Your Guide to Acne at The Skin Clinic Antigonish

Sep 29

8 min read

We treat a fair amount of acne at The Skin Clinic Antigonish, which makes a lot of sense when you consider that almost everyone will deal with a pimple at some point in their life.

But there’s a difference between the occasional breakout and acne. If you’re regularly breaking out, dealing with several pimples at once, or feel like just as one breakout clears another appears, it may be time to look a little closer at what’s going on with your skin.

First things first: What actually is acne?

One thing we want to make clear from the beginning: acne isn’t caused by laziness, bad hygiene or a lack of effort. Acne, or acne vulgaris, is a common inflammatory skin condition involving your hair follicles and sebaceous glands, which are responsible for producing oil.

It can show up as blackheads, whiteheads and pimples, or as deeper, more painful lesions such as nodules and cysts.

It’s also a chronic skin condition that can stick around for months, years or through different stages of life. It often starts around puberty, but acne certainly isn’t reserved for teenagers. Adult acne is common too, including acne that appears for the first time later in life.

And while a breakout can seem to appear overnight, there’s actually quite a bit happening beneath the surface.

What causes acne?

Acne develops when hair follicles become clogged with dead skin cells and sebum, the oily substance naturally produced by your skin. A bacteria called Cutibacterium acnes (C. acnes), which normally lives on our skin, can also contribute to acne and inflammation when conditions within the follicle change.

There are four main processes involved:

Excess sebum production: Your sebaceous glands produce more oil, which can contribute to clogged follicles.
Abnormal shedding of skin cells: Dead skin cells accumulate within the follicle instead of shedding normally.
C. acnes: This bacteria naturally lives on the skin but can contribute to the inflammatory processes involved in acne.
Inflammation: The inflammatory response contributes to the redness, swelling and tenderness associated with inflammatory acne.

But, what about hormones?

Hormones absolutely matter.

They can influence several of the processes involved in acne, particularly how much sebum your skin produces. It’s one reason acne so commonly begins around puberty and why hormonal fluctuations can continue to influence breakouts throughout adulthood.

So hormones aren’t necessarily a completely separate “cause” of acne. They’re one of the factors that can influence what’s happening inside the skin.

Why are some people more prone to acne?

Ever wonder why one person can seemingly use whatever they want on their face while someone else follows their skincare routine religiously and still breaks out? Unfortunately, skin doesn’t believe in fairness.

Genetics can play a significant role. If one or both of your parents experienced acne, you may be more likely to develop it too, and genetics can also influence how severely someone experiences acne.

Age, life stage and hormonal susceptibility matter too. Some people are simply more prone to breakouts during periods of hormonal change.

None of these things guarantee that you’ll develop acne. They simply help explain why some skin is more acne-prone than others.

What can trigger or worsen acne?

Here’s where things get a little more personal. A trigger isn’t necessarily the reason you have acne. It’s something that may bring on a breakout or make your existing acne worse, and your triggers won’t necessarily be the same as someone else’s.

Hormonal fluctuations

Breakouts can coincide with hormonal changes, including the menstrual cycle, pregnancy and other periods of hormonal change.

Stress

Stress doesn’t necessarily cause acne on its own, but it can make existing acne worse. So yes, the pimple that arrives just in time for the important event is particularly rude, but not necessarily completely random.

Cosmetics, skincare and haircare

Sometimes the products we’re using to help our skin aren’t helping quite as much as we think.

Certain skincare, makeup and haircare products can contribute to clogged pores and breakouts. If you’re acne-prone, look for terms such as oil-free, non-comedogenic or non-acnegenic.

And remember, more skincare isn’t always better skincare. Over-washing, scrubbing, excessive exfoliation and harsh cleansers can irritate your skin and make acne worse.

Friction, pressure and sweat

Helmets, chin straps, headbands, sports equipment and tight clothing can create repeated friction against the skin. Excessive sweating can also aggravate acne in some people, particularly when it becomes trapped beneath damp or tight clothing.

