- Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it’s called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.
- Pustules or pimples. Pustules or pimples are acne lesions that contain pus and are red at the base.
- Nodules. These are more serious acne lesions. They lodge deeper in the skin, are painful, and can cause scarring.
- Cysts. Like nodules, these lesions are deep within in the skin, are painful, and are filled with pus, and can cause scarring.
Many things can trigger acne in women:
- Hormone changes during puberty. During puberty, girls have an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.
- Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
- Medicines. Certain medicines, such as those used to treat epilepsy and types of depression.
- Pressure or friction on the skin. Friction caused by bike helmets or backpacks can make acne worse.
- Family history. If other people in your family have acne, there is a greater chance you will have it.
It is a myth that women get acne because they don’t wash enough. Too much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn’t do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.
Stress does not cause acne. But, acne may be a side effect of some medicines used to treat stress or depression. And in some cases, the social and emotional impact of acne lesions causes stress. Talk with your doctor if you have concerns.
While many women feel that eating chocolate or greasy foods causes acne, experts have not found a link between the diet and acne. Foods seem to have little effect on acne in most people. But, it’s important to eat a healthy diet for good health.