Types Of Acne, Their Causes, Ayurvedic Remedies & Diet To Follow

Have you noticed that despite your best skincare habits, red, tender bumps show up on your face frequently? These eruptions, commonly known as acne, mostly occur among teenagers. However, it can affect others too.

Acne, if severe, can be painful. Frequent acne breakouts might even cause scarring on your skin. However, identifying its type and cause can help you prevent its recurrence. Besides, Ayurvedic remedies can help you cure this condition holistically and improve your overall skin health.

Scroll down to know what causes acne, what are its different types, and how you can treat the condition.

What Are The Different Types Of Acne?

According to Ayurveda, Acne comes under the classification of minor skin diseases or ‘Kshudra Twak Rogas’. Referred to as a ‘Yuvana Pidaka’, Ayurvedic literature mentions a complete Ayurvedic Dosha balancing diet and skincare routine to treat acne.

“Although unsightly, acne is simple to treat, according to Ayurveda,” says Dr Zeel Gandhi, Chief Ayurvedic Doctor at Vedix.

The six most common types of acne lesions are medically grouped under the term Acne Vulgaris [1]. Apart from their broad classification, acnes are also differentiated by their type (inflammatory/ non-inflammatory) and severity.

A. Acne Vulgaris

1. Comedones

A comedonal acne occurs when dead keratin flakes and sebum block a hair follicle. Comedones are the most basic forms of acne with no inflammation. These are of two types - open comedones and closed comedones.

Type: Non-inflammatory acne

Severity: Comedones, due to their non-inflammatory nature, are considered mild forms of acne. Over-the-counter medication and natural remedies are usually prescribed to treat comedones.

A. Whiteheads

Whiteheads are uninflamed, closed comedones that result from dead skin flakes, sebum and dirt being trapped within your pores. Whiteheads usually occur on your face, especially on the oily zones such as the nose, cheeks and chin. They can also appear in other areas such as your scalp, back and chest.

B. Blackheads

The major difference between a blackhead and a whitehead is that blackheads are open comedones. This makes it easier to extract the hardened impurities from a blackhead. When exposed to the air, these impurities trapped within the pore get oxidized to assume their black colour.

2. Papules

In a papule [2], the blocked hair follicle gets inflamed due to Propionibacterium acnes (a type of bacteria that lives on your skin) infection. As a result, a papule looks like a raised reddish cyst on the surface of your skin and is often painful to touch. The main difference between a papule and a pustule is that there is no pus seen on the surface of a papule. However, if left untreated, a papule can get filled with pus and turn into a pustule.

Type: Inflamed acne.

Severity: One or two papules are regarded as mild acne. More than that will be classified as moderate to severe acne.

3. Pustules

Being infected by the Propionibacterium acnes, the blocked hair follicle attracts white blood cells as an immune mechanism to fight the infection. This results in a pus filled cyst called a pustule. Pustules have the appearance of a white or yellow pus filled bump with a red inflamed ring around them. These acne lesions are painful to touch and often require medical treatment to cure them.

Type: Inflammatory acne.

Severity: Moderate to severe. Pustules are often found occurring together with papules.

4. Cystic Acne

As the comedo or non-inflammatory acne continues to get filled with sebum and dead keratin flakes there is increased proliferation of Propionibacterium acnes bacteria. This triggers the body’s immune system, which releases white blood cells to curb the infection. Eventually the thin wall of the blocked hair follicle breaks, spreading the impurities to the surrounding dermal layer. As a result, there is further inflammation and the infection travels deeper into the surface of your skin, forming large suppurative cystic acne.

Type: Large Inflammatory acne that measures more than 10 mm in diameter.

Severity: Moderate to severe depending on the depth of the acne lesion and number of cystic acne formed in an area.

5. Nodules Or Nodular Acne

The major difference between a cystic acne and a nodular acne lesion is that nodules are hard to touch. This happens when the impurities trapped within the infected hair follicle solidify and form a large, hardened nodule. The surrounding areas of a nodule are usually sore and may appear red and inflamed. These too go deep into the epidermal layer and cannot be easily extracted or treated with basic topical acne medication.

Type: Inflammatory acne.

Severity: Moderate to severe.

Apart from the six common types of acne lesions that come under Acne Vulgaris, there are some lesser known acnes variations. These may be caused by similar symptoms of a blocked hair follicle and interference of Propionibacterium acnes bacteria or be triggered by a skin condition.

