Acne Types, Causes, and Treatments: A Simple & Complete Guide

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Types of Acne

Acne isn’t just one kind of skin problem—it comes in different types, depending on how the pimples look and how serious they are. The main types are comedonal acne, inflammatory acne, cystic (or nodulocystic) acne, hormonal acne, and sometimes fungal acne. Each type acts differently, which is important because knowing the type helps pick the right treatment.

Here are the main types of acne and what makes them different:

Comedonal Acne (Clogged Pores)

This is the type without redness or swelling. It shows up when pores get blocked by too much oil, dead skin, and dirt. These blockages create small bumps called comedones. Open comedones are blackheads (the dark color is from air, not dirt), and closed comedones are whiteheads (they stay under the skin). You often see this type on the forehead, nose, and chin. It usually looks like small white or black dots but doesn’t hurt and is easier to treat than other types.

Inflammatory Acne (Red Pimples)

This kind happens when bacteria get into a clogged pore and your body reacts. It causes red bumps (papules) and pus-filled pimples (pustules). Papules are tender red bumps, and pustules are like papules but filled with pus. These often show up in oily areas like the face, chest, or back. They can hurt to touch, and the skin around them is red or dark. These may leave marks after healing, so avoid picking or squeezing.

Cystic Acne (Deep Painful Lumps)

This is a serious type of acne with big, deep, and painful lumps under the skin. Nodules are hard and don’t have pus. Cysts are softer, filled with pus, and can feel like there’s fluid inside. These can show up on the face, back, chest, shoulders, or even buttocks. They often leave scars, so it’s best to see a doctor early if you think you have this kind.

Hormonal Acne

This acne is caused by hormone changes and often affects adults, especially women between 20 and 50 years old. It can appear as blackheads, red pimples, or deep cysts. It often shows up around the jawline, chin, and lower cheeks. Hormonal shifts during periods, pregnancy, menopause, or birth control changes can trigger it. In women, too much of a hormone called androgen can lead to this type. Men can get it too, like during puberty or hormone therapy.

Fungal Acne (Yeast-Related Breakouts)

Fungal acne isn’t real acne—it’s caused by yeast in the hair follicles. It can look like regular pimples but often itches. It usually shows up on the forehead, chest, or back, especially in hot, humid weather or after sweating a lot. Regular acne treatments don’t help and might make it worse. It needs antifungal treatments instead. If your pimples are itchy and don’t go away with normal medicine, it could be this kind.

Other kinds include acne mechanica (from rubbing or pressure like from sports gear) and irritated acne (from harsh products). Acne rosacea is another condition that looks similar but is different and affects adults with red skin.

Causes of Acne

Acne happens because of many different reasons working together. Knowing what causes acne can help you manage and avoid breakouts. The main causes are:

Hormones (Androgens)

Hormone changes, especially during puberty, are one of the biggest causes of acne. Androgens are hormones that increase during puberty in both boys and girls. They make the oil glands in your skin bigger and more active. More oil means a higher chance of clogged pores. In women, hormone changes during periods, pregnancy, menopause, or conditions like PCOS can also cause acne. Even some medications, like testosterone or steroids, can lead to breakouts.

Clogged Pores (Oil and Dead Skin Cells)

Not everyone with oily skin gets acne. Acne-prone skin often doesn’t shed dead cells properly. These dead skin cells mix with oil and block the pores. This creates a small clogged bump that can turn into a blackhead, whitehead, or pimple. People with acne often have skin that clogs more easily because of their genes.

Bacteria (C. acnes)

A type of bacteria called Cutibacterium acnes lives on everyone’s skin. It grows in blocked, oily pores. When this happens, your immune system reacts and causes redness, swelling, and pus. This is why pimples look inflamed. Antibiotics can help lower the bacteria and reduce swelling, but bacteria alone don’t cause acne—they just make it worse.

Genetics

If your parents had acne, you’re more likely to get it too. Your genes affect how sensitive your skin is to hormones, how much oil you make, and how likely your pores are to clog. While you can’t change your genes, knowing this can help you start treatment early if acne runs in your family.

