If you’re experiencing hormonal acne, acne vulgaris, cystic acne or acne inversa, you should learn the potential sources of your problem. By understanding the cause of your acne, you’ll be better equipped to proactively prevent its formation, rather than just treating it ex posto facto. Watch out for these key acne-inducing factors and their relationship to skin:

Blackheads appear as small black dots on the skin. They usually occur on the face – especially the nose and T-Zone – but can also be seen on the back, neck, chest, shoulders and arms. Blackheads are one of two types of comedones, or acne lesions caused by clogged pores. Blackhead comedones are open versus closed, leaving the plug at the top of the clogged pore exposed to air on the skin’s surface. It’s this exposure to oxygen that accounts for their color, which can not only be black but also gray, yellow or brown. When melanin – a pigment produced by oil glands and found within sebum – makes contact with air, it oxidizes and turns dark. Blackheads are a mild, usually painless form of acne, as there’s less inflammation associated with this type of lesion.
How to Handle It: Think of these as bigger, pissed-off whiteheads. Your best bet, says Zeichner, is to stock up on benzoyl peroxide, which kills the bacteria. A spot treatment like Murad Acne Spot Fast Fix ($22) should do the trick. Also, try not to pop them — as tempting as that may be. Since they're inflamed, they're more likely to scar if you go the DIY route.
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The severity of acne vulgaris (Gr. ἀκµή, "point" + L. vulgaris, "common")[24] can be classified as mild, moderate, or severe as this helps to determine an appropriate treatment regimen.[20] There is no universally accepted scale for grading acne severity.[15] Mild acne is classically defined by the presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions.[20] Moderate severity acne is said to occur when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and are found on the trunk of the body.[20] Severe acne is said to occur when nodules (the painful 'bumps' lying under the skin) are the characteristic facial lesions and involvement of the trunk is extensive.[20][25]
Another vice that can lead to worsened acne is alcohol. As we mentioned, your diet and acne are related. One glass of wine won’t trigger a breakout – even contains beneficial antioxidants! – but excessive alcohol consumption can alter your hormone levels. Making matters worse, many people drink due to stress, which also affects acne-inducing hormones. Alcohol impairs the liver’s ability to purify toxins, and if the liver is compromised, toxins are expelled through different channels such as your skin. It’s full of that sugar we just warned you about and weakens your immune system, which inhibits your body’s natural ability to fight off P. acnes bacteria. If you pass out after a night of drinking without washing your face, your pores are more likely to become clogged and create pimples. Almost everyone enjoys indulging in a drink every now and then, but moderation here is key.
A snoring partner can be one of the most difficult things to sleep through. Snoring tends to be position-specific so many doctors recommend switching positions to stop the snoring. Rather than sleeping on your back doctors recommend turning onto your side. Changing positions can cut down on noise and breathing difficulties for any snorer. Using a white noise fan, or sound machine can also help soften the impact of loud snoring and keep both partners undisturbed.
Post-inflammatory hyperpigmentation is not an acne scar, but a red, pink, brown or tan skin discoloration where acne has previously flared up. It'll usually disappear on its own in a year or so. Many skin lightening products claim to help reduce the visibility of these acne "scars." Their active ingredient, hydroquinone, works to slow melanin production and can reduce dark brown marks, but melanin isn't the cause of red and pink acne discolorations. A better option is to use the best foundation for acne prone skin you can find to hide the marks until they naturally fade away.

Oh, hello old friend. Salicylic acid is the go-to fix for pimply preteens. And cruising through the aisles at the drugstore, you’ll find it as the active ingredient on the majority of products labeled “acne wash” or “spot treatment.” Salicylic acid is a beta-hydroxy acid that works by dissolving excess oil and gently exfoliating away dead skin cells. Salicylic also has anti-inflammatory properties to help with inflamed cystic breakouts that can occur when blockages deep in the hair follicles rupture beneath the skin. It’s best to apply this ingredient as a toner, moisturizer, or leave-on spot treatment instead of a face wash to give it time to do its work. And keep in mind, salicylic acid can dry out the skin if over-applied, so maybe choose only one product with the ingredient to use every day.


Everything you need to know about blackheads Blackheads are small lesions that often appear on the face or neck. They are a feature of mild acne, and handling blackheads in the right way can help to prevent the acne from becoming more severe. We look at ways to reduce and treat breakouts. Learn more about what causes blackheads and how to get rid of them here. Read now
There are two big guns used to take down acne, and they're both great at doing entirely different things. Salicylic acid is a beta hydroxy acid that comes from willow bark and works primarily as an exfoliator, breaking down fatty acids like sebum so your pores don’t clog. (Glycolic acid works similarly but is less effective.) These acids are effective on comedones — whiteheads, blackheads, and other non-red bumps.
This inflammatory cascade typically leads to the formation of inflammatory acne lesions, including papules, infected pustules, or nodules.[1] If the inflammatory reaction is severe, the follicle can break into the deeper layers of the dermis and subcutaneous tissue and cause the formation of deep nodules.[1][66][67] Involvement of AP-1 in the aforementioned inflammatory cascade leads to activation of matrix metalloproteinases, which contribute to local tissue destruction and scar formation.[45]
Benzoyl peroxide (BPO) is a first-line treatment for mild and moderate acne due to its effectiveness and mild side-effects (mainly skin irritation). In the skin follicle, benzoyl peroxide kills C. acnes by oxidizing its proteins through the formation of oxygen free radicals and benzoic acid. These free radicals are thought to interfere with the bacterium's metabolism and ability to make proteins.[79][80] Additionally, benzoyl peroxide is mildly effective at breaking down comedones and inhibiting inflammation.[78][80] Benzoyl peroxide may be paired with a topical antibiotic or retinoid such as benzoyl peroxide/clindamycin and benzoyl peroxide/adapalene, respectively.[36]
Topical antibiotics deemed safe during pregnancy include clindamycin, erythromycin, and metronidazole (all category B), due to negligible systemic absorption.[47][137] Nadifloxacin and dapsone (category C) are other topical antibiotics that may be used to treat acne in pregnant women, but have received less study.[47][137] No adverse fetal events have been reported from the topical use of dapsone.[137] If retinoids are used there is a high risk of abnormalities occurring in the developing fetus; women of childbearing age are therefore required to use effective birth control if retinoids are used to treat acne.[20] Oral antibiotics deemed safe for pregnancy (all category B) include azithromycin, cephalosporins, and penicillins.[137] Tetracyclines (category D) are contraindicated during pregnancy as they are known to deposit in developing fetal teeth, resulting in yellow discoloration and thinned tooth enamel.[1][137] Their use during pregnancy has been associated with development of acute fatty liver of pregnancy and is further avoided for this reason.[137]
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Cystic Acne: The most severe type of acne, cystic acne requires dermatological care and prescription acne medication to treat. Even the best acne products available over the counter are no match for this painful condition in which the area of the outbreak becomes inflamed, but not infected. Cystic acne can result in permanent scarring. However, it's important to know that all acne lesions can scar. Scarring is related to size, amount of inflammation, genetics and delay in therapy.
Coconut oil is all the rage, with uses ranging from hair conditioning to cooking. But some swear by it as a natural acne treatment. To use coconut oil as an acne treatment, you can include it as part of a healthy diet. The fatty acids like lauric acid and caprylic acid are metabolized into antibacterial agents in the body. Or, you can apply a very small amount and rub directly onto your skin after cleansing for an extra hydrating boost.

Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
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