We all deal with acne of some type at a particular stage in our lives, and there is a no more frustrating thing than to have those pesky pimples break our look and self-confidence. Learning how to get rid of acne and pimples and prevent them from coming back seems to be the magic science everyone wants to practice.
Below, we give the whole low-down on acne: what are its causes, what the different types of acne are, and what the most effective acne treatments are. We also give some recipes for at-home acne treatments that actually work, if you’re a fan of DIY. Lastly, we take a holistic approach and break down the full skincare routine and various lifestyle steps you should take to completely prevent acne from coming back.
In this article:
- Common Causes of Acne
- Types of Acne
- Effective Acne Treatments
- Best Acne Home Remedies
- How to Prevent Acne & Pimples
Common Causes of Acne
To know where acne comes from, it is very important to understand its process, and how it is related to overall skin functioning. Chances are you are not breaking out because of one thing, but because of a combination of things that influence one another.
Sometimes treating one cause can prevent breakouts, but most of the time you will need to target all of the underlying issues. I’ll start off by explaining the basic processes that end up in pimples, and then I’ll go into details about all the little factors that can trigger that basic process.
Basic Cause of Acne
The blackheads and whiteheads are what is formed when the pores (i.e. hair follicles) get clogged. This is usually the first stage of a breakout.
They can get clogged naturally with the sebum (oil) from our own skin along with dead skin cells, although little debris from our environment can also join the mix. If the clog stays open and oxidized, then you’re dealing with a blackhead, although if some skin grows over it and it looks white or skin-colored then it is a whitehead.
Regular exfoliation and cleansing are the keys to keeping that clog from happening in the first place.
Once that poor clogged pore is exposed to the acne bacteria, the real trouble starts. The infection with p. acnes triggers a defense response in the skin that looks like a pimple, or even worse, a pustule.
The skin around the clogged pore becomes red and inflamed. It can feel painful, especially if touched, and it can even start producing an unpleasant puss that gets trapped beneath the skin and only makes the swelling look worse. This is why antibacterial and anti-inflammatory agents are also important when it comes to preventing and getting rid of pimples.
Elements that Exacerbate Acne
This one is not exactly possible to control, except through medical intervention, but it’s good to know about. The fluctuations of hormones, especially the way testosterone levels change in women throughout their menstrual cycle, can lead to unexpected increases in oil production in the skin.
The higher quantity of sebum that suddenly appears on the skin can clog the pores and cause breakouts. It is exactly the increase in hormone production during puberty that makes acne so common in teenagers. Usually women experience hormonal breakouts along the chin and jawline, although the reason why is not understood.
Lack of Proper Hygiene
This might mean you’re not washing your face regularly, or that you haven’t changed your bedsheets in a while. No matter what it might be, if you’re not keeping your skin or the things that come into contact with it clean, you are not helping the acne situation.
You can introduce both pore-clogging agents and bacteria by letting your face go too long without being washed, by falling asleep with makeup on, by touching it with unwashed hands, or by not washing your pillow cases, bed sheets, and hats as frequently as you should. This can seriously increase your chances of breaking out.
If you’ve ever noticed that one large pimple show up right before a final exam or important date, then you know that stress can cause breakouts. I think there are a couple possible reasons for this, although they are just theories.
The first is that stress releases hormones that can trigger an increase in sebum production. The second is that stress suppresses our immune system and makes us more prone to infections – this includes infection with the acne bacteria.
Regardless of the process, trying to limit the amount of stress you experience will definitely help prevent unwanted breakouts.
There is no magical way to eat that will clear your skin and get rid of pimples, although that is not to say that your diet won’t influence the appearance of your skin. Overall, if you eat a healthy and balanced diet, then your body will be healthier and function better, which we can only assume will also be reflected on the skin.
Many people find a correlation between eating specific foods and having breakouts, but of course the specific food that causes acne can change from person to person. If you have a flawless skincare routine, and your hormones are under control, you can try eliminating certain foods from your diet to see if it helps.
The things people often find they have to cut out of their diet are dairy, sugar, gluten, or red meats, while placing the blame on chocolate or oil is usually unfounded.
Comedogenic Skin Care or Makeup
The word comedogenic means something that is likely to clog the pores and cause acne. Some things are more comedogenic than others, especially when it comes to skincare and makeup ingredients. These days many makeup and skincare items are labeled as “non-comedogenic” but I think it’s always good to verify.
