Lee’s final and most severe acne category contains nodules and cysts. This sometimes-painful acne lies deeper in the skin and often looks like a rash of red bumps. Lee doesn’t list a specific cause for this category because it’s so subjective.
“Cystic acne has a lot to do with your hormones and genetics,” she explains. “If you have oily skin that you’ve inherited from your parents, or maybe you’re on hormone replacement, or it’s that certain time of the month, or you have polycystic ovarian syndrome and you’re secreting more testosterone — all those things can promote more breakouts.”
Searching for images of all three acne types side by side can help you place your own acne into one of these categories, and so will thinking critically about when you’re most likely to break out. Knowing that basic information might save you from some annoying skin-care trial and error.
Then, it’s time to take a long, hard look at your current skin-care routine.
Lee has treated many patients whose breakouts were caused by their own skin-care routines rather than naturally acne-prone skin. And she thinks that’s because the Internet obsession with skin care has gone too far. “We have so many sites that are devoted to skin care, like Reddit’s SkincareAddiction, where you can join other people that have the same feelings as you,” Lee notes. “It’s really kind of alarming these days how [skin advice] has been repeated so many times on the Internet that now people just think it’s true.”
When Lee thinks a patient’s routine might be doing more harm than good, she recommends they start over from scratch to determine what, if anything, is causing acne or irritation. “As dermatologists, we usually put people on a total detox,” she explains. “We’ll give them something like Cetaphil cleanser, a really mild cleanser that doesn’t have much in it, and then they start adding products back one by one [over time].”
So, you might not need to go on an acne-product shopping spree just yet. Lee says a simplified routine of dermatologist-approved products has the potential to change your skin, too. But if it doesn’t, there are other solutions.
Get very familiar with product labels and always look for key terms and ingredients when shopping.
There are two key ingredients Lee recommends for people with all types of acne, both of which are pretty easy to find and use. “Glycolic and salicylic acids will exfoliate and help to clean the debris out of your pores; they can help with brown spots and hyperpigmentation,” says Lee.