Diet

Food might affect acne for some people. Eating a lot of sugary foods or refined carbs (like white bread, soda, or candy) can spike your blood sugar. This causes hormone changes that increase oil production and can lead to acne. Some studies also link milk (especially skim milk) to acne, possibly because of the hormones in it. Chocolate with a lot of sugar may also play a role. Not everyone reacts to food the same way, but if you notice breakouts after certain foods, try cutting back. Eating more vegetables, whole grains, and proteins may help your skin.

Stress

Stress doesn’t directly cause acne, but it can make it worse. When you’re stressed, your body makes more hormones like cortisol, which can boost oil production and slow healing. People often see more breakouts during school exams, work stress, or emotional times. Plus, acne itself can cause stress, creating a cycle. Managing stress through sleep, exercise, or calming activities like yoga can help.

Environmental and Lifestyle Triggers

  • Greasy or heavy products: Thick makeup or oily creams can block pores. Use products labeled “non-comedogenic” (won’t clog pores).
  • Friction and pressure: Tight hats, helmets, or sports gear can irritate the skin and cause breakouts (called acne mechanica).
  • Sweating: Sweat mixed with oil and dirt can block pores, especially if it sits on the skin. Showering after workouts helps.
  • Pollution: Air pollution can settle on your skin and cause clogged pores or irritation.
  • Smoking: Smoking may worsen certain types of acne and makes skin heal slower.
  • Medications: Some medicines, like steroids or lithium, can cause acne-like breakouts.
  • Poor sleep: Not getting enough rest can raise stress and worsen acne. Try to get regular, good-quality sleep.

In short, acne happens when pores get clogged and inflamed, often due to hormone changes, bacteria, or genetics. Your environment, stress, and even your diet can also affect it. Finding out what triggers your breakouts helps you pick the right treatment and prevention steps.

Acne Treatment: Simple Steps for Each Type

Acne treatment works best when it matches the type of acne you have. A treatment that helps blackheads may not work for deep cysts. Below are ways to treat different types of acne, from drugstore options to prescriptions and lifestyle tips. Remember: most treatments take a few weeks to show results, and sticking with them is important.

Treating Comedonal Acne (Blackheads & Whiteheads)

  • Retinoids: These are Vitamin A creams or gels. They help your skin shed dead cells and unclog pores. A popular one is adapalene (Differin), now available without a prescription. Stronger ones like tretinoin are available by prescription. Use at night, starting every other day to avoid dryness.
  • Salicylic Acid: This helps remove dead skin and oil from pores. It’s in many acne face washes and spot treatments. Look for 0.5% to 2% in cleansers or pads.
  • Alpha Hydroxy Acids (AHAs): These exfoliate the skin’s surface. Glycolic and lactic acid help smooth the skin and fade marks. They come in toners, serums, or peel pads.
  • Benzoyl Peroxide (BP): Though mostly for red pimples, BP can help reduce blocked pores a little. Try a low-strength (2.5–5%) wash or gel.
  • Azelaic Acid: This gentle ingredient helps unclog pores and fade dark spots. It’s great for sensitive skin and safe for use during pregnancy.
  • Professional Extractions: A dermatologist or esthetician can remove blackheads safely. Chemical peels with salicylic or glycolic acid can also speed results.
  • Healthy Habits: Wash your face twice a day with a gentle cleanser. Avoid heavy makeup or hair products on your forehead. Don’t scrub hard—gentle care works best. Use an oil-free moisturizer to prevent dryness.

Comedonal acne usually gets better in 6–8 weeks with consistent care. The good news: it rarely causes scarring, so treat early and avoid picking.

