1. Non-Inflammatory Comedones

• Blackheads (open comedones)
  An oil and skin cell plug forms in the pore. It turns black because the oil oxidises with air exposure at the opening, not because it is dirty.
   
• Whiteheads (closed comedones)
  The same as a blackhead, but skin has grown over the opening of the pore, so it looks like a bump and eventually forms a white head (because it’s not oxidised by air).

What to Do:

• To normalise oil production both in quantity and quality
• Boost skin exfoliation to keep pores clear
• Soothe inflammation to calm the skin and stop redness
• Prevent acne bacteria breeding

• Cleanse with a gentle cleanser that clears away excess oil without stripping the skin. Our picks are either BioNike Acteen Cleansing Water or BioNike Acteen Purify Cleansing Gel.
   
• Exfoliate with a gentle exfoliating cleanser or treatment using chemical exfoliators such as AHA, salicylic acid (BHA) and glycolic acid that melt the clog. Microbeads work well too, but try to find ones that are biodegradable. This is becoming law this year in the EU, so expect future exfoliators to be more environmentally friendly. In the meantime, try Garnier Pure Active Daily Pore Scrub Wash, Avène Cleanance Mask Scrub or Bioderma Sebium Exfoliating Purifying Gel.
   
• Treat and moisturise with reputable products such as Acne Solutions Dermaceutics Mattfiying Hydrator, BioNike Acteen Hydramat Sebum Normalising Cream, La Roche Posay Effaclar K+ Oily Skin Anti Sebum or Eucerin Dermo Purifier Hydrating Care.  Your doctor or pharmacist may also recommend a topical treatment with retinoids (vitamin A), such as Differin, or benzoyl peroxide, such as Benzac Gel. Benzac also has an oily skin zits starter pack including a cleanser, moisturiser and gel.
   
• We also recommend that you have a professional deep cleanse facial once a month, at least in the beginning, to remove pimples and blackheads and learn to manage your skin problems. It speeds up acne healing with as little damage to the skin as possible.

2. Inflammatory Acne

• Papules
  If a comedone becomes inflamed (probably due to bacteria), it becomes a papule, a small, hard red or pink bump. It might be tender. Don’t pick or squeeze, as there’s no head to extract. Rather use an acne treatment, stat!, to reduce the inflammation. BioNike has a great spot treatment pen and Acne Solutions a Blemish SOS Spot Repair product - both perfect for focused spot treatment.
   
• Pustules
  This is your classic pimple, when it’s filled with pus and has a head on top. Here, picking is definitely to be avoided as you will cause scarring and pigmentation, and you can spread the infection to nearby pores. Use an acne treatment or, if you have several pimples, have a professional extraction facial.
   
• Nodules aka blind pimples
  Know those hard, hot lumps that form under your skin? Ouch! You’re not going to be able to squeeze it out as these inflamed bumps lie deep within the skin and need to be treated by a dermatologist, who will probably prescribe medication.
   
• Acne Conglobata
  Clusters of connected inflamed nodules, which often appear on the neck, chest, arms, and buttocks. It is more common in men and often leaves scars.
   
• Cysts
  These are similar to nodules, but contain pus. This is the most serious form of acne, and usually means there is a bad p.acnes infection. Definitely calls for a trip to your dermatologist. No one is happy with their skin in this condition.

What to Do:

• Prescribed medication: The doctor or dermatologist will give you prescription treatment such as topical or oral medication to reduce oil and clear bacteria, such as benzoyl peroxide, antibiotics and vitamin-A/retinoid therapy, e.g., RoAccutane, Oretane, etc. They will also prescribe medical skincare to treat the problem and gently soothe the skin and counteract dryness and irritation these medications may cause.
   
• Skin care: Ranges which doctors favour and you can use daily include SkinCeuticals, Lamelle, La Roche Posay, Avène, BioNike, NeoStrata, Bioderma, Environ, Cetaphil, Noreva and Eucerin.
   
• Professional treatments: They (and we) may also recommend, when suitable, adding deep-cleansing facials and microdermabrasion to your routine once a month to keep pores clear. You could also consider treatment options such as peels and light technologies (or a combination) to help normalise your skin again under the supervision of a medical doctor at their practice or at a medical aesthetic clinic.
   
• Technology treatments:
  • SkinRenewal Medical-Aesthetic clinics recommend Laser Genesis five-in-one treatment, which reduces the size of sebaceous glands, inflammation in pimples, pore size, and improves acne scarring and pigmentation. It is also healing and good to use after extractions. It also has a setting to improve the appearance of acne scarring.
     
  • Most of these treatments are made even more effective when used along with treatments such as Carboxytherapy and skin needling (e.g., with Dermapen).
     
  • Other light technologies that treat acne scarring and post-acne pigmentation: Syneron Candela eStyle (which also treats active acne) and Fraxel Dual.
  
   
• Sunscreen! It’s very important to use a sunscreen when you have acne, as UV exposure will cause pigmentation on the irritated skin area. Choose an oil-free, non-comedogenic sunscreen that is designed for oil-prone skin.  Try La Roche Posay Anthelios XL Anti Shine Tinted Dry Touch Gel Cream SPF 50+ or Bioderma Photoderm Nude Touch SPF 50+ for Combination to Oily Skin.