Frequently Asked Questions About Acne, Answered
If you're struggling with acne, chances are you have a lot of questions. Thankfully, our team of skin care experts have the answers! From what acne is and what can cause it to how to get rid of breakouts once and for all, we're answering some of the most frequently asked acne questions below.
- What is acne?
- What causes acne?
- What are the different types of acne?
- How can I get rid of acne?
- What is adult acne?
- Why do I breakout before my period?
- What are the best ingredients for acne?
- What is body acne?
- Can I wear makeup if I have acne?
- Am I cleaning my skin enough?
- Can food cause breakouts?
- Will my acne ever go away?
Acne—also known as acne vulgaris—is the most common skin disease in the United States, affecting men and women of all ethnicities. The disease is so common, in fact, that an estimated 40-50 million Americans may experience some type of acne at some point in their lifetime. While it's most often associated with puberty, acne can strike at any time during your life—which is why many skin care products are tailored for those affected by adult acne. The most common areas to experience acne include the face, neck, back, chest, and shoulders, but it can appear on the buttocks, scalp, and other areas of the body as well.
Acne is a skin disease that affects the skin's oil-producing—or sebaceous—glands. These glands are the same ones that produce the oil that keeps our skin naturally hydrated, but when they get kicked into over-drive and produce too much oil that's when the state of your complexion can go south. This overproduction of oil can combine with dead skin cells and other impurities on your skin's surface and clog your pores. A clogged pore is harmless enough on its own, but if it becomes compromised with bacteria acne can form.
Simply put, acne is caused when oil-producing sebaceous glands kick into over-drive and produce oil in excess. When that excess of oil mixes with dead skin cells and other dirt and grime that may be lingering on your skin's surface it can clog pores. Finally, when those pores become infiltrated with bacteria they can turn into breakouts. But there are few other factors that can cause acne. We list the most common below:
- Hormonal Ups and Downs: Oil-producing glands are affected by hormonal fluctuations—think: puberty, pregnancy, and right before your period.
- Genetics: If your mom or dad had acne, chances are you are likely going to have acne as well.
- Blockage of Oil: This can be caused by changes in the thickness or viscosity of your sebum, scarring from recent breakouts, dead skin cell buildup, improper cleansing and/or occlusive skincare products.
- Bacteria: Breakouts and bacteria go hand-in-hand—which is why a proper skin care routine is so important. This is also why it's key to keep your hands away from your face and to keep any materials that come into contact with your skin (like pillowcases, cleansing brushes, towels, etc.) clean.
- Stress: It's believed that stress can worsen existing skin conditions, so if you already have breakouts, if you're feeling extra stressed they may become worse.
- Lifestyle Factors: Some studies have shown that lifestyle factors—everything from pollution to your diet—may play a part in causing breakouts.
Just like different factors can cause acne, there are also different types of acne that you may experience, namely six major types of blemishes:
1. Whiteheads: Pimples which remain under the surface of the skin
2. Blackheads: Blemishes that occur when an open pore is clogged and that clog oxidizes and becomes dark in color
3. Papules: Small pink bumps that may be sensitive to the touch
4. Pustules: Blemishes that are red and filled with white or yellow pus
5. Nodules: Blemishes that are large, painful, and solid to the touch which remain deep under the surface of the skin
6. Cysts: Deep, painful, pus-filled pimples which are likely to cause scarring. Cystic acne is known to be one of the most difficult types of acne to address. “When your pores are clogged (by dead skin cells, debris, etc.), you can occasionally get a bacterial overgrowth in the area that tends to be deep in the skin. Your body's response to fight the infection may be a reaction—also called cystic acne. These tend to be red, swollen, and more painful than typical superficial acne bumps," Dr. Dhaval Bhanusali explains.
No matter what type of breakout you may be experiencing, the ultimate goal is getting it to go away. But, getting rid of acne isn't something that is going to happen overnight. The first step is reducing the appearance of acne and to do that you'll want to adopt and follow a skin care routine.
- First, ensure your skin is clean by washing it morning and night. This will help to remove any impurities that are on the surface of your skin—excess oil, dead skin cell buildup, makeup residue, etc.—and can keep your pores from becoming clogged in the first place.
- Next, use a spot treatment formulated with an acne-fighting ingredient to help fight flare-ups and whatever you do, do not pop pimples or pick at your skin. You can end up pushing the bacteria further down which can worsen the blemish and you can even cause scarring.
- After cleansing and using your spot treatment, always moisturize your skin. While it may seem counterintuitive to add hydration to already oily skin, if you skip this step you can run the risk of dehydrating your skin which can kick those sebaceous glands into high gear and cause them to produce even more oil. Opt for lightweight, oil-free moisturizers—we are partial to water-based gels formulated with hyaluronic acid.
While acne is most common in teens and young adults, for some, breakouts can continue—or suddenly pop up—later in life. Adult acne affects mostly women and unlike the breakouts that pop up here and there in youth, adult acne is cyclical and stubborn and can be paired with other skin care concerns including scars, uneven skin tone and texture, enlarged pores, and even dehydration. Acne after adolescence can be caused by everything from hormonal fluctuations, stress, genetics, climate, or even the products you use. With adult acne, blemishes most often occur around the mouth, chin, and jawline and with women they worsen around the time of her period.
