“When I said I wanted to look like a teenager again, I didn’t mean I wanted a face full of bumps,” complained a Costhetics staffer recently.

“I’m extremely self-conscious about it and it’s turning me into a hermit, just the way it did when I was a kid.” Poor dear. At 45, our colleague thought her acne days were behind her. In fact, “Adult acne is the worst, and more Australians than ever are dealing with it,” according to ABC.net. The good news is that acne doesn’t present a serious risk to your health, though it can leave scars on your skin…and your self-esteem.

The better news is that there are tons of options for dealing with the nasty red pustules. The tricky thing is that some of them can actually make acne worse. In order to treat acne effectively, you see, you must firstly identify the underlying cause of those angry red bumps. In this article, you’ll get some diagnostic tools to help you do exactly that.

Acne Bumps: They’re Not All the Same

In simplest terms, acne is a skin condition. Acne can show up on the face, forehead, chest, shoulders, and upper back. It’s not harmful to your physical health and occurs when hair follicles become plugged. Acne bumps take many forms:

• Comedones – Comedones refers to basic acne lesions which include:
• Blackheads – These comedones are open at the skin’s surface. As bacteria, dead skin cells, and other matter are pushed out through a hair follicle, they become black when they react to oxygen.
• Whiteheads – These comedones are closed on the surface, preventing a hair follicle from opening properly.
• Papules – These comedones form small red or pink pimples that are usually sensitive to the touch. They are due to simple inflammation.
• Pustules – Like papules, these bumps resemble a whitehead encircled with a red ring. The bump itself may be filled with pus, either white or yellow. Painful and hard to the touch, they are red and swollen due to inflammation in the surrounding tissue.
• Nodules – These painful bumps originate deep within the skin.
• Cysts – Pus-filled sacs create deep, often red pimples. They are painful to the touch and considered a more severe form of acne.

The Life Cycle of an Acne Bump

Pimples are the final step in the multi-phase development of acne that goes like this:

• Excess skin cells combine with sebum, an oily substance that lubricates skin and hair.
• The cells and sebum clog hair follicles, creating a plug.
• Healthy levels of skin bacteria (cutibacterium acnes) go into unhealthy overdrive due to the excess sebum.
• Hair follicles rupture, leading to the formation of a pimple.

That’s the “how” of acne production. Now let’s look at the “why.”

Differences between Mild & Severe Acne

The severity and type of bumps you have determine what kind of acne you have and how it should best be treated:

Mild Acne – Mild acne is identified by:

• Less than 30 lesions in total
• Less than 15 inflamed bumps of any kind
• Less than 20 whiteheads or blackheads

This form of acne may respond well to OTC topical treatments with full improvement in 6-8 weeks.

Moderate Acne – Moderate acne is identified by:

• 30-125 skin lesions in total
• More than 20, but less than 100 blackheads or whiteheads
• More than 15, but less than 50 inflamed bumps of any kind

This advanced form of acne is best suited to treatment by a dermal therapist. Prescription-strength medication and topical treatments may be recommended. Improvement takes weeks, not days, and many patients find their skin condition worsens before clearing.

Severe (Nodulocystic) Acne – This more severe form of acne is characterised by:

• Inflamed nodules and cysts
• Bumps that turn purple and deep red

Corticosteroids are the best approach to reducing the size, inflammation, and pain caused by severe acne. Prompt treatment is important as it may help to minimise future scarring.

Acne Conglobata – This severe form of acne is more commonly a problem for men and can be linked to steroid and/or testosterone use. It is characterised by:

• Inflamed nodules
• Nodules that connect to one another under the skin

This acne is commonly found on the back, buttocks, neck, chest, and arms. As with other types of severe acne, early diagnosis and treatment are important.

Friction Acne – Medically known as acne mechanica, this type of acne is the result of friction, heat, and pressure again delicate skin and produces:

• Small white bumps
• Inflamed skin

The culprit in acne mechanica is typically a baseball cap or helmet, earning the condition the nickname “sports-induced acne.” Good hygiene after an activity to clean skin and unclog pores is the best remedy.

7 Causes of Acne

The precise cause of acne remains unknown, but there are a variety of factors:

• Adolescent hormonal changes – Hormonal changes are the main reason adolescents suffer from acne. A flood of hormones called androgens can cause sebaceous glands to enlarge and produce more sebum. Adolescent acne generally resolves by the time people reach 30. Interestingly, adults who are troubled by acne after that age may have normal hormone levels, but their sebaceous glands are especially sensitive to even modest changes.
• Beauty products – Beware of oil-based cosmetics (like coconut oil), skin care products, and hair products. The oil/grease in the formulation can clog follicles and worsen skin lesions. Look for water-based products and those labelled “non-comedogenic,” which means that are specially formulated to keep pores from becoming blocked.
• Diet – There is some confusion about the role of diet in developing acne. It is generally agreed that food does not cause acne, but it can worsen its effects. In Pizza Doesn’t Give You Acne—But What About Sugar?, dermatologist Rajani Katta told The Atlantic, “Multiple studies have now found that diets with a high glycaemic load can trigger acne in certain persons.” High glycaemic foods raise blood sugar which increases oil production related to the development of acne.
• Genetics – If other members of your immediate family suffered from acne, chances are you will, too.
• Medications – Anti-seizure drugs, lithium, and commonly prescribed corticosteroids can all contribute to the development of acne, as do birth control pills.
• Stress – “Don’t worry, you’ll get pimples,” isn’t just an old wives’ tale. Time magazine reports that a stress-related hormone called CRH may be a contributor. CRH “can bind to receptors in the skin’s sebaceous glands, and that binding drives up the skin’s oil production — which can cause pimples.”
• Women’s hormonal changes – Estrogen levels related to a woman’s menstrual cycle can cause acne flare-ups at any age. Women are also prone to hormonally triggered acne strikes both when they are pregnant and when they are entering menopause. Another issue for women is polycystic ovary syndrome (PCOS), a medical condition that affects women’s hormones.

Now that you know why you have acne, you can figure out what to do.

Top Acne Treatments: Ask a Skin Care Professional

Costhetics takes tremendous pride in empowering people to make good decisions about their health and beauty. Empowered though you may be, however, you are not a skin care professional. Only an expert has the knowledge to diagnose the precise cause of your acne, as well as the experience to know which treatment modality to recommend:

• Daily Skin Care Routine – Clean skin is happy skin, but only if the cleanser you use is skin-friendly. The same is true of toners, moisturisers, serums, and sunscreens. Talk to your doctor, dermatologist or dermal therapist about products that are right for people with acne.
• Oral and Topical Medications – The Better Health Channel recommends antibiotics to kill bacteria and reduce inflammation, as well as specific acids to unblock pores and prevent new blockages. Doctors and dermatologists can prescribe topical creams with higher strengths of active ingredients than over-the-counter products.
• Photodynamic Therapy (PDT) – Researchers exploring Light Therapy in the Treatment of Acne Vulgaris found, “Amelioration of acne by light therapy, although comparable to the effects of oral antibiotics, offers faster resolution and fewer side effects and leads to patient satisfaction.”

Is There a Best Treatment for Acne?

When it comes to acne, it’s not necessarily a question of either/or. Here’s what clinicians report in their review “Treatment of Acne Vulgaris”:

• Acne responses to treatment vary considerably
• More than 1 treatment modality is often employed simultaneous
• Best results are achieved when treatments are individualised

If you have acne, don’t let embarrassment keep you from enjoying life to the fullest. Costhetics urges you to visit your doctor, dermatologist or dermal therapist and learn more about “modern medical miracles” that can help you achieve the smooth, clear skin you’ve always wanted.