Do you or someone you care about struggle with acne? Even though nearly 85 percent of teenagers and many adults have or will experience acne at some point during life, the insecurity and confusion that accompany this complicated skin condition can make it seem impossible to beat.

Thankfully, by understanding the different types, causes and triggers of acne, you can learn how to more effectively treat and prevent breakouts for a clearer, healthier and more confident complexion.

Causes of acne

Acne is a common disorder in which hair follicles located on the inside of a pore become clogged and form small lesions on the surface of skin. Sometimes this occurs when sebaceous glands, which are located in the pore next to the follicle, become overactive and produce too much oil, creating a blockage or plug. Then dirt, bacteria, dead skin and other debris accumulate on top of the plug, forming a blemish or comedone.

Perhaps most frustrating about acne is that its causes and triggers are often complicated – making it tricky to treat. Doctors haven’t singled out one cause, but believe the following factors play a role:

• Bacteria. From the stomach bacteria that help our bodies break down food to the follicle mites that make themselves at home in our hair, the human body is a living ecosystem. Many of these microorganisms are mostly harmless, including the naturally occurring bacteria that live off of the oil produced in hair follicles beneath the surface of skin. However, many individuals that experience acne have elevated numbers of these bacteria lurking within their skin.

But don’t worry, higher populations of these bacteria doesn’t mean that you’re dirty or lack hygiene. It just means that you might have to use an acne treatment that specifically targets these bacteria to control and reduce your acne.

• Hormones. Acne is most likely to occur during adolescence, when sebaceous glands grow and become overactive due to hormones called androgens. Hormonal changes during menopause and pregnancy can also trigger acne.

• Genetics. Acne tends to run in the family. If your parents experienced acne, then you and your children are more likely to develop this condition.

• Sweating. When sweat sits on the surface of skin, it’s the perfect place for dirt and other debris to cling before clogging pores. Humid conditions and exercise that increase sweating can increase the occurrence of acne.

• Beauty products. Acne that’s triggered by cosmetics is referred to as “acne cosmetica.” Typically, this mild form of acne occurs on the face, forehead and neck and is triggered when cosmetic ingredients clog pores, leading to a build up of acne-causing oil.

• Medication. Increased acne is caused by some medications, including certain types of birth control and steroids. Talk to your doctor if you suspect that your acne is triggered by a medicine.

There’s little evidence to support that certain foods – like chocolate and those that are greasy – can cause acne. Also, although stress is often blamed for triggering breakouts, it only exacerbates an existing condition. Dirt, another scapegoat, isn’t to blame either. While daily cleansing to remove dirt, dead skin and other impurities is an important step to prevent acne, too much scrubbing can actually worsen the condition.

Type of acne

1. Acne vulgaris. Acne vulgaris is the most common type of acne, and it can range from mild to severe. Mild or moderate cases of acne vulgaris include the following types of lesions:

• Whitehead. This type of blemish is also called a “closed comedone” and occurs when a plug causes the wall of the hair follicle to swell. Because air can’t reach the material trapped inside, it doesn’t oxidize and remains white.

• Blackhead. This type of blemish is also called an “open comedone” and occurs in oversized follicles where air is able to penetrate the plug and oxidize with skin’s natural pigment, melanin, creating a black appearance.

• Papule. A small red blemish that doesn’t contain pus is called a papule. Also known as a “pimple,” a papule forms when a breakage occurs near the surface of the hair follicle.

• Pustule. These reddish lesions are often raised and contain a white or yellowish fluid that consists of pus, oil, dead skin and white blood cells. Like a papule, these inflamed pimples are the result of a breakage within the wall of the follicle.

Cases of acne vulgaris that range from moderate to severe often occur when oil, bacteria and other debris spill out from the follicle to affect other areas of the skin. These lesions can be tougher to treat and include:

• Nodules. These large, painful lesions penetrate deep within the skin on the face and body and may be the result of multiple infected follicles that are adjacent to one another. Nodules are more likely to form scars and can last for a longer period of time – especially if squeezed. An acne condition that’s characterized by nodules is called “nodular acne.”

• Cysts. Similar to nodules, cysts are large lesions, but these contain pus. An acne condition with cysts is often referred to as “cystic acne.” If acne contains both cysts and nodules, it’s referred to as “nodulocystic acne.”

The most severe cases of acne vulgaris are rare and more difficult to treat. These conditions include:

• Acne conglobata. This extreme form of acne vulgaris is rare and most common in males between the ages of 18 and 30. It occurs when nodules and cysts spread beneath the surface of the skin to create large, often painful lesions and can be accompanied by blackheads and an unpleasant odor. This chronic condition is tough to treat and can cause significant scarring.

• Acne fulminans. If chronic acne conglobata is unsuccessfully treated, it can develop into acne fulminans. This condition is characterized by sudden, acute inflammation, fevers, joint pain in the hips and knees and severe acne with ulcers.

• Gram-negative folliculitis. This type of acne is caused by a bacterial infection and includes pustules and cysts. Gram-negative folliculitis is linked with the long-term treatment of acne using antibiotics. The bacteria that cause this type of acne are resistant to most medications, making it difficult to treat.

• Pyoderma faciale. Also referred to as “rosacea fulminans,” this rare form of acne is characterized by the sudden appearance of red, painful nodules and pustules on the face. This condition typically affects females between the ages of 20 and 40. It rarely lasts longer than one year and may cause scarring.

2. Acne rosacea. Although this type of acne is also known as “adult acne,” it shouldn’t be confused with acne vulgaris. Rosacea typically affects adults of English, Irish and Scottish descent who are over the age of 30, and most often occurs on the central part of the face, including forehead, chin and lower part of the nose. Widespread inflammation and the dilation or breakage of capillaries near the surface of skin creates a rosy pink or reddish appearance. Unlike acne, rosacea isn’t linked with whiteheads and blackheads. Individuals with mild rosacea may not be aware that they have the condition; however, deep flushing, red bumps and red cysts can characterize more severe forms.

