Acne-Prone Skin? Here’s How to Identify and Create the Right Routine

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Caring for acne-prone skin is about more than just applying blemish-busting products.

It can involve lifestyle changes, too — the first of which is often a new and improved skin care routine.

Read on for some expert tips on everything from picking and popping to effective clinical treatments.

The simplest way to understand acne is to split it into two categories: noninflammatory and inflammatory types.

Noninflammatory

Noninflammatory acne refers to clogged pores that appear as blackheads or whiteheads.

It’s the mildest type and is easy to spot. Blackheads have a dark appearance and can appear somewhat flat against the skin. Whiteheads are small skin-colored bumps.

Inflammatory

Anything with a red or more robust appearance is essentially classified as inflammatory acne.

This can range from papules and pustules to more severe nodules and cysts.

Papules are small red bumps, while pustules are small bumps that contain pus. Papules often turn into pustules.

Then there’s the deeper, more painful acne.

These inflamed bumps are typically larger than your usual pimple and feel as if they’re underneath the skin.

Acne vs. rosacea

Sometimes acne is confused with rosacea.

Rosacea is a chronic skin condition that often involves a tendency to blush easily and can often lead to chronic redness on the:

• cheeks
• nose
• forehead
• chin

Although there are four subtypes of rosacea, the type most commonly confused with acne is papulopustular or acne rosacea. This type involves acne-like breakouts.

On the other hand, acne vulgaris is a common type of acne characterized by inflammatory and noninflammatory lesions. It can involve pimples, blackheads, cysts, and other forms of acne.

It’s possible to have both acne vulgaris and acne rosacea at the same time.

Symptoms of acne rosacea can include:

• flushing and redness
• visible blood vessels
• acne-like breakouts and red skin
• sensitive skin
• raised patches of skin

Acne vulgaris involves clogged pores and may present as:

• pus-filled bumps
• blackheads
• whiteheads
• oily skin
• cysts and nodules

Besides the differences in symptoms, acne vulgaris is caused by clogged pores. The causes of acne rosacea are unclear, though it may involve a combination of hereditary and environmental factors.

Possible causative factors for rosacea include:

• hereditary factors
• an overreaction of the immune system
• a bacteria that causes intestinal infections called H. pylori
• a mite known as demodex
• the way the body processes the protein cathelicidin, which normally protects the skin from infection

Acne is caused by a combination of hormones, oil, and bacteria. When oil, dead skin cells, and bacteria clog the follicles, sebum can’t escape the pores. This leads to acne.

Each pore of your skin is also the opening to a hair follicle, which is made of a hair and sebaceous, or oil, gland.

The oil gland releases sebum, which keeps your skin lubricated and soft.

Causes of acne can include:

• your follicles producing too much oil
• dead skin cells accumulating in your pores
• bacteria building up in your pores

Overproduction of oil is usually because of hormonal changes, like:

• puberty
• the menstrual cycle
• pregnancy
• menopause

This is why hormonal birth control may help manage acne symptoms.

Although many teenagers experience acne outbreaks, acne can happen at any age.

Whatever the initial reason, acne occurs when pores become clogged and inflammation follows.

It’s common to link oily skin to acne. After all, excess oil is a known contributor to breakouts.

But dry skin types can still experience acne for a number of reasons, whether it’s due to environmental factors or a poor skin care routine that irritates the skin and clogs pores.

Knowing which skin type you have can help you care for your acne in the best way possible.

Dr. Yoram Harth, board certified dermatologist and medical director of MDacne, says there’s an easy way to work out your skin type.

First, wash your face with a mild “baby” soap. Gently pat it dry. Don’t apply any skin care products.

A couple of hours later, examine your skin. If it’s shiny, you have oily skin. If it appears flaky, rough, or red, you have dry skin.

Combination skin will appear dry on the cheeks and shiny on the forehead, nose, and chin (T-zone).

“Normal” skin, meanwhile, will have a healthy glow with no visible issues.

Bear in mind that it’s possible to be acne-prone without having dry or oily skin.

“The vast majority of people have had acne once in their lifetimes,” notes dermatologist Dr. Viseslav Tonkovic-Capin.

Treating acne doesn’t just involve trying product after product. It encompasses careful cleansing and some simple lifestyle changes.

