Acne is one of the most common skin conditions, affecting millions worldwide. While it’s often associated with teenagers, acne can occur at any age, from childhood to adulthood. Approximately 9.4 percent of people worldwide have acne.
So, if you are going through a bout of bad breakouts, then don’t worry, there are hundreds of thousands of people like you. Hope, this sense of camaraderie provides you some kind of relief (pun intended), and if not, we also have solutions that might help minimize it and let you live a zit-free life.
Understanding the A to Z of acne is crucial for effectively preventing and treating it. Whether you’re dealing with the occasional pimple or more severe forms like cystic acne, knowing the root causes and factors contributing to this can help you manage it better.
What Is Acne?
Your skin has tiny holes called pores all over. They can get blocked by oil, bacteria, dead skin cells, and dirt. When this happens, you may develop a pimple (also called a zit). If you get pimples too often, especially several at once and repeatedly, you have acne. So, long story short, acne is the skin condition that causes pimples. Acne typically appears on the face, chest, back, and shoulders, where sebaceous (oil) glands are most abundant.
Acne, obviously, does not pose any serious threat to your overall health. But, there is no denying that it can cause a lot of emotional distress. Acne flare-ups and scars can affect self-esteem and confidence and cause feelings of anxiety and depression. If acne or any other skin issue is deteriorating your mental health, it is best to seek professional help from both a dermatologist and a counsellor.
What Causes Acne?
The primary cause of acne is the clogging of pores due to a combination of oil (sebum) and dead skin cells. The skin naturally sheds dead cells, but when too many are produced or the body doesn’t shed them properly, they mix with oil and block the pores. This creates an environment where bacteria can thrive, leading to inflammation and breakouts, and hence, acne.
Several factors contribute to acne:
- Genetics: Your genes play a significant role in whether or not you’re prone to acne. If your parents had it, there’s a higher chance you might experience it too.
- Diet: According to a study, certain foods, especially those high in sugar and dairy, may trigger acne in some individuals. Eating a balanced diet rich in vitamins and minerals can help support healthy skin.
- Stress: When you’re stressed, your body produces more cortisol, a hormone that can increase oil production, which can worsen acne.
- Hormones: Hormonal fluctuations, particularly during puberty, menstruation, pregnancy, or while using birth control, can increase the size and activity of sebaceous glands, making acne more likely.
Types of Acne
Acne is not a one-size-fits-all condition. It manifests in various forms, ranging from mild breakouts to more severe and painful cystic acne. Understanding the different types of acne can help you better identify the cause of your skin concerns and choose the right treatments. In this section, we’ll explore three common types of acne: Hormonal Acne, Cystic Acne, and Adult Acne, providing detailed insights and actionable advice on how to manage each.
Hormonal
- What Is Hormonal Acne and Why It Occurs?
Hormonal acne is a common skin condition that occurs when fluctuations in hormones lead to an overproduction of oil in the skin. The excess oil combines with dead skin cells and clogs hair follicles, creating an environment where bacteria can thrive, which results in acne.
Hormonal acne is most commonly seen during puberty, menstruation, pregnancy, and due to the use of birth control. The hormonal changes that trigger acne primarily affect the sebaceous (oil) glands in the skin.
During puberty, both boys and girls experience a surge in androgens, which are male hormones present in both men and women. These hormones enlarge the sebaceous or oil glands, causing them to produce more oil, which increases the likelihood of clogged pores and acne.
Similarly, women experience hormonal fluctuations throughout their menstrual cycle, pregnancy, and while using hormonal birth control, which can exacerbate acne. 50% of women between the ages of 20 and 29 experience hormonal acne, often linked to menstrual cycles, pregnancy, and the use of hormonal birth control.
Common Areas Affected by Hormonal Acne
Hormonal acne tends to appear in specific areas of the face and body. The chin, jawline, and neck are the most common regions affected by this type of acne. These areas are particularly sensitive to hormonal fluctuations. For women, acne around the chin and jawline is often linked to menstrual cycles and hormonal imbalances, such as those seen in polycystic ovary syndrome (PCOS).
How Hormonal Acne Differs from Other Types of Acne
Hormonal acne differs from other types of acne primarily in its triggers and the areas it affects. While acne caused by diet or environmental factors may appear on the forehead, nose, and cheeks, hormonal acne primarily affects the lower half of the face, especially around the jawline and chin. The types of acne lesions also tend to be different—hormonal acne often involves deep cysts and painful nodules that can last longer and are more difficult to treat compared to whiteheads and blackheads.
Other key differences include the timing and persistence of hormonal acne. Hormonal acne often appears in cycles, flaring up during specific times of the month (like right before menstruation) and may be persistent, unlike acne caused by external factors, which may improve once the triggering factor is removed (e.g., a change in diet or skincare routine).
Tips for Managing Hormonal Acne
- Lifestyle Changes:
Exercise regularly: Physical activity can help balance hormones and reduce stress, both of which are linked to acne flare-ups.
Get adequate sleep: Poor sleep can increase stress, which may worsen hormonal acne.
Manage stress: Chronic stress raises cortisol levels, which can exacerbate acne. Meditation, yoga, and deep breathing exercises can help lower stress levels.
- Diet Adjustments:
Limit dairy: Studies have shown that dairy products may increase the likelihood of hormonal acne. Consider reducing your intake of milk and cheese if you’re prone to breakouts.
Reduce sugar and processed foods: High-glycemic foods can trigger insulin spikes, which may increase oil production and worsen acne. Focus on a balanced diet with plenty of whole foods, fruits, vegetables, and lean proteins.
