The Ultimate Guide to Acne Prone Skin, Meaning, Causes, and Care Tips

written by Allison Goins, Ph.D. | Published on March 19^th, 2024 at 12:00 pm

So many people grow up believing like a cringy hairstyle or questionable fashion choices, acne is something you grow out of. And one day you will look back with flawless skin and be glad its behind you. However, for so many people, myself included you never grow out of acne. If you have acne prone skin, meaning you notice that frequent blemishes seem unavoidable you are not alone.

And you should not blame yourself or assume you are doing something wrong. Understanding how complex the process of acne formation is and the factors contributing to it, is crucial for developing an effective skincare routine. So we are deep diving into exactly what it means to have acne prone skin and how you can combat those pesky blemishes before they form and once they arrive.

How Acne Forms- A Complex and Annoying Processes

Unfortunately acne is not a simple problem. It is a complex issue that is influenced by so many factors. Some of these factors are in your control and unfortunately some are not. If you have acne prone skin, meaning your skin is more likely to develop pimples there are several major areas that scientist generally agree are the key contributors:

Increased Sebum Production:

Sebum is your skin’s natural oil. It’s made by tiny glands all over your body, and it acts like a built-in moisturizer. Sebum is important because it helps keep your lock moisture into your skin and protects your skin by forming a thin barrier.

The production of your natural moisturizer, sebum is controlled by hormones. This means from puberty to menopause as your hormones change so can your sebum production. And if your body is excessively producing sebum, when it is combined with dead skin cells, your pores can become clogged; which paves the way for acne. An editorial published in the Journal of the American Academy of Dermatology found a significant correlation between sebum production and acne severity.

Follicle Hyperproliferation

Proliferation is the process of cells growing, dividing, and producing new cells. And in your skin this is typically very desirable because it means new, fresh, radiant skin. However when skin cells are over produced this can lead to problems. When they are over produced, skin cells can clump together in your hair follicles. This leads to the formation of plugs that obstruct pores. And when your pores get clogged this can be another thing that leads to the formation of acne.

P. acnes Bacteria

Acne can also be caused by bacteria. Propionibacterium acnes (P. acnes) is the name of a bacteria that thrives in the clogged pores. When pores get clogged this bacteria munches on sebum and then releases chemicals that irritate your skin. This irritation in the skin triggers inflammation and can cause acne to form or to be more irritating and painful.

Inflammation

Not only as a response to P. acnes, but in general if your hair follicles or pores become inflamed as a result of dirt or other irritants. Your body’s immune system can respond with redness, swelling, and the formation of pimples.

Some Additional Contributing Factors:

While those four factors are the main drivers of acne formation, other internal and external things can also influence the severity of your acne.

Genetics: Acne prone skin can be genetic. Meaning your overactive sebaceous glands could be a gift from an ancestor or your parents. Genes can also influence skin cell turnover and the immune response, all of which can contribute to acne development like we talked about above.
Diet: The direct link between diet and acne remains under investigation. However, some studies suggest a possible association between a sugary diet or a diet heavy in dairy consumption in causing acne to flare up. in some individuals.
Medications: Certain medications, like corticosteroids or oral contraceptives, can sometimes worsen acne. However you should definitely take the medications that your doctor prescribes you and talk to them or a dermatologist about strategies to find a balance.
Stress: Chronic stress is thought to exacerbate acne by stimulating the production of stress hormones like cortisol. These hormones can increase sebum production and worsen inflammation.

Harsh Skincare Products

By trying to treat acne or other skincare products you can actually do more damage than good. Aggressive cleansers, over usage of strong chemical exfoliants, and abrasive scrubs can irritate the skin and damage your skin’s natural barrier. A damaged skin barrier is another way to worsen acne.

Recognizing that no one of these factor is the reason your many have acne prone skin, but rather acne is complex and caused by several things. Understanding this complexity is crucial for developing an effective acne management skincare routine. Consulting a dermatologist can help you identify the specific factors that contribute to your acne and develop a personalized treatment approach that addresses the root causes.

Types of Acne: A Detailed Breakdown

Although acne is often talked about as one this it is actually a catch all term for several different types of breakouts. And knowing the difference in the different forms of acne and what causes them is important, because it affects how you treat them. Acne come in several different forms, each with distinct characteristics. Here’s a closer look at the different types of acne:

Comedones

When someone is describing acne as a comedone, they are talking about a non-inflammatory form of acne. There are two primary types of comedones.

Blackheads: These small, black bumps appear when sebum and dead skin cells clog the opening of a pore. The black color is not due to dirt, but rather a result of sebum oxidizing and turn black when it comes in contact with air. Blackheads are typically not painful, but that does not me you want them popping up and hanging around on your face.
Whiteheads: Unlike blackheads, whiteheads form when the clogged pore remains closed by a layer of skin. This prevents sebum from oxidizing and turning black so it has a white appearance. Whiteheads are typically smaller than blackheads and may feel slightly rough to the touch.

Papules and Pustules

Papules and pustules are a type of inflammatory type of acne. These are the breakout that are going to be read and painful.

