So, you’ve been out of school for a while, and breakouts are still keeping you from looking and feeling your best. It seems like you should have been able to leave it behind, along with folders, backpacks, and teenage angst. But as acne is not restricted to any age group, for many of us, acne didn’t stop when we graduated. In fact, it may have morphed and now may scar if left unattended. Unfortunately, what worked when you were a teen may not work for you today, and it can be exceptionally frustrating trying to understand what are all the types of acne. Fortunately, no matter the type or cause, there are solutions and more that can help. Read on to learn about the different types of acne and how to treat them.

What Are All the Types of Acne?
From a clinical point of view, acne is acne, with the “type” being the form, stage, or grade the acne takes. These range from mild, non-inflammatory blackheads, whiteheads, and milia to progressively more inflammatory papules, pustules, nodules, and cysts, which fall under the medical term acne vulgaris. Here is a brief breakdown of the main acne types:

• Blackheads: Named for their brownish or black appearance of pores filled with oxidized dead skin, oil, make-up, and debris.
• Whiteheads: The result of dead skin, oil, and debris trapped under the skin producing a whitish-colored cap or head.
• Pimples: One of the most prominent types of mild acne, pimples occur when a whitehead ruptures, causing inflammation and redness. These begin as small, red, raised, swollen, and sore bumps known as papules. While deeply seated under the skin, they do not contain sebum or pus. 

When inflammation increases, the papule ruptures, becoming a red, raised pustule with a white or yellow center containing pus, oil, and dead skin cells that can be painful.  Papules and pustules may result in scarring as they heal.

• Cystic Acne: Deep, hard, red, pus-filled, infected bumps in deeper tissues. Scarring and acne pits are likely to occur. Seeing a dermatologist for treatment of these severe forms of acne is strongly recommended.
• Nodular Acne: A severe form of acne with swollen, tender masses or lumps under your skin and pimples on the skin’s surface that develop when inflammation increases. As these can likely lead to scarring, seeing a dermatologist is highly recommended.

Beyond The Basic “Types”
Online discussions today delineate unique acne “subsets” often by what causes different types of acne or the various triggers involved.
While teen acne can begin during adolescence and continue throughout the teen years, for many it subsides upon entering adulthood. But adult acne, hormonal acne, bacterial acne, and fungal acne can persist long thereafter. And, although acne is not usually due to any one single thing, involving several factors and triggers, here are some defining characteristics that set these acne “sub-types” apart.

Adult Acne & Hormonal Acne
Adult acne and hormonal acne are not actually different types of acne in adults, but one and the same. This type of post-adolescent acne affects roughly 80% of the adults in the U.S. at some time during their lives. Its causes and symptoms are similar to other types of acne, with some differences.

• Hormonal Acne Causes: It occurs when hormonal fluctuations trigger an overproduction of sebum (the oily substance produced by sebaceous glands in our follicles) that join with bacteria and dead skin cells to clog pores, resulting in blackheads, whiteheads, pimples, and cysts.

Male hormones, like testosterone, dihydrotestosterone (DHT), and DHEAs, present in both men and women, are the driving force behind the normal stimulation of oil (sebaceous) gland activity. Stress causes the adrenal glands to go into overdrive, increasing the output of these hormones, also known as androgens, which influence sebaceous glands. Like teenage acne, dead skin cell accumulation, and bacteria also take part. As with all forms of acne, diet, humidity, improper skincare, lack of sleep, pollution, and picking or squeezing can trigger and worsen breakouts. But for adult acne, medications are often implicated.

• Who Is Affected: Men and women aged 20 to 50 can experience hormonal acne. But with approximately 50% of women in their 20s and 25% of women in their 40s getting this type of acne, and changing hormone levels women experience, women tend to be most affected. Pregnancy, menopause, irregular periods, birth control discontinuation, ovarian conditions like polycystic ovary syndrome, and menstruation often involve hormonal breakouts.

Studies show that women tend to stress more and produce a larger percentage of androgens in the adrenal glands than men do, thus explaining why stress seems to manifest in acne more frequently in women than men. Those taking testosterone or steroids are also prone to hormonal acne. And, as with most types of acne, if anyone in your family has a history of acne, you can be genetically predisposed to experience it yourself.

