Here’s a million-dollar question in the world of skincare: What causes acne? Several different factors come into play to result in breakouts, and bacteria is often one of them. Bacteria and acne are a very common duo, as bacteria play a crucial role in forming certain pimples. So, f you’ve got questions about bacteria and acne, we’ve got answers.
Dr. Whitney Tolpinrud, a board-certified dermatologist at Curology says, “Acne is often considered to be either inflammatory or non-inflammatory. Bacteria are thought to contribute to the inflammatory kind. It’s one of the possible components involved in the formation of papules, pustules, cysts, and nodules. Non-inflammatory acne (comedones like whiteheads and blackheads), on the other hand, doesn’t necessarily involve bacteria.”
But no matter the type, inflammatory or non-inflammatory, acne of all kinds forms when a buildup of excess oil, or sebum, produced by your pore’s sebaceous glands combines with excess dead skin cells to clog your hair follicles.¹ Then, if bacteria enter the mix, your body’s immune system begins to fight off the bacteria. That causes inflammation.²
Acne causes can range from fluctuating hormones to genetics,³ and breakouts affect many people during both adolescence and adulthood. Acne can occur on the face as well as the body, so if you’re experiencing breakouts on your back or other areas, relax! It’s completely normal (although annoying), so there’s no need to be alarmed. But because we’re on the topic of bacteria, you may be wondering, is acne a bacterial infection? In short, no, it’s not. We can’t stress this enough: Acne is not an infection.
Is there a difference between hormonal acne and acne vulgaris? The term “hormonal acne”—which often occurs around the jaw, chin, and cheeks—actually describes acne vulgaris partly caused by hormones and hormonal fluctuations. So that means hormonal acne is a type of acne vulgaris. Hormones (androgens, specifically) are a major factor in contributing to acne for many people because they cause sebaceous glands to produce more oil (sebum).⁴ More oil means greater chances of pores becoming clogged, which can lead to acne. This often happens during adolescence, but many people also experience hormonal acne well into adulthood. Luckily, hormonal acne can typically be treated the same way as any type of acne vulgaris. Doctors also sometimes recommend hormonal treatments like oral contraceptives to help clear up hormonal acne.⁵
Fungal acne may be easy to confuse with acne vulgaris, but it actually has a very different cause. Fungal acne (which isn’t actually acne) can occur when an overgrowth of yeast happens in the skin. The yeast (which is normally present on our skin) thrives in sebum created by the sebaceous gland, and as a result, acne-like bumps appear. How can you tell if the acne you’re experiencing is fungal? You may notice some itching that’s untypical of other kinds of acne. Also, typical over-the-counter acne treatments like those containing benzoyl peroxide or salicylic acid likely won’t help clear it up.⁶
Acne vulgaris is the medical term for a very common skin condition that refers explicitly to breakouts that consist of a combination of different kinds of acne lesions (and if that’s the case, chances are bacteria are likely involved).⁷ Thankfully, several over-the-counter products can help you say “see ya” to acne, including acne vulgaris. Here are a few we recommend:
Cerave Renewing SA Cleanser. This cleanser contains salicylic acid, a longstanding ingredient in topical acne treatments, to help gently treat breakouts.⁸
Differin Daily Deep Cleanser. This face wash includes benzoyl peroxide, which is known for fighting Cutibacterium acnes (C. acnes) bacteria—AKA, the bacteria that contribute to acne.⁹
The Cleanser by Curology. The Cleanser by Curology is free of fragrance and parabens and formulated to gently cleanse your skin.
La Roche-Posay Effaclar Clarifying Solution Acne Toner. If you’d like to add salicylic acid to your skincare routine in a way other than a face wash, this toner is a great option. It has alcohol in it, so take care if you have dry or sensitive skin.
Differin Gel. This acne treatment contains adapalene, which is an over-the-counter retinoid (a synthetic vitamin A derivative). Retinoids have shown to be highly effective acne treatments.¹⁰
The Moisturizer by Curology. To help keep your skin glowing and healthy, using a good moisturizer never hurts. Curology’s moisturizer is safe for sensitive skin and extremely lightweight, making it easy to work into your daily skincare regimen.
Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant. This lightweight leave-on exfoliant contains salicylic acid to help eliminate built-up layers of skin and keep your pores clear.
If you’re looking to help clear up current breakouts and help prevent new ones (who isn’t?), we have good news. You can do both simultaneously by following these easy tips:
Remove your makeup daily. You’ve probably heard this before, but it's for a good reason, so we’ll say it again: Makeup doesn’t directly cause acne vulgaris, but clogged pores do. That’s why it’s important to take off all your cosmetics at the end of the day, especially if they contain comedogenic (pore-clogging) ingredients.¹¹
Wash your face regularly. Morning and night—or after you sweat heavily, like after a good workout or yoga session—always remember to wash your face with your favorite gentle cleanser (like Curology’s).
Moisturize. Just because your skin is dry doesn’t mean it’s irritated. But dry skin can easily become irritated, which can make you more likely to have a breakout.¹² Find a great moisturizer to apply after washing your face as part of your daily routine and let your skin soak up all the goodness.
Use non-comedogenic products. Helping prevent future breakouts doesn’t necessarily mean needing to give up makeup altogether. Look for products that are non-comedogenic, meaning they’re free of ingredients known to cause clogged pores.
Be patient. Once you establish a good skincare routine and stick to it, it’s time to relax and have faith. Keep in mind that it can take a while—sometimes several weeks or longer—to notice a difference in your skin. So be patient (and consistent!) with any new routine before giving up.
If you want to treat a current breakout, the good news is you have plenty of options for acne medications. Remember, acne is a very common skin condition, but your skin is unique. A treatment that works well for one person may not work for you, and that's completely okay. Understanding what causes acne will help you know how to choose the right treatment for you.
If you’re feeling unsure about what your skin needs to beat breakouts, talking to a dermatology provider can help. You can get started with one at no extra cost when you start your Curology free* trial. Just take a quick skin quiz and snap a few selfies and one of our licensed medical providers will evaluate your skin.
If Curology is right for you, we’ll send you a 30-day supply of your Custom Formula with a mix of active ingredients chosen for your unique skin concerns, plus any of our recommended products, for free—just pay $4.95 (plus tax) to cover shipping and handling.
Acne is often considered to be either inflammatory or non-inflammatory. Bacteria are thought to contribute to the inflammatory kind. It’s one of the possible components involved in the formation of papules, pustules, cysts, and nodules. Non-inflammatory acne (comedones like whiteheads and blackheads), on the other hand, doesn’t necessarily involve bacteria.
1. Mayo Clinic Staff. Acne: Symptoms and causes. (2020, September 12).
2. Tanghetti, Emil A. The role of inflammation in the pathology of acne. The Journal of clinical and aesthetic dermatology. (September 2013).
3. Zaenglein A., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016, February 17).
4. Elsaie M. L. Hormonal treatment of acne vulgaris: an update. Clinical, cosmetic and investigational dermatology. (2016, September 2).
5. Zaenglein A., et al. Guidelines of care for the management of acne vulgaris. Ibid.
6. Rubenstein, R. M., & Malerich, S. A. Malassezia (pityrosporum) folliculitis. The Journal of clinical and aesthetic dermatology. ( March 2014).
7. LINDA K. OGÉ, et al.Acne Vulgaris: Diagnosis and Treatment. American Family Physician. (2019, October 15).
8. Jacqueline Woodruff, et al. A double-blind, placebo-controlled evaluation of a 2% salicylic acid cleanser for improvement of acne vulgaris.(2013, April 1).
9. Zaenglein A., et al. Guidelines of care for the management of acne vulgaris. Ibid.
10. Leyden, J., et al. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatology and therapy, (September, 2017).
11. American Academy of Dermatology. Acne: tips for managing. (n.d.).
12. American Academy of Dermatology. 10 skin care habits that can worsen acne. (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.
Empowering you with knowledge is our top priority. Our reviews of other brands’ products in this post are not paid endorsements—but they do meet our medically fact-checked standards for ingredients (at the time of publication).
* Subject to consultation. Subscription is required. Results may vary.
Allison Buckley, NP-C