Acne is one of the most prevalent skin care concerns affecting both youth and adults, and certainly one we see among our clients of all ages. While commonly thought of as a ‘young skin’ condition, acne is also very common in adults, particularly women. Chances are, you or someone you know is currently struggling with acne or has experienced it in the past. The key to conquering acne is first, understanding acne.

The Emotional Effects of Acne

For some people, having acne is merely an annoyance. For others, it can be a devastating and confidence-crushing experience.

From physical discomfort and scars to mental and emotional distress, acne can have severe psychological and social impacts. For many acne sufferers, it can mean withdrawing from friends and social activities out of embarrassment or piling on makeup when leaving the house. For others, including many adults, the challenges to self-esteem can have an impact on life-long confidence levels, as well as school and work performance 1.

What is Acne?

  • Acne is generally defined as a chronic inflammatory condition involving hormonal stimulation of the pilosebaceous units (hair follicles and their sebaceous glands)2. (Note: Not all acne is inflamed.)
  • It primarily affects areas of the skin with a relatively high number of oil glands, such as the face, chest, and back.
  • Acne is not just pimples. It presents as everything from a clogged pore or ‘blackhead’, to surface pustules and inflamed below-the-surface cysts.
  • Acne has a hereditary component and tends to run in families.

For those who suffer from acne, the most important thing to know is that it’s not your fault. It’s not about having dirty skin or eating too much chocolate. You didn’t do anything to cause your acne. The simple fact is that people who are acne-prone have an inherited trait that causes them to shed a greater number of dead skin cells into their hair follicles and/or have pronounced reactions to hormonal influences and other stimuli. That’s where the trouble starts.

Combine this inherited trait with certain lifestyle factors and it can make it harder for your skin to clear. We’ll take an in-depth look at those factors in a future post, but for now, let’s review how acne blemishes form.

Understanding Acne: How a Pimple Forms

Acne is complicated. The formation of acne lesions involves a number of biological processes that ultimately lead to a pile-up of skin cells and sebum within a hair follicle. Acne-prone individuals, in particular, have an over-abundance of these skin cells constantly shedding into their hair follicles and it is when these cells mix with oil that they form a clump or blockage below the surface of the skin. These ‘clogged pores’ have the potential to progress into something worse via the following stages of acne formation:

  1. Microcomedo formation – Sebum from oil glands mixes with excess skin cells in the bottom of a hair follicle to form a solid plug. This is usually undetectable except under close examination. Other forms of acne lesions start as microcomedos.
  2. Closed comedo formation – The plug continues to build. Because the opening of the pore is so tiny in comparison, the oils or plug cannot move to the surface.
  3. Open comedo (blackhead) formation – The hair follicle continues to fill with skin cells and sticky oil, pushing the plug to the surface and causing a dilation of the pore opening. Exposure to the surface causes oxidation and darkening of the sebum. (This darkening is what is visible as a ‘blackhead’.)
  4. Papule – When a comedo (open or closed) is left too long or cannot move to the surface, oxygen is cut off to the bottom of the follicle, where P. acne bacteria are waiting for these exact conditions in order to proliferate. They multiply, feasting on the sebum plug and creating waste that is irritating to the follicle walls. Inflammation and swelling set in that eventually ruptures the follicle wall, triggering an immune system response that rushes blood to the area to tidy up the mess and clean up the bacterial invasion. The redness and swelling of this stage indicate a papule.
  5. Pustule – Once the white blood cells of the immune system are called into action to clean up the site of a papule, they too start to pile up in the follicle along with fluids and other debris from the protection process. This ‘pus’ is easily recognized in a pustule.
  6. Nodule – These occur deeper within the skin, where they tend to form larger, sore lumps in the dermal layers of the skin and fester as inflamed bumps until they eventually drain or resolve.
  7. Cyst – These are larger areas of inflammation where several follicles have erupted together, or just an intense inflammatory reaction in a single site.

Contributing Factors

Each individual has a unique combination of contributing factors that can influence the development of acne lesions. As mentioned previously, we’ll take a closer look at each of these in a future post. But for now, understand that many factors influence acne. These can range from the number one factor, stress, to various other aggravators, including hormonal fluctuations, environmental influences, medications, cosmetics, lifestyle choices, and more. Because there are so many variables, all possible aggravating factors need investigation on a case by case basis. That’s where an esthetician can play a vital support role.

Estheticians as Resources

Estheticians are in a unique position to help. With their empathetic nature, they tend to invest heavily in their clients’ self-confidence levels, doing everything they can to solve the most challenging skin problems to help people feel better about themselves.  Estheticians combine their specialized training in skin physiology, extractions, and cosmetic chemistry, into an investigative approach to acne, looking at the whole person when designing treatment plans. Estheticians tend to have more time than doctors to spend with you, exploring your unique lifestyle, environmental, and holistic factors, and helping make sense of how it all is manifesting on your skin. In addition, estheticians have a variety of specialized, clinical-strength topical formulas to work with and can personalize a professional treatment plan without the use of drugs, as well as offer support and guidance along the way.

Left uncontrolled, acne has the potential to progress in severity to the point that it becomes a medical condition and should be referred for medical intervention. Particularly in families where severe acne and scarring is evident, taking early action at the onset of teenage acne is crucial. It is always better to work with a professional who can help determine what is needed and when.

Education is Key

There is a lot of misinformation and marketing hype promising the miracle cure to acne. The truth is that there is no one-size-fits-all solution to the problem. Acne is a multi-faceted condition and managing it requires an individualized approach. What may work for one person might not work for another.

By educating and sharing their knowledge of skin and the various factors involved in acne, estheticians are one of your strongest partners in combating this frustrating condition. It takes upwards of 90 days for an acne lesion to form. If you battle acne, you’ve probably spent months or even years self-diagnosing and experimenting with products before considering professional help.

Instead of jumping from one magazine article to a Pinterest DIY treatment to yet another drugstore product, try working one-on-one with a skin care professional. Getting clear doesn’t happen overnight, but it does happen. With the right combination of expert, professional treatments, supportive coaching, and lifestyle adjustments, your esthetician can create a personalized, drug-free plan to get you real results, while protecting the long-term health and vitality of your skin.


  1. Hazarika, Neirita, and M Archana. “The Psychosocial Impact of Acne Vulgaris.” Indian Journal of Dermatology 61.5 (2016): 515–520. PMC. Web. 15 Aug. 2018.
  2. Danby, F. William (Bill). “Acne: Diet and Acnegenesis.” Indian Dermatology Online Journal 2.1 (2011): 2–5. PMC. Web. 15 Aug. 2018.

Disclaimer: The information we provide on this site is for general use as an information resource only and is not to be used or relied on for any diagnostic or medical treatment purposes. Be sure to talk to a healthcare professional before making medical decisions.

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