One day your body and mind get along just fine, and the next you they're pitted against each other. It happens. When your body feels like your frenemy, information about different types of pimples and what they mean about your skin could really help you out. Because your body can drive you insane by doing the exact opposite of what you want, only to then suddenly be super normal and predictable. Sometimes it's hard to tell exactly what you're going to get.
However random your skin's outbursts may seem, believe it or not, they actually all happen for a reason. There are tons of explanations as to why your skin might have erupted with a familiar looking pimple or a breed you've never encountered before. There are actually many different types of pimple, from the modest blackhead, to the ferociously glowing, big, bright spot that you predict will unleash a gorgeously gooey surprise for you, later down the line. There are likely a handful of pimples you're familiar with, but for the ones you've yet to be acquainted with, you might want to know your enemy in advance.
So I spoke with Dr. Michael Swann, board-certified dermatologist and Mohs expert, about a variety of different types of pimples and what they mean about your skin.
Common Things That Aren't Acne
To start, Dr. Swann tells me over email, that it's important to make sure your pimples are a type of acne, not a similar looking condition. "Other things resembling acne, but technically different include: Milia (small, white, hard bumps that stay on top [of] the skin for months and love to be near the eyelids), sebaceous hyperplasia (large oil glands), dermatitis (inflammation from an allergic or irritant reaction), keratosis pilaris (bumps in seasonally allergic-prone people that love the triceps area of the upper arm and sometimes the lateral cheeks), and folliculitis (an infection of the hair follicle from bacteria overgrowth that is not normally present in the pore)." Explains Dr. Swann.
He adds, "Rosacea is an inflammatory response that can have an acne component, but is really due to inflammation or hypersensitivity that results in redness of the central face, pimples, and sometimes dry, irritated eyes." So firstly, evaluate where and when your pimples arise before putting them under the umbrella of acne.
1. Closed Comedones AKA Whiteheads
"Open comedones are blackheads, closed comedones are whiteheads." Dr. Swann tells me, "Comedonal acne, whether open or closed, is due to the pore getting backed up, causing a buildup of sebum. These tend to be smaller pimples. Your body responds to this with an inflammatory response which causes tenderness and swelling, further choking off the pore." Comedonal acne includes types of pimples that you're probably already familiar with. But, you might not know the whole story behind why they crop up.
"Pores can get choked off for a variety of reasons, but the beautiful small-pores found on the faces and backs of pre-adolescents just have a hard time accommodating the extensive sebum that is delivered from puberty onward." Says Dr. Swann, "Being a pre-adolescent is like commuting 45 minutes into LA to work, but you are commuting at 3am when there isn't too much traffic. Post-puberty is like using the same roads and rules, but switching to day shift and hitting rush hour traffic every day. The infrastructure just can't handle it as well. Wrecks happen, pimples get picked, which further limits the traffic or oil." He concludes, "As time goes on, the skin responds to the increased oil traffic by enlarging the size of the pores and also, oil traffic tends to decrease after puberty. When oil gets backed up, normal bacteria in the pore can flourish and increase inflammation."
2. Open Comedones AKA Blackheads
You certainly don't have to give in to comedonal acne, in fact, you can fight it. Dr. Swann tells me, "There are things you can do that can really help. A type-specific approach is really important. Sensitive skin types should be treated differently than resistant, 'tough' skin." But instead of going hell for leather in full attack mode, there's a better way to go about things. "I generally recommend patients to quit being aggressive at 'degreasing' and 'over-cleaning' their skin and to take a more gentle approach, with the mindset that being harsh can itself increase inflammation in the face." Says Dr. Swann.
"Benzoyl-peroxides and anti-microbials both limit the bacteria that tend to flourish. Mild exfoliants can help gently remove the dead skin that can block pores. Salicylic acid helps with the sebum plugs commonly blocking the pore in blackheads." Dr. Swann recommends.
3. Acne Vulgaris
Dr. Swann tells me, "Acne vulgaris is the most common (vulgar means common actually) and is most commonly seen as a result of a deeper blockage or proliferation of bacteria in the oil gland itself." He continues, explaining the methods of treatment available, "Treatments for acne vulgaris include: Antibacterials that minimize the over-proliferation of hair follicle bacteria, anti-inflammatories that reduce the inflammatory response, and turnover products for the epidermis such as retinoids (Tretinoin, Retin-A, Differin.)" So there are plenty of solutions if you're a victim of acne vulgaris.
4. Adult Female Acne
"Adult female acne is a distinct entity worth mentioning." Says Dr. Swann, "It occurs in females primarily age 25 to 40 with deeper pimples rising on the chin and mandible. Sometimes these are seen in association with more course terminal hairs in the same areas."
According to Dr. Swann, "Adult female acne arises [due to] hormonal changes that occur in middle adulthood and sometimes these hormonal changes are exacerbated after pregnancy. An increase in testosterone is the primary culprit. Spironolactone is an anti-testosterone diuretic that works very well in treating adult female acne with few side effects. I have had marathoners on this medicine for some time without much affect on their total body water." You don't have to sit put and suffer with adult acne, if it seems like you're suffering from it, speak to your dermatologist to find the best solution to suit you.
5. Acne Excorée
"Acne excorée is a less common type of acne that occurs from chronic picking or scratching at the face." Dr. Swann explains, "This type of acne is often associated with anxiety. Many of us are 'pickers,' but picking does lead to increased inflammation in the face and increased inflammation can lead to even more pimples due to swelling around [the] adjacent course." If this sounds like you, try to be aware of moments when you are feeling more anxious and control your picking. Alternatively, if you're really suffering and can't get a hold of it, consult your doctor for the best course of action.
6. Acne Mechanica
"Acne mechanica is a distinct subset of acne that is thought to be caused by blockage of pores from external oils and greases." Says Dr. Swann.
Fellow Bustler Faz Abdul Gaffa-Marsh, discussed body acne caused by sports bras and referred to the US National Library of Medicine's findings on acne mechanica, and discovered that, "...acne mechanica happens when there is friction, pressure or rubbing against the skin. It also happens when there is excess heat in the body." So if you're constantly moving in your day-to-day life or you have a busy exercise regime, the friction could be causing you to have acne.
Dr. Swann adds, "Interestingly… we also see acne mechanica [in] patients who use heavy products, sunscreens, and makeup." So acne mechanica isn't caused solely from leading an active lifestyle.
Keep your peepers peeled for changes to your pores and if you're in doubt as to what kind of pimples have popped up on your skin, you can always consult your local dermatologist for clarification!