Adult acne also presents itself in one of three ways:
- Persistent Acne: Also called continuous acne, persistent acne is acne that has extended from adolescence into adulthood. With persistent acne blemishes are almost constantly present.
- Delayed Acne: Or, late onset acne, delayed acne starts in adulthood, and can affect one in five women. Blemishes occur as premenstrual flare-ups or suddenly for seemingly no reason.
- Acne Relapse: Relapsing acne first occurs in adolescence, disappears, and then presents itself again in adulthood.
Unlike the oily skin teenagers with acne experience, many adults who are affected by acne can experience dryness, which can be made worse by acne-fighting spot treatments, cleansers, and lotions. What's more, while breakouts during puberty seem to disappear once they’ve cleared, adult acne can result in scarring due to a slower desquamation process—the natural shedding of dead skin cells to reveal new ones underneath.
If you find yourself always getting a flare up around your period you may find yourself wondering about the connection between menstruation and acne. Prior to your period you experience an increase in androgens—male sex hormones—and a decrease in estrogen—female sex hormones. According to the American Academy of Dermatology, this hormonal fluctuation can be responsible for excess sebum production, dead skin cell build-up, an increased number of acne-causing bacterium, and skin inflammation.
When looking for a product to help you reduce the appearance of acne breakouts, there are a few gold-standard—and FDA-approved—ingredients that you should look for in the formula. The most common include:
- Salicylic Acid: A beta-hydroxy acid that can be found in scrubs, cleansers, spot treatments, and more that works by chemically exfoliating the skin's surface to help unclog pores. Products formulated with salicylic acid have been shown to help reduce the size and redness associated with acne blemishes.
- Benzoyl Peroxide: Also available in a number of product formulas including cleansers and spot treatments, benzoyl peroxide helps to kill the bacteria that can cause acne flareups while also helping to remove excess oils and dead skin cell buildup that results in clogged pores.
- Alpha-Hydroxy Acids: AHAs including glycolic and lactic acids help to chemically exfoliate the surface of the skin to help to unclog pores and remove any pore-clogging buildup.
- Sulfur: Sulfur is found in spot treatments and face masks and helps to reduce acne-causing bacteria, clogged pores, and excess oil.
Body acne can show up anywhere from your back and your chest to your shoulders and your buttocks. If you have breakouts on your face and body, it is likely acne vulgaris explains Dr. Lisa Ginn. “When you have acne on your body, but not on your face, it’s often caused by waiting too long to shower after working out,” she says. “The enzymes from your sweat sit on the skin and can cause breakouts. I tell my patients to at least rinse off, even if they can’t take a full shower. Get water on your body within 10 minutes after exercise.”
While they may be caused by similar factors, there is one large difference between breakouts that appear on your face and ones that pop on your back, chest, and other areas of the body. That difference? “With the skin on your face, the dermal layer is 1-2 millimeters thick,” Dr. Ginn explains. “On your back, this layer is up to an inch thick. Here, the hair follicle is sitting in deeper skin, making it harder to get to.”
Of all the tools in your beauty arsenal, makeup is one of the best when you're dealing with acne—that is, the right kind of makeup. You'll want to look for non-comedogenic formulas that are oil-free to ensure you aren't clogging your pores. What's more, many makeup formulas have been created with acne-fighting ingredients and can even help you clear up the appearance of a bothersome blemish while you hide it from view.
You also may want to try color correcting concealers in green tones if your blemishes are very red and difficult to conceal. Green color correctors help to neutralize the appearance of redness and can help to create an illusion of clear skin when worn under concealers or foundations.
Just remember, when you do wear makeup over your acne to be sure you are properly removing it before bed. Even the best makeup for acne can cause clogged pores and worsen breakouts if it's left on overnight.
Of all the skin care non-negotiables, cleansing ranks at the top of the list...especially if you have acne. But, when you have oily, acne-prone skin you can often feel like you need to cleanse your skin more than the recommended twice a day. Before you go crazy with cleansers, know this. Over-cleansing your skin can strip away the natural oils that keeps your complexion hydrated. When skin becomes dehydrated, oil-producing glands start to make a more sebum to compensate for what they perceive to be a loss of moisture. So, by washing your face to try to remove excess oil you end up causing your skin to become more oily in the long run.
If you feel like you need to wash your face more than twice a day, talk to your dermatologist who can recommend a skin care routine that works with your skin and not against it.
The burning question for everyone struggling with acne is whether or not food plays a part. While some studies have shown that certain foods—excessive sugars, skim milks, etc.—may affect the appearance of the complexion, the jury is still out. Even though there's no definitive proof that acne is caused by food, it never hurts to eat a healthy, well-balanced diet and to drink the recommended amount of water each day.
If you have persistent acne that doesn't seem to budge you're likely looking for the light at the end of the tunnel. Often times the acne we experience during puberty will clear up on its own as we get older, but if you have adult acne, or breakouts that are a result of hormonal fluctuations a proper skin care routine and a dermatologist-approved plan of action can help to make a big difference in the appearance of your skin.