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Acne or acne vulgaris is a skin condition that occurs when a pore becomes clogged with dead skin cells, oils and a type of bacteria called Propionibacterium acnes (P. acnes). [1]

Most people experience acne between the ages of 12 and 24 but acne can occur at a later stage of life as well. 

What causes acne [2]

  • Hormones 
  • Stress 
  • Certain medications 
  • Poor hygiene 
  • Wrong skin care products 
  • Sun 
  • Unhealthy Diet

Types of acne [3]

Non-inflammatory acne  Inflammatory acne 

1. Blackheads

2. Whiteheads

1. Papules

2. Pustules

3. Nodules

4. Cysts

 

Non-inflammatory acne  

Non-inflammatory acne do not cause swelling. Non-inflammatory acne is divided into open and closed comedones (clogged pores). (4) 

1. Blackheads [5]  

Blackheads occur when a pore is clogged by a combination of sebum and dead skin cells. The top of the pore stays open, while the rest being clogged. This results in the black color seen on the surface. 

They are also called open comedones. 

Blackheads can appear on 

  • Face
  • Back
  • Chest
  • Neck
  • Arms
  • Shoulders 

Severity: Blackheads are mild form of acne. 

Treatment options  

Over-the-counter drugs : These contain ingredients such as salicylic acid, benzoyl peroxide, and resorcinol. They work by killing bacteria, drying excess oil, and forcing the skin to shed dead skin cells.

Manual removal, microdermabrasion, laser treatment and chemical peels also work for blackheads. 

How long does it take to cure blackheads? 

6-8 weeks

2. Whiteheads [6] 

Whiteheads can also form when a pore gets clogged by sebum and dead skin cells. But unlike with blackheads, the top of the pore closes up. It looks like a small bump sticking out from the skin. 

Whiteheads are called closed comedones. 

Whiteheads can appear on  

  • Face
  • Back
  • Chest
  • Sometimes The Neck And Shoulders 

Severity: Whiteheads are mild form of acne.  

Treatment options 

OTC treatments include gels, lotions, creams, ointments, soaps, and medicated pads. They may contain benzoyl peroxide, resorcinol, salicylic acid, or sulfur. 

How long does it take to cure whiteheads 

6-8 weeks

Inflammatory acne 

Inflammatory acne causes swelling and inflammation. Although sebum and dead skin cells contribute to inflammatory acne, bacteria can also play a role in clogging up pores 

1. Acne Papules (Pimples) 

Acne papules [7] are inflamed blemishes that look like red bumps on the skin. 
These can appear anywhere on the body including the neck, chest, shoulders, back and butt. 

Development  

Papules develop when the wall of the hair follicle ruptures and cellular debris and bacteria spill into the dermis (deepest layer of the skin). The rupture causes inflammation and the are turns red creating a red bump (pimple).

Severity: Pimples are moderate forms of acne.

Acne papules or pimples appear on the face majorly. 

Treatment options:

Papules are treated with non prescription drugs like benzoyl peroxide or salicylic acid and antibiotics like erythromycin. Birth control pills also help in treating papules. 

2. Acne Pustules 

    Acne pustules [8]are typical pimples with a white colored head. They can develop on the face, back or shoulders. They are a mix of pus, dead skin cells and excess oils.

    Development 

    When there is a rupture in the pore, the body signals to defend against bacteria. It sends white blood cells as a defence mechanism and this creates pus. 

    Pustules commonly appear on face, chest and back.

    Severity: Pustules are moderate forms of acne.

    Treatment options

    The best topical products for treating pustules contain peroxide, salicylic acid, and sulfur.

    3. Acne Nodules 

    Acne nodules [9] are large, inflamed lesions. They feel hard and painful. While papules and pustules occur the the skin surface, nodules form deeper in the skin. 

    Development 

    An acne nodule develops when the follicle wall ruptures deep within the dermis. Contaminated debris from the follicle pours into the dermis and infects neighbouring follicles. The area swells due to the damage and irritation, so nodules are quite painful.

    Nodules can be filled with pus but because they occur so deeply within the skin you won't see a white head.

    Acne nodules appear on the face, chest and back. 

    Severity: Nodules are severe forms of acne.

    Treatment options

    Prescription strength benzoyl peroxide, salicylic acid can treat acne nodules. Birth control pills, retinoids and antibiotics like isotretinoin work for such kind of acne. 

    4. Acne Cysts

      Acne cysts [10] are the most severe and painful forms of acne. They are large, soft, fluid-filled lumps under the skin's surface. 