Treating Cystic Acne (Deep, Painful Pimples)

  • Oral Isotretinoin (Accutane): This strong medicine is often the best choice for severe cystic acne. It shrinks oil glands, clears pores, and helps skin heal. It’s usually taken for 5–6 months. Many people see long-term or even permanent results. But it has side effects, like dry skin and lips, and women must avoid pregnancy while taking it. Regular doctor visits and blood tests are required during treatment.
  • Oral Antibiotics: If you’re not ready for isotretinoin, doctors may start with antibiotics like doxycycline or minocycline. These help reduce inflammation and bacteria. They work best when used with other treatments, like a topical retinoid and benzoyl peroxide. However, antibiotics usually can’t fully clear deep cysts and may be a temporary solution.
  • Hormonal Treatments (for women):
    • Birth Control Pills: Some can prevent new cysts by balancing hormones.
    • Spironolactone: This pill blocks hormone effects that lead to oily skin. Many women take it long-term to keep acne away.
  • Topical Treatments: Creams alone usually can’t reach deep cysts, but they help prevent surface breakouts. Retinoids and benzoyl peroxide washes can be part of your routine, especially for body acne.
  • Cortisone Injections: For large, painful cysts, a dermatologist can inject a tiny amount of steroid into the bump. This quickly reduces swelling and pain—sometimes within a day. It’s great for an emergency, like before a big event.
  • Other Procedures: Doctors can drain large cysts if needed. There are also treatments like light therapy or special peels that may help if nothing else works. These are usually done in a dermatologist’s office.
  • Skincare Tips: Don’t scrub or pick at your skin—it won’t help and may cause scars. Use gentle products and keep your skin clean. Choose oil-free, non-comedogenic moisturizers to avoid clogging pores.

Cystic acne is serious and often leaves scars if not treated early. Seeing a dermatologist is very important. Many people get great results with the right mix of treatments, especially isotretinoin or hormonal therapy.

Treating Hormonal Acne (Especially in Adult Women)

Hormonal acne is often deep, painful, and shows up around the jawline, chin, or neck. It tends to come and go with hormone changes—like your period, pregnancy, or menopause. While it can happen in men too, it’s more common and stubborn in adult women.

  • Hormone-Focused Medications (for women):
    • Birth Control Pills: Some birth control pills (like Yaz®, Ortho Tri-Cyclen®, and Estrostep®) help clear skin by balancing hormones. These are prescription medications and should be discussed with a doctor to find the right one for you.
    • Spironolactone: This pill reduces the effect of male hormones on the skin. It’s not a birth control pill, but it helps with oily skin and recurring jawline breakouts. Many women take it daily and see clear improvement.
    • Clascoterone Cream (Winlevi®): This newer treatment works like spironolactone but is a cream you apply to your skin. It helps both women and men with hormonal breakouts without affecting the whole body.
  • Regular Acne Products Still Help:
    • Even if your acne is hormone-driven, it still helps to use retinoids (like adapalene or tretinoin) and benzoyl peroxide. These fight clogged pores and bacteria.
    • A typical routine might include a gentle face wash, benzoyl peroxide in the morning, and a retinoid at night—plus spironolactone pills if needed.
  • Lifestyle & Diet Tips:
    • Some women find dairy or high-sugar foods make their acne worse. If you notice certain foods trigger breakouts, try cutting back on them.
    • Managing stress is important too—stress can raise hormone levels and make acne worse. Try to get enough sleep, exercise regularly, and consider stress-reducing habits like yoga or meditation.
  • Special Skincare for Adults:
    • Adult skin often needs both acne-fighting and anti-aging care. Look for gentle, non-drying products.
    • Niacinamide serums are a great choice—they calm redness, support the skin barrier, and can also improve fine lines.
    • Never pick at cysts—they’re painful and tempting, but squeezing them can cause deep scars.
  • Stick With It:
    • Hormonal acne often needs long-term care. Many women stay on birth control or spironolactone for years to stay clear. That’s okay—these are safe when used under medical advice.
    • Acne may get better with age, but there’s no set timeline. Until then, good treatment can keep your skin clear and your confidence strong.

If you notice your breakouts are linked to your menstrual cycle or other hormone changes, talk to a doctor. Even if hormone tests are normal, these treatments can still help.

(Note for men: Teen boys usually get hormonal acne too, but it responds to regular acne treatments. Adult men with acne might need medical advice if they’re on testosterone therapy or supplements that affect hormones.)

