Do you have acne? I was traumatized when I was diagnosed with acne in college; it felt like the end of the world. I didn’t think my skin was “bad enough” to be called acne, yet there I was in the dermatologist’s office complaining of breakouts I couldn’t control. Now that I work in skin care, I simply see the word as a way to define how often someone breaks out. If you’re breaking out several times a month, or you have more than a couple of breakouts at a time, I consider that acne.
But do you know that there are kinds of acne that don’t break out? The tricky part about acne comes in when someone isn’t having breakouts, but they have what I call textural acne, or bumpy acne. Often, these little bumps don’t come to a head and pop, the way a normal pimple might. Nevertheless, I still consider this acne, even if my client doesn’t.
Let’s look at the kinds of acne that you can get.
This is the more inflammatory, infected acne. This acne will generally come up as a localized bump and turn red. It will eventually develop a white head, pop, and then start to heal. This kind of acne is generally cause by a bacterial infection in the skin, and is treated with topical antibiotics.
This acne you can feel. Some bumps may be large enough to see. The bumps are either milia, or bumps that are under the surface and don’t go anywhere, or blackheads. Textural acne needs to be addressed because it is often a precursor to pustular acne. It is best treated with retinol.
Cystic acne is the one that hurts. These bumps show up under the skin. They can cause soreness and will often hang around for a long period of time, sometimes even weeks. They often don’t come to a head. Do not try to pop these! Chronic cystic acne will probably require a trip to see the dermatologist, as the infection is deeper than just the surface of the skin.
A Combination of Several Kinds
Most people with severe acne have both textural and pustular acne happening at the same time. The problem is that bumpy acne can become pustular acne easily, since bumpy acne is a prime environment for bacteria, which will inevitably become a pimple.
Each form of acne needs to be treated in a specific way. Pustular acne needs to be treated in a way that kills bacteria, usually with benzoyl peroxide or clindamycin. Textural acne generally requires something to unclog pores, like salicylic acid or retinol. Cystic acne is very difficult to treat topically, but you may find relief if you apply ice to reduce inflammation and numb soreness.
I like to focus my treatment efforts on textural acne first. This takes longer and requires more patience, but if you can unclog the skin, you ultimately will prevent pustular acne by eliminating the environment that produces the pustular acne in the first place.
It’s hard to treat multiple kinds of acne at once, unless your skin is super durable or oily. Acne treatments can be incredibly drying, and using a combination of several products can lead to inflammation, flakiness, and irritation. You may find that juggling your acne treatments with a gentle cleanser and moisturizer provides enough balance. Or maybe you’ll need to use one treatment on one day and another on another day. You’ll need to find the balance that is right for you. Check with your doctor for options if you’re using prescriptions and having trouble.