Effective prevention includes:

• washing your face twice a day and after sweating
• being gentle with your skin by avoiding harsh scrubs
• don’t pick or pop!
• if you have to, using safe extraction methods with a qualified dermatologist
• routinely washing things that come in contact with your skin
• using noncomedogenic products
• checking your hair care ingredients
• staying hydrated

Wash twice a day and after sweating

Washing your face when you wake up and before you go to bed is recommended.

Doing it more than twice a day, unless you’re particularly sweaty, can irritate the skin.

Be gentle; don’t scrub or use harsh exfoliants

This is dermatologist Dr. Brooke Bair’s top piece of advice.

“Acne is not a ‘dirt’ problem,” she says, “so scrubbing harder and using hard exfoliants don’t help and can only lead to more redness and irritation.”

No picking or popping!

It’s super tempting to pop that pimple. But doing so can lead to scarring.

It can also transfer bacteria into other pores and make what was a small pimple turn into deep, inflamed acne.

But if you must… do it safely

There’s a proper popping method, officially known as extraction.

Most medical professionals don’t encourage popping pimples, but many people do it anyway. It’s best to have a dermatologist perform this.

The best method involves applying a warm compress to open the pores and using clean Q-tips to gently push down on either side of the blackhead or whitehead.

It’s best not to attempt this with deeper acne types like pustules.

Routinely wash anything that comes into contact with your skin

Bedding, makeup brushes, and even phone screens can all harbor debris that can clog your pores.

To avoid clogging your pores, the American Academy of Dermatology advises changing sheets weekly and pillowcases two or three times a week.

Ideally, you should clean makeup tools every day. But if that’s not feasible, try washing them once a week instead.

Phones can be wiped with a special cleanser once or twice a day.

Opt for noncomedogenic products

Noncomedogenic is a label you’ve probably seen quite a lot on skin care products.

Sometimes it goes by the name of oil-free, non-acnegenic, or simply “won’t clog pores.” Every product used on acne-prone areas should have the labels “oil-free, noncomedogenic.”

You’d think any products labeled with this would only help acne-prone skin, right? Unfortunately not.

It’s best to check the full ingredient list before using. Avoid anything that contains potential irritants, like alcohol or fragrance.

Review your hair care routine

Hair care formulas — from shampoos and conditioners to generic styling products — can cause breakouts in areas like the forehead and neck.

Try to avoid any products containing oils. If you suspect your hair routine is your acne culprit, switch it up to see if there’s any improvement.

Oil in the hair itself can also transfer onto the skin. Try to keep your hair off your face as much as possible, especially at nighttime.

Stay hydrated

Keeping skin hydrated may help combat the excess oil that leads to acne. However, there’s limited research to back this up.

Still, there’s no harm in sticking to the 8×8 rule (drinking eight 8-ounce glasses a day).

Beware of diet and supplement claims

Online, you’ll find plenty of supplement-selling brands claiming to banish acne.

But unless you’re seriously deficient in a particular nutrient, there’s little evidence to prove they help the skin much.

The same goes for dietary advice. For example, only a small amount of research has found a link between diet and acne.

It’s best not to cut out a specific nutrient or entire food group without a medical professional’s advice.

A skin care routine that’s not right for your skin type or concerns can end up causing more problems.

Here’s every step you should consider taking when dealing with acne-prone skin.

You can find many of these products at your local drugstore. Some are more specialized and found at other retailers, so they may be more expensive. Use these recommendations as general guidelines of what to look for.

And remember: The more lightweight the product, the better for your pores.

Ingredients to look for

• Salicylic acid works to unclog pores and reduce inflammation. It’s ideal for blackheads and whiteheads but can also help pustules disappear quicker. Try Stridex pads or Clinique Acne Solutions clinical clearing gel.
• Benzoyl peroxide kills acne-causing bacteria and therefore works best on inflammatory acne. La Roche-Posay Effaclar Duo acne treatment and Paula’s Choice Clear daily treatment come highly rated.
• Retinoids exfoliate the skin’s surface, removing the dead skin cells that clog pores, among other things. They also help reduce inflammation and are commonly used in many acne regimens. If you’re starting out, consider trying Differin adapalene gel. Your dermatologist can also prescribe stronger retinoids.