Treating Fungal Acne (Malassezia Folliculitis)

Fungal acne looks a lot like regular acne, but it’s actually caused by a type of yeast, not bacteria. That’s why the treatments are completely different. It usually shows up as small, red, itchy bumps—often on the forehead, chest, back, or shoulders. It may flare in hot, humid weather or after sweating.

  • Antifungal Treatments:
    • Shampoos as Body Wash: Over-the-counter dandruff shampoos like Nizoral® (ketoconazole) or Selsun Blue® (selenium sulfide) can be used on the skin. Use them like a body wash 2–3 times a week—lather it on, let it sit for a few minutes, then rinse off.
    • Antifungal Creams: You can also use creams like clotrimazole or ciclopirox if the bumps are in smaller areas. These help kill the yeast and calm the skin.
    • Prescription Pills: For more stubborn or widespread fungal acne, a doctor may prescribe antifungal pills like fluconazole or itraconazole for a short time. These are very effective and can clear the skin quickly.
  • Skincare Tips:
    • Avoid oily products: Yeast feeds on oil, so skip thick or greasy skincare products. Choose lightweight, oil-free (non-comedogenic) moisturizers and sunscreens.
    • Shower after sweating: Fungal acne often appears after working out or sweating in tight clothes. Try to shower and change into dry clothes soon after exercise.
    • Wear breathable clothing: Tight or sweaty clothing (like workout gear or backpacks) can trap heat and sweat, which makes fungal acne worse. Stick with loose, breathable fabrics when possible.
  • Important Warning:
    • Don’t use antibiotics: If you treat fungal acne like regular acne—with antibiotics—it might actually get worse. If your “acne” is very itchy or not improving with standard treatments, it might be fungal, and a doctor can help confirm it.

Once treated correctly, fungal acne often clears up fast. If you’re prone to it, using antifungal shampoo once a week can help prevent it from coming back.

Quick Fixes for Painful Pimples and Sudden Breakouts

Sometimes, even with a good skincare routine, you get a big, painful pimple that shows up out of nowhere—maybe right before an event or photo day. While most acne treatments take time, here are some ways to calm things down fast:

  • Spot Treatments with Benzoyl Peroxide or Salicylic Acid:
    • Dab a small amount of benzoyl peroxide (like 5–10%) directly on the pimple once or twice a day. This helps kill bacteria and reduce swelling.
    • Salicylic acid (2%) can help unclog the pore. Try products like Murad Rapid Relief Acne Spot Treatment.
    • Don’t use too much—more won’t work faster and might irritate your skin.
  • Ice Pack or Cold Compress:
    • If a pimple is red, swollen, or painful, wrap an ice cube in a clean cloth and press it gently on the spot for 5–10 minutes. This helps reduce pain and swelling. Repeat a few times if needed.
  • Warm Compress:
    • If a pimple feels deep under the skin and hasn’t come to a head, a warm (not hot) cloth can help bring it up. Press gently for 10–15 minutes a few times a day. This can help it drain naturally—but don’t squeeze!
  • Pimple Patches (Hydrocolloid Stickers):
    • These small, clear stickers pull fluid out of the pimple and protect it from dirt and picking. They work best on whiteheads or popped pimples. Try brands like COSRX, Starface, or Nexcare.
    • Some patches also contain acne-fighting ingredients. They can flatten bumps overnight and are gentle on the skin.
  • Cortisone Shot at the Dermatologist:
    • For large cysts, a dermatologist can inject a small amount of steroid into the bump. It shrinks quickly—often within 1–2 days. This is a good option for emergencies, like before a wedding or big event.
  • Over-the-Counter Hydrocortisone Cream:
    • A tiny dab of 1% hydrocortisone cream (used for itching) can calm swelling for 1–2 nights. Don’t use it often, just in emergencies, and avoid using it on your whole face.
  • Pain Relievers:
    • Taking ibuprofen (Advil) or naproxen (Aleve) can reduce pain and inflammation for very sore pimples.
  • Keep It Clean:
    • Don’t overload the area with makeup. If you need to cover the spot, use a pimple patch under makeup or a concealer with acne medicine in it.
    • Always clean your skin gently and avoid touching or picking at pimples.
  • Don’t Pop or Squeeze:
    • It’s tempting, but popping a pimple can push the infection deeper and leave a scar. If it doesn’t pop with very light pressure, leave it alone. Use treatment instead and let it heal naturally.

