Not All Acne Is the Same: Dive into Skin and How to Treat It

Peter White

Peter White

Ajna Chakra
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Disclaimer:
I know there is already many posts about skin care, I have yet to see any talking about different types of conditions, so this post is all about different skin and acne types, and products or treatments you can do to treat the acne. I am not a professional, contact a dermatologist before taking or doing anything risky.

What are the different skin types?
The main skin types are normal, dry and oily, there are also sub-factors such as sensitivity and combination zones. Understanding your skin type will help you choose the right skincare.

Normal skin is balanced. It’s not too oily, not too dry, and usually feels comfortable all day. Pores are small, texture is smooth, and you rarely experience flakiness or excessive shine. If your face feels fresh and looks even without needing much effort, you probably have normal skin.
Dry skin lacks oil and moisture. It can feel tight or rough, especially after cleansing. You might notice flaking or fine lines becoming more visible. This type often struggles with dullness and needs consistent hydration, both from moisturisers and enough water intake.
Oily skin produces excess sebum, giving the face a shiny or greasy appearance, especially in the T-zone (forehead, nose, chin). Pores tend to be larger, and breakouts or blackheads are more common. The pro of oily skin is that it often ages more slowly because natural oils protect against fine lines.

Figure 1.0

1762639662129

Figure 1.0 shows the texture of each skin type.

How do I detect my skin type?
To know what types of skin you have you can try this simple test:
1. Wash your face with gentle cleanser.
2. Leave it bare (no products) for an hour.
3. Press a clean tissue or blotting paper on different areas of your skin.
If the tissue picks up oil all over, you have oily skin.
If tissue picks up nothing and there is noticeable flaking and/or dryness, you have dry skin.
If the tissue picks up nothing, and there is no noticeable dryness on your skin your most likely normal.
There is also combinations such as the T-Zone (forehead, nose and chin), where some sections are more oily or dry than others.

What is skin sensitivity?
Unlike oily or dry skin, this isn't a type it's rather a condition that can occur in any of the above skin types. The skin can easily become irritated, itchy, burning and red.
Skin sensitivity usually happens when the skin’s protective barrier weakens, allowing irritants, allergens, and microbes to penetrate more easily and trigger inflammation. This can result from over-exfoliation, harsh cleansers, environmental stress (like cold, heat, or pollution), or even genetics that affect barrier proteins such as filaggrin. Once the barrier is compromised, nerve endings in the skin become overreactive, causing stinging, burning, or redness even from mild products or water.
TLDR; sensitive skin is usually the result of a damaged barrier and an overactive inflammatory or sensory response.

Your skin is alive!
On your face lives a whole ecosystem called the skin microbiome. Billions of microorganisms (mostly bacteria, but also fungi and even tiny mites) that form a balanced community. When this ecosystem is healthy, it protects your skin like an invisible armour; when it’s disrupted, that same army can turn against you.
Healthy skin sits at a slightly acidic pH of around 4.7 to 5.5. This mild acidity keeps the microbiome balanced and strengthens the acid mantle (thin film of sebum, sweat, and dead cells that acts as your first defense against harmful bacteria, pollution, and moisture loss). When your pH becomes too alkaline (from harsh soaps, over-cleansing, or abrasive scrubs), the acid mantle weakens. Beneficial bacteria die off, the bad ones thrive, and your skin can become dry, tight, and more prone to irritation or breakouts.


Different types of acne.
Acne isn't just pimples, it's a wide spread spectrum of conditions/issues. Here I will breakdown the most common types of acne, their causes and what they look like.

1. Comedonal Acne (blackheads and whiteheads) - Caused by Blocked pores from excess sebum and dead skin cells.
This is the mildest form of acne and it doesn't cause inflammation, it's often linked to poor exfoliation, comedogenic ingredients, or hormonal imbalances that increase sebum production.
Whiteheads: Clogged pores that are sealed at the surface, forming small flesh or white coloured bumps. They can feel like tiny grains under the skin. Left side of Figure 1.1.
Blackheads: Pore that is open, and the oil inside oxidises when exposed to air, turning dark. Unlike many believe that the dark colour comes from dirt. Right side of Figure 1.1.
Figure 1.1
1762639698149


2. Papules - Inflammation caused by trapped oil and bacteria under the skin. They form when the wall of a hair follicle breaks from pressure causing redness and swelling (Figure 1.2). They're small, raised, red and tender, but there is no visible pus. Usually trigged by overproduction of oil, bacterial overgrowth, or using irritating skincare products that inflame the pore lining.
Figure 1.2
1762639725209


3. Pustules - these are infected papules filled with pus. Pustules are what people usually refer to as "pimples", white red bumps with red/yellow centre (Figure 1.3). Essentially papules with visible pus.
They are usually caused by hormonal changes, stress, poor hygiene, or over use of thick creams or oils that trap bacteria.
Figure 1.3
1762639754224


