Here’s what your acne breakout is actually telling you

Here’s what your acne breakout is actually telling you


Could you tell a pustule from a pimple? Why do you break out only on your chin? We know that not all acne is equal, which is why knowing these breakout basics will help you clear up your type of spots for good.

Acne happens when oil glands are activated

You probably encountered your first zit at puberty, which is when your adrenal glands began to pump out hormones that activated your sebaceous (oil) glands. Even though oil is a natural lubricant that protects the skin, “under certain circumstances, cells that are close to the surface block the openings of the sebaceous glands, and cause a buildup of oil underneath,” explains Melissa Aardema, a celebrity licensed medical esthetician. “This oil stimulates the growth of bacteria, which live on everyone’s skin and can very easily multiply and cause surrounding tissues to become inflamed.”

There are two main types of blemishes

Unfortunately, there are many types of blemishes, but the two most common are comedones and inflammatory lesions. Comedones are blackheads and whiteheads, while inflammatory lesions are red and raised bumps, pimples, and cysts. “Blackheads and whiteheads are essentially clogged pores with either a black or a white top,” explains Joshua Zeichner, MD, director of Cosmetic & Clinical Research and assistant professor of dermatology at Mount Sinai in New York City. “Inflammatory pimples are red, raised, and sometimes pus-filled or painful.” You should know these home remedies for blackheads.

Acne falls into three categories

Mild, moderate, and severe are terms you’ve most likely heard if you suffer from the occasional zit. According to Michelle Obama’s personal esthetician, JoElle Lyons-Lee, founder of JoElle SkinCare, you have mild acne if you have just a few whiteheads or blackheads, moderate acne if you have a “considerable amount” of blackheads, whiteheads, and inflamed pimples, and severe acne if you are experiencing “multiple cystic nodules under the skin.”

A zit isn’t always just a zit

Before trying to figure out the best way to treat your acne, it’s important to know the type of breakout you’re experiencing. “If the inflammation is right near the surface, you’ll get a pustule; if it’s deeper, a papule (pimple); deeper still and it’s a cyst,” Aardema explains. If the oil breaks through to the surface, the result is a whitehead, but if the oil becomes oxidized (that is, acted on by oxygen in the air), it changes from white to black, and the result is a blackhead. Check out the foods that improve your acne (and a few that make it worse).

Different types of acne need different treatment

Mild to moderate acne can usually be treated with over-the-counter products and clinical skincare treatments, such as facials, but someone suffering with severe acne would most likely need to see a dermatologist and esthetician, says Lyons-Lee. Regular washing with a gentle, oil-free cleanser and moisturizing with oil-free, non-comedogenic formulas are key to maintaining acne-free skin. Bonus if one or both has alpha hydroxy acids such as glycolic acid or salicylic acid, which can dissolve the bonds that keep dead skin cells stuck in place, blocking your pores. And as much as you want to pop that whitehead, don’t. Leave that to the experts. “Blackheads and whiteheads are on the surface, so you can usually remove them quite easily with steam and a comedone extractor,” Aardema says. “But pimples may need to be opened with a needle, and cysts usually require a steroid injection.” Interested in a DIY treatment?

Where you break out matters

Our experts all agree that the most common areas people break out are the face, chest, shoulders, and back. Allergies, food sensitivities, lack of sleep, and poor diet can all lead to breakouts in these areas. For example, your body wash or laundry detergent may be the cause of your back, chest, or shoulder acne. Read more about the facts and myths about adult acne that will help you on your way to clearer skin

Why you may be breaking out on your face

“Depending upon where the breakouts are on the face, they can indicate an imbalance of the digestive and respiratory system as well as a hormonal imbalance,” says Lyons-Lee. “Breakouts can also be a sign of a toxic liver or kidney as well as high blood pressure, bacterial infection, and illness.” According to Lyons-Lee, breakouts on the chin and forehead are often aligned with the stomach and digestive system. The chin area is “linked to the small intestine and may indicate a buildup of toxins or the need to incorporate more fiber in the diet,” and forehead acne could be a sign that you’re dehydrated or have a potential food allergy. Breakouts on the cheek are often representative of the respiratory system, according to Lyons-Lee. “There may be an increased amount of broken capillaries in these areas, especially if you are a smoker,” says Lyons-Lee. “If you are prone to allergies, these areas will be prone to breakouts as well.” If you experience whiteheads or blackheads near your hairline, it may be due to your hair products, suggests Dr. Zeichner.

Age plays a role in acne too

Teenagers tend to breakout more in the T-zone (forehead, nose, chin, and around the mouth), while adult women experience breakouts in the lower part of their face and jawline. Dr. Zeichner and many experts believe hormones play a role in this placement pattern.

Don’t forget about your diet

There’s preliminary evidence that specific foods cause breakouts. Our skin care experts agree that diets high in dairy, sugar, and fats may promote an inflammatory response in the body, which may throw of the skin’s pH balance and lead to acne. But ultimately, “how your skin reacts to what you eat just depends on your own personal makeup,” Aardema says. “In fact, there are people who eat a very poor diet and hardly ever experience breakouts or acne,” adds Lyons-Lee. But just in case, here are some of the worst foods for skin, according to a roundup of dermatologists.