What type of acne do I have?

If you’ve googled this before, you’re not alone. We spend so much time agonizing over where our acne comes from and why it exists, but the bottom line is acne-prone is a skin type. From there, many factors come into play. So instead of self-diagnosing what causes your acne (because it’s often a combination of things), the best way to break it down is by what grade it is. This will determine what will be the best treatments and ingredients needed to clear it. 

Grade I: Is mild and typically what you think of as blackheads and whiteheads (we professionals call these “comedones”), and they’re usually in the t-zone. This type of acne may also be marked with the occasional papule in the cheeks. While there are many facets to acne, the simplest approach to take charge of mild acne is to avoid comedogenic (pore-clogging) ingredients and start using exfoliating ingredients to remove the dead skin cells that lead to impactions inside the pores. Beware of products labeled “non-comedogenic,” even those you find at the dermatologist – this isn’t a term that’s regulated by the FDA. It’s oftentimes just used as a marketing term which makes it virtually meaningless when found labeled on products. Your aesthetician can instead help you understand the ingredients in your products and what’s safe to use with your Grade I acne.

Mild acne may be able to clear with just one to two appropriate products, but we recommend a four-step regimen for serious results. The best product for this type of acne is Mandelic Acid Exfoliating Cleanser used nightly for two minutes. Use it along with an acne-safe moisturizer for a great start to clear skin. Plus, take the time to clean out and analyze your makeup and old skin care as well to ensure you’re not continuing to clog your skin while trying to clear it at the same time. 

Grade II: Is characterized by papules that have redness and swelling around them, meaning there is a bit of inflammation to the skin. These blemishes can be found anywhere on the face and coincide with clogged pores and comedones as well. With this more moderate acne, you will need to focus not only on removing pore cloggers and exfoliating dead skin like Grade I, but also bringing down the overall inflammation that is leading to papules. The best way to reduce inflammation is to ice when you have pimples and potentially avoid foods that can trigger acne. The most common culprits are milk, ice cream, soy, peanut butter, and multivitamins. (Multivitamins contain the B vitamins Biotin and B12 as well as Iodine and all three have all been linked to flaring acne in acne-prone skin.) 

Grade II acne requires a four-step regimen of a cleanser, toner, treatment serum and moisturizer. These are all equally important in restoring balance to the skin. Not only do you want an antibacterial ingredient like Benzoyl Peroxide or Mandelic Acid, but also Vitamin A to clear impactions and begin the healing process in the skin. A fairly universal routine for this type of acne would be Mandelic Acid Exfoliating Cleanser or BP 3% Exfoliating Cleanser (twice daily), Skin Nourishing Toner (twice daily), Derm-A-Gel (nightly) and Dual Barrier Lotion used nightly (alternating with Day Treatment SPF in the AMs).

Grade III: Is where acne starts to get physically painful. While all grades of acne scar us emotionally, this will come with more tenderness in the skin and potential long-term damage. Grade III acne is marked by papules, pustules, and sometimes inflamed, pus-filled lesions that can be in clusters on various areas of the face. One may even feel nodules or cysts under the skin. There is no connection between the severity of acne and the results one can achieve though. Most often it is the willingness of the client to commit that determines the outcome and the inflammation and pain can be quickly reduced. While one may think they need a doctor's intervention, it is most helpful to first talk to an acne expert and learn what lifestyle triggers to avoid plus get on a regimen of workhouse products to kill the acne bacteria, reduce inflammation, and work on scarring all at the same time. 

This type of acne can require adherence to avoiding the above-mentioned foods and can absolutely not receive any pore-clogging ingredients. Additionally, icing daily makes a big impact. This type of acne is often genetic, but hormone imbalances can play a role. At Skin MPLS we see great success in clearing even severe acne and can typically work around hormone imbalances with a strict regimen. Here’s a great starting lineup for Grade III acne: BP 3% Wash (twice daily), 3% Mandelic Acid Toner (twice daily), Exfol-A (used nightly), and alternate Dual Barrier Lotion in the PMs with Day Treatment SPF in the AMs.

Grade IV: Although there is a Grade V, Grade IV is most commonly the most advanced form of acne. It is characterized by deep painful cysts and/or nodules all over the face with a lot of redness/inflammation. Particular cysts may be there for several months and the skin may be painful even to the touch. Even though this is a medical condition, treating it topically is essential to long term management. It is generally necessary while experiencing inflammation to abstain from dairy and potentially other acne-inducing foods. One may need frequent treatments to help drain the lesions. Icing your skin twice daily is extremely important. Your regimen may start off gentle and then become more active as the skin starts to normalize. While this is an excruciating experience, it is important to try to keep stress down and focus on healing. We treat Grade IV acne regularly at Skin MPLS but would not hesitate to refer out to a dermatologist in the event that prescriptions (such as Isotretinoin) may be needed.

The most universal products for Grade IV acne are BP 3% Wash (twice daily), 3% Mandelic Acid Toner (twice daily), Exfol-A (nightly), BP 10% Gel Medication (twice daily), Sulfur Clay Mask (2-4x/wk), Allantoin at night alternated with Day Treatment SPF in the daytime.