Ultimate Guide to Adult Acne: Types, Causes, and Treatments

The Ultimate Guide to Adult Acne: Types, Causes, and Treatments

Acne is a condition that affects nearly 50 million people in the United States but varies from person to person. Find out what causes your breakouts, how to fight acne scars and types of treatments to maintain your skin clean and beautiful.

Acne is a condition that affects nearly 50 million people in the United States but varies from person to person. Clearing up your acne may be a lot easier when you can pinpoint the type of acne plaguing your skin.

It happens to almost all of us. Concealer and foundation become our best friends. And no matter how many cleansers we try, clear skin seems impossible. We’re talking acne.

Sure, when you’re in your teens or even early twenties, acne is just something you expect and learn to live with. The only thing that gets you through it is reminding yourself, “it will go away someday.”

But what about the people who never grow out of it or experience acne later in life? Adult acne, especially in adult women, is a chronic condition that affects many people, yet doesn’t seem to have an obvious solution.

There are many factors that can cause acne—by getting to the root of how pimples appear on the skin, we’re one step closer to ridding ourselves of blemishes for good.

6 Different Types of Acne and What Causes Them

There are many different types of acne ranging in severity and symptoms. Within the range of common acne, also known as Acne Vulgaris, there are six different types of acne:

1. Whiteheads

When a pore becomes clogged, either with sebum, dead skin cells, or debris, a small, white bump appears on the skin. A thin layer of skin creates a closed comedones that cover this clogged bump, known as a whitehead. Whiteheads are very common, and they’re a non-inflammatory form of Acne Vulgaris. Although whiteheads start small, they can grow into larger, more painful blemishes, so it’s best to nip them in the bud.

Increased oil production, such as during puberty, menstruation, pregnancy, and menopause can lead to whiteheads. Using irritating products, such as cosmetics with abrasive and harmful ingredients, can also cause whiteheads to pop up.

2. Blackheads

Another type of non-inflammatory form of Acne Vulgaris that’s similar to whiteheads is blackheads. Instead of being closed like a whitehead, blackheads are caused by open comedones in the place of a hair follicle. Since it’s open, it appears dark because of the melanin pigment in the open skin. Blackheads also appear bumpy in texture and are very common.

They’re caused by a buildup of bacteria, namely a bacterium rightly called Propionibacterium acnes, on the skin that seeps into hair follicles. Blackheads are also a sign that the skin cells aren’t shedding consistently, causing dead skin cells to accumulate on the surface.

3. Papules

This type of acne is your typical red pimple. However, it’s not filled with pus. It’s a raised lesion on the surface of the skin that appears swollen, inflamed, and clogged. When a breakout of papules form in one place on the skin, a rash appears, and the skin surrounding it is very tender.

Common causes of papules include dermatitis, chickenpox, and eczema. These all have to do with irritated, inflamed skin, which can lead to the formulation of papules. The root of papules is inflammation. When these skin issues hit—or when a skin follicle wall breaks down, letting contaminants in—papule acne may ensue.

4. Pustules

Exactly what it sounds like, pustules contain pus. Raised lesions like papules, pustules are inflamed pimples that appear swollen and clogged. The skin around the acne is tender and usually red in color, but the actual pimple has a white or yellow bump on top. This type of acne is generally pus-filled (hence the color), but dermatologists warn against popping these pimples, as that could lead to acne scarring.

Pustules are a common form of acne that’s usually a case of oil and dead skin cells clogging the pores. Unlike whiteheads, pustules can become infected. When the skin is inflamed—due to psoriasis, rosacea, chickenpox, etc.—pustules are more likely to form.

5. Nodules

A severe form of acne, nodules, are the uncomfortable type of pimple that forms under the skin. There’s a lot of tension, and a lesion still forms slightly raised above the skin. This type of acne may not be as red as papules or pustules, but it may be more painful and require more medical attention. Similar to pustules, nodules are filled with pus, but you don’t see a white pimple form on the outside of the skin since the acne formed below the skin.

Like other types of acne, nodular acne is linked to overly active oil glands, dead cells building up in the pores, and an overgrowth of bacteria. This type of acne is also associated with hormones, which can change the chemical makeup of the skin’s oil.

6. Cysts

Cysts are one of the most severe types of acne and are often confused with nodules because they also form deep under the skin’s surface. Cysts are also severely inflamed, extremely painful, and filled with pus. The difference, however, is that cysts are much larger, they’re more likely to scar, and they’re more likely to burst.

A combination of bacteria, oil, and dead skin cells are responsible for the formation of cysts. The pores are clogged deep below the skin, much further than nodules, yet are visible above the skin. Cystic acne is relatively uncommon, but it’s more severe than other types of acne because the lesions are usually infected.

Common Theme Among the Causes of Acne

If you’re noticing a common theme here, it’s because there is one. Acne is generally caused by the sebaceous glands producing more oil than necessary, which ends up clogging the pores. When the pores become swollen or inflamed, either with oil, dead skin cells, or debris (aka dirt, pollutants, toxins, etc.), some type of acne may form.

However, one of the main drivers of acne is hormone levels. This is why acne is so prevalent in teenagers and young adults. Hormonal acne in women may also be linked to hormonal changes related to birth control, pregnancy, menstrual cycle, or menopause.

Some external factors may also be to blame for pesky breakouts, such as climates with high humidity. The high moisture level in the atmosphere can induce sweating, which may lead to clogged pores, but the thick air can also carry microscopic pollutants that enter the skin’s surface.

