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What Is Acne

What Is Acne

Acne is an inflammatory disease of the pilosebaceous unit — that’s the hair follicle plus its oil gland.

Four main things drive it:

  1. Excess sebum – oil glands go into overdrive (often hormone-related).

  2. Abnormal keratinization – dead skin cells stick together and clog pores.

  3. Cutibacterium acnes (C. acnes) – bacteria that thrive in blocked follicles, triggering immune reactions.

  4. Inflammation – the body’s overreaction turns small blockages into red, swollen lesions.

Types of Acne

  • Comedonal acne: blackheads (open) + whiteheads (closed).

  • Inflammatory acne: papules, pustules (small red or pus-filled bumps).

  • Nodulocystic acne: deep, painful nodules or cysts; risk of scarring.

  • Acne mechanica: triggered by friction or pressure (helmets, masks).

  • Fungal acne (Malassezia folliculitis): technically not acne, but looks similar; caused by yeast.

Lifeline Pattern

  • Cradle cap (seborrheic dermatitis in infants): linked to yeast overgrowth and immature oil production.

  • Teen acne: surge of androgens = more oil, clogged pores, and bacterial overgrowth.

  • Adult rosacea: the flip side — overactive immune and vascular response with lingering sensitivity. The thread: barrier fragility + inflammation.

What To Do

1. Diet

  • Help: low-glycemic foods, omega-3s, fiber, zinc, green tea.

  • Watch: high-sugar foods, dairy (especially skim), processed oils, whey protein.

  • Gut link: acne often improves when the gut microbiome and blood sugar are stable.

2. Lifestyle

  • Don’t over-wash — twice daily is enough.

  • Change pillowcases/towels often.

  • Manage stress (cortisol spikes oil).

  • Sleep and movement help hormonal balance and inflammation.

  • Avoid smoking — it thickens sebum and impairs healing.

3. Products & Routine

Goal: unclog pores, reduce bacteria, calm inflammation, support barrier.

AM

  • Gentle cleanser

  • Niacinamide serum (anti-inflammatory)

  • Lightweight moisturizer

  • Sunscreen (non-comedogenic)

PM

  • Cleanser

  • Active:

    • Benzoyl peroxide (kills C. acnes) or

    • Salicylic acid (unclogs pores) or

    • Adapalene/retinoid (normalizes cell turnover)


  • Moisturizer (repair + soothe)

Rotate actives slowly — irritation breaks the barrier and worsens everything.

4. Ingredients That Work

  • Retinoids (adapalene, tretinoin): regulate shedding, anti-inflammatory.

  • Benzoyl peroxide: antibacterial, prevents resistance.

  • Salicylic acid: dissolves oil plugs.

  • Azelaic acid: calms redness, fights bacteria, safe for rosacea overlap.

  • Niacinamide: reduces oil and redness.

  • Sulfur or zinc: gentle anti-inflammatory options.

Avoid heavy oils, coconut oil, or alcohol-heavy toners.

When To See a Doctor / Dermatologist

  • Deep or cystic acne

  • Scarring or dark marks

  • Painful breakouts

  • Acne not improving after 3 months of consistent care

  • Emotional distress from breakouts

  • Signs of hormonal imbalance (irregular cycles, jawline acne, hair growth)

Medical treatments:

  • Topical/oral retinoids

  • Antibiotics (short-term)

  • Oral contraceptives or spironolactone (for hormonal acne)

  • Isotretinoin for severe/resistant cases

The Bigger Picture

  • Barrier repair is non-negotiable for long-term balance.

  • Hormones and stress are the invisible hands in most acne and rosacea cases.

  • Consistency beats intensity — skin prefers quiet stability over “miracle” products.

November 04, 2025

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