Contrary to popular belief, not all oils clog the pores. Oils like grape seed oil and mineral oil are usually perfectly fine for acne-prone skin, while oils like coconut oil or wheat germ oil are much likelier to cause breakouts.
Whether an ingredient will cause breakouts changes from person to person, but there are some general comedogenicity ratings that you can look at. You can simply google the name of an ingredient along with the word “comedogenic” or you can input the whole ingredient list of the product you want to use into CosDNA, which will tell you which ingredients are likely to be comedogenic.
Lastly, you want to pay attention to your skin. If you notice your skin beginning to breakout after you start using a new product, you might want to stop using that product and seeing if the breakouts go away. If they do, it likely means there is something in the formula that is clogging your pores.
Stressful Skincare Routine and Compromised Skin Barrier
People with acne-prone skin often find themselves going overboard with their skincare routine, and using a lot of very harsh products. This is because they think their skin needs to be cleansed of all last remnants of oil and hydration, which they incorrectly assume are the reason for their breakouts.
This usually means using harsh scrubs, stripping cleansers that include sulfates, and toners with alcohol. If this sounds like your routine, especially if you don’t moisturize your skin, then don’t be surprised if you’re still breaking out.
These kinds of routines dry out the skin, which compromises its barrier functions. The natural oils our skin produces as well as the ingredients in good moisturizers act as occlusives and emollients that help to fill in the gaps between the skin cells of the stratum corneum (the top layer of the skin), and to prevent bad stuff from getting in.
If your skincare routine gets rid of all of the good ingredients that fill in the gaps and doesn’t replace them, it is much easier for bad bacteria to get into the skin and to cause acne infections.
Skin’s pH Is Off Balance
People rarely think about the acidity of their skin, but it’s actually an important factor in skin health. The skin’s ideal pH is between 4.5 and 5.5. At this level of acidity, the skin tends to function the best, by acting as a better barrier and being better able to retain moisture.
At a lower pH the skin also becomes an inhospitable environment to the acne bacteria, which cannot survive such an acidic environment. When the skin’s pH is balanced, we are much less likely to experience inflammatory acne.
A lot of things can throw the skin’s pH off balance, but the most frequent culprits are cleansers. Soaps and foamy cleansers often have a pH that is too high for the skin.
After a single use the skin will normally go back to normal on its own, but regularly using cleansers with a pH higher than 5.6 will make it harder for the skin’s pH to return to normal, and will make it much more susceptible to breakouts over time.
It is no surprise that those who live in polluted cities are likely to experience breakouts when compared to those who live in pristine environments. When the air is polluted and filled with all kinds of impurities and debris, that stuff can certainly get on the skin and wreak havoc.
Washing your face every night with a gentle, low-pH cleanser can help reduce the chances of breaking out from an unclean environment.
Types of Acne
There are a few different types of manifestations of acne, which range in severity from the bothersome blackheads and whiteheads, to ugly papules, which are what we normally refer to as pimples, to the potentially painful cystic pustules. The two biggest classifications are non-inflammatory vs. inflammatory types of acne.
Non-inflammatory acne refers to whiteheads and blackheads, which are pores that get clogged without being infected with the acne bacteria. Inflammatory acne is more serious, as it refers to clogged pores that can get infected with the acne bacteria, which makes them turn red, inflamed, and painful to the touch.
Blackheads, or open comedones, are a type of non-inflammatory acne. They look like little black or brown dots, and it seems like they most frequently show up on the nose.
They occur when the hair follicle (which I use interchangeably with the word “pore”) becomes clogged with a mixture of dead skin, sebum (oil), and any foreign contaminants. Due to being exposed to the air the clog gets oxidized, which is why it turns dark.
Blackheads are often confused with sebaceous filaments, which are a non-acne occurrence when the pores get filled up with dead skin and sebum, but not severely and without the oxidization. Sebaceous filaments are usually not noticeable to anyone except the person who has them, and are quite normal.
Closed comedones are best treated and prevented with the help of exfoliation, especially using salicylic acid. Following them up with a clay mask or an oil massage can do an even better job of pulling the impurities from the skin and clearing out the pores.
Whiteheads are more professionally referred to as closed comedones. Much like the blackheads, they occur when the pore gets clogged up with a mixture of oil, dead skin, and impurities.