If the various types of acne all share similar causes, why does one person get a less severe breakout, such as whiteheads or blackheads, while another person suffers from severe nodules or cystic acne? Researchers are unsure why one form of acne is more likely in a person than another. More studies need to be done, but researchers believe that oil production, humidity levels, hormones, immunity, nutrient deficiencies, and genetics may make someone more susceptible to one type of acne than others.

The Stages of a Pimple From Beginning to End

We’ve all woken up one morning with a honker right in the middle of our face. How did that get there so fast? It wasn’t there last night! Well, each pimple has a life span—birth, life, and death, if you will.

Is that a pimple? No, it’s just a freckle! (a.k.a. the beginning)

It all starts with a follicle or pore, which is a skin duct where a single strand of hair pops out. The follicle extends underneath the skin’s surface and branches out into a sebaceous gland, where oil production is managed for skin moisture. Ideally, oxygen flows freely through the pore. When the pore becomes clogged or blocked by excessive oil, dead skin cells, pollutants, or a combination, a pimple is born.

Yep, that’s a pimple alright…cheers to the middle

When oxygen is unable to flow through the pore, bacteria Propionibacterium acnes accumulates, and the pore may become infected.

The stages can be summed up:

It’s almost over—the end is near!

This is where some types of acne end, such as mild whiteheads or blackheads. However, if the skin ruptures, a bump or noticeable pimple may appear on the surface of the skin. This may grow to be a papule or pustule.

Nodules and cysts also appear at the end of a pimple’s life cycle. Instead of the infection healing on its own, an oil gland under the skin fills with oil like a balloon, leaving an inflamed lesion on the surface of the skin.

Evolution is real where acne is concerned

As you can see, the breakout of a simple whitehead or blackhead can evolve to papules and pustules and even nodules and cysts. It’s important to stick to a consistent, effective cleansing routine depending on your skin type and acne type to prevent the stages of acne worsening.

Good Face Tip: Whatever you do, don’t pop or pick at your breakouts! You think the redness will subside, but you’re only spreading bacteria, oil, and pus to the exterior of your skin’s surface. This can result in a worse breakout or rash across your face.

How to Maintain Skin to Prevent Outbreaks: Types of Treatment

Not all acne is the same, as we’ve just learned, so not all acne treatments are the same. Treatment for non-inflammatory acne, such as whiteheads or blackheads, is different from treatment for inflammatory acne, such as papules, pustules, nodules, and cysts.

In young adults with acne, as many as 20% are diagnosed with mild acne, 44% with moderate acne, and 36% with severe acne.

Topical treatments

Ranging from over-the-counter cleansers to dermatologist-prescribed creams, treating acne from the outside has been a long-term method used by just about every person dealing with bouts of breakouts.

Toners and cleansers with benzoyl peroxide have been proven an effective remedy for reducing bacteria, and therefore acne. New studies are finding that salicylic acid is also a strong acne treatment for lesions visible above the skin’s surface. Together, benzoyl peroxide and salicylic acid are a strong acne-fighting combination.

Topical retinoids are also a common treatment for both non-inflammatory and inflammatory acne. Prescription retinoids like Accutane are a lot more powerful than over-the-counter retinoids, such as retinol. The formal name for Accutane is Isotretinoin, and it’s believed to be the most effective treatment for severe acne-like cysts.

Oral antibiotics

In general, antibiotics are given to fight infection and bacteria in the body. When acne becomes severe, oral antibiotics may be prescribed to treat inflammatory acne. Some studies suggest that oral antibiotics are more effective when combined with other forms of treatment, such as topical retinoids.

Good Face Tip: When taking oral antibiotics, be sure to also take a strong probiotic. Antibiotics kill off both good and bad bacteria, so probiotics restore some of the good bacteria that your body needs to fight off disease. Plus, probiotics support a healthy immune system, which may be a contributing factor in skin health.

Birth control

In women, birth control has been believed to regulate the hormones estrogen and progestin, which may cause acne during puberty, menstruation, pregnancy, or menopause. In a series of 31 trials, one study found that some oral contraceptives were more effective at relieving the different types of acne. However, this is not a quick fix. Studies confirm that birth control may be an effective treatment for acne, but it often takes several weeks or months to notice relief.

DIY remedies

Essential oils and at-home face masks are on the rise promising to cure or reduce acne. Ingredients like tea tree oil, witch hazel, and bentonite clay are regarded as all-stars when it comes to reducing acne inflammation and preventing breakouts.

Other things to look out for in acne treatments

What may work for someone, may not work for you and vice versa. Many topical agents that were previously considered dangerous for pregnant women are now considered safe, widening the range of treatment options for pregnant women.

Lasers and light therapies have also proven to be effective acne treatments, although more uncommon.

How to Deal with Acne Scars

If you suffered from acne for many years before finding an effective treatment, you may have a new facial problem to deal with—acne scars. Acne scars affect millions of people, including up to 20% of teenagers. Like acne, scarring can cause emotional, psychological, and social issues. More studies are needed, but there are a few treatments for acne scars that have been proven to show improvements:

Conclusion

There’s nothing fun about adult acne or acne scars, and figuring out what causes acne can be confusing. Breaking out may be caused by an underlying issue (i.e. hormones, genetics, nutrient deficiencies, weak immunity, etc.), but it’s generally caused by bacterial and oil clogging a pore. There are thousands of over-the-counter treatments for acne, but that doesn’t mean they’re safe, healthy, or effective.

Different treatments may be more or less effective depending on the type of acne, since there’s no one-size-fits-all cure for acne. The most common and scientifically proven treatments for acne include benzoyl peroxide, retinoids, and antibiotics. In some women, low-dose birth control may be useful for achieving clear skin.