When you’re breaking out, you’re probably sure of a few things: First, patience is key—pimples take forever to heal, or at least it seems that way; second, you’re not supposed to pop them; and third, breakouts really suck. But, chances are, you’re less sure about what type of acne you’re dealing with. Unless you’re a dermatologist, you wouldn’t think that would be an issue. However, the first rule of acne skincare is that the type of pimple you have should dictate your acne treatment plan.
Think of blemishes like snowflakes (stay with us for a sec)! No two are alike, meaning blackheads require a totally different approach from whiteheads, post-acne hyperpigmentation—aka those lingering dark marks—need a separate arsenal, and cysts are in a league all on their own. Lucky for you, you (usually) don’t need to go to med school to treat acne breakouts. We’ve rounded up some of the most common acne types, and got the best at-home acne treatment tips from two top dermatologists. Here’s what you need to know about the different types of acne, as well as treatment options to try.
Ava Shamban, MD, is a board-certified dermatologist and founder of SKIN FIVE.
Purvisha Patel, MD is a board-certified dermatologist, MOHS and cosmetic surgeon, and founder of Visha Skincare.
You know those pesky black dots around your nose and chin that seem to keep popping up no matter what you do? Yep, those are blackheads. “They’re the buildup of sebum and dead skin cells in the follicle,” says Ava Shamban, MD, dermatologist and founder of SKIN FIVE. “They are not, however, blocked pores. They are open and functioning.”
Oil is supposed to be found in our pores, reminds dermatologist Purvisha Patel, MD, dermatologist and founder of Visha Skincare. But “Blackheads happen when the oil is thick and oxidized.” If the blackhead count has gotten out of hand, controlling the excess oil should help curb it. “Removing the oxidized oil removes the blackhead,” says Dr. Patel. “This can be done physically with a pore strip, for example, or chemically with a product such as an astringent or cleanser that dissolves the oil.” Try STARFACE Lift Off Pore Strips, as well as NO B.S. Purifying Facial Toner, which has tea tree oil and salicylic acid to help clear pores and treat mild acne.
Like blackheads, whiteheads are also caused by a buildup of sebum and dead skin cells in your pores. But in this case, the clogged pores have no exposure to air—which is why they don’t oxidize and turn dark. “This causes the white top to be trapped underneath and trying to escape,” says Dr. Shamban.
If you’re addicted to watching pore-extracting videos, there’s a good chance you’re seeing whitehead extractions. “It’s a manual process and typically done at home with an extractor or by an experienced health professional,” says Dr. Patel. But, she warns, extracting can cause more damage if not done properly. “Wash with a good exfoliating wash before and after extracting to dissolve the oil and clean the skin,” says Dr. Patel. “It is important to either get a professional or learn how to use a comedone extractor or there can be more inflammation that can result in scarring.” Try prepping skin with MURAD Clarifying Cleanser, which contains two types of salicylic acid to reach deep into pores, as well as green tea extract to soothe skin. Using non-comedogenic skincare products such as an oil-free moisturizer may help prevent whiteheads from forming as well.
Cystic breakouts and acne nodules—those painful, under-the-skin bumps—are typically considered the most severe form of acne. That’s because these inflamed, red acne lesions form deep within the skin, which makes them hard to treat and slow healing (remember, patience is a virtue). “Cystic acne tends to form deeper in the hair follicles and has the distribution along the jawline and neck area,” explains Dr. Patel. Plus, she adds, “There is commonly not a pustule or ‘head’ to the pimple,” so popping them is virtually impossible.
Over-the-counter spot treatments containing benzoyl peroxide or salicylic acid may help, but most cystic acne deserves a visit to your doctor’s office. “Spironolactone is a hormonal diuretic that counteracts follicular hormonal changes and results in decreases in oil production,” explains Dr. Patel. “This prevents the deep cysts from forming.” (She adds that the treatment generally works best on females.) In-office treatments such as chemical peels and lasers may help dramatically, while “Topical creams with retinol, tretinoin, or acids help exfoliate the skin to prevent the cysts from forming,” explains the derm.
Dr. Patel also reminds that overall health has a direct effect on skin health as well. “The skin is the largest organ and immune organ of the body. The gut is the second largest immune organ of the body,” she explains. “Stopping sugar and dairy [intake] and taking a probiotic can help decrease cystic acne to a certain extent.”
The period pimple struggle is real, and there’s science to prove it. “Hormonal acne flares and fluctuates with estrogen and progesterone, both of which vary greatly throughout the month due to the menstrual cycle,” explains Dr. Shamban. “Other culprits include the stress hormone cortisol and lack of sleep. Each is a contributor to increased oil production, buildup, and the inflammatory response.” Things like contraceptives (and, of course, your natural skin type) may play a role in triggering this type of acne as well.
Hormonal acne pops up most often on the lower jaw line, chin, and lower cheeks, and comes in the form of large, deep, and painful cysts with no head or visible pore, adds Dr. Shamban. The worst part? They’re often chronic, meaning they’ll come back again every month. To ensure your acne is treated correctly, be sure to consult with your dermatologist. “Diagnosing the cause of hormonal acne is important, as there are medications to help with the increased oil production,” says Dr. Patel.
You may not know the name of this skin condition, but you’ve definitely seen it before—possibly even on a baby. “Milia is the buildup of a different kind under the skin,” says Dr. Shamban. “It is the formation of the protein keratin that becomes trapped under the skin surface, creating a tiny micro ball.” These tiny white bumps might be tempting to pop, but it’s important to stay hands-off and leave the extractions to skincare pros.
This non-inflammatory acne can pop up anywhere, but they’re most common around the eyes. So if you’re noticing a spattering of little white bumps, it might be time to take a closer look at your eye cream. Heavy products can lead to a buildup on skin, making milia more likely. Swap your eye cream for a lightweight eye serum, like KORRES Black Pine 3D Eye-Lift Super Seru . It offers the same benefits you love in a regular eye cream (firming, brightening, and de-puffing), but the light texture won’t clog your pores.
Just when you think you’re in the clear, those dark marks—known as post-inflammatory hyperpigmentation—rear their ugly heads. Although it’s a natural part of the pimple healing process, they can sometimes be harder to treat than the breakout itself.
“Vitamin C can improve the dark spots considerably because it acts as an enzyme inhibitor, which prevents the melanin production that causes discoloration,” says Dr. Shamban. “It also acts as a chemical exfoliant to help slough off layers of skin where the discoloration is living.”
Dr. Patel recommends VISHA SKINCARE Advanced Correcting Serum which has retinol, vitamin C, vitamin E, and ferulic acid to help fade the appearance of scars. And always, always, always wear sunscreen to protect skin, especially if you have discoloration. “Wearing a SPF greater than 30 is important to decrease the exposure of the skin to the already inflamed skin—this decreases the chances of the areas getting darker and more noticeable.”
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