Unlike blackheads, however, the stuff that clogs the pore doesn’t oxidize. Instead, a bit of skin grows over the clogged pore, so that it looks like a tiny white or skin-colored bump. As long as this clog doesn’t become red or inflamed, it should heal well without leaving behind any scars or pigmentation.
You can help whiteheads disappear more quickly with the help of salicylic acid, especially if it’s in a spot treatment that also includes glycolic acid for exfoliation both inside and outside the pore. Antibacterials like benzoyl peroxide or tea tree oil can help prevent the whiteheads from becoming infected and turning into an inflamed pimple.
Papules, along with pustules, are what people normally mean when they use the word pimple, although pimple might also be used for whiteheads, nodules, and cysts. In other words, it’s not an official term.
Papules are the smallest stage of inflamed acne, and they occur when a pore that is clogged closer to the surface of the skin becomes infected with the acne bacteria and just a little inflamed. It usually looks like a small bump that is a little red, and perhaps also painful to the touch.
Anti-inflammatories like salicylic acid, azelaic acid and willow bark extract can help bring down the redness.
Pustules are probably the ugliest form of acne, even if it’s not the worst. Pustules are what shows up when a clogged, infected and inflamed pore also begins to produce pus.
Sometimes people confuse pustules with whiteheads, because they look like a tiny, pus-filled blister that sits on top of slightly reddened, inflamed skin. It’s important to resist the urge to pop these pimples, as you can easily aggravate the skin and leave behind a scar.
The best acne spot treatments for these kinds of breakouts are ones that take a combined approach, with a mix of both exfoliating, anti-inflammatory, and anti-bacterial agents.
Nodules are a type of pimple that takes root below the surface of the skin. The pore gets clogged and infected deeper down beneath the skin, so that on the surface of the skin all you can usually see is a reddish bump that is flatter than a papule or a pustule.
Since nodules are deeper under the skin, they are harder to eliminate using only spot treatments. Seeing a medical professional for a prescription of some sort might be necessary, especially if you get many nodules or if they occur frequently. Spot treatments, along with a good skincare routine, can help prevent nodules from forming.
Cysts are the toughest, meanest, largest, and deepest form of acne. Like nodules, they occur under the skin, although they tend to be larger and deeper, and they can be seriously painful. If you breakout in cysts often, you should definitely see a doctor or a dermatologist, since topical products are likely not going to be enough to treat the problem.
Effective Acne Treatments
There are a few ingredients that are proven to help with acne, whether by killing the acne bacteria, by promotion cell renewal through exfoliation, or by soothing the inflammation and redness caused by the infection.
Acne spot treatments alone will not help with your breakouts – they are just one part of a skincare routine that will keep your skin functioning healthily. These are the main ingredients used in spot treatments. You might see them used alone as the active ingredient, or in combination with each other which can be even more effective.
Also known as beta-hydroxy acid or BHA, this acid is always the first thing I recommend for treating breakouts and getting rid of pimples. It is derived from salicin, a compound that occurs naturally in willow bark extract, and it is somewhat similar to aspirin as an anti-inflammatory.
This wonderful chemical exfoliant can penetrate past oils to trigger the shedding of skin cells. It is also said to have antibacterial properties.
These two qualities make it the perfect acne fighter, as it penetrates the skin, breaks down the clog in the pore, triggers shedding of dead skin and encourages cell renewal, prevents the spread of acne bacteria, and even helps to reduce inflammation. In other words, it does it all and it doesn’t even irritate the skin or cause photosensitivity.
In acne spot treatments you will normally see it at a 2% concentration. This ingredient can help with breakouts at any reasonable pH but it is undeniable that it works best when its pH is between 3 and 4, which is quite acidic. Any higher and it won’t exfoliate as well, while at a lower pH it can seriously irritate the skin.
You will sometimes see salicylic acid combined with chemical exfoliants like glycolic or lactic acid in acne spot treatments for a more thorough exfoliation.
Benzoyl peroxide, often abbreviated as BP, is my personal holy grail for preventing breakouts. This is a powerful antibacterial agent that once applied makes the skin a totally inhospitable environment to the acne bacteria.
It also has an exfoliating effect, which allows it to penetrate the skin and promote skin shedding. For most people this ingredient is less useful as an acne spot treatment once acne has already surfaced, but it is an extremely effective preventative for all kinds of breakouts including hormonal ones.
