1. The Different Types of Acne

Let’s get the big physiology bit out the way: your acne type could be comedonal, inflammatory, hormonal or nodulocystic - and treatment for each will differ accordingly.

 

• Comedonal Acne - Blackheads and Whiteheads
  A comedone means a blocked pore, so this means your average blackhead and whitehead. These come about when the openings of your skin pores are blocked with oil and dead skin cells. Now that we understand what a comedone is, things are about to get even more interesting…
  
  Depending on what happens in the skin, you can have a closed comedone (a whitehead where there is no surface opening) or open comedone – your average blackhead forming in an open pore: when the surface is exposed to air, the oil oxidises, which turns it black and, hey presto! Blackhead!
  
  It’s best to start early with a simple topical anti-acne treatment before they have a chance to convert into one of the more severe acne types.

 

• Inflammatory Acne - Papules vs Pustules
  Add inflammation to the mix and a whitehead can become a papule - a hard red or pink bump. If there’s bacteria, you may get a pustule, filled with pus.
  
  These can be treated both topically with acne treatment and with oral medications.

 

• Hormonal Acne - Blind Pimples
  The normal fluctuation of hormones that women experience can result in a type of hormonal acne - firm red bumps (so-called ‘blind pimples’) popping up like clockwork once a month, especially on your chin and surrounding areas.
  
  This can be especially common in your 20s or 30s, but can continue right until menopause, if not addressed. These are caused by a build-up of hormones like testosterone and oestrogen which the body doesn’t quite process properly.
  
  Spikes in insulin caused by poor eating habits also sends your oil glands into overdrive and can lead to an onslaught of hormonally driven acne. And if you’re under pressure and feeling stressed, you may find a sudden emergence of blind pimples caused by cortisol, also known as – you’ve guessed it – the stress hormone.
  
  This kind of acne can be treated both topically and with oral medication, and changes in diet and lifestyle can also help.

 

• Nodulocystic Acne - Nodules and Cysts
  Commonly known as cystic or nodular acne, these angry, painful blind pimples are deep in the skin and often leave scars. They occur when blocked pores become irritated, and inflammation builds up deep in the pore and becomes more and more painful. Nodules are large and solid, while cysts are hard and filled with pus.
  
  You should get immediate treatment from your doctor or dermatologist - hopefully before you get to this stage - especially if you have a number of these. Antibiotics are often prescribed, as well as more medical solutions. But ultimately these won’t go away until the production of excess oil is reduced and controlled.

Read More. Want to Fix What Is REALLY Causing Your Acne Breakouts?

2. The Best Treatment And Products For Each Type Of Acne

So how to get rid of each type of pimple?
 

• If your problem is hormonal acne – that sudden monthly appearance of a few pimples around your chin and jaw area – the best way to fight this is with salicylic acid and benzoyl peroxide – probably best used in the week before your period.
  
  If this doesn’t work, dermatologists often prescribe an oral contraceptive, which helps to level out hormone fluctuations and keep the skin clear.
  
  You can also use this treatment for pimples and breakouts caused by poor eating/lifestyle habits or stress, unless they become inflamed and need more help to eliminate the bacteria causing the redness.
  
  For some intensive spot treatment for hormonal acne:
  Quick and effective spot treatments for the occasional annoying pimple include salicylic acid based BioNike Acteen Quick Pen Anti-Imperfector and Dermalogica Clear Start Breakout Clearing Booster. You can also try Celltone Spot Control Blitzer.
  
  Benzac AC5 Gel with benzoyl peroxide is the best solution for inflamed red pimples.
  
  Sulphur based products like Vichy Normaderm Phytosolution Anti Spot Sulfur Paste are a gentler spot treatment option for both blackheads and pimples if you have sensitive skin.
  
  If acne breakouts are more widespread:
  Go for an acne cream with salicylic acid like BioNike Acteen Hydramat Sebum Normalising Cream, Garnier Pure Active Matte Control, Eucerin Dermo Purifyer Oil Control Skin Renewal Treatment and Cetaphil Pro Moisturizing Lotion for Acne Prone Skin SPF30
  
  We also like these dermatologist-created products:
  Bioderma Sébium Global and La Roche Posay Effaclar K, or Bioderma Sébium Sensitive which is one of the best acne treatments if you have sensitive skin.

 

• Blackheads and whiteheads can be treated in more-or-less the same way. These can be avoided by daily cleansing with a gentle cleanser with salicylic acid that doesn’t strip your skin (remember, if you strip the protective barrier, your skin will overcompensate by producing more oil). Only use these where you have pimples or blackheads.
  