Morning

1. Cleanser. Cleansing skin in the morning can be a good component of an acne regimen. Oily skin types can try Cetaphil Oil-Removing Foam Wash. Opt for Differin Daily Deep Cleanser if you have dry or sensitive skin.
2. Toner. Use a toner to get rid of excess oil that may contribute to breakouts. Murad Clarifying Toner was designed especially for acne-prone skin.
3. Moisturizer. Whether your complexion is dry or oily, a moisturizer will keep skin hydrated. CeraVe Facial Moisturizing Lotion won’t clog pores. For ultra hydration, try Neutrogena Hydro Boost Water Gel.
4. Sunscreen. Some acne treatments can increase your skin’s sensitivity to sunlight. Protect it with a broad spectrum, SPF 30 sunscreen. Two popular options are La Roche-Posay Anthelios XL Ultra-Light Sunscreen and Tizo 2 Facial Mineral Sunscreen.
5. Makeup. While this isn’t an essential step, makeup can quickly cover pimples and residual redness. Both Clinique Anti-Blemish Solutions Foundation and Eucerin DermoPurifyer Cover Stick contain breakout-fighting salicylic acid.

Evening

1. Makeup remover. If you’ve chosen to wear makeup, properly removing it will help keep pores unclogged. Bioderma Sensibio H2O Micellar Water aims to soothe skin, while Natura Bi-Phase Makeup Remover is gentle and hydrating.
2. Cleanser. The day’s events can leave a great deal of grime on the surface of the skin. Gently get rid of it before bed with ArtNaturals Clarifying Face Wash or Avene Antirougeurs Cleansing Lotion.
3. Spot treatment. Applying a spot treatment after cleansing can allow the ingredients to work their way deep into the skin. As well as treating existing pimples, these products can target scarring and stop new breakouts. Try Peter Thomas Roth Acne-Clearing Gel or REN Nondrying Acne Treatment.

As needed

• Exfoliant. While exfoliating isn’t for everyone, exfoliating once or twice a week can help remove dead skin cells that can block pores and lead to breakouts. If you haven’t got much time, use Nip + Fab Glycolic Fix Cleansing Pads. Alternatively, try Drunk Elephant T.L.C. Framboos Glycolic Night Serum.
• Face mask. A well-formulated face mask, like Sunday Riley Saturn Sulfur Spot Treatment Mask or GlamGlow Supermud Clearing Treatment, can help combat oiliness and impurities, hydrate dry skin, and reduce redness. Use up to three times a week for optimal results.

Mild acne can usually be treated with the help of over-the-counter products.

If it doesn’t improve, you may consider making an appointment with a board certified dermatologist. If you don’t already have a dermatologist, our Healthline FindCare tool can help you connect to physicians in your area.

This is also the case for acne that’s classified as moderate or severe, such as cystic acne, or acne that’s scarring your skin. These types require prescription medication.

At your first appointment, you’ll be asked to detail your medical history and current skin care regime.

Your dermatologist will then examine your skin to determine whether you have acne, and if you do, which type it is.

You’ll likely leave with a prescription for medication —either topical, oral, or both —and some lifestyle recommendations. You may also be asked to consider certain procedures to help soothe the skin and minimize scarring.

Be prepared to go back for regular follow-ups, as your dermatologist will want to see how your skin is progressing and update your treatment plan accordingly.

Dermatologists use a number of treatments to help combat acne. These are split into prescription-strength medications and in-office procedures.

Medication

As Tonkovic-Capin explains, these can include:

• prescription topical antibiotics
• a short course of oral antibiotics
• topical retinoids

Both retinoids, such as tretinoin, and antibiotics, including benzoyl peroxide and tetracyclines, are ideal for cysts and nodules.

Acne that’s related to hormones may require a prescription for birth control pills (combination pills) or oral spironolactone (prescribed off-label, or for a use that hasn’t been officially approved).

However, even if hormones aren’t suspected to be a big culprit for your acne, these medications are often used successfully. Therefore, if you have acne, it’s worth asking your doctor if these would be good for you.

Procedures

Carried out in a dermatologist’s office, these can be useful for several forms of acne.

“Lasers and chemical peels are a great help in decreasing redness and smoothing the skin out,” Bair says.

Lasers and light therapies also have the ability to kill P. acnes (bacteria responsible for some types of acne), making them ideal for deeper forms of acne.

Chemical peels, meanwhile, can also be used in the treatment of some types of acne.

Your dermatologist can drain big, painful cysts that don’t improve with medication to speed up the healing process and reduce the chance of scarring.

Patience is key here. Use an acne treatment for at least 1 month before considering trying a new one. Expect to wait up to 3 months before seeing a big difference.

Not seeing any improvement? Consider switching to a new product or visiting a dermatologist for personalized advice.

Whichever route you decide to take, follow the instructions exactly for the best possible outcome.

Lauren Sharkey is a journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.