4. Nodules - Deep infection within the follicle and surrounding tissue. They are painful lumps under the skin with no visible head, and they do not contain pus (Figure 1.4). The inflammation runs deep, often lasting for weeks. Unlike surface acne, nodules won’t respond to over-the-counter treatments easily because the infection is below the skin barrier.
These are usually caused by severe hormonal imbalance, genetics, and chronic inflammation. These often need professional treatment (like prescription retinoids or anti-inflammatory therapy).
Figure 1.4
1762639780011


5. Cystic acne - Severe inflammation and bacterial infection deep in the dermis. They are the most severe type of acne. They’re soft, pus-filled lumps that can be painful and lead to scarring (Figure 1.5). They occur when bacteria, oil, and dead skin get trapped deep within pores, causing an immune response that forms a large pocket of infection.
Usually caused by hormonal surges (like during puberty), diet high in refined sugars or dairy, and stress
Figure 1.5
1762639800655


6. Fungal Acne (Malassezia Folliculitis) - Caused by Overgrowth of Malassezia yeast in hair follicles, not bacteria. Often mistaken for regular acne, fungal acne shows up as uniform, itchy, small bumps (Figure 1.6). usually on the chest, shoulders, or forehead. It thrives in warm, humid environments or after antibiotic use (which kills bacteria but lets yeast overgrow).
Key difference: Itchy, monomorphic bumps that don’t respond to normal acne treatments
Figure 1.6
1762639825817


7. Hormonal Acne - Caused by fluctuating hormones, particularly androgens (testosterone, DHEA). typically appears along the jawline, chin, and lower cheeks, especially in adults (Figure 1.7). It flares cyclically and involves deep, painful cystic lesions. Trigged by cortisol spikes and conditions like PCOS.
Figure 1.7

1762639859671


8. Acne Mechanica - Caused by Friction, pressure, or heat trapping sweat and bacteria. Commonly seen in athletes or from face masks, helmets, and tight clothing. The mechanical irritation clogs pores and causes breakouts (Figure 1.8).
Figure 1.8

1762639883982


9. Acne Rosacea - Chronic inflammation and vascular sensitivity, not clogged pores. Rosacea can look like acne with red bumps and pustules (Figure 1.9), but it’s actually a vascular condition involving dilated blood vessels and skin sensitivity. It’s triggered by heat, alcohol, spicy food, or stress.
Figure 1.9

1762639904469


Okay finally were past all the acne types and skin types! Now I am going to talk about products and treatments for all the different cases.
Before I start, please keep in mind the most important part of skin care is not the treatments or products you use, it's taking care of your body by hydration (drinking 2-3L of water), correct diet (eating organic high quality food, and limiting processed sugars), high quality sleep, exercise and hygiene.

What products should you use
In this section I'll list many types products and what they are good for.

PRODUCTS
Product TypePurpose/FunctionBest Skin TypeHelps with (acne type)Key ingredient
Gel CleanserDeep cleans pores, removes excess oilOily / CombinationComedonal acneNiacinamide, Salicylic Acid
Cream CleanserHydrates while cleansingDry / SensitivePrevents irritationCeramides, Glycerin
Exfoliating CleanserMild daily exfoliationOily / CongestedComedonal acneLactic Acid, BHA
Hydrating TonerAdds moisture & soothes skinDry / SensitiveBarrier repairHyaluronic Acid
Exfoliating TonerClears pores & smooths textureOily / CombinationBlackheads, PapulesGlycolic Acid, BHA
Gel MoisturizerLightweight hydrationOily / CombinationAll acne typesHyaluronic Acid
Cream MoisturizerDeeply nourishes skinDry / SensitiveIrritation recoveryCeramides, Squalane
Barrier Repair CreamStrengthens damaged barrierSensitive / Over-treatedRedness, post-acne healingNiacinamide, Fatty Acids
Niacinamide Balances oil, calms rednessAllMild acne, large poresNiacinamide, Zinc
Retinol (Vitamin A) Boosts cell turnover, unclogs pores.Oily / AgingCystic, Nodular, ComedonalRetinol, Retinal
Vitamin C SerumBrightens, fades dark spotsNormal / DryPost-acne marksL-Ascorbic Acid
Hyaluronic AcidDeep hydration & plumpnessAllDehydration, recoveryHyaluronic Acid
Azelaic AcidAnti-bacterial & pigment-reducingSensitive / Rosacea-pronePapules, PustulesAzelaic Acid
AHA (Glycolic/Lactic)Surface exfoliationNormal / DryWhiteheads, uneven toneGlycolic Acid
BHA (Salicylic Acid)Unclogs pores, reduces oilOily / Acne-proneBlackheads, papulesSalicylic Acid
Clay MaskDraws out oil & impuritiesOily / ComboBlackheadsKaolin, Bentonite
Sulfur MaskKills acne bacteriaOily / Acne-proneCystic, PustularSulfur, Zinc Oxide
Sunscreen (Mineral)Blocks UV, reduces post-acne marksSensitive / Acne-proneAll TypesZinc Oxide
Sunscreen (Chemical)Lightweight UV protectionNormal / DryPigmentationAvobenzone

What medication should you use
In this section I'll list many types medication and what they are good for.

