Comedonal acne occurs when dead skin cells get trapped within hair follicles. This combined with all the natural oils in your pores (sebum) can cause acne to form. Here are some factors that may be causing your comedonal acne:

• Diets high in sugars, fats and dairy
• Follicle injury from popping and picking pimples
• Over-hydration from high humid or using the wrong moisturizer for your skin type
• Laser therapy and/or chemical peels
• Comedogenic cosmetics (blocks pores)

The key to treating comedonal acne is to figure out what is causing it - although we know that’s easier said than done. It's recommended to talk with a specialist to get the best treatment for you but here are some things to do to get you started:

• Try topical over-the-counter medications to manage excess sebum and unclog pores (azelaic acid, glycolic acid, salicylic acid, benzoyl-peroxide, retinoids)
• Choose oil-free cosmetics and wash your face frequently with a gentle cleanser
• Reduce the amount of sugar, dairy and fatty foods you are intaking
• Stop smoking
• If OTC medications are not working, you may need prescription-strength topicals or oral medication (antibiotics, oral contraceptives, hormonal therapy, Accutane, Aldactone)
• In severe cases, you may need to turn to surgical treatments such as microdermabrasion, cryotherapy, or electrosurgery
• You can also try natural remedies (in addition to other treatments) like tea tree oil, witch hazel, and charcoal/clay masks

Inflamed acne happens when pores are deeply clogged with bacteria and dead skin cells which result in swelling, redness and irritation. Hormones may also be a culprit for inflammatory acne, whether it’s related to the menstrual cycle or stress. Other aggravators may include:

• Excess activity of androgens (male sex hormones)
• A diet with too much sugar and/or carbohydrates
• Certain medications
• Popping/picking other pimples, as it can spread and lead to scarring 

Since inflamed acne can easily be spread and cause scarring, it’s best to begin treatment as soon as possible. Depending on the severity of your acne, over-the-counter topical treatments may clear it right up, or you may need to consult a professional about prescription medications. 

• OTC topicals: benzoyl peroxide, salicylic acid, sulfur
• You can start by adding a cleanser with salicylic acid and use a spot treatment containing benzoyl peroxide. Keep in mind it may take a few months to see results and OTC treatment doesn’t always work for wipespread and reoccurring inflamed acne.
• Wash your face twice a day to minimize oil production
• Avoid products that may irritate your skin
• Prescription medications: topical retinoids, Accutane, oral antibiotics, topical antibiotics, hormonal treatments, etc.
• Avoid soda, white bread, white rice, and foods high in sugar

Nodulocystic acne forms when a combination of bacteria, oil and dry skin cells get trapped in your pores. Nodules are a result of bacteria or sebum getting trapped in your pores and turning into an infection underneath your skin, causing pores to become red and swollen. Cysts are the largest, deepest and most painful form of acne. They are filled with pus and tender to the touch.

Unlike the other forms of acne, nodules and cysts likely will not be able to be treated with over-the-counter products due to their lack of strength. It is recommended to consult with a doctor for the best treatment plan for you. Here are some things that may help nodulocystic acne:

• Prescription medications
• Zinc + sulfur (helps reduce the size and eliminates oil while soothing the area)
• Accutane
• Topical retinoids (removes and prevents severe acne by unplugging hair follicles)
• Benzoyl peroxide
• Salicylic acid
• Office procedures (acne drainage and extraction, chemical peels, laser therapy, blue light therapy, injections of medication)
• Hot compresses
• Natural remedies (tea tree oil, apple cider vinegar, aloe vera, castor oil)

*This type of acne is the most likely to scar and cause infections. It’s best to leave all nodules and cysts alone, meaning don’t pick or pop them.

Yeast is always present on our skin; however, when it becomes imbalanced, fungal acne can occur. This leads to an infection in your skin’s hair follicles and appears with acne-like symptoms. Some things that may trigger this imbalance may include:

• Wearing sweaty workout clothes for too long (trapped moisture)
• Medication such antibiotics which reduce bacteria on your skin and may allow for an overgrowth of fungus
• Compromised immune systems
• Dietary changes (try balancing your intake of sweets and carbohydrates)
• Regularly wearing tight, non-breathable clothing that traps sweat and moisture
• Warm, moist climates

Fungal acne has to be treated very differently than regular acne. In fact, by using typical anti-acne treatments, you can make fungal acne worse. Proper treatment will involve restoring the balance between yeast and bacteria on the skin. There are multiple ways to accomplish this:

• Shower more often, especially after working out or sweating excessively
• Wear looser clothes or more breathable fabrics to increase airflow to the skin
• Try a new body wash (dandruff shampoos with pyrithione zinc or selenium sulfide can be effective)
• Over-the-counter anti fungal treatments (athlete’s foot or jock itch)
• Eat a balanced diet (fruits, vegetables, and proteins help diminish overgrowth)