Before we head into the topic of acne, I cannot stress enough that acne has NOTHING to do with how clean or “dirty” your skin is - it’s an external symptom of internal inflammation that could be caused by a variety of triggers. Having acne does not make you dirty, less-than, ugly, or inferior in any way. It simply means that your body is trying to communicate with you. The next few blog posts will help you to decipher the message that your body is sending, but today we're focusing on the main types of acne breakouts and how to target them with skin care ingredients. Let’s jump in!
What is acne?
By definition, acne is a disease of the sebaceous follicle (aka, the oil gland) caused by inflammation. It can show up anywhere on the body but primarily occurs on the face, back and chest. Acne varies in severity depending on how much congestion exists within the follicle, but there are five main types of acne breakouts: blackheads, whiteheads, papules, pustules, and cysts.
Blackheads are the most common, and occur when our open pores fill with dead skin cells that oxidize - the exposure to oxygen is what creates that dark color. They commonly show up on the sides of the nose, the chin or the forehead - the areas of the face that tend to be oiliest. Whiteheads are closed pores that fill with oil, bacteria & dead skin cells. The white color is because the pore is closed - so the congestion hasn't oxidized.
Papules (inflamed bumps that are usually tender & pink/red in color) will eventually turn into pustules (typically bigger than a papule & filled with pus). Cysts are the most severe type of acne. They appear as a large, pink or red, inflamed bump deep under the skin. You can typically feel them before you can see them - they feel soft, tender, and can be very painful. It can vary for everyone, but my cysts usually formed along my jawline. Ouch!
Most people experience more than one type of acne breakout at a time - for example, you could have blackheads on your nose, a combination of papules and cysts on your chin, and whiteheads on your cheeks.
No matter which type of acne breakout you have or where it shows up, the key to healing is to focus on reducing inflammation & breaking up the congestion in the pore.
How to reduce inflammation
Here’s what doesn’t help: picking at, or popping, your pimple. Best case scenario: you pop your pimple, spreading bacteria to the surrounding area, which increases the likelihood of future breakouts. Worst case scenario: your picking increases the chance of scarring (both textural scars & hyperpigmentation), increases inflammation (actually, this happens in bcase scenario too...) and dramatically increases the amount of time that your pimple takes to heal.
Is it worth it? No. Here's what you can do instead:
Reach for some ice! Move the cube in slow circles over clean skin, being sure to not hold the ice cube in one place for too long. You can repeat this 1-3x/day to reduce inflammation and redness. Another option is blue or red light therapy, either an at-home, hand-held device/mask or a professional treatment. Blue light is antibacterial and red light is anti-inflammatory. When used in combination, they’re extremely effective at both healing and preventing breakouts.
Feeling really tempted to pick? Opt for a pimple patch or spot treat with a product designed to reduce inflammation (more on that below!). Out of sight, out of reach.
How to reduce congestion in the pore
A quick reminder that acne is merely an external symptom of internal inflammation - meaning that healing acne requires a well-rounded approach.
It's like getting into shape: you need to do more than just go to the gym; you also need to make sure your nutrition is aligned with your goals, you're getting enough sleep to keep you energized for your workouts, you're drinking enough water, you're staying committed to your fitness goals....
Skin care products are like the gym - they're important for keeping your skin healthy and strong, but they alone can't heal your acne.
That being said, skin care products can be incredibly effective at both reducing congestion in the pore and targeting inflammation.
The best ingredients for targeting blackheads & white heads: glycolic acid, mandelic acid, retinol, and salicylic acid.
The best ingredients for targeting papules, pustules & cysts: benzoyl peroxide, niacinamide, retinol, salicylic acid, and sulfur.
They all have their own portfolio of good-for-your-skin benefits, but here's a quick highlight of two that can be used regardless of acne type.
Retinol penetrates your skin to reach the middle layer, where it stimulates the production of collagen and elastin and "corrects" your skin cells. In 8-12 weeks of consistent use, you'll notice a reduced appearance of pores, textural scars and hyperpigmentation, fine lines/wrinkles, and less breakouts. It's recommended to start at a lower concentration 2-3x/week and, over the course of months, gradually increase either strength or frequency of use.
Salicylic acid gently exfoliates the surface of the skin. It's great for acne-prone or oily skin because it is oil soluble, meaning that it can break up oil and congestion inside the pores. It also has antibacterial and anti-inflammatory properties, making salicylic great at both preventing future breakouts and healing current ones. Look for a leave-on product - salicylic in a cleanser won't stay on your skin long enough to make any noticeable difference.
You might notice that when first using either of these ingredients (and the above recommended, as well) that you experience more breakouts, not less. While annoying, this is normal. Those pimples were already formed and would have shown up regardless. These ingredients just sped up the process - which is okay, because they'll also speed up the healing. It can take up to four weeks before you start seeing visibly clearer skin. Hang in there! It's worth it.
Please note: active ingredients should be added into a skincare routine with care. I’d start with 1-2 of these ingredients, used 2-3x/week in the evening. You can work with a skincare provider to find which ingredient and routine would be best for your skin type and concerns (I can help with that!). Active ingredients are sensitizing, so always wear SPF 30+ during the day - this will protect your skin from sun damage and prevent any hyperpigmentation from developing or getting worse. This is especially important for those who are working on reducing acne scars (more to come on this!).
And thus ends the quick (ish?) overview on acne. Like I said - there's a lot more to come. One last note before I go....
Acne can feel very isolating. It can take over your life, leaving you feeling like you need to shrink, or stay small to avoid drawing attention to your breakouts. Your acne might be new, and you may be scrambling to figure out why it showed up, or maybe you've had acne for so long that you have a hard time believing you'll ever not have it. Please know that your acne doesn't define you. You are so much more than what you see in the mirror.
And also: healing is possible. I did it - and you can too!
You deserve to love your skin. Stay tuned.