Acne, whether you’ve struggled with it for years, or just get a random zit before your period, is a source of agony for many. This makes finding the right acne treatment—in the right ingredient, formula and concentration—the absolute beauty holy grail. But before you get to work and reach this step, you’re probably wondering why you’re breaking out in the first place, what your zit means, and what you can do to never get one again. Here’s what we know.

Why do I get acne?

You usually get a pimple when the pores of your skin become blocked with a mix of oil, dead skin and bacteria. This shows up on the surface as inflammation in the form of a whitehead, blackhead or cyst. Eventually, the pores become clogged and push their contents to the skin’s surface. It is important to note that it is multifactorial. You can be hit with a zit for many reasons, some of which you can control and others you can’t. It is not a definitive list—because so many things can cause breakouts at different times in your life. But if any of these issues ring a bell, here’s what you can do.

You could have oily skin

Some people are genetically programmed to make more oil. Skin cells stick together within the follicles (especially if you aren’t exfoliating) and then trap oil from reaching the surface. This causes oil to fill the pore, which when melded with any bacteria in the area, leads to acne.

Your beauty products could be getting in the way

You might be trying really hard to eat better, sleep more often and stick to your anti-acne routine. But if your products aren’t working for you, they could be causing acne. Mineral oil, for example, which is in many moisturisers, could clog your pores and cause blackheads or whiteheads. Fragrance, if you’re sensitive to it, could also increase inflammation and make you more prone to zits.

You’re about to get your period

Just before you get your period, oestrogen and progesterone levels fall, and testosterone levels are higher than usual. This triggers your sebaceous glands to secrete more sebum. Too much can result in clogged pores and breakouts. This is true in the case of medical conditions like polycystic ovary syndrome (PCOS), which cause an overproduction of androgens, which can cause hormonal acne. These are usually seen on the bottom half of the face.

You’re stressed out

When you’re nervous, upset or overwhelmed, your body is in a fight-or-flight mode for longer than it should be. This causes the production of a corticotropin-releasing hormone and cortisol. These promote the overproduction of oil, which leads to a worsened inflammation.

You’re eating sugary foods

When blood sugar levels spike, the body produces more insulin and insulin-like growth factor-1 (IGF-1). Eating foods with a high glycemic index can cause breakouts. Increased insulin ups the level of androgens, which increases sebum production.

You’re not washing your face enough (or you’re over-washing it)

To help prevent pimples, it’s important to remove excess oil, makeup, and sweat daily, so you can prevent congestion. Exfoliating is key too. You can ensure that you break down the glue between dead skin cells so they don’t stick together and accumulate. But, at the same time, if you over-cleanse, you could dehydrate your skin, which could make things worse. When skin is too dry, it causes a backup of dead skin, as well as excess sebum production to overcompensate, which hampers the balance even further.

Acne prone skin can be caused by a number of reasons

What are the different kinds of acne?

The five main kinds of acne are whiteheads, blackheads, papules, pustules and cysts.

What It Is What You Can Do 
Whiteheads They form when a pore gets clogged by sebum and dead skin cells. However, it is non-inflammatory.
Blackheads These are similar to whiteheads, but the top is oxidised, so it looks black and dark. 
Papules  These occur when the walls surrounding your pores break down due to intense inflammation. This results in a hard, painful bump.
Pustules  Pustules are filled with pus, and are super inflamed. They are painful and warm to the touch. 
Cysts  They are caused due to clogs very deep in the skin. They take the longest to go away, and are most likely to scar.

What are the major topical skincare ingredients I can use?

Because battling acne is an inside-out game, it is important to see a dermatologist so you can ascertain if you need medications to treat your breakouts—they may prescribe antibiotics, birth control or pills that can balance out your hormones or sebum levels. If you get an infrequent breakout—near your period or after a holiday—topical ingredients can work to prevent, stop them in their tracks, and treat. These are some of the most popular ones you’ll spot on ingredient labels:

Beta Hydroxy Acid

The structure of the salicylic acid molecule makes it oil soluble, so it is able to break down the oil collected in the pores. It is able to penetrate so deep into the skin, it can dissolve the intercellular glue that causes the stickiness of dead skin. It is also keratolytic, so it softens the top layer of the skin and improves exfoliation. This is an ideal ingredient to use if you have blackheads or whiteheads, and works as a great preventative agent.

Benzoyl Peroxide

Benzoyl peroxide works to neutralise P.acnes (Propionibacterium acnes) that triggers acne—when it is applied, it breaks down and releases oxygen, which kills the bacteria. It can cause dryness and irritation if you apply too much of it though, so doctors suggest layering it as a spot treatment.

Retinoids

Retinoids bind to the skin’s nuclear receptors and causes them to normalise the cell turnover cycle, so it works as the gold standard for acne therapy. It can increase the turnover rate by getting rid of the top layer of dead skin cells, and promoting the growth of new collagen and healthy new skin ones. Read more about how to incorporate retinoids into your skincare routine here.

Alpha Hydroxy Acids

AHAs like lactic acid and malic acid are water soluble, so they can’t burrow as deep into the skin as salicylic acid can. Instead, it exfoliates the dead skin cells on the surface, preventing them from sticking together.

Azelaic Acid

Azelaic acid is a comedolytic, so it breaks down pore blockages and keeps new ones from forming, and it is able to get rid of the bacteria on the surface, reducing redness and inflammation in the process.

What can I do as soon as I feel a zit coming on?

Keep your hands off! You don’t want to risk transferring any bacteria from your fingers onto the inflamed area and making it worse. Pros suggest icing the area—it soothes and may reduce redness. You may want to treat the area with small amounts of salicylic acid and benzoyl peroxide, and then layer a moisturiser to prevent dryness. Find it too red, itchy and painful? A hydrocortisone cream can work in a pinch, or a zit sticker can help flatten it and help it heal.

If you did pop it, oops! You’ll want to clean the area well with your face wash (preferably one with anti-acne ingredients) and then apply antibiotic cream to prevent infection. Doctors suggest keeping the area moisturised, and using healing ingredients like ceramides to encourage as less inflammation and scarring as possible. Once it’s healed, you’ll want to up your sunscreen game to prevent scarring—this is key if you want to protect yourself from post-inflammatory hyperpigmentation. It’s also a great time to look at your prevention strategies—what products are working for you, and which ones should you skip next time around?

Give yourself a little leeway too. Acne is part and parcel of having skin—sometimes things are smooth sailing, and sometimes you’re up against the perfect storm of inflammation, redness, congestion, breakouts and scarring. Your self worth isn’t tied to your acne (or lack of it), so take a moment to pause before you start slapping on the lotions and potions to get rid of it.

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