MEDICATION
Medication / ActivePurposeBest For (Skin Type)Helps with (acne types)OTC / RX
Benzoyl PeroxideKills acne-causing bacteria (C. acnes)Oily / Acne-pronePapules, PustulesOTC
Adapalene (Retinoid)Regulates turnover, prevents cloggingAllComedonal, CysticOTC (0.1%) RX (0.3%)
Azelaic Acid (higher strength)Reduces bacteria & pigmentationSensitive / RosaceaPapules, Post-inflammatory marksRX (15-20%)
Clindamycin / ErythromycinTopical antibiotic, reduces inflammationOily / ComboPustules, PapulesRX
Tretinoin (Retinoic Acid)Strong cell turnover, collagen boostNormal / OilyCystic, Nodular, ScarringRX
Spironolactone (Oral)Reduces androgen-driven oil productionOily / HormonalHormonal acneRX
Oral Antibiotics (Doxycycline)Reduces inflammation & bacteriaOily / ComboSevere cystic acneRX
Isotretinoin (Accutane)Permanently reduces sebum productionOily / Severe acneCystic, NodularRX
Zinc (Picolinate / Gluconate)Anti-inflammatory, reduces sebumAllMild acne, healingOTC Supplement
DIM (Diindolylmethane)Balances estrogen/testosteroneHormonal / AdultHormonal acneOTC Supplement
Omega-3 Fatty AcidsReduces inflammation & regulates oilDry / ComboAll acne typesOTC Supplement
ProbioticsSupports gut–skin axisAllFungal or stress-related acneOTC Supplement
Collagen PeptidesImproves elasticity & healingAging / DryPost-acne textureOTC Supplement

What are some good treatments
This is the final section, here I will talk about different types of treatments that you can do to fight your acne.

TREATMENTS (HOME AND CLINIC)
Treatment TypePurpose / MechanismBest For (Skin Type)Helps With (Acne Type / Concern)Downtime / Risk
Chemical Peels (AHA/BHA/TCA)Controlled exfoliation & resurfacingOily / Combo / AgingScars, blackheads, hyperpigmentation1-7 days
MicroneedlingStimulates collagen via micro-injuryNormal / ComboScarring, texture1-3 days redness
HydraFacialExfoliation + extraction + serum infusionAllCongestion, dehydrationNo downtime
MicrodermabrasionPhysical exfoliation removes dead skinNormal / OilyTexture, dullness, mild scarsMild redness
LED Light Therapy (Red/Blue)Kills bacteria & reduces inflammationAllActive acne, rednessNone
Laser Resurfacing (CO₂/Fraxel)Stimulates deep collagen remodelingNormal / OilyScarring, pigmentation3–14 days
Radiofrequency MicroneedlingHeat-induced collagen tighteningAll except very sensitiveAcne scars, laxity3-5 days
Oxygen FacialInfuses oxygen & serumsDry / SensitiveDull, dehydrated skinNone
Enzyme / Clay MasksGentle exfoliation or oil controlSensitive / OilyComedonal acneNone
Chemical ExfoliationMild resurfacingOily / ComboTexture, clogged poresMinimal irritation
Cryotherapy FacialsReduces inflammation via cold exposureAllActive acne, puffinessNone

"Just use accutane g. 🤦‍♂️"
Thank you for reading!
 
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Disclaimer:
I know there is already many posts about skin care, I have yet to see any talking about different types of conditions, so this post is all about different skin and acne types, and products or treatments you can do to treat the acne. I am not a professional, contact a dermatologist before taking or doing anything risky.

What are the different skin types?
The main skin types are normal, dry and oily, there are also sub-factors such as sensitivity and combination zones. Understanding your skin type will help you choose the right skincare.

Normal skin is balanced. It’s not too oily, not too dry, and usually feels comfortable all day. Pores are small, texture is smooth, and you rarely experience flakiness or excessive shine. If your face feels fresh and looks even without needing much effort, you probably have normal skin.
Dry skin lacks oil and moisture. It can feel tight or rough, especially after cleansing. You might notice flaking or fine lines becoming more visible. This type often struggles with dullness and needs consistent hydration, both from moisturisers and enough water intake.
Oily skin produces excess sebum, giving the face a shiny or greasy appearance, especially in the T-zone (forehead, nose, chin). Pores tend to be larger, and breakouts or blackheads are more common. The pro of oily skin is that it often ages more slowly because natural oils protect against fine lines.

Figure 1.0

View attachment 4303522
Figure 1.0 shows the texture of each skin type.

How do I detect my skin type?
To know what types of skin you have you can try this simple test:
1. Wash your face with gentle cleanser.
2. Leave it bare (no products) for an hour.
3. Press a clean tissue or blotting paper on different areas of your skin.
If the tissue picks up oil all over, you have oily skin.
If tissue picks up nothing and there is noticeable flaking and/or dryness, you have dry skin.
If the tissue picks up nothing, and there is no noticeable dryness on your skin your most likely normal.
There is also combinations such as the T-Zone (forehead, nose and chin), where some sections are more oily or dry than others.

