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Acne Types, Causes, and Treatments for Adults and Teens

By Dr. Randy Rudderman
In Medical Spa Articles

Whether you’re a teen suffering from acne or an adult trying your hide your breakout, acne can cause stress, embarrassment, or pain. While many people think their acne is something they must live with, there are advancements in acne treatment that can help treat your acne, heal your skin, and help you regain your confidence.

What is Acne?

Acne is a common skin condition that occurs when hair follicles (tiny holes or pores in your skin) become clogged, infected with bacteria, or inflamed. Clogged pores can happen when there is too much oil, bacteria, or skin cell production, or because of hormonal changes.

These clogged pores cause raised lesions that are often referred to as pimples or zits. These lesions contain a combination of dead skin cells, oil, and sebum (an oily, waxy substance produced by your body’s sebaceous glands). Acne can show up anywhere, including your face, neck, chest, shoulders, and back.

According to the American Academy of Dermatology Association, acne is the most common skin condition in the United States, affecting 40–50 million people at any one time.

Are There Different Types of Acne?

There are several types of acne, both inflammatory and non-inflammatory:

  • Whiteheads: Also known as closed comedones, whiteheads occur when pores are clogged all the way through and appear as a little white bump on top of the skin. Whiteheads can’t be fixed by squeezing or popping them. This can cause scarring, so it is wise to skip the popping.
  • Blackheads: The opposite of whiteheads, blackheads are known as open comedones because the head of the pore remains open while the rest of the pore is clogged. They are black because the pores are open, exposing the bacteria to oxygen. This reaction, known as oxidation, darkens the material inside. Blackheads can be removed by squeezing, although that approach is not recommended because it can cause scarring.
  • Papules: These small, red, tender bumps form when oil or excess skin cells block a pore and mix with bacteria on your skin called Cutibacterium acnes (or C. acnes). The bacteria then creates an inflamed lesion. Papules do not contain pus.
  • Pustules: Commonly called pimples, pustules are small, bulging bumps with a white center and red, inflamed skin surrounding them. Pimples contain yellowish fluid known as pus and are usually found in clusters on your skin. Pustules form when a blocked pore gets infected and/or by hormonal changes in the body. Despite what you see on TikTok, popping pustules may cause the bacteria to spread and should be avoided unless performed by a medical professional.
  • Nodules: Nodular acne consists of firm bumps that are deep under the skin’s surface and result from a painful infection within the pores caused by C. acnes bacteria. Nodular acene requires the help of a medical professional.
  • Cysts: The most severe form of acne, cystic acne is the result of an infection deep within the skin. Acne cysts are inflamed, large, pus-filled, and painful. This is the most difficult kind of acne to treat and requires medical attention.

Who Gets Acne?

People of all races and ages get acne. Acne commonly starts during puberty between the ages of 10 and 13 and tends to be worse in people with oily skin.

Although acne remains largely a scourge of adolescence, about 20% of all cases occur in adults. Some adults may experience acne for the first time in their life in their 30s, 40s, or 50s.

Among adults, women tend to get acne more often than men; it affects 12–14% of women between 25 and 50 years of age. Post-pubertal acne is described as an inflammatory mild-moderate form, whose cause is still unknown and whose incidence is increasing

What Causes Acne?

Acne develops as the result of:

  • Excess oil (sebum) production
  • Hair follicles clogged by oil and dead skin cells
  • Bacteria
  • Inflammation

But what causes this oil, bacteria, and inflammation in the first place? Scientists are still not sure why some skin is more prone to this inflammatory reaction.

Possible causes include:

  • Hormones: It’s likely that hormones play a role in acne, both in teens and in adults. In adult women, acne may be due to or triggered by fluctuating hormone levels, such as during periods, pregnancy, after discontinuing or starting birth control pills, perimenopause, and menopause.
  • Family history: Some research suggests that genetics may be a cause. If you have a close blood relative, such as a parent, brother, or sister with acne, you may be more likely to get adult acne.

If you already have adult acne, there are several factors that can trigger an outburst:

  • Hair and skin care products: Read the labels on your skin care and hair care products carefully, including your moisturizer, cleanser, sunscreen, and all other products. They should state at least one of the following:
    • Non-comedogenic
    • Non-acnegenic
    • Oil-free
    • Won’t clog pores
  • Medication side effect: Acne is a side effect of some medicines. Talk to your doctor to see if acne is a possible side effect of any of the medications you are taking.
  • Stress: In response to stress, our bodies produce an excess of androgens (a type of hormone) that stimulate the oil glands and hair follicles in the skin. If you are suffering from ongoing acne, constant stress may trigger an outbreak.
  • Smoking: One study found that smoking may play a role for some women with acne. In this study, the women had noticeable whiteheads and blackheads that often covered a large area of their face. Some also had a few pimples.

Watch out for acne myths!

Despite what you may have been told, the following factors are unlikely to cause, trigger, or worsen acne:

  • Chocolate
  • Greasy food
  • Dirty skin
  • Makeup (especially if it’s oil free)

Can I Treat Acne Myself?