      Development 

      Acne cysts are formed in the same way as acne nodules. They are a severe form of acne nodules. Acne cysts are filled with pus and blood. They often lead to scarring. 

      Acne cysts appear on the face, chest, neck, back, and arms.

      Severity: Cysts are severe forms of acne.

      Treatment options

      Prescription strength creams, birth control pills, oral antibiotics, retinoids and steroid injections can treat acne cysts. 

      Why popping a pimple is never a good idea 

      When you squeeze a pimple, you can accidently push the contents deeper into the pore, making the blemish much worse. [11]

      Acne pimple can be opened under the supervision of a dermatologist. Dilute steroid can be injected in them in a sterile way to decrease the inflammation and cut down on scarring. 

      Treating acne 

      It is best to identify your acne and consult a dermatologist in case of severe acne. There are a wide range of prescription oral and topical treatments. [12]

      Aesthetic in office treatments 

      • Chemical Peels
      • Facials
      • Laser Treatment
      • Dermal Filler Treatments

      Wonder ingredients for non-inflammatory acne [13]

      Salicylic acid

      It is a naturally exfoliating ingredient and is also lipophilic (having an affinity towards oil) or oil loving. A type of beta hydroxy acid (BHA), SA works by dissolving oil, dead skin cells and debris from inside the pore while exfoliating dead surface skin cells. 

      How Salicylic acid treats acne?

      It is derived from willow tree bark, wintergreen oil or sweet birch and hence is extremely safe.

      Benzoyl peroxide 

      It is an antibacterial ingredient that kills the acne-causing P. acnes bacteria that live deep in the pores and survive on oil, cell debris and skin tissue. It seeps into the skin and treats acne from the source while reducing redness and inflammation.

      How Benzoyl peroxide treats acne?

      1. Fast-acting
      2. Easily accessible 
      3. Acts as a first line of defence

      Sulfur

      It helps dry out the surface of your skin to help absorb excess oil (sebum) that may contribute to acne breakouts. It also dries out dead skin cells to help unclog your pores.

      How Sulfur treats acne?

      1. It is gentle on skin 
      2. Antimicrobial in nature
      3. Abundantly available

      Wonder ingredients for inflammatory acne 

      Niacinamide 

      It aids in the reduction of breakouts by easing inflammation and preventing transepidermal water loss. The moisture content of the skin is normalized, which helps prevent further breakouts by reducing excess oil production. [14]

      How Niacinamide treats acne?

      1. Anti-inflammatory properties
      2. Hydrating and soothing effect on skin

      Tetracycline and Erythromycin 

      These are oral antibiotics that act against  P. acnes in people with moderate to severe inflammatory acne.

      How these antibiotics treat acne?

      1. No side effects
      2. Anti-inflammatory properties

      Isotretinoin

      It is a prescription medication you take orally, may help control severe acne, which is characterized by many large cysts on the face, neck and shoulders.

      Pregnant women or women who might become pregnant can't use this medication, as it's linked to birth defects. Isotretinoin can cause very dry skin, eye dryness, and irritation. 

      It can also be very expensive. So its use is restricted to the most severe cases for which other treatments haven't worked.

      Oral contraceptives

      Birth control pills [15] contain estrogen and progesterone that decrease the sebum levels and acne.  Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. 

      Treatment options for severe acne

      • Antibiotics, Such As Tetracycline, Doxycycline, And Amoxicillin
      • Topical Corticosteroids
      • Oral Contraceptives For Hormonal-related Acne
      • Systemic Retinoids, Such As Isotretinoin
      • Steroid Injections
      • Chemical Peels That Are Available In Pharmacies Or Online
      • Photodynamic Therapy To Combat Bacteria
      • Drainage And Extraction To Remove Large Cysts

      Understanding the kind of acne can help in treating it effectively. Begin by knowing your skin and acne type. 

      You can treat mild to moderate acne with customized skincare. Customization solves your skincare struggles because the products in your regimen are made only for you. A good skin care regimen goes a long way in getting and maintaining healthy skin. 

      Skinkraft customizes skincare products for you based on a unique SkinID™ questionnaire. Skinkraft products are dermatologically driven, research based and contain safe ingredients. 

      Skinkraft customized skincare regimen recommends the following 3 products in your regimen. 

      1. Your customized cleanser
      2. Your customized moisturizer
      3. Your customized active to treat acne

      Begin by knowing your skin