Acne Types & Causes

TEEN ACNE

Dealing with acne, especially as a teen, is kind of the worst. A teen’s body is producing more androgen hormones than before, and it’s going through a slew of other changes, too. More androgen leads to more oil in your skin, and when dead skin cells mix in with that, boom. Pores clog.

 

Acne bacteria love a blocked pore. They want to get in there and multiply, and since they’re part of your skin’s microbiome, they’re always in and around your pores, ready to cause inflammation and subsequent pimples.

 

Yeah, it’s frustrating. But, if you stay positive and find a simple, effective skincare routine, you can get it under control.

 

ADULT ACNE

Maybe you never had acne as a teen. Maybe you did, and you thought once you hit adulthood the curse would finally lift.  But many of us battle acne in our 20s, 30s, and 40s. Zits can even surprise us all the way into our 60s. You can blame hormones— the root of most adult acne issues.

 

Increases in androgen hormones (including testosterone) trigger too much sebum production and cell turnover at your pores—which is like an open invitation for pore clogging. Women have more acne as adults than men, and can blame it on hormone fluctuations from menstrual cycles or pregnancy. Other acne-causing culprits might be shaving, hormone-triggering medications, or just plain stress.

 

Too much sebum leads to clogged pores. But with too little, skin can get dry and irritated. Like everything in life, calm skin requires balance.

 

 

SPORTS ACNE

You’re just trying to stay active and healthy, and look what you get. Sports zits. Also called acne mechanica, it’s caused by pressure and friction from your gear, or tight workout clothes, helmets, backpacks, sport bras, hats—anything that’s up against your skin while you exercise can bring it on.

 

You might notice it on your forehead from a hat, or on your chin from helmet straps, on the shoulders, chest, back, butt—anywhere that trapped dirt, oil and bacteria can nestle in and clog your pores.

 

Keeping your workout clothes and your bed clothes clean should help you avoid a flare-up.

 

 

NAME THAT ZIT

 

Non-inflammatory acne refers to clogged pores, or comedones.

Inflammatory acne means those red, raised lesions, often with white centers. More severe inflammatory acne can include cysts and nodules—those tender pus-filled lumps under the skin. Want more specifics? Let’s meet the blemishes.

 

 

Non-inflammatory acne:

 

WHITEHEADS

 

Formed by a pore completely blocked up with dead skin cells and sebum. Since no air can get into a completely plugged pore, it won't get dark, like a blackhead.

 

BLACKHEADS

 

Formed by a pore partially plugged with sebum and dead skin cells. The surface turns black because of a chemical reaction between the plug and the air around it.

 

Inflammatory acne:

 

 

PUSTULES

 

A small, inflamed, bump topped by a white or yellow pus-filled lesion that may be red at the base.

 

PAPULES

 

This is your classic pimple—a small, inflamed, usually pink bump that can be tender to the touch. With no pus at the center of the lesion (because then it would be a pustule.)  

 

CYSTS

 

A cyst, or pseudocyst, is a large, dome-shaped swelling filled with pus that's usually inflamed and painful. Oh, and they can become infected and cause scarring. Fun, right?

 

NODULES

 

A painful red lump that’s larger than a pimple and lodged deep down in the skin. They usually occur with severe acne. And they can scar. 

 

 

ACNE MARKS

 

When inflammation happens during a skin injury or acne breakout, your skin produces extra melanin (pigment), which darkens the area. This is known as post-inflammatory hyperpigmentation.

 

Excessive sun exposure may make it worse, as skin produces more melanin to protect itself against UV radiation. So it’s SUPER important to apply sunscreen daily and diligently. Opt for a non-comedogenic, oil free sunscreen with at least a 30 SPF that’s suitable for acne-prone skin.

 

Tips for avoiding dark spots:

Don’t rub your eyes. Don’t pick at your pimples or scratch your bug bites. And wear sunscreen every. Single. Day. (Have we mentioned that yet?) 

 

 

RED IN THE FACE

 

When acne bacteria grow and multiplies, inflammatory mediators called cytokines are released in the skin. These messenger molecules cause blood vessels to dilate, and red acne marks appear.

 

If your acne is associated with generalized redness, particularly across the nose and cheeks, you may have acne rosacea, and your next move should be a trip to see a dermatologist for a conclusive diagnosis.

 

 

ACNE LEVELS

Dermatologists categorize common facial acne into three levels of severity.

In adolescent acne, different types of acne often occur together and are associated with oily skin.

 

MILD

Less than 20 blackheads and/or whiteheads. Less than 15 pimples (pustules or papules).

 

MODERATE

20 to 100 blackheads and whiteheads, plus 15 to 50 pimples (pustules or papules).

 

SEVERE

Over 100 blackheads and whiteheads, over 50 pimples and over 5 cysts or nodules. This type of acne risks causing permanent scarring. Dermatologists will treat severe acne with medication, including antibiotics.

 

 

What causes acne?

 

Believe it or not, this is still a mystery. Genetics, hormone changes, stress, pore-clogging topical products, medications that affect hormones, environment, and diet all factor into acne formation somehow.

 

HERE’S WHAT WE DO KNOW

 

Hormones cause increased sebum (oil) production in the skin, and these hormones produce new surface skin cells, causing old cells to shed. Shedding cells trap sebum and prevent it from exiting pores and getting up to the skin’s surface. The acne bacteria in and around your pores then seize the trapped sebum and try to consume it.

 

Acne bacteria thrive and multiply where there’s no oxygen, so a clogged pore is their dream home. Trapped sebum, dead cells, and happily multiplying bacteria can then result in inflammation, which means…hello, zits.

 

 

ACNE PREVENTION TIPS

 

AVOID FOOD THAT TRIGGERS YOUR ACNE.

If you notice that certain foods cause you to break out, take a hint and avoid them.

 

Not sure what sets your acne off? Try avoiding high-glycemic index foods that raise your blood glucose/sugar level, which triggers androgen production and increases sebum in the skin. Examples are white bread, white rice, chips, french fries, doughnuts, pastries, and drinks or foods with added sugar.

 

KEEP YOUR HANDS OFF YOUR FACE.

We touch a lot of surfaces that harbor a lot of microscopic gunk. So just…don’t touch your face. Who knows what you’ll get on there?

 

SERIOUSLY, DON’T POP YOUR PIMPLES.

Yes, we know it’s oddly satisfying, but please resist the urge. When you pop a pimple, it explodes inward as well as outward, driving bacteria deeper and potentially causing more (or worse) breakouts.

 

KEEP YOUR STUFF CLEAN.

Keep your towels and sheets clean, keep your hair away from your face when sleeping, and alwayswash your face before bed.