The first step to an Acne-free skin: What causes my Acne?

I get a lot of questions about breakouts and acne. That is not surprising, because almost everyone has a breakout now and then. And a single breakout can ruin your mood and make you feel insecure; let alone several. And although acne is very common in adolescence, troubled skin is also very common in adults, especially with pregnant women. Because in my experience the right approach to overcome breakouts or acne is not always followed, I decided to write a blog about it. 

Different sorts of Acne 

The most important thing to know if you suffer from acne is that there are different sorts of acne. And to make it even more complicated, you can also suffer from multiple sorts at the same time. In order to properly treat acne, you will first need to find out exactly what its cause is. Otherwise, it's possible that you will not see the effect of your chosen treatment. Or even more frustrating: that your breakouts get worse.

Which pimples can you distinguish?

1 Hormonal Acne

This is the "official" acne which is caused by certain hormones that cause an overdrive in the sebum production, increase skin cells, and clog sebaceous glands.

Of all breakouts, this "real acne" is usually the most difficult to treat. The infections are usually deeper in the skin. In women, you often see the pimples on the jawline and chin. This form often occurs in adolescents, but also during pregnancy, in menopausal women, in women who use certain contraception (for example the Mirena IUD) and in women just before their period.

The primary cause of acne when you're pregnant is the increased hormone levels in the first trimester. The higher level increases the skin's production of natural oils. It's hard to predict who will develop pregnancy acne. You have a higher risk, though, if you have a history of acne or have acne flares at the start of your menstrual cycle. If you do not develop acne during the first trimester, it's unlikely you'll have breakouts that are out of the ordinary during the second or third trimesters.

But even if you are not in the teenage or transitional phase, you may still have a hormonal imbalance. For example due to:

• chronic stress, something we can probably all relate to, especially in these times. Stress makes hormonal acne worse through the production of cortisol. Read more about how to treat the effect of stress on your skin.
• too many endocrine-disrupting chemicals (EDC's) in the skincare that we use like parabens or BPA in our plastic utensils. Click this video here to learn everything about EDC's. 
• poor bowel function caused by the bacteria in your gut which directly affect hormones like insulin, estrogen, and testosterone. That explains why hormonal acne worsens by eating sugars, dairy, and other food products that peak insulin production.

Now you might understand why in the majority of cases I am not in favor of prescribing antibiotics pills in the treatment of acne. When you're pregnant you have to deal with pregnancy hormones. There is nothing that you can or want to change here. But what about the other influencers on our hormones? Try to have a look at your own eating habits and lifestyle and find out what there is to gain! 

Of course, there are also topical treatments that you can try to fight hormonal acne. Managing acne when you're pregnant can be tricky because many over-the-counter treatments come with a high risk of birth defects. That's why I will dedicate one of my next blog posts on how to treat the different types of acne!

2 Acne due to a chronic inflammatory process of the body

Breakouts that are caused by a chronic inflammatory process of the body are often more superficial and less large than the ones you see with the hormonal acne. Due to underlying problems such as an allergy to food, a leaky gut or bacterial overgrowth of the intestine, your body (and your immune system) reacts very violently to certain (external) substances from skin bacteria, fungi and skin mites (Demodex). You can compare it with hay fever, your own immune response reacts very strongly to something that does not bother other people at all. 

Often you will see a combination of these breakouts and hormonal acne. A hormonal imbalance can be created by a disturbed bowel function. Or the other way around when the stress hormone creates a hormonal imbalance and causes a chronic inflammatory process in the body.

3 Acne due to an overgrowth of yeasts, mites or bacteria

Yeast

Yeast acne does not respond to antibiotics. Antibiotics normally prescribed for acne kill the bacteria that help to control the yeast on your skin. Without these good bacteria, your yeast acne can even get worse. 
Yeast breakouts are usually skin-colored and small and occur mainly on the forehead. Sometimes they can even be a little itchy. Yeasts love moisture and heat, so they manifest themselves especially in the summer months. This type of acne is usually easy to treat but often it often comes back. 

Mites

An overgrowth of skin mites (Demodex) can also cause breakouts. It is very easy to determine mites on your skin with a microscope, but unfortunately, not many doctors check this. This type of acne is easy to treat, but not with the standard acne treatments. If you have a lot of Demodex mites on your skin, your skin is usually a bit red and you often see some fine flakes between the breakouts. As with yeast acne, the skin may also itch a little. When you often have eye infections or irritations, it is likely that you have an overgrowth of skin mites!

Bacteria

Breakouts due to bacterial overgrowth are usually somewhat smaller and redder than yeast breakouts. Sometimes they have a small white cup, but you don't see blackheads. Occasionally you will see small scabs appear.

If you see similarities in your breakouts, you can always see your doctor to the right treatment. But this will only get rid of the yeast, mites or bacteria. If you do nothing about the cause, there is a good chance that these little residents move back in! So have a look at your face cleaning ritual, the functioning of your skin barrier, or reduced immune system.  

4 Breakouts due to skin irritation 

Sometimes pimples are a superficial skin problem, caused by irritation. The surrounding skin is often red and restless, and the pimples are small. A well-known cause of irritation breakouts is the misuse of skincare products. You don't want to know how often this happens! What I also see a lot is that women with hormonal acne, eventually get these breakouts because they treat their skin too aggressively.

If you have these kinds of pimples, your skin will recover quickly if you leave your skin be for a while, and then gently introduce mild products again.

More soon in my next blog

I can imagine that this was quite a lot of information. And that you are curious about the way how to treat these different sorts of acne. I would love to elaborate on that in a next blog!

Acne can make you feel really insecure, but there are ways to overcome it. With the right treatment and a bit of patience.  In the meantime, try to take it easy with sugars and dairy. Also, keep in mind that stress does not help. Sufficient sleep and relaxation do the (troubled) skin well.  Read more about how to treat the effect of stress on your skin.