Acne is unpleasant, unpredictable, and can feel unavoidable. In fact, at some point on our journey from adolescence to adulthood, the majority of people will experience some form of acne. For most, signs and outbreaks of acne occur during adolescence and clear up over time. Hormones are one of the primary driving factors behind the unpleasant lesions. Thus, as you age and they stabilize, so too does the oil and chemical balance in your skin. For many people, prominent signs of acne persist into adulthood and can severely impact social interactions and diminish overall quality of life.

There is no single place on our dermis (skin) where all people will experience acne. Each individual and their acne’s causes and effects are unique. As such, instances of acne have been reported across all areas of the body. It is most common, however, for acne sufferers to experience lesions on their faces, backs, chests, and shoulders. Given that there are two distinct types of acne lesions, we will take a look at the unique causes and treatment options available for both types of unpleasant blemishes.

The first type are comedones. Comedones are commonly referred to as both blackheads and whiteheads. These types of pimples are caused when the skin’s sebaceous glands, which secrete an oil that protects your face called sebum, become blocked. This means that somewhere, either at the skin’s surface or slightly beneath it, there is a blockage that prevents necessary oil secretions from exiting your skin. If the pore itself is closed, a whitehead is formed. This looks like reddening of the surrounding pores and a top that is distinctly white, colored by the pus beneath it. A blackhead, on the other hand, occurs when grime, oils, and dead skin cover the pore but do not enclose it. Thus, as the oils push themselves toward the surface, the black grime clogging your pore also goes to the surface.

In both cases, these lesions should clear up over time and not leave any scarring. It is crucial, however, that during active acne outbreaks, you use additional skin cleansers and sun protection to prevent scars. It is not necessary to squeeze these yourself since you will be leaving an open and exposed pore that is more likely to become infected. Instead, the proper course of treatment is generally to start with a benzoyl peroxide-based cream or cleanser. This is a common active ingredient in acne products, and it will clear most mild cases. In more serious cases, extraction of the pimple can be conducted by a dermatologist and is a simple procedure.

Some acne outbreaks are significantly more serious and lead to inflamed, reddened pustules, called papules. A papule forms when a completely blocked pore fills with subdermis pus, which can often cause an entire area to become red, inflamed, and painful. This type of deep acne can cause permanent scarring and should be dealt with by a dermatological professional.
It is very important in cases with papules to also refrain from touching, squeezing, or further irritating the affected area. Instead, you should speak with your dermatologist about surgical extraction options as well as an oral medication with a high rate of success for serious acne sufferers. There are a number of products available, and your dermatologist will make the best recommendation based on your particular skin needs and acne issues. Given that some of these oral medications can have serious side effects, it is important to fully discuss and adhere to your treatment plan.

Regardless of whether you currently suffer from acne or simply have bouts of it from time to time, following a smart skincare routine will reduce your likelihood of outbreak. Some general rules of thumb are to fully remove makeup before bed, cleanse and moisturize skin at the end of the day, and utilize topical benzoyl peroxide at the first signs of an acne outbreak to prevent it from continuing. If you are one of the millions of individuals that live with acne scars, there are dermatologic services that can help reduce their appearance and help them fade over time.