Papules: These small, red bumps represent the initial stage of inflammatory acne. Papules develop when a clogged pore gets inflamed. Often this happens as a result of P acnes bacteria and your body’s immune response. Papules are typically tender to the touch but lack pus.
Pustules: These are probably what you think of when you think of a pimple. Pustules are papules that have developed a white or yellow pus-filled center. The pus is a collection of white blood cells fighting the bacterial infection within the pore. Pustules are typically more inflamed and tender than papules.

Nodules and Cysts

Nodules and cysts are another type of inflammatory type of acne. These are going to be the largest and most painful breakouts.

Nodules: These are large, solid, and often painful pimples that develop deep within the skin. They form when inflammation is no longer contained in your pore or follicle, but is pushing out and effecting other skin tissue. Nodules can be red or purple and leave noticeable scars if not treated properly. You definitely want to consult a dermatologist to help you treat nodules that pop up.
Cysts: The most severe form of acne, cysts are large, pus-filled lesions that develop deep under your skin’s surface. They can be extremely painful and are prone to rupturing, leading to significant scarring. Even more than nodules cysts need professional treatment by a dermatologist.

By understanding the different types of acne, you can tailor your skincare routine to target specific concerns and achieve clearer, healthier skin. Or depending on the type of acne you have, you might want to seek out a dermatologist. It is important to say, consulting a dermatologist is the only way to learn the type and severity of your acne. You can make informed guesses but visiting a dermatologist is definitely the fast track to an individualized treatment plan.

New Hope: Scientific Solutions for Acne

Fortunately, there has been a ton of research not only understanding what causes acne, but also what treats it and helps you effectively manage your acne.

Topical Retinoids

Derived from vitamin A, retinoids are the cornerstone of any acne treatment. Retinoids are considered not only a gold standard anti-aging skincare active, but also a gold standard acne fighting skincare ingredient. There are a couple of different way that retinoids help manage acne. At the most effective strengths retinoids are only given by prescription. There are some newer over the counter retinoids that you can purchase in drugstores like Adapalene.

Promoting Skin Cell Turnover

Retinoids promote skin cell turnover, helping to shed dead skin cells that can clog pores. This reduces the formation of comedones, the precursors to pimples. If you are using a topical retinoid, it can help speed up the turn over and make your skin shed more dead cells.

Normalization of Keratinization:

Retinoids not only speed up the shedding of skin cells, but also they regulate the way skin cells grow and differentiate. This means they can prevent the abnormal clumping of cells in your pores and follicles that can also contribute to acne.

Anti-inflammatory Effects:

Retinoids possess anti-inflammatory properties, helping to reduce redness and swelling associated with inflammatory acne lesions.

Exfoliation

incorporating an exfoliating step in your routine to prevent the dead skin cells from clogging up your pores can be very helpful. Over exfoliating can lead to damaging your skin barrier so you definitely have to strike a balance.

Related Post: Should You Use Peptides or Retinol?

Salicylic Acid

Salicylic acid is a beta hydroxy acid. It has the ability to loosens the bonds between dead skin cells to promote skin cells shedding properly and preventing your pores from being clogged. Salicylic acid is most effective for the non-inflammatory forms of acne like whiteheads and blackheads, but may also have some anti-inflammatory benefits. Salicylic acid is often available in over-the-counter cleansers, toners, and spot treatments. Benzoyl peroxide is available over the counter. There are tons of skincare products that are formulated with it.

Benzoyl Peroxide

Benzoyl peroxide is a chemical that has antibacterial properties. It works by releasing oxygen that disrupts the bacterial cell wall and inhibits bacterial growth. With its antibacterial properties, benzoyl peroxide targets P. acnes bacteria, reducing inflammation and preventing new breakouts. Benzoyl peroxide is another one of the gold standard ingredients for managing acne. However, benzoyl peroxide can be irritating to some people and it can bleach your towels. It can cause dryness and redness. So it’s important to start with a lower concentration or using it infrequently and then gradually increase it as your skin gets used to it and can tolerate it.

A Combination Approach

In many cases, a combination of these topical medications may be more effective than using a single ingredient alone. A dermatologist can recommend the most appropriate combination of medications based on your individual needs and acne severity.

It’s crucial to consult a dermatologist for personalized treatment plans tailored to your specific skin type and acne severity. A dermatologist can recommend the most appropriate combination of topical medications, oral medications, or light therapies to achieve optimal results.

Conclusion

Acne, though distressing, is a treatable condition with the right approach. By understanding the science behind acne formation and its influencing factors, you can make informed decisions about your skincare routines and product choices. Remember, seeking professional guidance from a dermatologist is key to achieving clearer, healthier skin.

References

Harper, Julie C. “An update on the pathogenesis and management of acne vulgaris.” Journal of the American Academy of Dermatology 51.1 (2004): 36-38.
Sutaria AH, Masood S, Saleh HM, et al. Acne Vulgaris. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459173/
Webster GF. Acne vulgaris. BMJ. 2002 Aug 31;325(7362):475-9. PMID: 12202330; PMCID: PMC1123998.