Benzoyl peroxide is effective at fairly high pH, and it does have pro-oxidant activity, which means it is not the ideal treatment for those with sensitive or mature skin. While it does help with acne, it can irritate or dry out the skin. It usually works well at a 2.5% concentration, although you can also find acne spot treatments with 5% and 10% concentrations of BP.
Benzoyl peroxide seems to work especially well when used in a routine that also includes exfoliation with glycolic acid. It’s better to start off with the weaker concentration to avoid sensitizing the skin.
The pro-oxidant effect, which can very slightly increase cell degradation and cause premature aging, can be countered with serums or moisturizers rich in antioxidants. Benzoyl peroxide does cause photosensitivity to the skin, so make sure to use it in conjunction with a product that contains at least 30 SPF.
Tea Tree Oil
Tea tree oil, abbreviated as TTO, is the go-to natural option for acne spot treatments. This essential oil is prepared through a steam distillation process from the bark of the tea tree. This ingredient has a very strong medicinal scent that tends to linger, which is why I ultimately stopped using it and switched to BP.
Tea tree oil at a 5% concentration was shown to be just as effective as 5% benzoyl peroxide, although unfortunately there hasn’t been much more research since the initial study. Those who use tea tree oil find that it works very quickly to calm down redness and inflammation, and is also effective as an acne preventative over time.
Willow Bark Extract
You might remember from earlier in this article that salicylic acid, my favorite anti-acne ingredient, was initially derived from willow bark extract. Willow bark extract is very rich in salicin, so it has an anti-inflammatory effect.
It can rapidly calm down redness, irritation, and inflammation, which are the key signs of a breakout. Shortly after it’s applied, pimples become smaller, and they end up healing more quickly as well.
Many people like to say that willow bark extract is essentially equivalent to salicylic acid, but that is not true. Salicylic acid has both exfoliating and antibacterial properties that willow bark extract does not possess. Despite this, it is still a wonderful treatment for acne.
When used alone in acne spot treatments it is great for pregnant women who often try to avoid salicylic acid and benzoyl peroxide. In natural formulas you will often see it paired with tea tree oil, while in more traditional formulas you might see it combined with salicylic acid.
Sulfur, sometimes spelled sulphur, is an unconventional spot treatment ingredient that works well but also has quite a few drawbacks. Sulfur works similarly to salicylic acid, in that it is a keratolytic agent, meaning that it helps the skin shed itself.
Anecdotally, it seems that sulfur works very well for Malassezia, which is more commonly known as fungal acne. Once sulfur is applied to the skin, it reacts with the skin’s pH to form polythionic acid, an acid that is toxic to fungus.
The drawback to using sulfur is that it has a very high pH so it can irritate and dry out the skin. It is a good idea to balance the skin’s pH with a toner after using a sulfur treatment.
Best Acne Home Remedies That Work
You can find many recipes for anti-acne home remedies online, but the truth is that most of them are not great. Either they are not going to be effective enough to adequately get rid of pimples, like yogurt or honey, or they can be actively harmful to the skin like baking soda, lemon juice, or toothpaste. That being said, it is possible to mix up your own at-home remedy for breakouts that will be safe and effective!
I previously mentioned how wonderful tea tree oil is as a remedy for breakouts. It helps to kill the acne bacteria as well as to soothe irritated and inflamed skin.
Some of the best acne spot treatments on the market include it as their key ingredient, but you can also purchase the essential oil and make your own anti-acne treatment with it. For maximum efficacy you want the tea tree oil to be about 5% of your formulation, no matter what you mix it with.
As with any DIY skincare recipe, only make enough to use once, and prepare a new mixture for yourself before each application. This way you can make sure your product stays safe and effective even if you don’t use preservatives.
Mattifying, Anti-Inflammatory Acne Home Remedy
- 1 teaspoon of alcohol-free witch hazel extract
- 1 drop of tea tree oil
Mix the witch hazel and tea tree oil together in a small, shallow bowl. Apply it to clean skin with a cotton pad, concentrating on the area where you are breaking out. Once it dries finish with a layer of moisturizer.
The witch hazel in this formula mattifies the skin, tightens the pores, and acts as an anti-inflammatory to relieve pain and irritation, while the tea tree oil helps control the acne bacteria and to further calm down the skin.
