Everything You Need To Know About Acne

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Acne is one of the most common skin diseases. In many, acne begins in adolescence and, after a while, passes almost without a trace. Others often overtake after 25 years. So what to do about it?

We have prepared for you some informative articles on

acne. And most importantly, we tried to write them in simple, understandable language in the question-and-answer format. We hope they will help you!

In this article, you will find answers to the most common questions about acne: what it is, why it appears, how not to confuse it with other skin diseases, who to ask for treatment, whether you can get rid of yourself, how to build your care.


What is Acne?

What is Acne

Yes, acne is classified as a skin disease, and therefore it has its own cipher according to the International Classification of Diseases ICD-10. Here’s a definition from “Clinical Recommendations”:

Acne (acne vulgaris, acne disease) is a chronic inflammatory disease of the sebaceous glands. It is manifested by open or closed comedones and inflammatory lesions of the skin in papules, pustules, knots.

Do many people suffer from acne?

Very much! According to statistics, acne is faced with:

  • 85% of boys and girls between the ages of 12 and 24;
  • 8% of those aged 25 to 34;
  • 3% of those between the ages of 35 and 44.

And over the last decade, the number of cases of acne in adults has seriously increased and continues to increase. And most often, it develops in women.


Why do pimples even appear?

Unfortunately, the cause of acne is still unknown. But the main factor is now considered hereditary predisposition and the background for development – abortion.

Other provoking factors include:

  • Hormonal;
  • Psychogenic;
  • Immune;
  • Anatomical;
  • Biochemical;
  • Microbiological (Cutibacterium acnes).

Difficult? Do not rush to frighten and close the article. Now we will briefly analyze each factor, and everything will become much clearer!

Genetic factor

A hereditary predisposition is a key factor. It is she who controls all other triggers of acne disease. It has been proven that if parents had acne, it is likely to develop in children. And at the same time in a more serious form.



Seboroe, or oily skin – a condition in which the sebaceous glands secrete too much sebum and at the same time also change its composition.

There are three peaks of abortion activity:

  • Infancy – the first 3 months of life;
  • adolescence – puberty;
  • mature age – 40-60 years.

The cause of sabotage – hormonal failure associated with increased production of sex hormones – androgens. As a result, the sebaceous glands produce too much sebum.

There are two kinds of seborrhea:

  • Fatty – the skin actively shines, you can feel the stickiness, the pores are enlarged, there may be closed comedones, grayish complexion;
  • Dry – the sebum is more viscous, the pores are not greatly enlarged, there may be flushing, itching, inflammation.

It is also possible to have a mixed form, in which some areas suffer from fatty seborrhea, others from dry.

And in seborrheic, as the composition of the skin sebum changes, the skin’s protective function is reduced, and the natural microbiological balance is disturbed. And on this fertile soil often appears acne.

Seborrhea develops with a genetic predisposition and against the background of some chronic diseases (HIV, Parkinson’s, Itsenko-Cushing’s disease, mental illness) and prolonged use of certain medications.


Hormonal factor

Imbalance of sex hormones in favor of men – the most important factor of acne disease. It is the excess of dihydrotestosterone that “launches” abortion. Moreover, the increase in its number can be physiological (a little earlier, we just mentioned three peaks of seborrheic activity) and associated with endocrine diseases.


Psychogenic factor

Stress increases the fatness of the skin and aggravates acne. It’s all about the hypothalamic-pituitary-adrenal axis. Roughly speaking, the hormonal background changes dramatically during stress, the Cebu begins to be produced more actively, and inflammation increases.

That is why it is important to maintain peace of mind despite everything and under all circumstances. Less stress, as they say!


Immune factor

Immunity in healthy people and people with acne varies. The compositions of the skin and intestines microbiome also differ.

There is a direct relationship between the activity of acne and the activity of the immune system. It’s related to immune cells. They, on the one hand, fight the pathogen; on the other, support inflammation.

It is also necessary to avoid any skin irritation (physical, chemical, “ultraviolet”), as it provokes hyper-development of sebum.


Anatomical factor

The anatomical structure of the sebaceous glands is directly related to genetics. Unfortunately, people with acne have sebaceous glands ducts on the face and back that are thinner, longer, and more sinuous. This makes it difficult for sebum to reach the surface and also provokes the development of blackheads.


Biochemical factor

Here you can find long, tediously, and difficult to paint all the violations of biochemical processes in the skin … Here is just the most important information. Acne is observed:

  • Increased activity of sebaceous glands;
  • High sensitivity and propensity to inflammation;
  • Thickening of the layer, changing its organization, reducing the barrier function;
  • pH often goes into alkaline – 5.8-6.0.

The skin becomes oily, sensitive, inflamed, sometimes dehydrated, poorly refreshed, pores easily clogged.