These quick fixes won’t “cure” a pimple instantly, but they can help reduce its size, pain, and redness much faster than doing nothing.

Healing Your Skin After Acne – Fading Scars and Marks

Once your acne starts clearing up, the next step is helping your skin recover. Some pimples leave behind red or dark spots, while others cause deeper scars like dents or raised bumps. The good news is, with the right care, your skin can heal and look much smoother over time.

Top Ingredients That Help Fade Scars and Improve Skin Texture

  • Retinoids (Vitamin A Creams):
    • Retinoids like tretinoin or adapalene help your skin make more collagen and renew itself.
    • They fade dark spots and improve rough or uneven areas.
    • You can use prescription creams like Retin-A or over-the-counter options like Differin® (adapalene).
    • Use a pea-sized amount at night and apply moisturizer after if your skin feels dry. It takes months, but results build over time.
  • Vitamin C:
    • A powerful antioxidant that brightens dark marks and helps your skin build collagen.
    • Apply a vitamin C serum (10–20%) in the morning under sunscreen.
    • Look for options like The Ordinary or Timeless Vitamin C serums.
  • Niacinamide (Vitamin B3):
    • A gentle ingredient that helps fade dark spots, reduce redness, and strengthen the skin barrier.
    • Found in many serums and moisturizers, like The Ordinary Niacinamide 10% + Zinc.
    • Use morning or night—it’s safe and easy to add to your routine.
  • Azelaic Acid:
    • Helps both with leftover acne and pigmentation. It brightens skin and gently exfoliates.
    • Good for sensitive skin or during pregnancy.
    • Products like Finacea® or The Ordinary Azelaic Acid 10% are common choices.
  • AHAs (Glycolic or Lactic Acid):
    • These exfoliate the skin, improve texture, and fade dark spots.
    • Use glycolic or lactic acid toners or serums a few nights a week.
    • Don’t mix them with retinoids on the same night to avoid irritation.
  • Hydroquinone (for Dark Spots):
    • A strong pigment-lightener. It helps stubborn dark marks fade faster.
    • OTC creams with 2% are available, or stronger versions by prescription.
    • Use sunscreen daily when using this to prevent sun damage.
  • Peptides and Growth Factors:
    • Help the skin repair and produce more collagen.
    • Found in serums like NIOD Copper Peptides or The Ordinary Buffet + Copper Peptides.
    • Not as strong as retinoids, but helpful when used regularly.
  • Soothing Ingredients:
    • Things like allantoin, panthenol (Vitamin B5), and centella (cica) calm skin and speed healing.
    • Look for cica creams like La Roche-Posay Cicaplast Baume or K-beauty cica products.
  • Silicone Gels or Sheets (for Raised Scars):
    • If you have thick, raised scars (often on the chest or back), silicone sheets or gel (like ScarAway®) can flatten them over time.

Sample Simple Routine:

  • Morning: Cleanser → Vitamin C serum → Niacinamide → Moisturizer → Sunscreen
  • Evening: Cleanser → Retinoid or AHA (alternate nights) → Moisturizer

Be gentle—only add one new product at a time and watch how your skin reacts. Healing scars takes time, but with consistency, you’ll see your skin become smoother and clearer.

Professional Treatments and At-Home Devices for Acne Scars

If you have deeper scars from acne—like dents, ice pick marks, or uneven texture—some treatments can help smooth the skin. Many of these work by helping your body make more collagen and repair damaged areas.

