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3 causes of acne and blemishes that could be to blame for your breakouts

Get to the bottom of what’s causing acne and blemishes so you can help stop them for good.

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Curology Team
May 24, 2022 · 5 min read

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We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.
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  3. > 3 causes of acne and blemishes that could be to blame for your breakouts

Most everyone experiences acne and blemishes every now and then, but you may notice different marks on your face that aren’t exactly what you’d call pimples. That’s because, technically speaking, the term “blemish” applies to more than just acne. So what exactly is the difference between acne and blemishes, what can cause them, and what are the different kinds of blemishes that most commonly occur? Understanding what kinds of marks are considered acne versus which are other types of blemishes can help you learn the best way to treat both, to get a clearer, healthier complexion.

What causes acne and acne blemishes?

Acne is a common skin condition that affects many people, and the word “blemish” can describe the lesions you may notice if you experience acne. Some people may refer to a blemish as any face mark (not just acne!) such as a dark spot, scar, or patch of irritated skin. More on that in a bit!

First, let's talk about what causes and contributes to acne. It can develop due to a combination of different factors. Understanding what might be contributing to your pimples can help you find the proper treatment for them. Excess oil and dead skin cells clog the follicle, bacteria thrive in the excess oil, and then inflammation results. That is how many types of acne form.¹ That's the short version of the story, but many other factors can come into play as well, including hormones, stress, and comedogenic hair and skincare products:

Hormones

Hormones are one of the biggest factors that contribute to acne. Certain hormonal fluctuations cause glands in your skin to release more oil (called sebum), which collects in the pores and can contribute to acne. This may occur during adolescence, when hormones are in flux, in response to hormonal cycles like menstruation or menopause, in response to hormonal therapy, or even from changes in diet.²

Stress 

Stress can indirectly contribute to acne breakouts,³ so if you notice blemishes popping up before a big event, stop and take a deep breath. Know that stress acne, while annoying, is totally normal. Try to give yourself some time to relax and practice self-care to keep your stress—and blemishes—to a minimum.

Pore-clogging products 

Your beauty products could be filled with comedogenic ingredients, which can clog your pores. Look for hair and skincare products with non-comedogenic ingredients instead to keep breakouts to a minimum.

What are the most common types of blemishes?

Blemishes can refer widely to any mark on your skin, including those caused by acne. Some of the more common acne-related blemishes⁴ include:

  • Whiteheads. These are closed comedones that contain excess oil and dead skin cells. When sebum builds up in the hair follicle, the pore can become clogged, resulting in a whitehead. They are “closed” to the air by a thin layer of skin.

  • Blackheads. Blackheads are open comedones filled with oil and dead skin cells. They are “open” to the air.

  • Papules. These pimples look like small, inflamed red bumps.

  • Pustules. These pus-filled blemishes are inflammatory. They typically appear red around the head.

  • Cysts. Cystic acne consists of large, soft blemishes that go deep under the skin’s surface and may feel swollen and tender. Cystic acne may also result in scarring. Cysts (like other types of acne) can occur in different places, including the body, as some people experience cystic “bacne” (cystic acne on their back).

  • Nodules. Nodules are hard, painful bumps without pus that occur deep below the skin’s surface. Nodules can also cause acne scarring.

What causes dark spots? 

Even when it disappears, acne can leave scars or other spots that may appear as pigmented skin, raised bumps, or indentations. If you’re wondering how to clear up dark spots from acne (which aren’t considered scars!), there are a variety of at-home topical treatments, such as retinoids and alpha hydroxy acids, or treatments a dermatologist can perform.⁵

Non-acne blemishes

While acne lesions may be one of the most common types of blemishes, there are some common face marks that aren’t acne:

  • Sunspots. Sunspots, also called age spots, are flat dark marks on the skin. As the name suggests, they typically appear in people over 50, although you may still notice them at a younger age if you spend a lot of time in the sun. Age spots develop with sun exposure, so don’t forget the SPF.⁶

  • Birthmarks. If you have a birthmark, it could be due to a clump of pigment cells or blood vessels that didn’t form properly. Either way, birthmarks are typically harmless and quite common.⁷ What’s more, they’re one-of-a-kind—and uniqueness is something to celebrate!

