Acne Lesson 1: What Is Acne and Why Do I Have It?

If you’re struggling with breakouts, rest assured that you’re not alone. Acne is the most common skin condition in the United States. We recognize acne can be terribly frustrating, embarrassing, and even scarring. That’s why it’s our mission to educate and support you through your entire healthy skin journey from beginning to end. Whether you’re dealing with teen or adult acne, we’re here to answer your questions and provide expert skincare advice. So let’s get started!

Acne vulgaris: This is the medical term for “common acne.” It refers to blackheads, whiteheads, papules, or pustules.

Blackhead: This is a type of non-inflamed acne known for its dark-tipped plug at the surface of your skin. The black color occurs when oil and dead skin cells in a hair follicle are exposed to the air, leading to oxidization.

Closed comedo: This is another name for a whitehead or a non-inflamed lesion with a white center.

Comedo: When a dilated hair follicle is plugged with keratin and sebum, it’s called a comedo (or comedones if there are more than one).

Cyst: These are deep, under-the-surface acne lesions that are painful to the touch. Cystic acne consists of infected pores that can also lead to scars.

Nodule: Nodules are basically the same thing as cysts, except that they contain a larger amount of infected material that affects deeper layers of skin.

Open comedo: This is another name for a blackhead.

P. acnes: This is the abbreviated name of an acne-causing bacteria called propionibacterium acnes. When trapped in clogged pores along with excess sebum and dead skin cells, P. acnes has the perfect breeding ground for a breakout.

Papule: These red-colored lesions are typically small, firm bumps on the surface of your skin.

Pimple: A common term for small papules and pustules.

Pustule: This is an inflamed lesion that looks like a whitehead surrounded by red, irritated skin.

Rosacea: While rosacea is not technically acne, it is sometimes called “adult acne” because of its red pimple-like bumps.

Whitehead: This is a closed comedo, a lesion formed with oil and dead skin cells blocking the opening of a hair follicle.

The most common root of acne-prone skin is found in your gene pool. Acne is an inherited condition of the pores. Yes, you have your parents to thank for this. If either of your parents struggled with acne in their younger years, you likely will as well. Thankfully, we know more about how to prevent and treat it now, so there is hope for those wanting clear, healthy skin in spite of their genetics.

If you have breakout-prone skin, your skin cells tend to get easily stuck inside your pores. When combined with oil and a surplus of dead skin cells, a plug forms, and the surrounding skin becomes inflamed. This leads to the development of breakouts.

Another reason why people with acne-prone skin more easily develop pimples is due to a condition called retention hyperkeratosis. This means that the rate at which dead skin cells are being shed is four to five times faster than seen in healthy skin. A thick build-up of excess dead skin cells clumps together, forming a mass that impacts the hair follicle and leads to acne. This is where regular exfoliation becomes a very important step in the skin-clearing process.

While the way that your pores behave is inherited, what triggers acne for you might be different from what triggered it for your relatives. Here are some of the most common acne-provoking factors:

Hormonal imbalance - The monthly hormonal changes that affect women cause an increase in testosterone around the time of ovulation, which normally occurs in the middle of the menstrual cycle. An increase in testosterone does signal the sebaceous glands to produce more oil, which can lead to clogged pores. Pregnancy and menopause can also be triggers for hormonal acne.

Tip: Avoid dairy products (milk, cheese, ice cream, and yogurt) the week before your menstrual cycle begins, as well as the first week of menstruation. Dairy products interfere with healthy hormone levels and increase inflammation and inflamed pustules.

Gut dysbiosis - Scientific studies have proven a direct line of communication between our gut microbiome and our skin. When the bacteria in the gut become disrupted, this is known as dysbiosis. Not only does an imbalanced gut microbiome impact your immune system, but it also gives acne-causing bacteria access to your bloodstream. Food sensitivities and intolerances can lead to gut dysbiosis as well as antibiotics and other prescription drugs, including Accutane. Other causes of dysbiosis are pesticides, the over-consumption of sugar and alcoholic beverages, poor dental hygiene, and stress.

Stress - Cortisol is a steroid hormone that plays a very important role in helping your body respond to stress. When you’re feeling stressed, cortisol is released; this can be a trigger for excess oil production in your skin that, once again, could lead to clogged pores and pimples. While it’s likely impossible to remove all forms of stress from your life, there are effective ways to manage stress so that cortisol levels don't get too high. One great way to reduce stress is to get at least seven to eight hours of sleep each night. Read our blog on the correlation between stress and acne to dive deeper.

Diet  - What we eat directly affects the health of our skin. Sugar and simple carbs, iodine (salt), maca root powder, dairy and soy products, peanuts, and biotin are some of the likely culprits that trigger flare-ups. Sugar and simple carbs cause inflammation, which is the root of both disease and premature aging. In Lesson 4, we will discuss cleaning up your diet to clear up your skin.

Pore-clogging ingredients - Cosmetics, skincare products, lotions, and hair care products can cause acne flare-ups if they contain pore-clogging ingredients. Even products that are labeled non-comedogenic, non-acnegenic, oil-free, or won't clog pores may still be problematic. Learn to read ingredient lists closely and recognize possible acne triggers. A full list of pore-clogging ingredients is provided in Lesson 6.

Medications - Read over the labels of all over-the-counter and prescription medications you take to see if acne is a side effect. This is especially common with both oral antibiotics and oral contraceptives. To find out if your birth control pills could be causing acne, click HERE. If you suspect that one of your medications could be triggering your acne, talk to your doctor about alternative options. Learn more about drugs and chemicals that cause acne HERE.

Medical conditions - If your acne is particularly stubborn despite a consistent skincare routine, an undiagnosed medical condition could be the culprit. Talk to your doctor about your skin problems and treatment options for various acne-causing conditions. Polycystic Ovarian Syndrome (PCOS) is caused by a hormonal imbalance that causes oily skin and acne as well as irregular periods, excessive hair growth, weight gain, and thinning hair.

Family history can predispose you to acne flare-ups, but proper treatment will minimize or prevent flare-ups entirely despite genetic predispositions. At Art of Skin Care, we offer complete skincare routines for treating and preventing breakouts. It’s our goal to help you keep your skin looking as clear and healthy as possible. If you haven't already, you can get started on your clear skin journey by signing up for our Acne Coaching.

See Lesson 2 to learn more about the various types of acne. >>>