June is Acne Awareness Month—and acne sufferers, take heart. You aren’t the only one experiencing breakouts these days. While teenage acne is, of course, common, it’s more shocking to hear that 54 percent of women age 25 and older experience facial acne. And according to the International Dermal Institute, clinical studies show that between 40 and 55 percent of the adult population are diagnosed with low-grade, persistent acne and/or oily skin at some point.
Thankfully, treatments are readily available. The hardest part may be identifying the types of products and medications that work best for your skin. To help, we’ve enlisted top dermatologists to put together a guide to common types of acne and the best options for treatment. Clear skin, here you come.
What commonly causes acne?
While it’s clear that more adults are breaking out these days, it’s not always clear what is causing the surge in adult acne. “Acne can be caused by a wide range of things,” says Dr. Paul Lorenc, board-certified aesthetic plastic surgeon in New York City. “Hormonal acne is more common in women and happens during puberty. There’s also acne caused by rosacea, stress, certain medications and bad hygiene.”
Scientifically speaking, there’s a lot going on underneath the skin that leads to breakouts, adds Dr. Heather Woolery-Lloyd, a board-certified dermatologist in Miami. “Basically, the ‘pores’ in our skin are lined by skin cells called keratinocytes. In normal skin, those keratinocytes naturally slough out of the pore easily. However, in acne, the keratocytes become very sticky and they build up in the lining of the pore to form a pimple,” she explains. “This looks like a whitehead or blackhead. Many things can cause the lining of the pore to get sticky.”
Most commonly, hormones are the culprit, Lloyd says. That’s why you’ll likely notice breakouts around your monthly cycle. “As the lining of the pore becomes more sticky, oil and bacteria build up inside of the pore. This is when you see papules and cysts under the skin.”
Common types of acne and how to identify it
If you’re hoping to treat breakouts, you’ll first need to identify the “type” of acne you’re suffering from.
“The most common way to categorize acne is inflammatory vs. non-inflammatory,” explains Lloyd. The difference will likely be obvious. “Non-inflammatory acne has no significant redness or inflammation—you’ll see whiteheads and blackheads. With inflammatory acne, papules, pustules, nodules and cysts are present. Nodules and cysts are seen in more severe acne.”
Lloyd says the easiest way to check for inflammatory acne is to look for the following:
Papules: Usually appear as pink or red bumps, varying in size. There’s no fluid inside of these and they are usually painless, unless you irritate them.
Pustules: This type of acne goes deeper into the skin than papules. They appear yellow or white and contain pus.
Nodules: Appear as large, painful bumps filled with blood or pus.
Cysts: Appear as red bumps that contain pus. This is the most severe form of acne and can be quite irritating.
Best treatments for different types of acne
Non-inflammatory acne treatments
Mild, non-inflammatory acne can usually be treated at home with products containing salicylic acid, says Lorenc.
Hormonal acne treatments
“If you have hormonal acne, you can speak to your doctor and see if they’ll put you on birth control or a pill like Spironolactone,” recommends Lorenc. “If your acne is severe, you might want to consult a doctor about Accutane or other acne medication.” (Note, these medications do come with side effects.)
Severe, inflammatory acne treatments
“For more severe acne with nodules and cysts, prescription treatments like antibiotics, topical retinoids and isotretinoin are used,” explains Lloyd.
Talking to your dermatologist about how to best treat your acne may be your best bet. “There is a wide range of prescription topical and oral medications, but they require a consultation with a medical professional,” explains Lorenc. In-office, he says aestheticians can perform a range of treatments that may help, including chemical peels, facials, laser and dermal filler treatments.
At home, you can treat scars and dark marks acne leaves behind, too. “If you’re left with dark marks from your acne, use products with botanical brightening ingredients and retinol,” recommends Lloyd. “I also suggest using a product with SPF because acne marks can get darker over time when exposed to sunlight.”
Don’t give up on your cleansers and other favorite products, either. “All things considered, it’s important to maintain a good skin care regimen throughout any course of treatment,” Lorenc says.