B. Acne Conglobata

Acne conglobata is a rare and severe form of acne where nodules and cysts form together. Being deeply embedded in the epidermal layer, this nodulocystic acne condition poses a high risk of scarring or disfiguring the face. It is more common amongst adolescent men and can break out on the chest, back, thighs and the face. These large acne lesions are filled with foul smelling pus and require medical attention to heal them.

C. Acne Tarda

Acne Tarda [3] is often referred to as ‘adult acne’ as it occurs or persists after adolescence. It is more common in women who have been diagnosed with some endocrine disorder or PCOS which leads to hyperandrogenism. It is characterized by inflammatory acne spreading all over your face or concentrated in the lower part of your face. This can later get severe depending on the trigger factors in your body.

D. Acne Mechanica

Acne Mechanica is similar to acne vulgaris in appearance but differs in its underlying cause. It occurs due to direct mechanical stress on your skin. Constant pressure, rubbing or friction from clothes and other wearables such as watches, jewelry, masks etc. can result in this type of acne. This is common amongst people who have acne prone skin and are involved in excess physical activity such as sportsmen.

What Causes Different Types Of Acne?

A. Ayurvedic Diagnosis Of Acne

Various internal and external factors mentioned below can affect the balance of your Doshas or life energies that govern your body functions. According to Ayurveda, an aggravation of Doshas can put your body into a state of disease which include skin problems. ‘Yuvana Pidakas’ or acne are caused due to a vitiation of the Vata, Pitta and Kapha Doshas which in turn aggravates the Rakta dhatu (blood) and the mamsa dhatu (muscles). Severe cases of acne also involve ‘rasavaha’ or the formation of pus. A Vata- Pitta imbalance results in an increase in keratinocytes and excess Kapha leads to excess sebum secretion. This eventually clogs up your skin pores and results in the formation of acne.

B. Dermatological Diagnosis Of Acne

A healthy pilosebaceous unit regulates sebum production and natural disposal of dead skin cells. An imbalance of the pilosebaceous unit [4] usually due to hormonal changes can result in over-secretion of sebum and an increase in keratinocytes. This leads to the blockage of hair follicles giving rise to comedonal acne.

Non-inflammatory comedonal acne when infected by Propionibacterium acnes bacteria can turn into a severe form of inflamed acne (pustules, nodules). The pus within the hair follicle is due to an immune response which attracts white blood cells to the site of infection.

This disorder of the pilosebaceous unit causing acne can be triggered by one of the various factors that are mentioned below:

1. Hormonal changes during puberty that leads to increased levels of the androgen hormone. Androgen levels also increase during early pregnancy. This is why some women experience acne problems till their second trimester.

2. Changes in the levels of your estrogen and progesterone can play a role in acne formation. Hence, many women experience acne problems before or during their menstrual cycle.

3. Genetic skin disorder.

4. More common in women diagnosed with polycystic ovarian syndrome.

5. Use of skincare products that are comedogenic.

6. Consumption of oily, spicy foods or foods that have high sugar content.

7. Stress leading to imbalances in metabolism and accumulation of toxins in the body.

8. Over exposure to heat, friction and sun.

9. Skin diseases leading to dry skin or skin barrier impairment.

10. Lack of good hygiene and a proper skincare routine.

11. Certain medicines (lithium, androgenic steroids, corticosteroids) can also trigger acne.

How To Identify Different Types Of Acne?

Acne is a broad term that includes various subtypes with often similar symptoms. Thus, diagnosing the exact type might be confusing. To help you understand your acne better, we have mentioned below some of the basic symptoms of the acne subtypes.

1. Blackheads

Symptoms:

• Open comedones that look like small black bumps on your skin.
• No inflammation.
• No pus or skin irritation.

2. Whiteheads

Symptoms:

• Closed comedones that appear as small white/ skin toned bumps on the surface of your skin.
• Non-inflammatory.
• No pus formation, redness or skin irritation.

3. Papules

Symptoms:

• Papules are reddish bumps on your skin.
• Inflammatory acne.
• No visible pus.
• Often painful to touch.

4. Pustules

Symptoms:

• Pustules are often larger than comedones.
• They have a white or yellow pus-filled head with a red inflamed ring around them.
• Inflammatory acne.
• Painful to touch.