Picking and squeezing

We know. It’s tempting.

But picking and squeezing can increase inflammation and your risk of permanent acne scarring.

Certain medications

Some medications can cause or worsen acne in certain people, including oral corticosteroids, some hormonal medications and certain anticonvulsants.

If you think a medication may be affecting your skin, talk to your healthcare provider. Don’t stop a prescribed medication on your own.

Diet

There isn’t a universal list of foods that “cause acne,” despite what the internet may have told you.

Research has found associations between acne and certain dietary patterns, including high-glycemic diets and some dairy consumption. But the relationship is complex, and the evidence isn’t strong enough to make broad dietary recommendations for everyone with acne.

Rather than unnecessarily eliminating entire food groups, pay attention to your own patterns and speak with a healthcare professional if you’re concerned.

Causes, risk factors and triggers are different

An easy way to remember it:

Causes are what’s happening within the skin to produce acne.

Risk factors help explain why you may be more susceptible to developing it.

Triggers are things that may bring on a breakout or make existing acne worse.

Understanding the difference can be helpful when you’re trying to figure out why your skin keeps breaking out despite doing “all the right things.”

How can you identify your acne triggers?

Acne can feel completely random. Sometimes it is. But sometimes patterns emerge.

Pay attention to when your breakouts happen. Do they appear around your menstrual cycle? During particularly stressful periods? After adding a new skincare or haircare product? After heavy sweating or wearing equipment that rubs against your skin?

A simple record of your breakouts alongside changes in products, medications, your menstrual cycle and other potential triggers can be helpful. Where acne appears can sometimes provide useful context, but location alone can’t tell us what’s causing it.

And if your acne is painful, deep, persistent, scarring or simply isn’t behaving like you think acne should, that’s a good reason to have your skin properly assessed.

Not all acne looks the same

Knowing what type of acne you’re dealing with matters because not every breakout should be treated the same way.

Non-inflammatory acne

Blackheads (open comedones): Clogged follicles that remain open at the skin’s surface. And no, that dark colour isn’t dirt. It happens when the contents of the clogged follicle are exposed to air.

Whiteheads (closed comedones): Clogged follicles that remain closed beneath the surface, creating small flesh-coloured or white bumps.

Inflammatory acne

Papules: Small, tender, pink or red bumps associated with inflammation.

Pustules: Inflamed lesions containing visible white or yellow pus.

Nodules: Large, firm and painful lesions that develop deeper within the skin.

Cysts: Deep, painful, pus-filled lesions that can carry a higher risk of permanent scarring.

Plot twist: Not every breakout is acne

This is another reason we’re big believers in assessing the skin before throwing treatments at it.

Several skin conditions can look surprisingly similar to acne, including:

Folliculitis: Inflammation of the hair follicles that can cause red bumps or pustules.
Rosacea: A chronic inflammatory skin condition that can cause facial redness and acne-like bumps.
Malassezia folliculitis, sometimes called “fungal acne”: Despite the nickname, it isn’t actually acne. It’s a type of folliculitis involving Malassezia yeast that can cause clusters of small, often itchy bumps.
Perioral dermatitis: An inflammatory skin condition that can cause clusters of small bumps, often around the mouth, nose or eyes.
Milia: Small, firm cysts containing keratin that can look like stubborn whiteheads.
Sebaceous hyperplasia: Enlarged sebaceous glands that can appear as small, skin-coloured or yellowish bumps.
Keratosis pilaris: Small, rough bumps caused by keratin plugging the hair follicles.

If you’ve been treating your “acne” forever without much success, it may be worth making sure it’s actually acne in the first place.

Treating acne: support, don’t punish

If there’s one thing we’d like you to take away from this guide, it’s this:

Acne doesn’t need to be scrubbed, stripped or dried into submission.

