layer of skin, which gives a white appearance. |
Blackheads |
A blackhead is similar in nature to a whitehead in that it's caused by clogged pores. However, it isn't covered by skin. Instead, it rises to the surface of the skin, causing the trapped oil and dead skin to turn black due to exposure to air. As such, blackheads appear as black or dark-looking pimples. |
Inflammatory Papules |
Papules are swollen red bumps on the skin. Similarly to other forms of acne, they eventuate due to excess oil and dead skin cells getting trapped in your pores. Generally, the pressure build-up forces the pore's walls to rupture, causing it to spread to other surrounding areas. Papules' red and swollen characterisation actually occurs due to your body's immune response. |
Inflammatory Pustules |
As the name suggests, this form of acne generally contains fluid or pus and presents as red, inflamed skin and large white bumps. Your body's inflammatory response causes the pimples to fill with pus, composed of oil, bacteria, and dead skin cells. |
Nodules |
Nodules are painful forms of acne that present as larger, hard bumps underneath the surface of the skin. Essentially, nodules develop when a particular type of bacteria gets trapped in your pores, causing infection deep within your skin. This results in an inflammatory response that causes swelling and redness. This acne is considered severe and requires medical intervention, as it's deep within your skin and can cause significant scarring. |
Cysts |
Cystic acne is suggested to be the most severe form of acne. Cysts look similar to boils and appear as fluid-filled nodules that occur when your body has an intense inflammatory reaction in your pores. |
What factors contribute to acne?
From genetics and hormones to stress, weather, and personal care products, there are several reasons people experience acne. You might simply be more prone to breakouts due to your skin type. For example, those with naturally oily skin types may experience acne more than others.
[Read Full Article: How to Determine Your Skin Type: The Ultimate Guide]
While skin conditions are unique to each person, various factors contribute to a person's skin makeup — and the reason why some people experience acne and others don't. Let's take a closer look at a few of the common reasons linked to acne breakouts.
While the following factors may play a role in acne, it's important to note that more research is required to understand whether or not these factors play a role in causing acne, or if they exacerbate it.
1. Hormone fluctuations
It seems like a rite of passage to experience breakouts as you hit puberty, right? Well, there's a simple reason for this. Teenage acne is most commonly believed to be the result of fluctuating hormones, like androgens.
Believe it or not, the sebaceous glands — the glands that produce oil and have a significant role to play in acne — are extremely sensitive to hormones. Some researchers believe hormonal fluctuations may encourage your sebaceous glands to produce more sebum than necessary, resulting in breakouts.
2. Genetics
Genetics plays a pretty significant role in acne. If your parents had acne, the chances of you also developing acne are relatively high.
According to a study published in the National Library of Medicine, people with a first-degree relative who had adult acne (i.e., a parent or sibling) are more likely to have it. The same study concluded that people with parents who both had acne are at a higher risk of experiencing acne breakouts.
3. Gender
Believe it or not, women are more likely to experience adult acne than men. This is thought to occur due to hormonal fluctuations experienced exclusively by women. This includes:
- Menstruation
- Pregnancy
- Polycystic ovary syndrome (PCOS)
4. Medications
Many medications contain hormones, corticosteroids, and lithium. Unfortunately, these medications may make certain people more susceptible to experiencing acne.
5. Environment
Your environment can play a significant role in the health of your skin. For instance, studies have shown that people who live in cities with high air pollution are more susceptible to inflammatory acne and skin irritation.
What are different treatment options available for acne-prone skin?
As with all skincare concerns, we firmly believe that expert advice and quality care are the secrets to healthy skin. As such, we recommend booking a skin consultation with our Senior Dermal Therapist to receive a bespoke treatment plan tailored to your unique skin needs. Your treatment plan should be as unique as your skin.
While we'd strongly recommend a customised approach, we understand that not everyone can access these services. As such, please use the following as a guide, and always seek professional advice from a healthcare practitioner before trialling any products or skincare solutions.