Incorporate anti-inflammatory foods: Omega-3 fatty acids, found in foods like fish, flaxseeds, and walnuts, can help reduce inflammation in the skin.
- Medications:
Topical treatments: Retinoids, benzoyl peroxide, and salicylic acid can help reduce oil production and treat acne lesions.
Oral contraceptives: Birth control pills can help regulate hormones and reduce hormonal acne. Certain pills, like those containing ethinyl estradiol and norgestimate, have been shown to help control acne.
Spironolactone: This medication blocks androgens and is often prescribed to women with hormonal acne, particularly when oral contraceptives are not an option.
Cystic
Cystic acne accounts for about 20% of all acne cases and is considered the most severe form of acne. It is characterized by deep, painful pimples and cysts beneath the skin’s surface. It occurs when the hair follicles become deeply inflamed. Cystic acne manifests as in large, painful cysts or nodules beneath the skin’s surface. These cysts are typically filled with pus and can be tender to the touch. Cystic acne is more likely to cause scarring due to its deep, inflammatory nature.
Cystic acne can persist into adulthood, with approximately 5% of women over 25 continuing to experience it. Hormonal changes related to menstruation, pregnancy, or conditions like polycystic ovary syndrome (PCOS) often trigger cystic acne in adults.
Unlike regular pimples, cysts are located deeper within the skin. The body’s immune system responds by sending white blood cells to fight the infection, which causes inflammation. This process creates a cyst that is often painful, swollen, and red.
Risk Factors for Cystic Acne
- Genetics: If your parents had cystic acne, you are more likely to develop it as well.
- Stress: Increased stress can worsen acne by triggering hormone production, which leads to more oil production.
- Skincare products: Using products that are too harsh or comedogenic (pore-clogging) can irritate the skin and worsen cystic acne.
Treatment Options for Cystic Acne
- Oral Medications: Oral antibiotics like tetracycline or doxycycline can help control the bacteria and reduce inflammation.
- Cortisone Injections: A dermatologist may inject the cyst with cortisone to reduce inflammation and speed up the healing process.
- Oral Retinoids (Accutane): For severe cystic acne that doesn’t respond to other treatments, oral isotretinoin (commonly known as Accutane) may be prescribed.
- Laser Therapy: Certain types of laser treatments, like light and heat therapy, can target the deep layers of the skin to reduce oil production and kill acne-causing bacteria.
Adult
Adult acne typically affects individuals over the age of 25. Approximately 25% of adult women between the ages of 20 and 40 have acne, with many experiencing it well beyond their teenage years. Adult acne is caused by several factors, such as hormonal changes, stress, a diet that includes high-glycemic foods, a lot of dairy, and processed sugar, using harsh skincare products, etc.
Differences Between Teenage and Adult Acne
| Adult Acne | Teenage Acne |
| Driven by hormonal imbalances during puberty | Driven by stress, diet, and hormonal imbalances |
| Manifests as breakouts on the cheeks and forehead | Manifests as smaller and more localized breakouts around the chin, jawline, and neck |
| Easier to treat and naturally fades away after teenage years | More persistent and harder to treat |
How To Deal with Adult Acne
Adult acne can sometimes be more challenging to treat than teenage acne, as it often involves hormonal changes and requires more complex treatments. Adult acne may require a combination of topical treatments, oral medications, and lifestyle adjustments to manage effectively.
Professional Treatments
When over-the-counter treatments don’t effectively manage acne, professional treatments offered by dermatologists can provide more targeted solutions. These treatments range from chemical peels and microdermabrasion to laser therapy, as well as cortisone injections for cystic acne.
- Chemical Peels:
Chemical peels involve applying a solution to the skin that exfoliates the outer layers, removing dead skin cells and unclogging pores. This treatment helps reduce the appearance of acne and acne scars by promoting cell turnover. In fact, deep chemical peels (like those using trichloroacetic acid (TCA)) can improve the appearance of acne scars in about 60-70% of patients.
- Microdermabrasion:
Microdermabrasion is a non-invasive procedure where a device is used to exfoliate the skin’s surface, removing dead skin cells and promoting collagen production. This treatment helps unclog pores and can improve the overall texture of the skin, making it particularly beneficial for those with mild to moderate acne or acne scars. Up to 60% of patients report a noticeable improvement in the appearance of their acne after undergoing microdermabrasion treatments.
- Laser Therapy:
Laser treatments, such as laser resurfacing or light-based therapies, target the deeper layers of the skin to reduce inflammation, kill acne-causing bacteria, and stimulate collagen production. These therapies are especially effective for people with persistent acne or scarring. Popular options include blue light therapy, which kills acne bacteria, and fractional laser resurfacing, which helps with scarring.
Acne Success Stories
Reddit user Luvhley has had moderate to severe acne scarring. The things that worked best for her were RF PRP Microneedling treatments and Potenza Microneedling with collagen injections.
Alice had struggled with acne since her teenage years and her confidence took a hit because of it. She finally became acne-free in her mid-20s, and her journey has nothing short of undulating. Read her full journey here!
Dr. Bhagyashree is a doctor herself, who has struggled wit h acne. You can check out her journey from 2018 to 2024 in this YouTube video.
The Journey to Acne-Free Confidence
So, there we have it, a comprehensive guide to acne of all types. Acne can be a painful experience. But, with the right treatment and the guide by your side things become a lot easier. If you are experiencing intense acne breakouts, it is best to seek professional intervention at the earliest. Do not worry, a solution will, definitely, be on your way. At AskDoctor.ai, we understand how painful and infuriating acne can be. You can check out our acne heroes who are leading a zit-free life after opting for comprehensive care and a little nudge from our guides.
Leave a Reply