Acne vulgaris is a skin condition that occurs when pores or hair follicles become clogged with oil and dead skin cells.
The outbreak of lesions, such as whiteheads, blackheads, and pimples, requires different treatments based on their root cause and severity. Persistent inflammatory acne may also lead to scarring and cause emotional distress.
While acne typically affects teens and young adults, any age group can develop the condition.
This article gives a rundown of acne symptoms, types, causes, and treatment options.
What is Acne?
Skin breaks out in acne when pores or hair follicles become clogged with excess oil (sebum), dead skin cells (keratinocytes), or dirt.
Sebaceous (oil) glands produce a natural oily substance that protects and hydrates the skin. However, too much sebum can stick to keratinocytes and dirt inside the pores, resulting in the buildup of dead skin, follicle blockage, and irritation.
Inflammatory acne develops when skin bacteria (Cutibacterium acnes) enter a clogged follicle, break the pore’s walls, and cause an infection that spreads to the surrounding areas.
Types of Acne
There are two basic types of acne based on their severity and formation - inflammatory and non-inflammatory.
Non-Inflammatory Acne
Non-inflammatory acne exhibits mild symptoms, usually without signs of infection, such as redness, swelling, pain, or pus. They are caused by clogged pores and form lesions called comedones. Non-inflammatory acne includes these two types:
- Whiteheads - Closed plugged pores with a flesh-colored top.
- Blackheads - Open plugged pores with a black top.
Inflammatory Acne
Inflammatory acne is a more severe skin inflammation condition that can cause swelling, irritation, and infection. This type is more likely to leave scarring or cause permanent skin damage.
The most common inflammatory acne types are the following:
- Papules - Red, swollen bumps with no pus.
- Pustules - Swollen or firm bumps with white or yellow pus.
- Nodules - Painful, red, or flesh-colored lumps underneath the skin.
- Cysts - Red or white painful lumps filled with pus.
Note: Take a closer look at types of acne, how they differ, and what treatment method to adopt.
What Causes Acne?
Various factors provoke acne flare-ups or worsen the condition. Triggers can be internal or external, or a combination of both. It is essential to discover what causes acne before attempting to eliminate or repair skin damage.
Physical Triggers
The most prominent external or physical causes for acne breakouts are the following:
- Hair follicle blockage – Clogged pores may occur due to sebum overproduction, excessive or hormonal sweating, and the buildup of dead skin cells.
- Bacterial overgrowth – When the skin’s natural surface bacteria (e.g., Cutibacterium acnes) multiply or spread to surrounding areas, the skin becomes red, tender, and inflamed.
- Inappropriate skincare products – Harsh, irritant cosmetics can clog pores and aggravate your skin condition. An expert skincare guide can help you understand what products to use for your skin type and how to identify comedogenic (pore-clogging) ingredients.
- Environmental factors - Overexposure to pollutants and high humidity can lead to the accumulation of dirt and toxins, which clog the pores and form comedones.
- Friction, pressure, or rubbing – Applying too much pressure on the epidermis can damage the protective outer skin layer, increasing the risk of a bacterial acne-causing infection.
Note: Learn more about inflammation and how to reduce it effectively.
Psychological Triggers
Chronic stress impacts overall health and skin quality. Prolonged exposure to daily stressors may lead to or worsen various skin disorders, including eczema, psoriasis, and acne.
Acne breakouts occur when elevated cortisol levels increase sebum production. Cortisol, the so-called “stress hormone”, prepares the body for a perceived threat.
Excess sebum clogs the pores, contributes to acne formation, and prolongs healing. This environment may also worsen the condition due to proliferation of bacteria.
Note: Learn more about how stress influences skin quality and ways to treat stressed skin.
Foods
There is no conclusive scientific evidence about specific food groups or diet plans that directly cause or prevent acne vulgaris.
However, studies show that high-glycemic foods may worsen the condition and contribute to associated health conditions, such as obesity and insulin resistance. Foods with a high glycemic index include processed foods, white bread, pastry, corn, grapes, watermelon, mango, banana, etc.
On the other hand, low-glycemic foods decrease glycemic load and eliminate blood sugar spikes responsible for sebum production and more frequent acne breakouts. Skin-friendly food choices include non-starchy vegetables, greens, apples, raw carrots, berries, and foods rich in omega-3 fatty acids (e.g., salmon, chia seeds).