The body’s biochemical reactions are also due to genetic features.


Microbiological factor

Cutibacterium acnes (Propionibacterium acnes – the outdated name of this microorganism) – the usual “resident” microbiome of human skin. It affects the production of sebum because it feeds on it. But their excessive growth exacerbates the course of the disease.

Are all-all the causes of acne? What about chocolate, smoking, tonsillitis?

Yes, these are the main causes of acne. Their key influence has been proven by modern research.

Aggravated but not cause acne can:

  • Milk and dairy products;
  • Smoking;
  • Some medicines;
  • Insulin resistance.

Chronic tonsillitis, chocolate, bacterium Helicobacter pylori, subcutaneous mite Demodex Folliculorum are also not the root cause of acne.


Why pay so much attention to the causes of acne?

Why pay so much attention to the causes of acne

Realizing the causes is the first step to treating acne. This understanding will help you work with exactly what you can change and not waste energy on those aspects that do not depend on you.

Black dots, little pimples, subcutaneous bumps – is it all acne?

Well, it’s time to focus on the types of acne elements. Inflammation on the skin is important to distinguish to make a big picture, assess the extent of the disease, and prepare a treatment plan.

  • Open comedones are the so-called “black dot” on the surface of the skin. By the way, the dark color appears because of oxidation. How to distinguish open comedones from sebaceous threads will talk a little later;
  • Closed comedones – a bump that rises above the surface of the skin. May not be inflamed for a long time;
  • Papula is an inflamed, red pimple. Soft, swollen, without thous;
  • Pustoula – an inflamed pimple with a pus formation;
  • The nodes are inflamed papules that “sprawl” on the skin tissue. After permission often forms scars and scars.

It is important to understand that acne elements are dynamic formations. They gradually move from one stage to another. Therefore, the disease should be evaluated in dynamics.


Is it true that if pimples appear on the chin, the problem with “female” organs?

No, it’s not. The so-called map of pimples, which walks on the Internet, has nothing to do with reality. You don’t have to rely on her and trust her.

How does acne develop?

If we briefly and very simplistic describe the stages of acne, we can distinguish 4 stages:

  1. The production of skin sebum is increasing;
  2. There is the excessive oration of skin cells;
  3. The growth of Cutibacterium acnes is on the rise;
  4. An inflammatory reaction joins.

And with all these stages, you can work including with the right home care. But we’ll talk about it later.


How to assess the severity of acne?

The best way to rely on the classification of Kligman and Plelig (G.Plewig, M.Kligman, 2004):

Severity Comedons Papula, pustules Papuls (alt;1 cm) Knots, cysts, fistulas inflammation Scars

Comedonal <20 <10 No No No No

Paulo-empty -legal (Easy) >20 10-20 <10 No Clear No

Paulo-empty-iron (Middle) >20 >20 10-20 little Strong eat

Conglobatnaya (Heavy) Multiple >20 A lot Very strong and deep eat eat

Also, secrete acne subtypes in women:

  • Persistent acne – begins in adolescence and goes into adulthood. It occurs in 80% of women with acne;
  • Later acne – first develops after 25 years;
  • Recurrent acne – begins in adolescence, then goes into remission and again the development of the disease.

In adolescents, pimples and comedones are concentrated in the forehead, nose, and chin (T-zone) with less pronounced inflammation in adults – on the cheeks, around the mouth, and on the chin (U-zone) with more pronounced inflammation.

And acne can develop not only on the face but also on the skin of the upper torso (back and chest), hands, buttocks, and thighs. It’s all a picture of acne.


What degree of acne can be cured by home care?

That’s the most important question!

If you have a comedone or mild form of the popular-empty stage of acne, competent home care can take acne under control, significantly improve the situation and bring it to remission.

But in the middle papule-empty and conglobate stage of acne, treatment must be under the strict supervision of a dermatologist and, if necessary, a gynaecologist and/or endocrinologist. Proper home care here is also critical, but only it will not create a miracle. Comprehensive work on all fronts is important!


What tests should be taken for acne?

Unfortunately, we can’t give a universal list of acne tests simply because the attending physician prescribes the necessary tests after assessing the current picture of the disease and collecting history.

The doctor may prescribe tests for acne:

  • To identify the co-factors that affect the disease;
  • For the appointment of systemic therapy, physiotherapy;
  • To control the condition during acne treatment with some drugs.

Acne tests may include general blood tests, general urine analysis, biochemical blood test, glucose-tolerant test, insulin resistance index, iron, general iron, latent iron, transferrin, ferritin, vitamin B12, vitamin D, sex and thyroid hormones, pelvic ultrasound, thyroid ultrasound, etc.


What can be confused with acne?

Acne can be confused with three skin diseases – demodicosis, Malassezia-folliculitis, and rosacea. And also with several states – a mask, an individual reaction. Separately, let’s talk about black dots and sebaceous threads.