There’s no cure for rosacea, and unlike acne vulgaris, affected individuals are unlikely to grow out of it once it appears. But, thankfully, the symptoms of rosacea can be treated and managed with laser therapy, oral and topical medications. For an at-home treatment, try Pevonia Your Skincare Solution Rosacea Skin Pack, which blends natural ingredients to strengthen capillaries and calm skin for a more balanced, even tone.

Acne solutions

There are many different ways to treat acne. Most methods target the triggers of acne and function to:

• Reduce the production of oil within the skin
• Exfoliate to remove dead skin cells and encourage cell turnover
• Kill bacteria
• Reduce inflammation

For mild or moderate forms of acne on the face and body, use an over-the-counter topical treatment and incorporate an acne cleanser into your daily routine. Look for blemish-fighting ingredients including salicylic acid, benzoyl peroxide, sulfur, resorcinol or lactic acid. Some treatments blend natural extracts with active ingredients to fight blemishes. Neova Acne Cream is formulated with benzoyl peroxide, green tea and aloe vera gel for balanced treatment that soothes and calms as it corrects mild to moderate acne.

Avoid oily or greasy lotions and makeup as these may worsen acne, and instead look for those intended for oily or acne-prone skin. If the acne persists or worsens, see a dermatologist or family doctor—you may have a more severe form of acne that requires professional treatment.

To treat more severe forms of acne, your doctor will likely use one of the following types of treatments:

• Topical prescription medications: Topical ointments that include special derivatives of vitamin A may be prescribed including Tretinoin (Avita, Retin-A, Renova), adapalene (Differin) and tazarotene (Tazorac, Avage). These work by encouraging cell turnover to prevent follicles from becoming clogged. Your doctor may also prescribe a topical antiobiotic or a treatment that blends an antibiotic with benzoyl peroxide, clindamycin or erythromycin.

These ointments can cause side effects including stinging, burning, peeling or itching.

• Oral prescription medications:

• Antibiotics. Oral antibiotics may be prescribed to treat severe to moderate acne. Often, these are prescribed in tandem with a topical ointment. Oral antibiotics may increase your skin’s sensitivity to the sun and cause nausea.

• Contraceptives. For women, oral contraceptives can improve acne. However, these medications may be accompanied by side effects including depression, headaches and nausea.

• Accutane (Isotretinoin). For severe acne, your doctor may prescribe Accutane (Isotretinoin). Although Accutane is extremely effective, it can cause severe side effects that range from increased sun sensitivity and poor night vision to an increased risk of depression and suicide. This medication can also cause severe birth defects if taken during pregnancy. For this reason, women are required to be closely monitored while taking Accutane.

• Light therapy: Professional and at-home light therapy devices expose acne to specific wavelengths of light that kill blemish-causing bacteria while improving the overall texture of skin and reducing the appearance of scars.

• Laser therapy: If overactive oil glands are to blame for acne, professional laser treatments can damage these glands to impair their ability to produce oil.

• Cosmetic treatments: Cosmetic procedures, including chemical peels and microdermabrasion, can help control acne while improving the look of scarring and redness.

In addition, those who suffer from severe or chronic acne may seek treatments to reduce the appearance of scars. These treatments may include dermabrasion, microdermabrasion, laser therapy, light therapy, soft tissue fillers and surgery. To learn more, speak with a dermatologist.

Acne treatment and prevention at home

Whether you’re struggling with an existing case of acne or trying to prevent future breakouts, there are several habits that can help control acne:

• Embrace acne cleansers. Cleanse twice per day with an acne cleanser. Choose a gentle formula like pH Advantage AM/PM Acne Skin Care Cleanser, which features salicylic acid to kill blemish-causing bacteria and dissolve excess oil.

• Avoid oily lotions and cream cosmetics. Look for lotions and cosmetics that are oil-free and labeled “noncomedogenic” or “nonacnegenic.” For light coverage that won’t irritate existing acne, opt for Colorescience Let Me Be Clear Primer that contains salicylic acid to help clear your complexion and Dermablend Quick Fix Concealer SPF 30 Natural to conceal blemishes.

• Remove makeup before bed. While it’s always important to remove makeup in the evening before bed, it’s especially important for those that struggle with acne. Use a gentle makeup remover like Avene Micellar Lotion Cleanser and Make-Up Remover that’s hypoallergenic, noncomedogenic, oil-free and alcohol-free.

• Wear loose clothing. According to the beauty and health blog The Daily Glow, tight clothing causes friction with the skin, which can clog sweat glands and trigger acne. If you struggle with body acne, pick clothing made of materials that help wick sweat and moisture away from the skin. Also, keep in mind that headwear including baseball caps and stocking hats can promote pimples along the hairline and forehead.

• Shower after sweating. If you struggle with acne on the face or body, it’s essential to shower soon after completing a work out or any sweat-inducing activity. Use a specially formulated acne wash like Murad Acne Body Wash, which includes salicylic acid and other key ingredients to help control and prevent the formation of blemishes from head to toe.

For other tips on acne treatment and prevention, check out the Complete Acne Handbook.

Remember, you’re not alone in your struggle to conquer acne. But since there are so many factors that affect the triggers, types and treatment of acne – including sex, age and lifestyle – it’s important to understand your condition. If you have questions or concerns related to your acne, consult a doctor.

See also:

Covering Up: How to Hide Blemishes and Hyperpigmentation

Complete Acne Handbook

Jobs That Can Irritate Your Skin (and a Slew of Solutions)

Banishing Back Acne