What is skin sensitivity?
Unlike oily or dry skin, this isn't a type it's rather a condition that can occur in any of the above skin types. The skin can easily become irritated, itchy, burning and red.
Skin sensitivity usually happens when the skin’s protective barrier weakens, allowing irritants, allergens, and microbes to penetrate more easily and trigger inflammation. This can result from over-exfoliation, harsh cleansers, environmental stress (like cold, heat, or pollution), or even genetics that affect barrier proteins such as filaggrin. Once the barrier is compromised, nerve endings in the skin become overreactive, causing stinging, burning, or redness even from mild products or water.
TLDR; sensitive skin is usually the result of a damaged barrier and an overactive inflammatory or sensory response.

Your skin is alive!
On your face lives a whole ecosystem called the skin microbiome. Billions of microorganisms (mostly bacteria, but also fungi and even tiny mites) that form a balanced community. When this ecosystem is healthy, it protects your skin like an invisible armour; when it’s disrupted, that same army can turn against you.
Healthy skin sits at a slightly acidic pH of around 4.7 to 5.5. This mild acidity keeps the microbiome balanced and strengthens the acid mantle (thin film of sebum, sweat, and dead cells that acts as your first defense against harmful bacteria, pollution, and moisture loss). When your pH becomes too alkaline (from harsh soaps, over-cleansing, or abrasive scrubs), the acid mantle weakens. Beneficial bacteria die off, the bad ones thrive, and your skin can become dry, tight, and more prone to irritation or breakouts.


Different types of acne.
Acne isn't just pimples, it's a wide spread spectrum of conditions/issues. Here I will breakdown the most common types of acne, their causes and what they look like.

1. Comedonal Acne (blackheads and whiteheads) - Caused by Blocked pores from excess sebum and dead skin cells.
This is the mildest form of acne and it doesn't cause inflammation, it's often linked to poor exfoliation, comedogenic ingredients, or hormonal imbalances that increase sebum production.
Whiteheads: Clogged pores that are sealed at the surface, forming small flesh or white coloured bumps. They can feel like tiny grains under the skin. Left side of Figure 1.1.
Blackheads: Pore that is open, and the oil inside oxidises when exposed to air, turning dark. Unlike many believe that the dark colour comes from dirt. Right side of Figure 1.1.
Figure 1.1
View attachment 4303525

2. Papules - Inflammation caused by trapped oil and bacteria under the skin. They form when the wall of a hair follicle breaks from pressure causing redness and swelling (Figure 1.2). They're small, raised, red and tender, but there is no visible pus. Usually trigged by overproduction of oil, bacterial overgrowth, or using irritating skincare products that inflame the pore lining.
Figure 1.2
View attachment 4303528

3. Pustules - these are infected papules filled with pus. Pustules are what people usually refer to as "pimples", white red bumps with red/yellow centre (Figure 1.3). Essentially papules with visible pus.
They are usually caused by hormonal changes, stress, poor hygiene, or over use of thick creams or oils that trap bacteria.
Figure 1.3
View attachment 4303533

4. Nodules - Deep infection within the follicle and surrounding tissue. They are painful lumps under the skin with no visible head, and they do not contain pus (Figure 1.4). The inflammation runs deep, often lasting for weeks. Unlike surface acne, nodules won’t respond to over-the-counter treatments easily because the infection is below the skin barrier.
These are usually caused by severe hormonal imbalance, genetics, and chronic inflammation. These often need professional treatment (like prescription retinoids or anti-inflammatory therapy).
Figure 1.4
View attachment 4303538

5. Cystic acne - Severe inflammation and bacterial infection deep in the dermis. They are the most severe type of acne. They’re soft, pus-filled lumps that can be painful and lead to scarring (Figure 1.5). They occur when bacteria, oil, and dead skin get trapped deep within pores, causing an immune response that forms a large pocket of infection.
Usually caused by hormonal surges (like during puberty), diet high in refined sugars or dairy, and stress
Figure 1.5
View attachment 4303540

6. Fungal Acne (Malassezia Folliculitis) - Caused by Overgrowth of Malassezia yeast in hair follicles, not bacteria. Often mistaken for regular acne, fungal acne shows up as uniform, itchy, small bumps (Figure 1.6). usually on the chest, shoulders, or forehead. It thrives in warm, humid environments or after antibiotic use (which kills bacteria but lets yeast overgrow).
Key difference: Itchy, monomorphic bumps that don’t respond to normal acne treatments
Figure 1.6
View attachment 4303542

7. Hormonal Acne - Caused by fluctuating hormones, particularly androgens (testosterone, DHEA). typically appears along the jawline, chin, and lower cheeks, especially in adults (Figure 1.7). It flares cyclically and involves deep, painful cystic lesions. Trigged by cortisol spikes and conditions like PCOS.
Figure 1.7

