One of the enduring mysteries of the acne world is why different people often require completely different treatments to get clear. If we all suffer from the same acne, then why do I get pimples after eating onions while most women say they get acne from dairy products and sugar?
After years of helping people get over acne and reading a well over 1000 medical studies, I’ve come to realize that we don’t all suffer from the problem and that there are different types of acne. While all of the types look the same on the skin, each type has different internal causes.
Here are the different acne types I’ve identified:
Please consider this list as work in progress. It’s possible I have missed some acne types, and if I do identify new ones, I’ll update this page. However, this list should cover most people and be more than enough to get you started on the right track.
I’ll talk about each in more detail, but first, let’s talk about how the different acne types fit in with what we discussed on the previous page.
On the previous pages, we mainly talked about proximal causes, things that happen in the skin. But many different distal causes influence the proximal causes. These distal causes can and will vary between individuals. For example, one person may get acne from sugar and dairy products while another one mainly gets stress-related breakouts.
So we have entirely different distal causes that lead to similar proximal causes in the skin. Obviously, these two cases require different treatment plans. One likely benefits from meditation and self-compassion practices while the other needs to make dietary changes.
This is what I mean when I talk about acne types.
I’m not saying you can “draw a line on the ground” and say everything that falls on this side is hormonal and everything on that side is inflammatory and there are no overlaps. I do believe that everyone has a mixed type. Meaning, a part of the problem is hormonal, part inflammatory, part stress, etc. But I do also believe most people will have a dominant type. One, or perhaps two, of the types will have a much stronger effect than the others. It stands to reason that using treatments to address those types are much more likely to work than just a random collection of treatments found online.
Acne causes help you to focus on effective treatments
And that’s the point of acne types. To help you to focus on the subset of treatments that have a much higher likelihood of working.
Another point is to address the causes systematically. Let’s say that after going through the rest of this chapter you determine that you have hormonal- and emotional-type acne, and perhaps some gut problems mixed in.
Before reading this, you might have read information online that shows sugar and dairy are bad for acne, and you decided to cut them out. After a while, you notice that your acne got a bit better, but you wouldn’t say it made a drastic change. Slowly, your old dietary habits crept back. A few months go by, and you decide to try some meditation to get your stress under control. After a couple of weeks, your acne goes down from 7 to 4, a real improvement. You feel happier, more confident and perhaps decide to celebrate by going out with friends and indulging in ice cream or other sweets. Two weeks later, you are back at 7 and wonder why meditation stopped working. You might even conclude it didn’t help after all.
My hope is that the idea of acne types idea helps you to see acne holistically. That it helps you to understand that you have to address the hormonal component and the stress component.
In the above example, you might have realized that the flare-up was due to indulging in foods that spike insulin levels and decide to cut back on such foods. The combined effect of meditation and a healthy diet could bring your acne down to 1 or 2. Add in some self-compassion exercises, and you’ll realize you are a worthy and lovable person despite having mild acne.
So your acne has gone from 7 down to 1 or 2, and you don’t let the remaining mild acne interfere with your life because you realized that your self-worth isn’t contingent on not having any acne. That’s what I call real progress.
But enough talk. Let’s go over each of the acne types and discuss how you can figure out your acne type