Note: Learn how insulin resistance affects weight loss.
Medication
Certain types of medication can provoke acne eruptions or aggravate the condition. These include but are not limited to:
- Corticosteroids
- Androgenic steroids
- Birth control pills
- Thyroid hormones
- Antibiotics tetracycline and streptomycin
- DHEA supplements
- Drugs containing bromides, iodides, or lithium
- Anticonvulsants
- Some anticancer drugs
Some medicine-related skin flare-ups are difficult to differentiate from acne. For example, acneiform drug reactions only resemble acne and require medical assistance and evaluation.
Hormones
Hormone-related acne develops due to an imbalance in the production of estrogen, progesterone, and testosterone.
Hormonal fluctuations may activate excess sebum production that clogs the pores, producing bumps, lumps, and skin lesions. Depending on the severity and type, hormonal acne can be both inflammatory and non-inflammatory.
The most common causes for a hormone-triggered acne breakout are the following:
- Puberty
- Menstruation
- Polycystic ovarian syndrome (PCOS)
- Perimenopause
- Menopause
- Thyroid issues
- Increased levels of androgen
Some patients benefit from over-the-counter topical solutions, while others turn to hormone-balancing supplements and hormone replacement therapies to clear acne and manage symptoms.
Who Can Get Acne?
Acne can affect people of all ages, genders, and ethnic backgrounds.
Factors that increase the chances of developing acne include the following:
- Hormonal changes – People often experience acne during puberty, menstrual cycles, pregnancy, perimenopause, and other periods of hormonal fluctuations.
- Lifestyle factors – Lack of sleep, diets high in refined carbohydrates, poor skin care, and chronic stress can increase the risk of acne.
- Genetics – People whose parents had acne are more likely to develop the condition.
Where Can Acne Appear?
Acne breakouts can affect any part of the body. The areas most prone to acne include:
- Face
- Neck
- Shoulders
- Back
- Chest
At What Age Is Acne the Worst?
While it is more prevalent in teenagers and young adults, acne can occur at any life stage.
Studies show that 85% of people between the ages of 12 and 24 struggle with acne, while 25% of women and 12% of men report acne in their forties.
How Is Acne Diagnosed?
Acne vulgaris requires medical assistance and an evaluation of the severity of the lesions. Your primary care physician will refer you to a dermatologist who will identify the acne type and the underlying cause.
The routine examination includes checking the patient’s medical record, current medication, hormone therapies, and skincare products. The doctor will discuss your symptoms and perform a physical examination to determine acne type and severity.
They may also run additional blood tests that point to higher levels of acne-triggering hormones, such as testosterone.
How to Prevent Acne?
Acne prevention starts with top-quality skin care for acne-prone skin and modifying lifestyle habits that increase the risk of developing acne.
The following preventive measures may help minimize or prevent breakouts.
- Use microbiome-friendly skincare products – Use cleansers, serums, and moisturizers with probiotics, prebiotics, and antioxidants to balance the skin’s microflora and maintain clear pores.
- Avoid foods with a high glycemic index – Sugars and processed carbohydrates disrupt hormones and may lead to breakouts. Avoid white flour, white rice, potatoes, sugary foods and drinks, chips, processed cereals, etc.
- Improve lifestyle habits – Managing stress, sleeping for 7-9 hours at night, and adopting orderly lifestyle habits can balance hormones and reduce hormonal acne.
If these measures don’t help, patients can try more potent, targeted treatments.
How to Treat Acne?
Treatment requires a previous diagnosis of the acne type, cause, and severity of symptoms. The approach depends on the patient’s skin type, current skin condition, and tolerance to specific medications or therapies.
Acne Facials
Acne facial treatments treat mild to moderate acne types (whiteheads, blackheads, papules, and pustules). Vibrant Skin Bar skin experts achieve lasting results with Acne Eraser Facial, which consists of four steps: cleansing, extraction, exfoliation, and serum treatment. The treatment lasts 60 minutes and costs $125.
Medical-Grade Skincare Products
Medical-grade skin products with non-comedogenic, anti-inflammatory ingredients, such as Vibrant MUD or Osmosis MD Clarify Blemish Retinal Serum, help calm, protect, and hydrate acne-prone skin.
Vibrant MUD is a clarifying clay mask formulated with bentonite clay, kaolin clay, and activated charcoal. Combined, they deeply cleanse, unclog, and detoxify the pores. Probiotics and soothing botanicals also hydrate and nourish the skin.