• Hormonal Acne Symptoms: Hormonal acne may be mild, as with blackheads, or become inflamed, red, sore, or painful bumps like whiteheads, papules, pustules, or fluid-filled cysts.  It often appears on the chin, lower face, jawline, and neck but may appear anywhere on the face, back, chest, and shoulders. There is a longer healing time and more propensity to scar due to slower cell turnover rates.

• Managing Hormonal Acne: It is essential to address acne when it first appears to prevent progression and scarring. Here’s a safe, effective way to manage it:
• Step 1: Reduce oil production with a Sulfate free Salicylic Acid cleanser to help control breakouts without irritation. The best face wash for adult acne will also contain oil-controlling Niacinamide and exfoliating Jojoba Beads for gentle, daily use.
• Step 2: Treat with a sebum-normalizing acne spot cream with Zinc, Peptides, and other plant derivatives.
• Step 3: Follow with a non comedogenic face moisturizer to promote balance and repair.
• Step 4: Use an oil-absorbing acne mask with purifying Kaolin Clay weekly to expedite skin-clearing for optimal results.

Combining this with stress reduction, healthier food choices, better sleeping habits, exercise, and avoiding oil-based make-up can help improve breakouts. Practice acne positivity, remembering that your acne doesn’t define you – you are not alone or at fault. Do your best to be patient and gentle with yourself on your skin-healing journey. If natural skin care products and lifestyle modifications fail to clear your acne, or you have severe acne symptoms, see a dermatologist who can prescribe medications and offer other suggestions, such as laser treatments, light therapy, or steroid injections (for cysts).

Bacterial Acne
Wait, isn't all acne bacterial? Yes, it is! So why the distinction? Standby!

• Bacterial Acne Causes:  P. Acnes Bacteria was long considered the prime bacterial culprit of acne, but researchers have broken down the different types of acne bacteria and isolated a new offender; A higher incidence of C. Acnes Bacteria (cutibacterium acnes) is deemed one of the leading acne influencers.

Fueled by the triglycerides in sebum, it thrives on the skin’s surface near the follicle opening. Ironically when those who experience acne use harsh chemicals or products to eradicate breakouts, this drives the C. Acnes bacteria down into the follicle to find more “food to feed on,” exacerbating breakouts. Lipase, the byproduct of this “feeding,” breaks down, serving up free fatty acids, which are inflammatory mediators that signal white blood cells to fight infection. This causes damage to the follicle wall and a surge of inflammatory mediators. 

To add insult to injury, this type of C. Acnes Bacteria excels at forming a biofilm, a large cluster of bacteria that scientists speculate sticks in the pores, contributing to clogging. Add in the lower incidence of lamellar granules, and you have a perfect acne storm. These vital components of the epidermis contain antimicrobial peptides that fight against bacteria, fungi, and viruses and stimulate wound healing. They also contain an enzyme (Cholesterol Sulfatase) that assists in healthy production and shedding (desquamation). So, with less of this enzyme in acne-prone skin, dead skin cells fail to shed normally, leading to more pore clogging and breakouts.

• Who Is Affected: Since bacteria is involved in most types of acne, anyone with acne, except Fungal Acne, is affected by so-called “bacterial acne.”

• Bacterial Acne Symptoms: Bacterial acne appears mostly as blackheads and whiteheads of varying sizes in the oily T-zone on the forehead, nose, and chin. But it can occur elsewhere on the face, upper back, chest, jawline, and neck where more sebaceous glands reside.

• Managing Bacterial Acne: To minimize the bacteria, the Clear-Control Collection contains powerful actives (Tea Tree, Rosemary, Zinc Peptides, Cinnamon and Thyme Extracts) that work to reduce dead skin cell build-up (hyperkeratinization), promote oxygen action in follicles, and reduce sebum production.

Salicylic Acid in the ProCorrective® Clear-Control Blemish Treatment, unlike other acids, has the unique ability to penetrate deeply into the pore to help inhibit the growth of C. Acnes bacteria. Tote an Alcohol Free toner for blemishes and cotton pads for bacterial control on-the-go.