What’s your blemish’s color trying to tell you?

Remember, blemishes come in all shapes and sizes, so a quick assessment of the color can help identify a face mark.

  • White acne blemishes are often whiteheads. A pustule may also appear white but with a red ring around it.

  • Red blemishes may have several different causes. Acne lesions, for example, are a common blemish that will often appear red. Rosacea may also present with red acne-like bumps.⁸ Cold sores are another type of blemish that occurs around the mouth and may appear red and irritated.⁹

  • Brown blemishes may be age spots, birthmarks, melasma, or a different type of hyperpigmentation.

When is it time to see a medical provider?

There are many different reasons you may want to see a medical provider. If a blemish is changing, or if you have any doubts, always have a medical provider examine it. This is especially true if you notice the blemish is developing irregular borders, multiple colors, or increasing in size. Routine skin checks with a medical professional are always a good idea. 

For pimples, you may want to see a medical provider if you have persistent acne, acne scars, or want advice on how to treat your acne. 

A medical provider may prescribe a variety of treatments for acne from over-the-counter options, such as benzoyl peroxide and salicylic acid, to prescription retinoids and antibiotic creams. There is no shortage of acne treatment options available, so don’t be afraid to make an appointment if you want a professional opinion of your blemishes.

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Acne and blemishes can be frustrating, which is why Curology creates personalized, dermatology-backed skincare made for you. Curology can help you find the right acne treatment for you by using the right ingredients to target your specific acne. You won’t only receive effective acne treatments for your skin, but you’ll get guidance from dermatology providers to answer all your questions, too.

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FAQs

What causes acne and acne blemishes?

Acne is a common skin condition that affects many people, and the word “blemish” can describe the lesions you may notice if you experience acne. Some people may refer to a blemish as any face mark (not just acne!) such as a dark spot, scar, or patch of irritated skin.

What are the most common types of blemishes?

  • Whiteheads. These are closed comedones that contain excess oil and dead skin cells.

  • Blackheads. Blackheads are open comedones filled with oil and dead skin cells. They are “open” to the air.

  • Papules. These pimples look like small, inflamed red bumps.

  • Pustules. These pus-filled blemishes are inflammatory. They typically appear red around the head.

  • Cysts. Cystic acne consists of large, soft blemishes that go deep under the skin’s surface and may feel swollen and tender.

  • Nodules. Nodules are hard, painful bumps without pus that occur deep below the skin’s surface. Nodules can also cause acne scarring.

What causes dark spots?

Even when it disappears, acne can leave scars or other spots that may appear as pigmented skin, raised bumps, or indentations. If you’re wondering how to clear up dark spots from acne (which aren’t considered scars!), there are a variety of at-home topical treatments, such as retinoids and alpha hydroxy acids, or treatments a dermatologist can perform.

When is it time to see a medical provider?

There are many different reasons you may want to see a medical provider. If a blemish is changing, or if you have any doubts, always have a medical provider examine it. This is especially true if you notice the blemish is developing irregular borders, multiple colors, or increasing in size. Routine skin checks with a medical professional are always a good idea.

• • •

P.S We did the research so you don't have to:

1. Toyoda, M., & Morohashi, M. Pathogenesis of acne.Medical electron microscopy : official journal of the Clinical Electron Microscopy Society of Japan.( March 2001).

2. Elsaie M. L. Hormonal treatment of acne vulgaris: an update. Clinical, cosmetic and investigational dermatology. (2016, September 2).

3. Yosipovitch, Gil et al. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta dermato-venereologica. (2007).

4. Cleveland Clinic. Acne. Ibid.

5. Thiboutot, D. M., et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. Journal of the American Academy of Dermatology. (2018).

6. Mayo Clinic Staff. Age Spots. (2022 February 11).

7. National Library of Medicine. Birthmarks. (2022 February 18).

8. Gallo, R. L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology. (2018).

9. American Academy of Dermatology. Cold sores: Overview. (n.d.).

We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.

*Subject to consultation. Subscription is required. Results may vary.

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Allison Buckley Avatar

Allison Buckley, NP-C

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