View attachment 4303548

8. Acne Mechanica - Caused by Friction, pressure, or heat trapping sweat and bacteria. Commonly seen in athletes or from face masks, helmets, and tight clothing. The mechanical irritation clogs pores and causes breakouts (Figure 1.8).
Figure 1.8

View attachment 4303553

9. Acne Rosacea - Chronic inflammation and vascular sensitivity, not clogged pores. Rosacea can look like acne with red bumps and pustules (Figure 1.9), but it’s actually a vascular condition involving dilated blood vessels and skin sensitivity. It’s triggered by heat, alcohol, spicy food, or stress.
Figure 1.9

View attachment 4303554

Okay finally were past all the acne types and skin types! Now I am going to talk about products and treatments for all the different cases.
Before I start, please keep in mind the most important part of skin care is not the treatments or products you use, it's taking care of your body by hydration (drinking 2-3L of water), correct diet (eating organic high quality food, and limiting processed sugars), high quality sleep, exercise and hygiene.

What products should you use
In this section I'll list many types products and what they are good for.

PRODUCTS
Product TypePurpose/FunctionBest Skin TypeHelps with (acne type)Key ingredient
Gel CleanserDeep cleans pores, removes excess oilOily / CombinationComedonal acneNiacinamide, Salicylic Acid
Cream CleanserHydrates while cleansingDry / SensitivePrevents irritationCeramides, Glycerin
Exfoliating CleanserMild daily exfoliationOily / CongestedComedonal acneLactic Acid, BHA
Hydrating TonerAdds moisture & soothes skinDry / SensitiveBarrier repairHyaluronic Acid
Exfoliating TonerClears pores & smooths textureOily / CombinationBlackheads, PapulesGlycolic Acid, BHA
Gel MoisturizerLightweight hydrationOily / CombinationAll acne typesHyaluronic Acid
Cream MoisturizerDeeply nourishes skinDry / SensitiveIrritation recoveryCeramides, Squalane
Barrier Repair CreamStrengthens damaged barrierSensitive / Over-treatedRedness, post-acne healingNiacinamide, Fatty Acids
Niacinamide Balances oil, calms rednessAllMild acne, large poresNiacinamide, Zinc
Retinol (Vitamin A) Boosts cell turnover, unclogs pores.Oily / AgingCystic, Nodular, ComedonalRetinol, Retinal
Vitamin C SerumBrightens, fades dark spotsNormal / DryPost-acne marksL-Ascorbic Acid
Hyaluronic AcidDeep hydration & plumpnessAllDehydration, recoveryHyaluronic Acid
Azelaic AcidAnti-bacterial & pigment-reducingSensitive / Rosacea-pronePapules, PustulesAzelaic Acid
AHA (Glycolic/Lactic)Surface exfoliationNormal / DryWhiteheads, uneven toneGlycolic Acid
BHA (Salicylic Acid)Unclogs pores, reduces oilOily / Acne-proneBlackheads, papulesSalicylic Acid
Clay MaskDraws out oil & impuritiesOily / ComboBlackheadsKaolin, Bentonite
Sulfur MaskKills acne bacteriaOily / Acne-proneCystic, PustularSulfur, Zinc Oxide
Sunscreen (Mineral)Blocks UV, reduces post-acne marksSensitive / Acne-proneAll TypesZinc Oxide
Sunscreen (Chemical)Lightweight UV protectionNormal / DryPigmentationAvobenzone

What medication should you use
In this section I'll list many types medication and what they are good for.

MEDICATION
Medication / ActivePurposeBest For (Skin Type)Helps with (acne types)OTC / RX
Benzoyl PeroxideKills acne-causing bacteria (C. acnes)Oily / Acne-pronePapules, PustulesOTC
Adapalene (Retinoid)Regulates turnover, prevents cloggingAllComedonal, CysticOTC (0.1%) RX (0.3%)
Azelaic Acid (higher strength)Reduces bacteria & pigmentationSensitive / RosaceaPapules, Post-inflammatory marksRX (15-20%)
Clindamycin / ErythromycinTopical antibiotic, reduces inflammationOily / ComboPustules, PapulesRX
Tretinoin (Retinoic Acid)Strong cell turnover, collagen boostNormal / OilyCystic, Nodular, ScarringRX
Spironolactone (Oral)Reduces androgen-driven oil productionOily / HormonalHormonal acneRX
Oral Antibiotics (Doxycycline)Reduces inflammation & bacteriaOily / ComboSevere cystic acneRX
Isotretinoin (Accutane)Permanently reduces sebum productionOily / Severe acneCystic, NodularRX
Zinc (Picolinate / Gluconate)Anti-inflammatory, reduces sebumAllMild acne, healingOTC Supplement
DIM (Diindolylmethane)Balances estrogen/testosteroneHormonal / AdultHormonal acneOTC Supplement
Omega-3 Fatty AcidsReduces inflammation & regulates oilDry / ComboAll acne typesOTC Supplement
ProbioticsSupports gut–skin axisAllFungal or stress-related acneOTC Supplement
Collagen PeptidesImproves elasticity & healingAging / DryPost-acne textureOTC Supplement

What are some good treatments
This is the final section, here I will talk about different types of treatments that you can do to fight your acne.