5. Cystic Acne

Symptoms:

• Cystic acne looks like large pus filled boils on your skin.
• Inflammatory acne.
• They are usually large in size and have their roots deep under your skin.
• Cysts are soft to touch due to the infected pus trapped within them.
• Painful to touch.
• High chances of developing acne scars if not professionally extracted.

6. Nodular Acne

Symptoms:

• Nodules look like hard bumps under your skin. They can be the colour of your skin or red and inflamed.
• Inflammatory acne.
• No visible pus head.
• Often painful to touch.

Your Ayurvedic doctor is most likely to first determine your Prakriti or unique body constitution to understand the role of your Doshas behind your acne. Post this, he may prescribe you a complete Ayurvedic treatment to treat your acne.

Important Note:

The best way to get your acne type diagnosed is by visiting your skin doctor. This will also help you to get the correct medication and chalk out the best skincare routine to improve your overall skin health.

How To Treat All Types Of Acne?

A. Natural Ways To Treat Various Types Of Acne

1. Cleanse With Non-Acnegenic Cleansers

Skin hygiene is an important step to control your acne problems. Clean your face with mild non-acnegenic cleansers that gently remove surface impurities, excess sebum and dead skin cells. Regular cleansing can prevent build-ups and keep your pores clean, thus preventing the formation of comedones. Opt for a deep clean once in a while, depending on your exposure to sun and pollution.

2. Face Steaming

Face steaming is a great way to loosen stubborn impurities that tend to block your pores. Add some green tea to the boiling water and let your skin absorb the goodness. Green tea can help to control the excess secretion of sebum which leads to acne.

3. Gentle Exfoliation

Gently exfoliate your skin with mild exfoliators to clear comedonal non-inflammatory acne such as whiteheads and blackheads. However, consult your doctor before exfoliating if you are experiencing moderate to severe acne. Inflammatory acne such as papules, pustules and nodules may get further irritated due to over-exfoliation. There is also a chance of spreading the infection to the surrounding areas of your skin.

4. Oil Control Natural Clay Masks

Natural oil control masks especially those that have tea tree oil can help curb the overproduction of sebum. Clay masks are often astringent in nature and have a cooling effect on your skin. This helps calm irritated acne prone skin and deep cleanse your pores. Apply your mask after a face steam to help your skin to absorb the skin benefitting properties of the mask better.

5. Use Water-based Moisturizers And Sunscreens

After exfoliation or application of a face mask, make sure to moisturize. Even if you have oily, acne prone skin, do not leave your skin without a moisturizer. This can dry out your skin and in turn trigger the sebaceous glands to produce more sebum. Opt for water based non-comedogenic moisturizers that don’t clog your pores and provide optimum hydration for your skin.

Sunscreen is a must for all skin types and especially if your skin is susceptible to acne. Over-exposure to the sun can further irritate your skin becoming a trigger for acne. Use light sunscreen that is non-acnegenic to protect your skin and prevent product build-up in your pores.

B. Ayurvedic Remedies For Different Types Of Acne

1. Mukha Lepas

Ayurveda prescribes a list of skin beneficial herbs with specific gunas (qualities) and effects on your Doshas and the skin diseases you are diagnosed with. The below mentioned mukha lepas are specifically concocted to treat the condition of Yuvana Pidaka (acne).

A. Yastimadhu, Chandanam, Manjistha and Milk

As per research the combination of these powerful Ayurvedic herbs with milk have shown to produce therapeutic relief to patients suffering from mild to severe cases of Yuvana Pidaka. Yastimadhu’s calming effect on the skin pacifies vitiated Vata and Pitta Dosha and prevents scarring from acne lesions. Chandanam too improves your overall skin complexion and pacifies Pitta. Manjistha is the ancient skin herb used in numerous Ayurvedic skin medicines for its ‘rakta shodhana’ or blood purifying abilities. Together with milk that cleanses your pores, this mukha lepa is the ultimate acne healing Ayurvedic face mask.

How To Use: Mix the ingredients (available in powdered form in Ayurvedic shops) with milk and apply on the affected areas. Leave it on for 15 minutes and wash off with tepid water for best results.