1. Non-inflammatory acne
Characterised by: whiteheads and blackheads
Non-inflammatory acne occurs when too much oil, bacteria, and skin cell production clogs your pores, often resulting in whiteheads and blackheads.
Treating blackheads and whiteheads often comes down to one simple solution: building the right skincare ritual. This means investing in the right products for your skin type, ensuring you use quality ingredients, opting for non-comedogenic products, and creating a sustainable routine you religiously stick to.
Likewise, steer clear of products like pore strips that can damage the skin's surface and worsen the severity of your acne. Instead, you may find a difference by investing in a quality cleanser, vitamin A serum, glycolic acid products (i.e., our Radiant Day Cream or Miracle Cream Cleanser), and moisturiser to help remove dead skin cells and excess oil.
Additionally, some people see benefits from using over-the-counter (OTC) treatments that contain sulphur, salicylic acid, or benzoyl peroxide, which help to dry out the skin.
2. Inflammatory acne
Characterised by: Papules and pustules
There are several solutions that healthcare professionals will recommend and prescribe, depending on the severity and form of your inflammatory acne. Consider the following:
- Over-the-counter benzoyl peroxide — owing to its antibacterial activity, benzoyl peroxide may also help treat inflammatory acne. According to Healthline, it is often used alongside antibiotics to prevent the skin's surface bacteria from becoming resistant. According to a 2013 study, combining benzoyl peroxide with a topical antibiotic is proven in clinical trials to reduce total P acnes count by 99.7% after one week.
- Topical retinoid — When used topically, vitamin A helps to prevent clogged pores by helping the skin exfoliate and renew. The downside? One of the main side effects of topical vitamin A products is that they can cause skin irritation, including redness, peeling, and a burning sensation. Additionally, they can make your skin more sensitive to the harshness of UV rays. We recommend working with our skin care experts to find the right tailored solution for your skin.
- Birth control pills — Depending on the severity of your acne, some healthcare professionals may recommend women take birth control pills, which can help to reduce oil production by lowering androgen levels. In turn, this helps to decrease the likelihood of your pores getting clogged. However, it's important to note that while the pill may be beneficial for the skin, it can have several other side effects. As such, you must speak with your skincare and healthcare professionals to ensure you understand all options available.
3. Nodulocystic acne
Characterised by: Nodules and cysts
As nodulocystic acne occurs much deeper in your skin, over-the-counter treatments generally aren't strong enough as they're designed to treat the surface level. Due to the severity of this type of acne, it's recommended that you see a dermatologist as early as possible to begin a treatment plan to avoid pain and permanent scarring.
While each person's treatment plan will look different, your dermatologist and healthcare professionals may recommend products such as isotretinoin (oral retinoid), antibiotics, topical retinoids, birth control pills, spironolactone (helps to lower androgen levels in women), or steroids.
How to know your acne severity level
When diagnosing acne, it's measured by severity levels, which are broken into three categories: mild, moderate, and severe:
- Mild — this category refers to people with less than 20 comedones and 15 lesions.
- Moderate — this category refers to people with anywhere between 20 to 1-00 comedones and 15 to 50 inflammatory lesions.
- Severe — this category refers to people with more than five pseudocysts, 100 comedones, or 50 inflammatory lesions.
| Simple skincare tips for acne-prone skin | |
| Double-cleanse your face at night to eliminate sweat, excess oil, and bacteria that could clog pores. Rinse with lukewarm water. | Use your fingers to apply your cleanser, as washcloths and mesh sponges can cause unnecessary irritation. |
| Use gentle skincare products to avoid irritation. | Don't touch your face excessively during the day, as you're transferring bacteria. |
| Avoid excessive sun exposure and tanning beds. Not only does the sun damage your skin, but certain acne medications will also make you extra sensitive to UV light. | Let your skin naturally heal. Fight the temptation to pick, pop, or squeeze your pimples, as you're likely to delay the healing process and cause avoidable scarring. |