TREATMENTS (HOME AND CLINIC)
Treatment TypePurpose / MechanismBest For (Skin Type)Helps With (Acne Type / Concern)Downtime / Risk
Chemical Peels (AHA/BHA/TCA)Controlled exfoliation & resurfacingOily / Combo / AgingScars, blackheads, hyperpigmentation1-7 days
MicroneedlingStimulates collagen via micro-injuryNormal / ComboScarring, texture1-3 days redness
HydraFacialExfoliation + extraction + serum infusionAllCongestion, dehydrationNo downtime
MicrodermabrasionPhysical exfoliation removes dead skinNormal / OilyTexture, dullness, mild scarsMild redness
LED Light Therapy (Red/Blue)Kills bacteria & reduces inflammationAllActive acne, rednessNone
Laser Resurfacing (CO₂/Fraxel)Stimulates deep collagen remodelingNormal / OilyScarring, pigmentation3–14 days
Radiofrequency MicroneedlingHeat-induced collagen tighteningAll except very sensitiveAcne scars, laxity3-5 days
Oxygen FacialInfuses oxygen & serumsDry / SensitiveDull, dehydrated skinNone
Enzyme / Clay MasksGentle exfoliation or oil controlSensitive / OilyComedonal acneNone
Chemical ExfoliationMild resurfacingOily / ComboTexture, clogged poresMinimal irritation
Cryotherapy FacialsReduces inflammation via cold exposureAllActive acne, puffinessNone

"Just use accutane g. 🤦‍♂️"
Thank you for reading!
good grey mirin
 
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Disclaimer:
I know there is already many posts about skin care, I have yet to see any talking about different types of conditions, so this post is all about different skin and acne types, and products or treatments you can do to treat the acne. I am not a professional, contact a dermatologist before taking or doing anything risky.

What are the different skin types?
The main skin types are normal, dry and oily, there are also sub-factors such as sensitivity and combination zones. Understanding your skin type will help you choose the right skincare.

Normal skin is balanced. It’s not too oily, not too dry, and usually feels comfortable all day. Pores are small, texture is smooth, and you rarely experience flakiness or excessive shine. If your face feels fresh and looks even without needing much effort, you probably have normal skin.
Dry skin lacks oil and moisture. It can feel tight or rough, especially after cleansing. You might notice flaking or fine lines becoming more visible. This type often struggles with dullness and needs consistent hydration, both from moisturisers and enough water intake.
Oily skin produces excess sebum, giving the face a shiny or greasy appearance, especially in the T-zone (forehead, nose, chin). Pores tend to be larger, and breakouts or blackheads are more common. The pro of oily skin is that it often ages more slowly because natural oils protect against fine lines.

Figure 1.0

View attachment 4303522
Figure 1.0 shows the texture of each skin type.

How do I detect my skin type?
To know what types of skin you have you can try this simple test:
1. Wash your face with gentle cleanser.
2. Leave it bare (no products) for an hour.
3. Press a clean tissue or blotting paper on different areas of your skin.
If the tissue picks up oil all over, you have oily skin.
If tissue picks up nothing and there is noticeable flaking and/or dryness, you have dry skin.
If the tissue picks up nothing, and there is no noticeable dryness on your skin your most likely normal.
There is also combinations such as the T-Zone (forehead, nose and chin), where some sections are more oily or dry than others.

What is skin sensitivity?
Unlike oily or dry skin, this isn't a type it's rather a condition that can occur in any of the above skin types. The skin can easily become irritated, itchy, burning and red.
Skin sensitivity usually happens when the skin’s protective barrier weakens, allowing irritants, allergens, and microbes to penetrate more easily and trigger inflammation. This can result from over-exfoliation, harsh cleansers, environmental stress (like cold, heat, or pollution), or even genetics that affect barrier proteins such as filaggrin. Once the barrier is compromised, nerve endings in the skin become overreactive, causing stinging, burning, or redness even from mild products or water.
TLDR; sensitive skin is usually the result of a damaged barrier and an overactive inflammatory or sensory response.

Your skin is alive!
On your face lives a whole ecosystem called the skin microbiome. Billions of microorganisms (mostly bacteria, but also fungi and even tiny mites) that form a balanced community. When this ecosystem is healthy, it protects your skin like an invisible armour; when it’s disrupted, that same army can turn against you.
Healthy skin sits at a slightly acidic pH of around 4.7 to 5.5. This mild acidity keeps the microbiome balanced and strengthens the acid mantle (thin film of sebum, sweat, and dead cells that acts as your first defense against harmful bacteria, pollution, and moisture loss). When your pH becomes too alkaline (from harsh soaps, over-cleansing, or abrasive scrubs), the acid mantle weakens. Beneficial bacteria die off, the bad ones thrive, and your skin can become dry, tight, and more prone to irritation or breakouts.


Different types of acne.
Acne isn't just pimples, it's a wide spread spectrum of conditions/issues. Here I will breakdown the most common types of acne, their causes and what they look like.