Acne and demodicosis

Demodicosis is a skin disease caused by the action of the Demodex tick. This microscopic tick lives in the ducts of the sebaceous glands and actively feeds on the sebum. And he loves the night, the heat (30-40 degrees Celsius), and the humidity.

The main difference between demodicosis and acne:

  • It develops at the age of 30-60 years;
  • With age, the disease worsens;
  • Not associated with hormonal disorders;
  • It leaks without comedones;
  • Only the skin of the face is affected;
  • Active rashes around the mouth and eyes;
  • There may be rashes on the scalp;
  • In demodecousion, folliculitis can defeat only one side of the face;
  • At night itch feels as if light touches down;
  • The situation worsens in summer and humid climates;
  • There are no scars;
  • Also connect eye diseases – blepharitis, redness of the conjunctiva.


Acne and Malassesia-folliculitis

Malassezia-folliculitis is a skin disease caused by the fungus Malassezia. It also lives on the surface of the skin.

The main differences between Malaysians and folliculitis are from acne:

  • Mostly affected breasts and back, the skin of the faceless often;
  • If the face is affected, it is mainly its periphery and chin;
  • Active rashes in the form of papules and pustules;
  • There is burning and itching;
  • Antifungal therapy quickly brings results;
  • Antibacterial therapy is absolutely not effective;
  • The disease progresses in the summer months, in warm environments, and with increased physical activity.

There is also a more difficult situation when acne is complicated by Malaysian folliculitis. This often happens when antibiotics are taken and used unchecked.


Acne and rosacea

Rosacea, in its papulo-empty stage, looks like a papule-empty form of acne. But the cause of rosacea lies in the violation of microcirculation. It has nothing to do with the sedboria.

The main differences between rosacea and acne:

  • It develops at the age of 30-60 years;
  • With age, the disease worsens;
  • Not associated with hormonal disorders;
  • It leaks without comedones;
  • Only the skin of the face is affected;
  • Active outbreaks of erythema (redness of the skin caused by the rush of blood to capillaries);
  • Redness is concentrated in the forehead, cheeks, nose, chin, and there are vascular asterisks;
  • The situation worsens after sun exposure;
  • There are no scars;
  • Also often connected eye diseases – blepharitis, redness of the conjunctiva.



Make – the appearance of atypical pimples (papule, pustule, comedones) after wearing a hygienic mask. They usually appear after 4-6 weeks of regular and prolonged wearing of the mask.

Under the mask, the skin sweats and even irritates and even injured. As a result, its pH changes, the microbiome is disturbed, the barrier function suffers, the pores are blocked, sensitivity is increased, and inflammation joins.


Individual reaction

An individual reaction is an allergy or blockage of pores due to the use of the wrong remedy.

The individual reaction is often accompanied by rash, redness, itching, burning, soreness. In this case, you need to stop using the product because something in its formula or the skin did not fit.


Black dots and sebaceous threads

Very often, open comedones are confused with sebaceous threads. We have prepared for you a simple reminder of how to distinguish these states from each other.


How to build home care for acne?

We will talk about specific skin remedies with acne in the next article. In the same final block, let’s take a look at the main steps of home care for acne.

So, we did not pay so much attention to the causes of acne and the processes that occur in the skin. With the right care, we can influence some of them!

Key components of home care for someone and mild acne:

  • Soft cleansing;
  • Regular exfoliation of keratinized cells;
  • Restoring protective features;
  • Support for a healthy microbiome;
  • Antioxidant work;
  • Normalization of skin sebum production;
  • Dealing with comedones, papules, and pimples;
  • Removal of the inflammatory factor;
  • Sun protection.

And now briefly about each of these steps!


Soft cleansing

Careful cleaning is a necessity for skin of any type. If conventionally trouble-free skin can still withstand the foams cleaned to a squeak, then it is already a sentence for skin with acne.

What to do:

  • Use a foam with a balanced pH of about 5.5 or slightly more acidic based on soft surface-active substances. It’s going to be your basic foam. The vast majority of foams in ERIKA are soft, and we always point them out in the text.
  • You can also choose a foam with a small salicylic acid content, with tea tree, with clay. Leave this option for the evening or 2-3 times a week.
  • It is better than the evening cleansing was two-stage: 1. Hydrophilic oil or cleansing balm, 2. Foam for washing. Thus, the excess skin sebum, the remnants of sunscreen, and tonal remedy will be removed.
  • Choose hydrophilic oil without mineral oil in the composition. Mineral oil is not dangerous but can sometimes be poorly washed off the skin. We don’t need that.
  • Add soft enzyme powder to care. Use dissolved 1-3 times a week instead of foam for washing.


Enough exfoliation

Regular soft exfoliation helps to fight the blockage of pores, improves the micro reel, brightens the marks after pimples, and enhances asset absorption.