  We like: BioNike Acteen Purifying Cleansing Gel, Eucerin Dermo Purifyer Oil Control Cleansing Gel and Cetaphil Acne Prone Skin Foam Wash.
  
  You should do some gentle exfoliation either daily or twice weekly, depending on the type of exfoliator you’re using. Try Garnier Pure Active 3 in 1 Wash/Scrub/Mask or Bioderma Sébium Exfoliating Gel.
  
  It may be tempting to try pore strips, but you should probably avoid these, particularly if you have sensitive or rosacea-prone skin. They also tend to remove sebaceous filaments - harmless sebum plugs that are not blackheads - so may not be actually solving the core problem.
  
  Keep things under control by having or doing a monthly facial that includes extraction. If you decide to DIY, be very gentle: Cleanse your skin, then use gentle - not hot - steam to soften the pores, then wiggle the skin slightly with the sides of your fingers rather than pressing hard with your nails. If it won’t come, leave it alone as you could cause scarring and deep damage. Rather go for professional extraction.

 

• Nodular or cystic acne: Nodulocystic acne – AKA those dreaded blind pimples – is something we want to avoid, and we hope you treat the problem by seeing a dermatologist before it gets to that stage - not only because it becomes so red, painful and angry, but if left untreated, it can lead to severe skin damage as well as having a long-term impact on your self-esteem and confidence.
  
  It is caused by the hormonal stimulation of oil glands and is usually genetic. Blind pimples should never be popped or picked as this just causes worse inflammation. Very difficult to treat at home, a dermatologist may prescribe an antibiotic, topical medical treatment or cortisone injection. And they may recommend an oral isotretinoin (vitamin A) treatment such as Roaccutane or Oratane to shrink the sebaceous glands that are overproducing oil.
  
  Products to use during treatment: It is vitally important to use intensely hydrating skin care (such as Bioderma Sébium Hydra Cream and Vichy Normaderm Anti Blemish Day Cream) and SPF 50+ sun protection when on tretinoin treatment as your skin becomes very dry and sun sensitive.
  
  Our sunscreen picks are Nivea Sun Shine Control Mattifying Effect SPF50 and Roche Posay Anthelios XL Anti Shine Dry Touch Fluid SPF 50+ - both formulated for oily combination skins.

 

• Inflammatory acne – AKA angry red pimples - can be treated with creams containing benzoyl peroxide (such as Benzac AC5 Gel) to kill bacteria, but may be quite drying, so moisturising becomes even more important.

For all of these, self-medication and homemade acne remedies are not a good idea, and often make the problem worse. Whatever the pimples and whatever the cause – checking with a good skin therapist, pharmacy advisor or dermatologist before embarking on any sort of spot treatment is recommended.

A cautionary note for darker skin tones: The higher incidence of melanin in the skin makes it more prone to acne scars and hyperpigmentation. While salicylic acid and benzoyl peroxide are safe acne treatments to use, any form of retinoid cream (like Differin) makes the skin more sensitive which can cause dark marks. Always use a full spectrum SPF30+ sunscreen every day to minimise potential pigmentation problems from acne.

Read More. Expert Advice on How to Finally Get Rid of Your Acne

3. Lifestyle Changes to Treat Acne

It’s important to understand that your lifestyle can have a significant effect on your skin. Small lifestyle changes can help to make the treatment of acne (and the chances that they’ll stay away) more effective.

 

• Are you attacking those pimples? Stop now. It’s time to be gentle. Use only gentle, alcohol-free products and cleanse gently with your fingertips rather than any kind of abrasive cloth. Check the ingredients on your products – look out for the word ‘noncomedogenic’ – which literally means ‘won’t cause blocked pores’.

 

• Even though it’s a good idea to gently cleanse your face with your fingertips, that’s the only time your hands should touch your face! Avoid picking, squeezing or even just touching those offending bumps, because chances are your hands are very seldom absolutely clean! And keep your phone clean too. Keep it away from your face when chatting.

 

• The hair products you use are also important. Choose gentle, oil-free hair products and choose a style (if possible) that keeps your face away from your face. Don’t forget to rinse your conditioner well, especially off your back, as that can clog pores.

 

• With pimples, it’s important to be careful about sun exposure, especially on darker complexions, as the inflammation + UV rays can lead to dark marks where you had the pimples.
  
  Some ranges have sun protection specially for acne-prone skin (Avène Cleanance SPF 50+ and Bioderma Photoderm AKN SPF 30) as well as to help fade dark marks (Bioderma Photoderm SPOT SPF 50+ and BioNike Defence B-Lucent Anti Dark Spots Protective Cream SPF 50).
  