1. Comedonal Acne (blackheads and whiteheads) - Caused by Blocked pores from excess sebum and dead skin cells.
This is the mildest form of acne and it doesn't cause inflammation, it's often linked to poor exfoliation, comedogenic ingredients, or hormonal imbalances that increase sebum production.
Whiteheads: Clogged pores that are sealed at the surface, forming small flesh or white coloured bumps. They can feel like tiny grains under the skin. Left side of Figure 1.1.
Blackheads: Pore that is open, and the oil inside oxidises when exposed to air, turning dark. Unlike many believe that the dark colour comes from dirt. Right side of Figure 1.1.
Figure 1.1
View attachment 4303525

2. Papules - Inflammation caused by trapped oil and bacteria under the skin. They form when the wall of a hair follicle breaks from pressure causing redness and swelling (Figure 1.2). They're small, raised, red and tender, but there is no visible pus. Usually trigged by overproduction of oil, bacterial overgrowth, or using irritating skincare products that inflame the pore lining.
Figure 1.2
View attachment 4303528

3. Pustules - these are infected papules filled with pus. Pustules are what people usually refer to as "pimples", white red bumps with red/yellow centre (Figure 1.3). Essentially papules with visible pus.
They are usually caused by hormonal changes, stress, poor hygiene, or over use of thick creams or oils that trap bacteria.
Figure 1.3
View attachment 4303533

4. Nodules - Deep infection within the follicle and surrounding tissue. They are painful lumps under the skin with no visible head, and they do not contain pus (Figure 1.4). The inflammation runs deep, often lasting for weeks. Unlike surface acne, nodules won’t respond to over-the-counter treatments easily because the infection is below the skin barrier.
These are usually caused by severe hormonal imbalance, genetics, and chronic inflammation. These often need professional treatment (like prescription retinoids or anti-inflammatory therapy).
Figure 1.4
View attachment 4303538

5. Cystic acne - Severe inflammation and bacterial infection deep in the dermis. They are the most severe type of acne. They’re soft, pus-filled lumps that can be painful and lead to scarring (Figure 1.5). They occur when bacteria, oil, and dead skin get trapped deep within pores, causing an immune response that forms a large pocket of infection.
Usually caused by hormonal surges (like during puberty), diet high in refined sugars or dairy, and stress
Figure 1.5
View attachment 4303540

6. Fungal Acne (Malassezia Folliculitis) - Caused by Overgrowth of Malassezia yeast in hair follicles, not bacteria. Often mistaken for regular acne, fungal acne shows up as uniform, itchy, small bumps (Figure 1.6). usually on the chest, shoulders, or forehead. It thrives in warm, humid environments or after antibiotic use (which kills bacteria but lets yeast overgrow).
Key difference: Itchy, monomorphic bumps that don’t respond to normal acne treatments
Figure 1.6
View attachment 4303542

7. Hormonal Acne - Caused by fluctuating hormones, particularly androgens (testosterone, DHEA). typically appears along the jawline, chin, and lower cheeks, especially in adults (Figure 1.7). It flares cyclically and involves deep, painful cystic lesions. Trigged by cortisol spikes and conditions like PCOS.
Figure 1.7

View attachment 4303548

8. Acne Mechanica - Caused by Friction, pressure, or heat trapping sweat and bacteria. Commonly seen in athletes or from face masks, helmets, and tight clothing. The mechanical irritation clogs pores and causes breakouts (Figure 1.8).
Figure 1.8

View attachment 4303553

9. Acne Rosacea - Chronic inflammation and vascular sensitivity, not clogged pores. Rosacea can look like acne with red bumps and pustules (Figure 1.9), but it’s actually a vascular condition involving dilated blood vessels and skin sensitivity. It’s triggered by heat, alcohol, spicy food, or stress.
Figure 1.9

View attachment 4303554

Okay finally were past all the acne types and skin types! Now I am going to talk about products and treatments for all the different cases.
Before I start, please keep in mind the most important part of skin care is not the treatments or products you use, it's taking care of your body by hydration (drinking 2-3L of water), correct diet (eating organic high quality food, and limiting processed sugars), high quality sleep, exercise and hygiene.

What products should you use
In this section I'll list many types products and what they are good for.

