Winning the Battle Against Acne

For anyone who has battled with acne you know how frustrating it can be.  Acne not only affects teens but is also common in adulthood. Starting to break out in your 20’s, 30’s and even 40’s seems not only unfair but can be very confusing.  The first step to treating acne is determining what type of acne you have and what is causing it.  Once this is achieved treatment is usually straightforward and very successful!


Acne 101:


1.     Comedones,also known as blackheads and whiteheads, are caused when pores are clogged by sebum (oil and dead cells).  A blackhead is caused by an open pore while a whitehead is from a closed pore.

·     Causes:  lack of proper washing, excess oil, sweating, touching the face with dirty hands.

·     Treatment:  treatment is usually very straightforward by washing face morning and night with a cleanser appropriate for your skin type.  Avoid touching your face and clean your skin after sweating.  Regular cleansing facials and medical peels to remove dead cells can be very helpful.  We recommend a Clarifying HydraFacial every few months.


2.     Papules and Pustulesare caused by inflammation in the pore.  Papules are smaller and do not contain pus.  As the pore gets more inflamed it attracts bacteria.  Pustules are inflamed pores filled with P. acnes bacteria. These are what we typically think of as a pimple.  Picking or squeezing papules and pustules can create more inflammation and can lead to scarring.

·     Causes: diet (sugar, food allergies or sensitivities, etc.), hormone imbalance, stress, weak immunity.

·     Treatment: this form of acne is more difficult to treat. Reducing inflammation in the body will result in less inflammation in the skin.  Identifying dietary triggers, stress management and taking a broad spectrum probiotic can be helpful.  If P. acnes is severe then a topical or oral antibiotic can be effective short term while working toward establishing better gut flora (healthy bacteria).  Blue LED light therapy kills P. acnes and red LED reduces inflammation.  Reducing skin and lymphatic congestion through treatments such as Clarifying HydraFacial, Chemical Peels and proper home care are important components to resolving this type of acne.


3.      Nodule and Cysts are two types of deeper, more problematic acne.  Nodules are large, hard, inflamed papules deep beneath the surface of the skin .  Cysts are softer than nodules.  They are closed pockets of tissue that are filled with pus.  Both nodules and cysts can be painful and should not be picked or squeezed as this will very likely cause scarring.  

·     Causes:  hormone imbalance is the main cause of cystic acne.  Onset is common during puberty but can occur in adulthood due to increased stress, thyroid imbalance and hormone changes.  Medications that affect hormones can also cause cystic acne

·     Treatment: the most important treatment for cystic acne is identifying the cause and correcting the hormone imbalance.  In conjunction with internal treatment there are very effective skin treatments that should be considered. Medical facials targeted at deep skin layers such as laser therapy, blue LED light therapy to kill the P. acnes bacteria, and topical and/or oral antibiotics.  IF there is scarring from cystic acne chemical peels, micro-needling and laser resurfacing treatments are very effective.  


Regardless of the type or severity of your acne the first step to successful resolution is finding a skin health professional to work with.  Having a comprehensive treatment plan that includes treating the cause of your acne as well as the acne itself is very important.  Once your acne has resolved keeping up with a long term treatment plan will ensure you continue to have beautiful, acne free skin.


Dr. Heidi Rootes ND

Owner, Surface Skin Lab