Clarify contains potent acne-fighting ingredients, including niacinamide, mandelic acid, lactic acid, retinal, and tea tree oil. The formulation reduces inflammation, exfoliates the skin, and unclogs pores, contributing to a cleaner, brighter complexion.
OTC Topical Solutions
For mild, non-inflammatory acne, you can use over-the-counter (OTC) creams, lotions, cleansers, and gels that contain benzoyl peroxide, salicylic acid, sulfur, and resorcinol. These ingredients help remove dead skin cells and excess sebum.
Prescription Topical Solutions
Topical antibiotics, retinoids, azelaic acid, and dapsone prevent or minimize moderate to severe acne breakouts. They remove dead skin cells, fight off bacteria, or reduce inflammatory acne (e.g., papules or pustules).
Prescription Oral Medications
Doctors prescribe oral antibiotics and retinoids alone or in combination with topical treatments for severe acne, such as cysts or nodular acne. They lower inflammation, fight acne-causing bacteria, and reduce the risk of scarring. However, it is necessary to be patient, because visible improvement usually takes several weeks or even months.
Steroid Injections
Corticosteroid injections are used for severe forms of acne, such as cysts and nodules. The injections are administered into the lesions, reducing their size, inflammation, and pain within 48 hours. They also lower the risk of scarring.
Hormone Therapies
Hormone replacement therapies rebalance disrupted hormones that cause skin breakouts during hormonal shifts, such as perimenopause or menopause. Medications include oral contraceptives (birth control pills) and spironolactone.
Light Therapies
Photofacial treatments use pulsating red or blue light technology to reduce skin inflammation, eliminate acne-causing bacteria, and soothe irritated skin. Light therapy is very effective for acne. Patients usually need an initial series of four to six sessions and possible maintenance treatments.
Photodynamic Therapy (PDT)
This innovative acne treatment utilizes a photosensitizer in combination with intense pulsed light and oxygen to reduce acne and clear the complexion. Patients usually need two to five treatments to see an improvement.
BroadBand Light (BBL)
BBL therapy and its Forever Clear® protocol are particularly effective for acne. BBL delivers pulses of broad-spectrum light to kill acne-causing bacteria, reduce inflammation, and regulate oil production, reducing breakouts and improving skin clarity. At Vibrant Skin Bar, one BBL session costs $399.
Note: Get more recommendations for the best skincare products for oily acne-prone skin.
Acne FAQ
Below are our patients’ FAQs about acne. Our answers provide more useful information on how to manage the condition.
Does Drinking Water Help Acne?
Drinking adequate amounts of water (e.g., eight cups daily) enhances circulation and hydration. It can improve overall skin health and contribute to clearer skin when combined with appropriate skin care and other preventative measures. However, water alone cannot reduce acne.
Does Acne Go Away with Pregnancy?
Pregnancy is a period of significant hormonal fluctuations that often trigger hormonal acne, especially during the first trimester. Some women experience clearer skin, but many develop breakouts. Their skin often clears after childbirth, when hormone levels return to normal. However, this varies from person to person.
Are Acne the Same as Pimples?
Acne is the term for the overall skin condition, while pimples are the symptom – bumps on or under the skin that can be inflamed, pus-filled, or solid. The terms “acne” and “pimples” are often used interchangeably.
Does Acne Age You Slowly?
A study from 2016 suggests that people with acne-prone skin are better protected against premature aging, with wrinkles and thinning skin appearing later than in people with no history of acne. More research is needed to confirm these findings.
What Happens If You Don’t Treat Acne?
Without timely or appropriate treatment, acne can develop into severe lesions, nodules, or cysts. These acne types leave permanent skin damage, such as scarring or hyperpigmentation. Acne scars can lower self-esteem and cause emotional distress.
When Should You See a Dermatologist About Acne?
If consistent, appropriate skin care, dietary and lifestyle changes do not improve your acne, see a skin specialist. They can identify the condition’s underlying cause and recommend appropriate treatment.
Conclusion
Acne is a great challenge to anyone struggling to maintain healthy, glowing skin. Without an adequate skincare routine and professional help, this issue can quickly spiral out of control. Seeking expert advice before attempting to treat the condition is essential.
Contact the Vibrant Skin Bar skin experts for more information about available acne treatments in the Phoenix area.
