Acne & blemish-prone skin – Symptoms, causes and treatment advice

Published: October 2017

Published: November 2024

Dealing with acne-prone skin can be a frustrating and ongoing challenge for many people. Whether you experience occasional breakouts or frequent flare-ups, understanding your skin type and the best ways to care for it is key to achieving a clearer complexion.

In this article, we’ll explore the difference between blemish-prone and acne-prone skin, common triggers that can worsen it, and practical tips and treatments to help manage and improve your skin’s health. With the right approach, you can reduce breakouts and feel more confident in your skin daily.

Acne-prone skin and blemish-prone skin are similar but distinct. Although both terms are often used reciprocally when discussing skin that is prone to breakouts and flare-ups, acne and blemish-prone skin have several differences.

• Acne-prone skin tends to develop persistent breakouts, often due to excess oil, bacteria, and hormonal changes that lead to clogged pores and inflammation. 
• Blemish-prone skin, on the other hand, is more generally susceptible to occasional imperfections like blackheads, whiteheads, or uneven texture but might not experience consistent or inflamed acne. 

Acne is most common in teenagers, with 70-95% experiencing some degree of blemished skin. Around 15-30% of them will use acne medication to relieve symptoms*. Acne can also continue into adulthood, and some people, especially women, may experience it for the first time after age 25.

*C.C.Zouboulis, Hautarzt 2014 65: 733-750

Acne typically appears on the face, neck, shoulders, chest and back. It ranges in severity from light acne (known as Acne Comedonica) through moderate acne (Acne Papulopustulosa) to severe acne (Acne Conglobata). Learn more about types of acne here.

But acne doesn’t just affect people’s skin; it impacts their quality of life too. Acne's psychological impact can be considerable as symptoms can be stressful and cause issues around self-confidence. This is one reason why it’s important to consult a dermatologist if you are troubled by your skin condition. 

There are a range of effective Acne treatment options available and timely medication can prevent a deterioration in skin condition and subsequent damage, such as hyperpigmentation and scarring.

Acne is sometimes confused with rosacea as it can also cause papules and pustules. Rosacea is a hypersensitive skin disorder where facial blood vessels enlarge causing a reddened appearance. Rosacea requires different treatment to acne and you can find out more about how to care for it here. If you are unsure if you have acne or rosacea, ask your doctor.

As there are different types of acne, there are also different types of blemishes. The word 'blemish' is normally used when something is temporary (such as blackheads and whiteheads), whereas the word 'spot' suggests something more permanent (such as age spots and sunspots).

Here is an explanation of some of the most commonly used terms:

• Blackhead (or open comedone): a small, dark, flat blemish resulting from a blocked sebaceous gland. The dark colouration is caused when sebum reacts with oxygen and has nothing to do with dirt.
• Whitehead (or closed comedone): a raised, round blemish with a milky-white cover. Also, it is the result of a blocked sebaceous gland. A type of pimple.
• Pimple: an inflamed (raised and coloured) blemish that fills with pus and is usually painful. It is the colloquial term used for all blemishes: comedones, papules and pustules.
• Papule: a solid elevation of the skin that does not contain pus, an inflamed pimple.
• Pustule: when a whitehead or pimple increases in size and severity, it is known as a pustule, an inflamed pimple with pus.
• Nodule: hard acne lesion (area of damaged tissue) lodged deep within the skin. Normally, on larger areas of skin such as the back and shoulders.
• Cysts: soft, pus-filled acne lesion lodged deep within skin. Caused when the follicular wall bursts in the late stages of inflammation.

Learn more about different types of acne.  

Acne can be triggered by a variety of factors that affect skin health. Common causes include genetics, hormones, medications, diet, stress, smoking, and inappropriate skincare. Read more below:

Genes determine our skin type; some of us have more reactive skin and are more prone to inflammation, blemishes and acne than others. If both your parents had acne, there is a higher chance that you will develop the condition.

Acne is a hormonal condition. Hormones are responsible for the development of the sebaceous glands, and they also stimulate sebum production. An overproduction of sebum is one of the symptoms that defines blemish-prone skin. The increase in hormones during puberty is the main reason why acne is most prevalent in adolescence. However, hormones continue to affect men and women differently at various life stages.

Changes in hormone levels during the menstrual cycle often cause flare-ups for women in their 20s and 30s, with late-onset cases generally referred to as Acne Tarda. Find out more about the relationship between hormones and acne.

Some medications, including antidepressants, antiepileptics, steroids and lithium, are known to cause acne. Prolonged use of antibiotics can also impact skin health, potentially leading to acne. Acne Fulminans, a rare condition, can also be developed as a side effect of anabolic steroid abuse by some bodybuilders.

There is some evidence of a correlation between diet and acne. A diet with a high glycemic index and lots of dairy products may trigger or exacerbate acne. Read more about how foods can cause acne.

Stress can trigger hormones, which in turn stimulate sebum production and exacerbate Acne. Read more about how stress can trigger acne.

Research indicates that smoking exacerbates acne by causing oxidative stress to skin and altering sebum composition*.

*B. Capitanio et al from British Journal of Dermatology 2007. ed. 157 pp 1040-1085

An inappropriate skincare routine can significantly contribute to acne-prone skin in several ways. Using too harsh or drying skincare products can strip the skin of its natural oils and damage the skin barrier, leading to overproduction of sebum as the skin attempts to compensate for the loss. This excess oil can clog pores, creating an environment conducive to acne development.

