Ugh, I HATE ACNE! Who doesn’t though? Acne is why I became obsessed with skin and why I chose a career in esthetics.  I resented spending my money on products that over promised but under delivered.  Acne is a sinister inflammatory disorder of the skin marked by papules, pustules, comedones and/or cysts.  It has an unsavory ability to leave a lasting impression long after it’s gone; sometimes it never really leaves.  Fortunately there’s help for us all, but for now I would like to start by describing types of pimples, grades of acne, causes and types of acne, and finish by leaving you with a few tips on controlling breakouts.


1 .)  HORMONAL  ACNE  –  normally  found  on  the  chin  and/or  along  the  jaw  (think  muzzle  or  surgical  mask).  It  doesn’t  necessarily  mean  that  your  hormone  levels  are  off  their  normal  levels,  it  just  means  that  this  is  the  zone  of  the  face  which  is  very  responsive  to  any  changes  in  progesterone, testosterone  and  stress  hormones.  Pregnancy, oral  contraceptives,  and  menopause  are  common  triggers  of  hormonal  acne.

You’ll need two things in your skin care routine: an anti-inflammatory  treatment (benzoyl  peroxide or salicylic  acid) and  a  preventor  in  the  form  of  a  retinol.  Also  take  a  look  at  your  skin  care  and  makeup.  Are  you  using  harsh  exfoliants which  will  spread  your  acne  by  leaving  tiny cuts behind  where  bacteria  can  set  up  shop  and  multiply?  How  are  you  cleansing  your  skin? Is  your  makeup  long  wearing ?  Is  it  heavy/full  coverage? Try switching to a lighter formula and building coverage only where you need it.    The  tiniest  changes  can  help  big  time.

2) ACNE  COSMETICA – Comedogenic or irritating  ingredients  in  products  such  as  makeup,  laundry  detergents,  or  hair care cause acne cosmetica.  Try  regularly  cleaning pillow cases and cleaning makeup brushes once a week or two .  Obviously  you’ll  need  to  discontinue  using  which ever  product  gave  you  acne  cosmetica if you know what it is.

3 .)  INFLAMMATORY  ACNE – is chatacterized by redness  and  it may be uncomfortable .

4.) ASPHYXIATED  ACNE -is characterized by a rough surface because of a keratolytic buildup paired with reduced  cell  turnover  that  traps  sebum.  Asphyxiated  acne  is  common  in  dry  environments  and  may  be  the  result  of  using  skin  care  products  with  drying  ingredients, alcohol  for  example,  without  the  use  of  a  daily hydrator .  Again Retinol  will  speed  up  cell  turnover  and  dissolve  the  bonds  holding  the  dead  skin cells  to  the  follicular  walls and surface while killing the bacteria trapped beneath  the  keratolytic  buildup .

5.) BACTERIAL  ACNE –  Propionibacterium  Acnes  (P. Acnes) is the bacteria  responsible  for  acne.  It  flourishes  in  warm,  humid  environments  but  cannot  live  in  the  presence  of  oxygen. That’s  why  benzoyl  peroxide  and  salicylic acid are TOP DOG at  killing off acne lesions as they drive oxygen into pores and obliterate P. Acne bacteria.

6.) CYSTIC ACNE – if you have cystic  nudules  you know it because the are painful.  They dwell beneath the surface of your skin and sometimes remain for weeks or months.  Scars are far more common with cystic acne because of their depth and the severe inflammation that destroys the follicle.

7.) SYSTEMIC  ACNE – is a acne vulgaris on other areas of the body such as arms, back, chest and shoulders and face too.  Disease, illness, medication, or diet-related issues may be culpable, but  you’ll need to go see a Dermatologist to get the most effective  treatment.


c9a7a23e9d13c83d65c5fd7142b42ec2CLOSED COMEDONES

Androgen hormones are a group of hormones (primarily testosterone and androsterone) that controls the development and maintenance of masculine characteristics.  While present in both ladies and gentlemen, levels are much higher in men.  In women, androgen is converted into estrogen.  High androgen levels result in “virilizing effects” equaling acne and hirsutism (excessive hair growth in inappropriate places of the body).  If acne is present on the skin, androgen hormones increase the adherence of keratinocytes to the follicle wall and increase sebum production.  That my friends, is how  you develop clogged pores!


Papules form due to increased sebum and P. Acne bacteria that build up BEHIND the plug and trigger an inflammatory response in your skin.


P. Acnes grow, multiply, and generally reek havoc and cause inflammation.


Inflammed ruptures in the follicle wall cause inflammation & tissue destruction with possible scaring.

Types of acne

Types of acne.



GRADE  I – May include open or closed comedones.  Inflammatory  lesions and cysts aren’t typical.  Scaring  is  unlikely  because  lesions  tend  to  be  superficial.  Hyperpigmentation  and  texture  changes  are  possible  if  you  are  doing  extractions  at  home.

GRADE  II  –  Open  and  closed  comedones  are  common  in  both  GRADE  I and GRADE  II,  however  papules  and  pustules  are  unique  to  GRADE  II  acne  simplex.