B. Lodra, Vacha, Dhanya And Rose Water

Lodra, Vacha and Dhanya are ancient Ayurvedic herbs that are combined to create the powerful Lodhradi Mukha Lepa. Application of this lepa gives relief from Kandu (itching) daha (burning sensation) and improves acne affected areas. Often used along with ‘Arogyavardhini Vati’, the Lodhradi Lepa pacifies all three Dosha and purifies the vitiated ‘Rakta Dhatu’ (blood). Being rich in tannins and flavonoids, these herbs exhibit antioxidant, anti-inflammatory and skin healing properties.

How To Use: Mix the powders of Lodra, Vacha and Dhanya with rose water to prepare the face pack. Apply it on the acne affected areas and leave it on for 15 minutes and wash off with lukewarm water.

C. Neem, Guduchi, Shalmali, Jatiphala

Neem and Guduchi being excellent Pitta, Kapha and Rakta Dosha pacifiers. Along with skin healing properties of Shalmali and Jatiphala, this Ayurvedic lepa is a strong topical medicine for acne. Shalmali and Jatiphala are also effective against acne scars.

How To Use: Mix these herbs with lukewarm water or rose water and apply on acne infected skin. Let it dry for 15 minutes and wash off with tepid water.

D. Haridra, Shatavari, Ashwagandha, Rakta Chandanam

Haridra or turmeric is a known antibacterial agent. Shatavari and Ashwagandha help to control hormonal imbalances that trigger acne. Rakta Chandanam is a powerful blood purifier. When combined, these traditional herbs make for an ideal acne treating Ayurvedic lepa.

How To Use: Mix all ingredients with water and apply on the affected areas. Keep it for 15 minutes and wash off. Repeat frequently till acne clears off.

2. Panchakarma Vidhi

The ancient Ayurvedic procedure of Panchakarma Vidhi is prescribed in cases of severe or persistent acne. This process detoxifies and purges your body of harmful toxins and opens up the blocked channels. The three main procedures in the Panchakarma Therapy that can heal acne are:

• Nasya: The process of administering herbal oils through the nasal cavity to clear blockages.
• Vamana: Vamana or therapeutic vomiting reduces excess Kapha Dosha in your body.
• Virechana [5]: This involves the administration of purgatives to clear excess Pitta Dosha through the lower channels of your body.

3. Ayurvedic Oral Medicines

Ayurvedic oral medicines are often prescribed along with the Mukha Lepas in acne treatment. These medications often include skin healing, Dosha calming and blood purifying herbs that are administered orally. These Ayurvedic herbs also help to improve your digestive system and balance your hormones. Some of the well known Ayurvedic medicines for acne treatment are mentioned below.

• Triphala Guggulu
• Arogyavardhini Vati
• Maha Manjishtadi Kashaya
• Avipathi Choornam

Vedix Tip: The Ayurvedic procedures of Abhyanga (herbal oil massage) and Udvartana (herbal exfoliation) have proven to be beneficial for removing comedonal acne such as blackheads and whiteheads.

C. Home Remedies To Cure Different Types Of Acne

Many common herbs, spices and ingredients in your kitchen and garden have the potential to heal mild to moderate acne with repeated use. Including these natural ingredients in your usual 5 step skincare routine will not only clear away stubborn acne but also make your skin glow.

1. Cleansing

Switch your usual synthetic cleanser with an organic one. You can use any of the following ingredients to clean your face:

Raw Milk Raw milk has lactic acid that is effective against blackheads and whiteheads. It is also gentle on acne infected skin and prevents clogging of your skin pores.

Coconut Milk Enriched with Vitamin C and anti-bacterial properties, coconut milk acts as a great cleanser for acne prone skin.

Tender Coconut Water Tender coconut water is known for its ability to clear persistent acne scars and blemishes. It not only improves acne affected skin but also helps in brightening skin tone.

Rose Water Rose acts as a good healing ingredient for inflammatory acne. It not only soothes your skin but its antioxidant and anti-inflammatory properties improve skin conditions and prevent inflammation and redness.

2. Exfoliation

Exfoliation, as previously mentioned, is suitable for mild non-inflammatory acne such as blackheads and whiteheads.

Cream Of Milk And Sugar Apply some cream of milk or malai and sugar on your face and let it dry. Now gently massage against the direction of hair growth to remove comedonal acne. The lactic acid in milk acts as a dead skin remover and clears your pores of trapped impurities.

Oatmeal Oatmeal’s anti-inflammatory and hydrating properties benefit skin that is affected by acne. It acts a gentle exfoliator and helps remove whiteheads and blackheads within a few repetitions.