Nourishing Acne Treatment
- 1 teaspoon of rosehip oil
- 1 drop of tea tree oil
Mix the rosehip and tea tree oils together in a shallow bowl, using a Q-tip to get everything evenly dispersed. Apply the mixture to clean skin using a cotton pad or by massaging it in with clean hands, concentrating on the breakout-prone areas.
The rosehip oil will help moisturize the skin and prevent acne scars forming, while the tea tree oil will help eliminate the breakouts.
Soothing Acne Treatment
- 1 teaspoon of organic honey
- 1 drop of tea tree oil
Mix the tea tree oil and honey together in a clean bowl, using a clean mask brush. Apply the mixture to cleansed skin with the brush, using upwards strokes. Let it sit on your skin for 10-15 minutes, and then rinse away. Finish off with the rest of your skincare routine.
The honey will help to hydrate and soothe the skin, while the tea tree oil will help get rid of pimples.
How to Prevent Acne & Pimples
The secret to preventing acne is to keep your skin as healthy as the rest of your body. The first place to start is by following a gentle and effective skincare routine like the one I outline here.
- In the evenings, make sure to remove all of your makeup thoroughly, using makeup remover, face wipes, micellar water, or even by oil cleansing with a non-comedogenic oil.
- Use a gentle cleanser to finish off your cleansing process. The best cleanser for preventing breakouts would have a pH below 5.6, and it won’t strip the skin of moisture. CeraVe Hydrating Cleanser and CosRX Low pH Good Morning Cleanser are both excellent choices that are very gentle to the skin. The best way to cleanse the skin is by using circular motions, and massaging upwards and outwards. It is important to make sure all remnants of cleanser are gone, which is easiest to do by wiping the face with a paper towel or a damp microfiber cloth at the end.
- Keep your skin regularly exfoliated to prevent build-up of dead skin cells that can clog the pores. Salicylic acid is by far the most frequently recommended exfoliant, and I think it works best when used on a regular basis (either once a day or every other day, depending on your skin).
- Keep your skin well moisturized. You can use a non-comedogenic moisturizer, although if your skin is very oily, you might find that a hydrating serum or essence is more than enough.
- Make sure to use sunscreen in the daytime, in order to protect your skin, maintain your youth, and to help post-acne scars and marks fade more quickly.
- Your acne spot treatments should be used after you exfoliate the skin and before you moisturize it. Some people prefer to apply spot treatments, especially ones with benzoyl peroxide, after moisturizing because they find they are less irritating that way. The moisturizer acts as a buffer, which allows the spot treatment to penetrate into the skin more slowly.
Here are some more general tips for acne prevention.
- Change and wash your pillowcases, towels, sheets, hoodies, hats, and other fabrics that come into contact with your skin regularly. Bacteria from our face can transfer over to the fabric and then reinfect the skin, so it is important to keep them clean.
- Stick to as healthy a lifestyle as possible. Eat lots of fruits and veggies, get an adequate amount of exercise, get enough sleep every night, and drink plenty of water. Avoid smoking or drinking alcohol to excess. The healthier our body is, the likelier it is that our skin will reflect that fact.
- Don’t neglect your mental health! Stress can exacerbate acne, so it is important to try and mitigate it. Ideally, you would try to avoid unnecessary stressors in your life, but we all know that is easier said than done, especially under this capitalist system. Practicing self-care, seeing a therapist, and maintaining a support system of friends and family is a surprisingly effective way of preventing breakouts not to mention being overall happier.
- There are non-fabric items that come into contact with the face regularly, which you should wipe down with alcohol every once in a while. These include phones, headphones, their cords, and anything else that might come in contact with your face frequently.
- Picking or prodding at your skin doesn’t help prevent or get rid of pimples. Make sure to avoid it, as well as to avoid touching your face altogether. It takes a lot of self-restraint, but tinted acne spot treatments to your skin can also help.
- Shampoo and conditioner can also get on the skin and cause breakouts, so make sure to rinse them away thoroughly during your shower, and wash your face with a gentle cleanser towards the end of your shower, after you’ve shampooed and conditioned.
- Due to the state of health care in certain countries, seeing a doctor for skin issues is not always feasible. However, acne is certainly considered a disease. If it’s severe enough that over-the-counter solutions don’t work, definitely try to seek professional help. A doctor can check your hormone levels and prescribe hormones or birth control, while a dermatologist can give you a prescription to stronger anti-acne medications like adapalene, clindamycin, or even oral tretinoin.
Photos via @mod.young, Instagram