Treatments at the Dermatologist’s Office

  • Microneedling:
    • This involves tiny needles that poke the skin gently to trigger healing and collagen growth.
    • Over time, it fills in scars and improves texture.
    • Usually done in a series of 3–6 treatments (once a month).
    • Some versions use radiofrequency (RF) for deeper results (called RF microneedling).
  • Laser Treatments:
    • Fractional Lasers (like Fraxel or CO2): Help with deep scars by resurfacing the skin and boosting collagen.
    • Vascular Lasers (like Vbeam): Help fade redness left behind by acne.
    • IPL (Intense Pulsed Light): Targets both red and brown spots and helps even out skin tone.
  • Subcision:
    • A needle is used to break up scar tissue under the skin, helping dents rise and smooth out.
    • Often combined with fillers or microneedling.
  • Chemical Peels:
    • Strong peels done by a doctor can improve surface scars and discoloration.
    • Often done in a series of treatments.
  • Punch Excision or Elevation:
    • For very deep ice pick scars, a small tool removes or lifts the scar so the skin can heal more evenly.
  • Dermabrasion:
    • An older method that sands the skin—less common now, as lasers are more precise.

At-Home Devices

  • Microneedling Tools (Dermarollers):
    • These can be used at home but are less powerful than professional versions.
    • If you try this, use short needles (0.3–0.5 mm) and be careful to clean the tool properly.
    • You can apply serums like hyaluronic acid afterward to boost effects.
  • LED Light Therapy Masks:
    • Red light helps calm the skin and may support collagen growth.
    • Blue light kills acne-causing bacteria.
    • Use a few times a week with eye protection. Results are subtle but helpful.
  • High-Frequency Wands:
    • These use gentle electrical currents to calm acne and speed healing.
    • Not strong enough to treat scars deeply, but can help prevent new breakouts.

What to Expect

  • For deep scars, the best results often come from combining treatments (like subcision + microneedling or laser + filler).
  • Improvement may take several months but can be 50–75% better with the right plan.
  • Always see a qualified dermatologist for advanced treatments.

Supplements and Diet to Help Your Skin Heal

Your skin repairs itself from the inside out. Eating the right foods and taking certain supplements can help fade acne scars and improve your skin’s health over time.

Helpful Supplements and Nutrients

  • Zinc:
    • Zinc helps reduce inflammation and supports wound healing.
    • Many people with acne have low zinc levels.
    • A daily dose of 30–50 mg of zinc (like zinc gluconate or picolinate) can help, but don’t take too much long-term without also getting copper.
    • Foods with zinc: oysters, red meat, pumpkin seeds, lentils.
  • Collagen Peptides:
    • Collagen is a protein that gives skin its strength and bounce.
    • Taking collagen powder (10g daily) might help your skin build more collagen and heal scars.
    • Mix it into coffee, tea, or smoothies. Brands like Vital Proteins® are popular.
  • Vitamin C:
    • Vitamin C helps the body produce collagen and heal skin.
    • You can take 500 mg daily or eat lots of fruits like oranges, strawberries, and bell peppers.
  • Vitamin E:
    • Vitamin E is an antioxidant that supports skin repair, but don’t take high doses unless your doctor says so.
    • It’s safer to get it from a multivitamin or through food (nuts, seeds, spinach).
  • B Vitamins (Especially B3/Niacinamide):
    • B vitamins help with skin health and repair. Niacinamide (B3) can reduce inflammation and support healing.
    • Take a daily multivitamin to cover your bases.
  • Omega-3 Fatty Acids:
    • Found in fish oil or flaxseed, these help reduce inflammation and support healthy skin.
    • Try to eat fatty fish (like salmon) or take an omega-3 supplement.
  • Protein:
    • Your skin needs protein to rebuild itself.
    • Make sure to get enough from lean meats, fish, eggs, beans, or protein shakes.
  • Hydration:
    • Drinking enough water helps keep your skin soft and supports healing. Aim for at least 6–8 glasses a day.
  • Avoid Smoking and Too Much Alcohol:
    • Smoking harms your skin and slows healing. If you smoke, quitting can make a big difference.
    • Heavy drinking can dry out the skin and deplete vitamins, so try to drink less if possible.

Diet Tips for Healing Skin

  • Eat lots of fruits and vegetables—they’re full of vitamins and antioxidants.
  • Choose whole grains and lean proteins to give your body the fuel it needs to repair.
  • Avoid too much sugar or processed foods, which can cause inflammation and make scars worse.
  • Protect your skin from the sun every day with SPF 30 or higher. Sun damage can make scars darker and slow healing.