What to do:

  • You can use enzyme powder or a peeling stingray. And not all at once.
  • Scrubs for skin with acne are forbidden!
  • Scats are enough 1-3 times a week. If there is a reaction in small papules and pustules, you need to reduce the use.
  • Acid toners are also exfoliating agents. They are better applied to the skin with a cotton pad.
  • The exfoliation is even more dangerous than the lack of exfoliation.
  • The frequency of use of a product depends on the specifics of care and your skin condition. It is better to be smaller and more accurate than often and rigidification.


Restoring the protective barrier

The barrier function in the skin with acne is broken. This means that the skin quickly loses moisture, is easily inflamed and irritated, poorly resists pathogens from the outside. Fortunately, it is in our power to correct this case.

What to do:

  • Pay attention to drugs based on lamellar emulsion or with physiological lipids(ceramides, cholesterol, unsaturated fatty acids) in the composition.
  • It is best to choose an emulsion or cream with a suitable regenerative composition. The main thing is that the texture is not too saturated for your skin.


Microbiome support

Maintain a healthy balance of microorganisms can eat right and take dietary supplements and the help of cosmetics.

Maintain a healthy balance of microorganisms can eat right and take dietary supplements and the help of cosmetics.

What to do:

  • Add toner/serum/essence/cream with pro-and prebiotics;
  • In lactose and bifidobacteria, lactococci, saccharomycetes, galactose are helphelpingrestore a healthy microbiome, strengthen the protective barrier, calm, remove the inflammatory factor, moisturize, regenerate.
  • Prebiotics in the form of inulin, oligosaccharides, amino acids, beta-glucan “feed” the natural healthy microflora of the skin.


Antioxidant work

Skin with acne suffers from oxidative stress. Free radicals attack cells, disrupt the composition of the skin sebum.

What to do:

  • Put an antioxidant serum into care.
  • The win-win option is niacinamide. It is not only a powerful antioxidant but also normalizes the production of sebum, strengthens barrier functions, reduces moisture loss, brightens spots after pimples.
  • Another option is vitamin C. It can be a stable form. For example, sodium ascorbyl phosphate, which also has anti-inflammatory and antibacterial properties. Or acidic form, but with caution and in concentration from 5 to 15%.
  • Serum with vitamin C is used strictly in the morning, niacinamide – at any.



Increased production of sebum (severe) – the background for the development of acne. Ideally, we should eliminate the cause of abortion. Otherwise, even retinol will be effective only temporarily. But cosmetic products with Sebo-regulating components will not be superfluous.

What to do:

  • Effective components that help normalize the operation of the sebaceous glands: niacinamide, salicylic acid, hamamelis, phytoestrogens, retinol, sofoljans, butyl advocate, zinc.


Dealing with comedones and pimples

All the components of care that we are currently disassembling are directly or indirectly aimed at resolving comedones and pimples without scars.

What to do:

  • Never push pimples on your own. And if you still decided to clean, turn to a proven beautician.
  • The worst enemies of acne elements: salicylic acid, retinoids, azelaic acid.
  • To protect the pimple from your hands, use sticker patches against acne.


Removal of the inflammatory factor

The skin with acne often becomes very sensitive and inflamed. Our task is to extinguish the inflammation.

What to do:

  • Exclude any skin injury: no unnecessary friction and irritation, mandatory protection from the sun.
  • The care includes well-added products with soothing components: Centella Asian and its derivatives, Rezulin and chamomile, peptide Rigin (Palmitoyl Tetrapeptide-3), copper peptide (Copper Tripeptide-1), alpha-bisabolol, etc.


Sun protection

UV protection is your pass into the world of healthy and young skin. The idea that the sun treats pimples is a dangerous myth. Ultraviolet damages cells, reduce immunity, provokes photoaging, causes pigmentation, reduces barrier functions.

What to do:

  • Sunscreen in the daytime is your best friend.
  • Oily skin with acne should give preference to creams and emulsions on mineral/physical filters. They contain zinc oxide and titanium dioxide. Among the advantages – additional seborregulation and anti-inflammatory effect. Of the cons – a small whitening and updating the coating every 2-3 hours.
  • Another option is sunscreen on stable chemical filters of the new generation. The most common of these are Uvinul A Plus (Diethylamino Hydroxybenzoyl Hexyl Benzoate), Uvinul T 150 BASF (Ethylhexyl Triazone) Tinosorb S (Bis-Ethylhexyloxylphenol Methoxyphen Triylazine). Of the pluses – no need to update in the urban environment, do not cause reactions, very pleasant to use. Of the cons – do not matte.

The second part of the article will focus on specific remedies against acne. In it, you will find many examples of effective cosmetics for problem skin and a few examples of integrated care. Stay with us!

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