Comedogenic products(ones that clog pores) can also exacerbate the problem by trapping dirt, bacteria, and dead skin cells with follicles. If the skin is not cleaned properly, impurities can accumulate, increasing the risk of inflammation and breakouts.

Find out more about the effective skincare routine for acne-prone skin.

There are many complex and interrelated factors involved in the development of blemishes and acne.

Acne is an inflammatory disease present at every stage of its development, with micro-inflammation (non-visible) as a root cause where damaged cells release cytokines to attract immune cells to the site of injury or infection. This leads to acute inflammation, characterised by increased blood flow and permeability, causing localised swelling, redness, heat, and pain.

If the threat persists, it becomes subacute inflammation, where macrophages clear debris and promote healing. Finally, visible inflammation emerges, with systemic effects such as fever and fatigue, as the body's response becomes more pronounced. Factors like hormonal changes, bacteria, and shifts in sebum composition can trigger this process, making some individuals more prone to inflammation due to genetic and hormonal influences.

The sebaceous glands secrete an oily sebum that suppresses skin and hair. Excess sebum production (triggered by hormones), which typifies blemish- and acne-prone skin, is known as seborrhea. Excess sebum on the skin’s surface interferes with the natural process by which skin sheds dead cells (desquamation). The composition of the sebum lipids, which build up in the sebaceous glands, also causes further micro-inflammation.

Hyperkeratosis is when the outer layer of the skin becomes abnormally thick. This happens due to the overproduction of skin cells, often triggered by hormones, and the skin's inability to shed dead cells effectively. As a result, these dead skin cells can block the sebaceous glands, leading to sebum buildup (oil). This buildup causes the follicle wall to bulge, resulting in comedones commonly known as black and whiteheads.

Propionibacterium acnes (or P. acnes) is a type of bacteria that usually lives harmlessly on the skin's surface. However, people with acne-prone skin can be more sensitive to it, and it can trigger inflammation. When the skin produces too much sebum (oil), it creates a favourable environment for P. acnes to grow. This bacteria starts to multiply in the plugged sebaceous glands, leading to further inflammation and the formation of papules and pustules.

In severe cases, the follicle wall can burst during the later stages of inflammation. This rupture releases lipids, fatty acids, dead skin cells, bacteria, and other cell fragments into the surrounding skin, which can cause additional inflammation and worsen acne.

Managing acne and blemish-prone skin can be difficult, often due to hormonal changes, excess oil production, and bacterial growth.

Here are some effective treatments to help control acne, reduce blemishes, and restore skin clarity:

Use a gentle, non-comedogenic cleanser for acne-prone skin twice a day to remove excess oil, dirt, and make-up without stripping the natural moisture from your skin. Eucerin DermoPurifyer Oil Control Cleansing Gel is a non-comedogenic, fragrance-free cleanser specially formulated for blemish-prone skin. It contains 6% Ampho-Tensides to cleanse gently yet effectively, removing dirt, makeup, and excess sebum without drying out the skin. Its gentle, soap-free formula makes it ideal for daily use, even alongside medical treatments, and helps prevent "maskne" (mask-induced blemishes). This cleanser leaves the skin feeling refreshed and is safe for sensitive skin.

Gentle exfoliation a few times a week to remove dead skin cells and prevent clogged pores. Chemical exfoliants like AHAs (alpha hydroxy acids) and BHAs (beta hydroxy acids) are often more effective and less abrasive than physical scrubs. Find out more about how to exfoliate your skin properly.

Eucerin DermoPurifyer Skin Renewal Treatment is designed to improve skin texture for those with blemish-prone skin. It contains a 10% Hydroxy Complex of glycolic, salicylic, and polyhydroxy acids, which helps exfoliate, unclog pores, and reduce blemishes. The formula smooths rough patches, reduces the appearance of fine lines, and minimises dark spots, promoting a clearer, more even complexion.

Acne-prone skin still needs hydration. Use a lightweight, oil-free moisturiser that won’t clog pores. Ingredients like hyaluronic acid can provide moisture without adding excess oil.

The Eucerin DermoPurifyer Oil Control Adjunctive Soothing Cream is a gentle moisturiser designed for acne-prone skin, especially for those undergoing drying acne treatments. It hydrates, reduces dryness, and soothes irritation, helping the skin feel soft and comfortable. Formulated with ceramides and other calming ingredients, it helps maintain the skin's moisture barrier, leaving it balanced and less prone to discomfort.

Consider incorporating retinoids like adapalene into your routine. They help promote cell turnover, prevent clogged pores, and reduce the appearance of acne scars.

Apply a non-comedogenic sunscreen for acne-prone skin daily to protect your skin from UV damage, which can worsen acne and lead to post-inflammatory hyperpigmentation.

Eucerin Oil Control Sun Gel-Cream SPF 50+ offers high sun protection for oily, blemish-prone skin, helping prevent sun-induced damage without clogging pores. Its non-greasy, mattifying formula absorbs quickly and reduces excess shine. Infused with sebum-regulating ingredients, it helps keep skin clear and smooth while defending against UVA/UVB rays and preventing sun-induced blemishes. Read more about choosing a sunscreen for acne-prone skin.

Maintain a balanced diet rich in fruits, vegetables, and whole grains, and stay hydrated. Reducing stress through mindfulness practices or exercise can also positively impact skin health, improving your skin’s natural resilience.

If over-the-counter treatments aren’t effective, seek professional advice. A dermatologist can recommend prescription medications or treatments, such as hormonal therapy or laser therapy, tailored to your skin’s needs. Find out more in acne medication and possible side effects.