Fungal Acne, Not So Fun
Fungal Acne (Pityrosporum Folliculitis or Malassezia Folliculitis) occurs when Malassezia yeast, a type of fungus, builds up and infects the hair follicles.

• Fungal Acne Causes: Fungal Acne is not limited to one cause. While we all have yeast naturally living on our skin, various health conditions, certain diets, and even antibiotics can cause this yeast to increase, resulting in Fungal Acne. Those with acne have fewer lamellar granules than normal skin types. Without their healing antimicrobial peptides to protect the skin barrier, acne-prone skin is vulnerable to fungal invaders.

• Who Is Affected: Young adult males and adolescents with oily skin, which creates an environment that yeast love, are the most commonly affected. People who live in hot, humid climates, sweat a lot, have weakened immune systems and other fungal infections, and use layers of heavy, oil-based products, are also vulnerable. Anyone who shaves, tweezes, waxes, wears tight clothes, and frequents hot tubs that can damage the hair follicles can also develop Fungal Acne.

• Fungal Acne Symptoms: Fungal Acne mimics Bacterial Acne with itchy, irritated, red, inflamed bumps and whiteheads that cause people to confuse it with common acne.

Unlike Acne Vulgaris, the bumps are typically uniform in size and often appear in clusters along the frontal hairline (forehead and temples), chin, neck, upper back, chest, shoulders, and upper arms. Chances are that your blemishes are a symptom of Fungal Acne if you also have dandruff, psoriasis, seborrheic dermatitis, or tinea versicolor, which are also related to yeast overgrowth.

• Managing Fungal Acne: A dermatologist may take a skin sample or use a Wood’s Lamp to determine if you have Fungal Acne. Unlike treating teen acne or hormonal adult acne, it requires antifungal treatments and diligent hygiene to treat it. OTC topical antifungal medications with clotrimazole, butenafine, or ketoconazole, and washing with dandruff shampoos containing Zinc Pyrithione multiple times a week may do the trick.

To help keep Fungal Acne in check, the ProCorrective® Clear-Control Blemish Treatment & ProCorrective® Clear-Control Moisturizer feature Cinnamon and Thyme Extract proven to inhibit the growth of fungi and bacteria. Keep skin and clothing clean and dry by changing clothes and showering immediately after the gym or sweating. Wearing loose, breathable clothes that allow airflow and avoiding tight clothing to prevent yeast growth are essential. Taking a break from hair removal and avoiding anything that touches or rubs the skin can help.

Balancing your diet and limiting refined carbohydrates will also help prevent yeast overgrowth. If you must take antibiotics or other medications, using probiotics may help offset the effects with good bacteria. If it doesn’t clear up after about a month, visit a dermatologist who can evaluate your skin and prescribe an oral antifungal medication to stop the infection, if necessary.

Location, Location, Location
The different types of acne and what they look like vary, often (but not always!) according to location as follows:

• Chin, Jawline & Neck - Adult acne on chin, jawline, and neck areas are often symptoms of hormonal acne, but can also be bacterial or fungal.
• Forehead - This area often correlates with stomach issues but may be due to hair products. Fungal acne and bacterial acne are often seen here.
• Cheek - Adult acne on cheeks can be a sign of irregularity or food allergies, but it may also be simply due to not keeping your phone or pillowcase clean.
• Nose - Breakouts on your nose are likely due to excess oil clogging your pores and are often bacterial.
• Chest & Back - All types of acne can appear here, exacerbated by clothing friction, excessive sweating, etc.

Tips for acne care:

• It is always important for those who are acne-prone to avoid skin care and hair care products with oils and other comedogenic ingredients that can clog pores.
• It is recommended that those who are pregnant should avoid Retinoids and Salicylic Acid acne treatments during pregnancy. Instead, they can use our Soothing Propolis Concentrate with antiseptic Propolis and decongesting Lavender to calm and minimize bacteria.

Want to maximize results for your healthiest skin ever? Boost skin health with an in-depth consultation for your ideal products and a series of professional treatments, such as the ProCorrective® Clear-Control Treatment, SpaTeen® Blemished Skin Treatment, Plantomer Treatment, YouthRenew™ Hydra-Glow Peel and Lacto-Flora Peel. Then, visitFind A Spa for an oasis near you offering Pevonia!