The goal is generally to improve the acne that’s already there while helping prevent new lesions from developing. The right approach depends on your type of acne, how severe it is, how your skin behaves and what you’ve already tried. And often, acne treatment works best when we address more than one of the processes behind it.

Topical treatments

Depending on your skin and acne, treatment may include:

Benzoyl peroxide: Helps reduce C. acnes and inflammation.
Topical retinoids: Help prevent clogged follicles and can reduce inflammation.
Salicylic acid: Helps unclog pores and exfoliate the skin.
Azelaic acid: Can help with clogged pores and inflammation and may also improve post-acne dark marks.
Prescription topical medications: A healthcare provider may recommend topical antibiotics or other prescription medications depending on your acne.

This is why randomly adding another acne product every time you break out isn’t necessarily the answer. The goal is to choose treatments that make sense together and give them enough time to work.

Where do professional treatments fit in?

Professional treatments can sometimes be incorporated into an acne treatment plan, but they’re not a replacement for appropriate medical acne management. Depending on the individual, options may include chemical peels, certain laser treatments or professional extractions.

Current acne treatment guidelines don’t provide enough evidence to broadly recommend procedures such as chemical peels, laser and light devices or microneedling as treatments for active acne. That’s why we look at the person in front of us rather than automatically recommending a procedure simply because they have acne.

Active acne and acne scarring are two different conversations

First, we want to get active acne appropriately controlled. Once that’s happening, we can look at what the acne has left behind.

Post-acne marks, uneven texture and acne scars may benefit from a completely different treatment plan. This is where options such as microneedling, certain laser treatments and other procedures may play a role depending on the type of scarring or concern.

In other words, stop the fire first. Then we can talk about repairing the damage.

When skincare isn’t enough

Sometimes acne needs medical treatment. Moderate, severe, persistent or treatment-resistant acne may require prescription medication from an appropriate healthcare provider. Options can include:

Oral antibiotics: Certain antibiotics can be used to treat inflammatory acne. Their use is generally limited when possible and they’re typically combined with topical acne therapy.

Hormonal therapies: Combined oral contraceptives and spironolactone may be appropriate options for some patients.

Isotretinoin: Oral isotretinoin may be recommended for severe acne or acne that hasn’t responded adequately to standard topical or oral treatments. It requires medical assessment, prescription and monitoring.

The right medication depends on the person, which is why prescription acne treatment needs to be individualized.

A few things acne-prone skin generally appreciates

You can’t control your genetics or every hormonal fluctuation, but you can make life a little easier for your skin. Try some of these tips:

Cleanse gently once or twice daily and after sweating.
Choose non-comedogenic skincare, makeup and haircare.
Don’t scrub or aggressively exfoliate.
Try not to pick or squeeze blemishes.
Follow your acne treatment consistently and give it time to work.
Wear an appropriate non-comedogenic sunscreen.
Pay attention to your triggers rather than assuming everyone with acne needs to avoid the same things.

The boring answer is often the right one: consistency usually beats aggression.

When is it time to ask for help?

You don’t need to wait until your acne is “bad enough” to ask someone about it. Consider having your skin assessed if your acne is persistent, painful, scarring, suddenly becomes more severe, isn’t responding to appropriate over-the-counter care or is significantly affecting your confidence or quality of life.

It’s also worth asking for help if you’re simply overwhelmed by products, aren’t sure what your skin needs or aren’t even sure what you’re dealing with is acne. Getting the right treatment earlier can be particularly important when there’s a risk of permanent scarring.

Not sure where to start? That’s what we’re here for.

An acne consultation at The Skin Clinic Antigonish isn’t about handing you a ten-step routine and sending you on your way. We want to understand the bigger picture.

We’ll look at your skin, talk about your lifestyle, review what you’re currently using, discuss what you’ve already tried and find out what you’re hoping to improve. From there, we can recommend appropriate next steps and let you know if we think additional medical assessment is needed.

Because when it comes to acne, more isn’t always better. The goal is to understand what your skin actually needs and build a plan from there. Book a consultation today