PRODUCTS
Product TypePurpose/FunctionBest Skin TypeHelps with (acne type)Key ingredient
Gel CleanserDeep cleans pores, removes excess oilOily / CombinationComedonal acneNiacinamide, Salicylic Acid
Cream CleanserHydrates while cleansingDry / SensitivePrevents irritationCeramides, Glycerin
Exfoliating CleanserMild daily exfoliationOily / CongestedComedonal acneLactic Acid, BHA
Hydrating TonerAdds moisture & soothes skinDry / SensitiveBarrier repairHyaluronic Acid
Exfoliating TonerClears pores & smooths textureOily / CombinationBlackheads, PapulesGlycolic Acid, BHA
Gel MoisturizerLightweight hydrationOily / CombinationAll acne typesHyaluronic Acid
Cream MoisturizerDeeply nourishes skinDry / SensitiveIrritation recoveryCeramides, Squalane
Barrier Repair CreamStrengthens damaged barrierSensitive / Over-treatedRedness, post-acne healingNiacinamide, Fatty Acids
Niacinamide Balances oil, calms rednessAllMild acne, large poresNiacinamide, Zinc
Retinol (Vitamin A) Boosts cell turnover, unclogs pores.Oily / AgingCystic, Nodular, ComedonalRetinol, Retinal
Vitamin C SerumBrightens, fades dark spotsNormal / DryPost-acne marksL-Ascorbic Acid
Hyaluronic AcidDeep hydration & plumpnessAllDehydration, recoveryHyaluronic Acid
Azelaic AcidAnti-bacterial & pigment-reducingSensitive / Rosacea-pronePapules, PustulesAzelaic Acid
AHA (Glycolic/Lactic)Surface exfoliationNormal / DryWhiteheads, uneven toneGlycolic Acid
BHA (Salicylic Acid)Unclogs pores, reduces oilOily / Acne-proneBlackheads, papulesSalicylic Acid
Clay MaskDraws out oil & impuritiesOily / ComboBlackheadsKaolin, Bentonite
Sulfur MaskKills acne bacteriaOily / Acne-proneCystic, PustularSulfur, Zinc Oxide
Sunscreen (Mineral)Blocks UV, reduces post-acne marksSensitive / Acne-proneAll TypesZinc Oxide
Sunscreen (Chemical)Lightweight UV protectionNormal / DryPigmentationAvobenzone

What medication should you use
In this section I'll list many types medication and what they are good for.

MEDICATION
Medication / ActivePurposeBest For (Skin Type)Helps with (acne types)OTC / RX
Benzoyl PeroxideKills acne-causing bacteria (C. acnes)Oily / Acne-pronePapules, PustulesOTC
Adapalene (Retinoid)Regulates turnover, prevents cloggingAllComedonal, CysticOTC (0.1%) RX (0.3%)
Azelaic Acid (higher strength)Reduces bacteria & pigmentationSensitive / RosaceaPapules, Post-inflammatory marksRX (15-20%)
Clindamycin / ErythromycinTopical antibiotic, reduces inflammationOily / ComboPustules, PapulesRX
Tretinoin (Retinoic Acid)Strong cell turnover, collagen boostNormal / OilyCystic, Nodular, ScarringRX
Spironolactone (Oral)Reduces androgen-driven oil productionOily / HormonalHormonal acneRX
Oral Antibiotics (Doxycycline)Reduces inflammation & bacteriaOily / ComboSevere cystic acneRX
Isotretinoin (Accutane)Permanently reduces sebum productionOily / Severe acneCystic, NodularRX
Zinc (Picolinate / Gluconate)Anti-inflammatory, reduces sebumAllMild acne, healingOTC Supplement
DIM (Diindolylmethane)Balances estrogen/testosteroneHormonal / AdultHormonal acneOTC Supplement
Omega-3 Fatty AcidsReduces inflammation & regulates oilDry / ComboAll acne typesOTC Supplement
ProbioticsSupports gut–skin axisAllFungal or stress-related acneOTC Supplement
Collagen PeptidesImproves elasticity & healingAging / DryPost-acne textureOTC Supplement

What are some good treatments
This is the final section, here I will talk about different types of treatments that you can do to fight your acne.

TREATMENTS (HOME AND CLINIC)
Treatment TypePurpose / MechanismBest For (Skin Type)Helps With (Acne Type / Concern)Downtime / Risk
Chemical Peels (AHA/BHA/TCA)Controlled exfoliation & resurfacingOily / Combo / AgingScars, blackheads, hyperpigmentation1-7 days
MicroneedlingStimulates collagen via micro-injuryNormal / ComboScarring, texture1-3 days redness
HydraFacialExfoliation + extraction + serum infusionAllCongestion, dehydrationNo downtime
MicrodermabrasionPhysical exfoliation removes dead skinNormal / OilyTexture, dullness, mild scarsMild redness
LED Light Therapy (Red/Blue)Kills bacteria & reduces inflammationAllActive acne, rednessNone
Laser Resurfacing (CO₂/Fraxel)Stimulates deep collagen remodelingNormal / OilyScarring, pigmentation3–14 days
Radiofrequency MicroneedlingHeat-induced collagen tighteningAll except very sensitiveAcne scars, laxity3-5 days
Oxygen FacialInfuses oxygen & serumsDry / SensitiveDull, dehydrated skinNone
Enzyme / Clay MasksGentle exfoliation or oil controlSensitive / OilyComedonal acneNone
Chemical ExfoliationMild resurfacingOily / ComboTexture, clogged poresMinimal irritation
Cryotherapy FacialsReduces inflammation via cold exposureAllActive acne, puffinessNone

"Just use accutane g. 🤦‍♂️"
Thank you for reading!
Very good thread. Bump
 
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Good thread but just use accutane
 
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Nice thread, Bump
 
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