Scaring  begins to rear it’s ugly head in the acne vulgaris category.   Sometimes medical intervention is necessary because ultimately when all is said and done, having scars can make us feel as bad as having acne does.  It’s like great, my acne is gone and my skin is clear, but I’ve got permanent scaring! It is just unfair.

GRADE III –  Inflammation, bacterial  lesions, open/closed comedones, and scaring.

GRADE IV –  Cystic and  nodular  lesions  are  typically  saved  for  GRADE  IV  acne vulgaris and  medical  intervention  may  be  absolutely  critical  to  not  only  clear  up  your  lesions ,  but  to  rid  your  skin  of  hyperpigmentation  and  scaring.

Your dermatologist can absolutely help reduce the amount of scaring and erase it all together with lasers.  However, if you are a person of color, you gotta be REEEAALY careful with lasers because the wrong one can hyperpigment you for life.  ALWAYS go to a derm for laser work.

It is absolutely  possible  to  obtain  clear  skin  with  the  help  of  an  esthetician  and  the  sooner  you  get help the better.  For my clients who  are  dealing  with  acne I make it crystal clear that  there  is  no  known  cure  for  acne,  but  there  are  ways  to  control  it  and  clear  it  up.  Then  I  stress  the  importance  of  establishing a  facial  schedule  of  one  peel  every  two  weeks  to  rid  the  skin  of  bacteria,  boost  collagen  and  elastin  production  (to  plump up the “pits” of  scas)  and  quickly  fade  inflammation  and  hyperpigmentation.  A few clients who have come to me with acne have been able to get one facial a month and get clear skin, but those clients were usually breaking out because they were over exfoliating in combination with failing to use moisturizers, doing something else to disrupt their skin’s barrier or pH levels, or generally  introducing their complexion to bacteria on a daily basis.  Lastly  I  prescribe  the  appropriate  cleanser, toner,  retinol,  moisturizers  and  any  additional  serums their skin may need.


1.  Gently Exfoliate & Increase Cell Turnover

Blended peeling agents that control bacteria & oil production while loosening the impacted  stratum corneum which not only opens pores, it allows treatment  products  to  penetrate  more  effectively.

Topical  retinoids ,  salicylic  acid ,  Azelaic  acid, alpha  hydroxy  acids  and sulfur  are  ideal  when  treating  this major cause of acne.

2.  Control Sebum Production

Increased  sebum  production + P. Acnes build up behind plug= Inflammatory  response

Over drying skin makes skin produce sebum in excess which causes more breakouts!! You guys, it’s so true!!! Please please please stop using alcohol and washing your face three and four times a day!! It’s counterproductive.  It’s inappropriate.  It’s just wrong!!! Can you tell how I feel by the number of exclamation  points I have used? Hehe.

Try natural astringents that moisturize  will avoid over-production  of  sebum.  Also salicylic acid, ginger root, green Burnet root, Licorice root, cucumber extract and cinnamon  bark help control sebum.  You can use Borage seed oil, Grape seed oil and essential wheat germ oil to balance Oily and acneic  skin.

3.  Decrease P. Acnes Proliferation

First things first: control bacteria population! Aim for antibacterial & antimicrobial topical agents and oral or topical antibiotics.  Visit your dermatologist (not your GP) to see if your acne needs to be treated with antibiotics  or not.

Next, topical sources of oxygen such as benzoyl peroxide and hydrogen peroxide are imperative because p. acnes  are anaerobic.

Review your current skin care and make any appropriate  changes and seek the help of an esthetician for in-office treatments that increase circulation/blood flow to deliver oxygen which kills P. Acnes and assists in clearing breakouts.


Inflammation  is  both  the  cause  and  result  of  acne .  When the  amount  of  P .  Acne  bacteria  increases, sebum  is  broken  down  into  irritating  free  fatty  acids  causing  your  immune  system  to  sit  up  and  take  notice.  White  blood  cells  weaken  the  follicular  wall  resulting  in  a  rupture  and  increased  inflammation.  Aim at using anti-inflammatory  topical ingredients designed to both soothe current irritation and help avoid future inflammation.  Aloe vera, salicylic acid, bisabolol, panthenol, licorice extract, and EGCG from green tea are all very helpful.

Inflammation is the cause of the hyperpigmentation left behind by pimples.   It’s actually called Post-Inflammatory Hyperpigemtnation.  Exposing those dark spots to the sun won’t even out your skin tone.  The sun will only make matters worse because it’ll darken those spots even more and make them harder to get rid of.  Plus, a lot of the ingredients that are used to clear your skin cause you to be slightly more sensitive to burning.  NOBODY wants burned, hyperpigmented, acne riddled skin.  Ain’t nobody got time for that!

Bottom line: just because acne is a tough case to solve doesn’t mean it isn’t possible.  It make take professional help, but at least you’ll have healthy, clear skin.  If you need help or have questions leave them in the comment box and I’ll answer them to the best of my ability.

God Bless!


Photos : Pinterest

PCA Skin skin biology & chemical peel textbook

Watch Caroline Hirons and Dr. Sam Bunting talk acne:

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