Some types of acne are easier to treat than others, and you should consult with a licensed medical aesthetician if you have persistent or painful blemishes. There are also many treatments available for acne scars. In addition to any treatment you receive, healthy skin care habits will help you get the best results.

Here are 10 tips for your daily skin care routine:

  1. Wash your skin twice a day and after sweating.
  2. Use your fingertips to apply a gentle, non-abrasive cleanser. Don’t use a washcloth for this task.
  3. Use gentle, alcohol-free products and oil-free products.
  4. Avoid the temptation to scrub your skin.
  5. Rinse with lukewarm water (not hot).
  6. Shampoo daily if you have oily hair.
  7. Let your skin heal naturally. Don’t pick, pop, or squeeze as this will make the acne harder to clear and will increase scarring.
  8. Avoid touching your face throughout the day. The oils from your hands can cause flare-ups.
  9. Stay out of the sun and tanning beds. Ultraviolet (UV) light damages your skin, and some acne medications make your skin very sensitive to UV light.
  10. Avoid nicotine.

What are the Best Treatments Options?

Today, virtually every case of acne can be successfully treated. While acne medication may be necessary, advanced spa treatments can be a game-changing alternative or supplement to medication.

Here are some of the best treatments currently available for active acne as well as acne scars.

BroadBand Light® (BBL)

BBL treatments deliver light energy deep into your skin to boost your body’s natural ability to heal and regenerate skin cells. The heat from the laser kills acne-causing bacteria, improving current acne and preventing future problems from forming. Any area of your body can be treated with BBL. This is a non-invasive and gentle procedure with virtually no downtime.

Chemical Peels

Chemical peels work by rapidly exfoliating the skin’s surface to enhance cell turnover and improve the skin’s appearance. The treatment reduces pore blockages and pimples by keeping dead skin cells and excess oil from clogging the hair follicle.

Chemical peels come in many different strengths and acidic formulations. Some common acids in chemical peels are alpha hydroxy acids (AHAs), beta-hydroxy acids (BHAs), and trichloroacetic acid (TCA). BHAs are excellent for treating blemishes, large pores, and uneven texture. TCA is often used to treat more advanced visible signs of discoloration caused by acne.

It is important that chemical peels are performed by a licensed aesthetician with access to high-performing peel solutions. Your skin care professional may also recommend take-home skin care products for optimal, extend results

Facials

Facials are a safe and effective way to clean and exfoliate your skin. A licensed aesthetician will properly clean and exfoliate your skin to eliminate oil and other debris that is clogging your pores. They will also perform extractions to get rid of blackheads and whiteheads.

We also offer a HydraFacial treatment. This patented technology combines deep cleansing and exfoliation treatment with hydrating and moisturizing serums. It’s designed for all skin types, so even the most sensitive skin types can easily tolerate the procedure.

Medical-grade Skin Care Products

There are many topical skin care products that can help address your acne. They range from sulfur, salicylic acid, and benzoyl peroxide to topical retinoids (derived from vitamin A) that help unclog pores, such as retinol, adapalene (Differin), and tretinoin (Retin-A). The American Academy of Dermatology considers retinoids to be “the core of topical therapy for acne.”

Related Reading: What Is The Difference Between Retinol & Retin-A?

Medications

If you have deep, painful acne, your doctor may prescribe:

  • Medication that you apply to your skin
  • An antibiotic to kill C. acne bacteria
  • Hormonal therapy (for women)
  • Isotretinoin, a prescription medicine for severe acne

If your acne is severe, please see a physician to learn about the medical options available to you.

Visit Our Medical Spas

Our beautiful Medical Spas are located in Midtown Atlanta and Alpharetta. We provide concierge-style services in beautifully appointed spa rooms and our results will speak for themselves. The spa, licensed medical aestheticians, and expert injectors are supervised by two on-site board-certified plastic surgeons.

Our licensed aestheticians can treat a wide range of skin care concerns including, but not limited to, acne, blackheads, skin laxity, sun damage, rosacea, fine lines, wrinkles, scarring, and hyperpigmentation.

If you have questions or concerns about caring for your skin, you should make an appointment to see a licensed medical aesthetician at our Medical Spa.


References

https://www.aad.org/acne-causes
https://pubmed.ncbi.nlm.nih.gov/17007539/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835905/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/


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Dr. Randy Rudderman

Since 1989, Dr. Randy Rudderman has been in private Plastic Surgery practice in Atlanta, focusing on the full range of aesthetic procedures – eyelid surgery, breast augmentation and breast lifts, liposuction, abdominoplasty, facelifts and facial reconstruction, among others. He also has a distinguished career in the reconstructive surgery arena, including facial and breast reconstruction. He has worked as a key member of teams from several prestigious organizations – including the AO-ASIF (Association for the Study of Internal Fixation) Foundation in Davos, Switzerland, and has conducted research at Case Western Reserve University Medical Centers, CWRU Engineering School, and NASA – producing breakthroughs in joining the science of facial biomechanics and reconstructive Plastic Surgery with rapidly evolving technological innovations.

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