What is Acne?

All types of acne — blackheads, whiteheads, pimples, and cysts — develop when pores in our skin become clogged. The culprit is sebum [see-bum], an oil in our skin. Our bodies make more sebum when our hormones surge. This is why teens get acne. This is why women often breakout before their periods. Since hormones fluctuate in the years leading up to menopause, many women in their 40s and 50s get acne.

Acne occurs as:
• Blackheads (plugs of sebaceous secretions (skin fats, which may be liquid like oil or
more waxy) which appear black due to oxidation);
• Whiteheads (like blackheads but sealed with skin cells, giving the appearance of a
white plug);
• Pustules (tiny infections in a pore which appear red, swollen and contain pus and
other fluid); and
• Cysts (deep infections which occur as painful, sometimes red bumps but resist the
extraction of their contents).

A blackhead appears when sebum and dead skin cells clog the pore. While the pore is clogged, its surface remains open. This lets us look into the pore and see a black color. Your dermatologist may call a blackhead an “open comedo” (co-me-dough).

A whitehead forms when the excess oil and dead skin cells clog the pore and block the opening of the pore. Because the pore closes, dermatologists call this type of acne a “closed comedo.”

** Blackheads and Whiteheads are example of non-inflammed comedones.

The excess oil does more than clog pores. Bacteria that normally live on our skin, P. acnes, thrive in this excess oil. Immersed in excess oil, the bacteria can rapidly increase in number. As the bacteria multiply in a clogged pore, the pore becomes inflamed. Inflammation is what causes a pimple to look red, hot, and swollen.

When inflammation reaches deep into the skin, an acne cyst forms. This is the most severe type of acne. Cysts can be very painful. People often see permanent scarring after this type of acne heals.


Common feedback received on acne appearance vs root cause.

Candida, fungus, yeast & mold
- very uneven skin tone, rash like pimples. The spots sit under the skin are small and dont hurt.
- Occasionally they'll come to the surface but the heads are very small. The skin has a shine to it and is oilier thannormal in problem areas.
- Most common part of the face affected is the T-zone.

Congested liver
- alot of blackheads and clogged pores.
- Often dry skin. Breakouts appear anywhere on the face and easily come to the surface with a head. Surface pimples are very red and can be sore to touch.

Adult hormonal problems including PCOS, PMT, menopause,childbirth, breast feeding,and estrogen dominance
- pimples more frequently sit under the skin and dont always surface (headless).

- pores are clogged with many blackheads and whiteheads.
- The pimples are often cystic or blind, can be very painful and someitmes take weeks to heal.
- There arent many blackheads or whiteheads and amount of oil on the skin is irrelevant to the problem. You can still get this type of acne with very dry skin.
- women often experience most of their acne along wthe jawline.

Heatiness / Dampness / Constipation
- acne often appear near jawline and sit under the skin and down always surface.

Cosmetic acne
- the pores are very clogged with many blackheads, whiteheads. Breakouts are mild but frequent.
- there are no cystic acne. The pimples are small and often appear in cluster.

Puberty
- acne can range from mild to very severe. the skin is often oily.
- pimples are usually very red and sit on the surface , but in severe cases there can be large cystic acne or pustules.
- it is more common for boys to suffer from more severe types of acne than girls in this stage.

Stress
- acne can range from mild to severe depending on the amount of the stress, but usually shows up as hormonal