  We've mentioned that if you are taking any sort of medication for your skin, your skin may be even more sensitive to ultraviolet light – so stay out of the sun!

 

• What you eat and drink can affect your skin. If you don’t regularly drink water – start now, because there absolutely is no better way to hydrate your skin from the inside out.

 

• Just a few slight alterations to your diet can also make a difference. Those foods that cause a spike in blood sugar, and consequently insulin, are not only bad news from a weight point of view but can also trigger changes in your body that promote extra activity in your oil glands and the growth of those horrible pore-clogging cells.
  
  More whole grains, veggies and legumes and less sugar, white starches and refined products will help to regulate your insulin levels and help calm your skin. Adding Omega 3s, either in your diet or through a supplement, can also help. Find out more about how your diet can help clear your acne.

 

• We’re understanding that our gut health also plays a very important role in our skin health, including pimples - that inflammation cycle. Read our story on gut health here.

 

• One of those lifestyle baddies that exacerbates skin problems is stress. Try to keep stress levels down and make sure you exercise. Regular exercise will not only help with stress, but it also improves blood circulation and consequently more oxygen in skin cells. Just remember that if your exercise, you need your clean your face after sweating – don’t let it dry on your skin!

 

• Lastly, stop burning the midnight oil. There’s a reason why it’s called ‘beauty sleep’! When you are sleep deprived, you get more stressed, and stress increases the production of glucocorticoids, which can lead to abnormalities in skin structure and function, and actually make acne worse.

Read More. You Need to Know How Diet Can Actually Help Clear Your Acne

4. Professional Acne Treatments: Off to The Doctor!

Apart from prescribing oral medication or topical treatments, what can your dermatologist do?

Mild chemical peels and microdermabrasion are effective for treating blackheads, and deeper peels can help with more severe acne. Lasers and various light therapies are useful for reducing bacteria on the skin, and sometimes procedures can be used to drain acne cysts. It goes without saying that all of these should only ever be performed by trained and qualified professionals.

Whatever treatment your doctor prescribes, it will only work if you are compliant and stay the course. We know what it’s like (we’re only human), once your skin starts clearing up, you may be tempted to stop treatment because it’s a chore or because, especially if you’re on an intensive treatment like tretinoin, it doesn’t always feel great. But as with antibiotics, always, always continue with treatment until your doctor says you should stop.

New medical interventions are also available to improve the appearance of scarring, and may include laser, releasing the scar tissue, etc. The important thing to remember is that it’s better to treat scars while they are still fresh and red, for best results.

Read More. Your Complete Guide: How to Get Rid of Acne Scars & Dark Marks

5. Meanwhile…How to Hide Your Pimples

Depending on your particular problem, there’s usually a way to improve the appearance of your spots, if not covering them up completely. Concealing is an art form, and time and patience is required to achieve the most effective, natural-looking result.

 

• If your skin generally looks oily, stay away from oil-based make-up. Rather use a cream-to-powder foundation like Revlon New Complexion One Step Compact Makeup. Don’t neglect moisturiser though – just make sure it’s oil free.

 

• Whiteheads can be covered with a drier textured thick-ish concealer like Revlon Colorstay Concealer and Black Opal Total Cover Spots & Scars Concealer. Use a brush to cover the spot and the red area around it. Set with a powder foundation like Yardley’s Even Complexion Pressed Powder or Maybelline Super Stay Full Coverage 16hour Powder Foundation that matches your skin tone.

 

• Experts say that the key to covering blackheads is patience. Carefully layered liquid or cream foundation and concealer, finished with a powder foundation, should do the trick.

 

• Those angry red spots are difficult to conceal, but according to the experts, the redness can be cancelled with a green concealer on the spot itself. Then add a yellow-based concealer and blend this with the un-spotty skin around the spot. Don’t use too much powder, which may actually remove some of the concealer and spoil your artwork. LA Girl has both a green and yellow concealer in their range.

 

• If you're unlucky enough to be left with acne scars, , a full-coverage powder foundation (like the one from Yardley) will usually cover them, or try Black Opal’s True Colour Stick Foundation or Total Coverage Spots & Scars Concealer. There are also products like BioNike Defence B-Lucent Skin Evening Concentrate and Dermactin Equatone Dark Spot Serum available that help to reduce discoloration, so do your research and find one best suited to your skin type.

Here’s to a spot-free future!

Read More. Valuable Tips on How to Use Concealers to Really Conceal