3. Herbal Steaming

Face steaming is recommended for skin that is prone to acne. This opens up your pores and allows easy extraction of the plaque clogging your hair follicles. Throw in a few neem and tulsi leaves from your garden or add a spoon of green tea for more oil-controlling, skin purifying and anti-bacterial benefits.

4. Face Packs

A. Multani Mitti, Green Tea And Rose Water Face Mask

Amongst clay masks, multani mitti has proven to be the most effective in acne treatments. Both multani mitti and green tea are great oil controllers and prevent clogging of pores. Flavonoids in green tea also help to heal the skin. Rose water adds to the astringent property of this face mask and helps in improving the texture of your skin.

How To Use: Add multani mitti, green tea and rose water and let it soak for 15 minutes. Apply on affected areas and let it dry. Wash it off later.

B. Neem, Tulsi And Hibiscus Face Pack

Neem and Tulsi are power packed with skin benefitting nutrients and anti-bacterial properties that combat acne causing bacteria on your skin. Hibiscus is extremely hydrating for your skin and also enables blood circulation and sebum regulation abilities. It also battles blemishes and acne scars caused by inflammatory acne.

How To Use: Blend 7-8 hibiscus flowers, neem and tulsi leaves and apply on the acne affected skin. You can also add some aloe vera gel to it for extra skin soothing and moisturizing benefits.

C. Amla, Coriander leaves, Marigold Leaves And Buttermilk Face Pack

Amla and coriander are rich sources of antioxidants and are known for their skin healing abilities. Coriander along with marigold leaves are also powerful anti-bacterial agents that inhibit the proliferation of Propionibacterium acnes bacteria on your skin. Buttermilk cleanses your pores and prevents secretion of excess sebum, thus regulating acne causing factors.

How To Use: Blend 1-2 amla, a bunch of coriander leaves and marigold leaves and add a small cup of buttermilk to it. Apply and leave on for 20 minutes or till dry and wash off for clear skin.

D. Besan (Gram Flower), Honey, Pomegranate And Turmeric Face Mask

Besan is a great oil fighter when it comes to acne prone skin. The zinc in besan helps to cure various skin disorders. Combined with the antibacterial properties of turmeric and pomegranate, this face pack readily heals acne and enhances the texture of your skin. Add honey for further hydration and improvement of your skin tone.

How To Use: Mix all ingredients with lukewarm water to form a paste. Apply this for 15 minutes and wash off.

5. Moisturizing

Moisturize with natural emollients and moisturizers to keep your irritated skin hydrated and nourished.

• Aloe Vera Gel
• Honey
• Coconut Milk
• Tea Tree oil
• Basil Oil

D. Medical Treatments For Different Types Of Acne

1. Topical Medicines

Topical medicines include gels, creams, lotions and solutions that are directly applied to the affected areas to control the factors causing acne.

These include - Retinoids, Isotretinoin, Benzoyl Peroxide, Salicylic Acid.

2. Oral Antibiotics

In case of severe inflammatory acne conditions oral antibiotics are also administered to inhibit the growth of P. acnes bacteria and reduce inflammation.

These include - Azithromycin, Clindamycin, Doxycycline, Levofloxacin.

3. Hormonal Medicines

Hormonal medicines may be prescribed especially for women for whom acne is a result of androgen imbalance.

These include: Oral contraceptives.

4. Acne Removal Procedures

Other acne removal procedures include : Chemical peeling, professional comedone extraction, laser treatments.

E. Ayurvedic Diet To Cure All Types Of Acne

Your diet plays an important role in regulating your acne. Ayurvedic texts stress upon the consumption of a wholesome diet that includes all six tastes for keeping your Doshas in equilibrium. Follow the below mentioned guidelines to prevent acne and improve your overall skin health.

1. Include blood purifying and detoxifying foods in your daily diet:

Raisins, brahmi, giloy, ginger, green tea.

2. Consume foods that pacify excess Kapha and Pitta Dosha:

Apple, berries, mangoes, oranges, avocados, asparagus, zucchini, cucumber, cabbage, celery, garlic, onions, sprouts, barley, oats, wheat.

3. Eat vegetables and fruits that pacify excess Vata Dosha:

Apricots, banana, cherry, coconut, kiwi, lemon, carrots, green beans, leeks, spinach, oats, quinoa, rice.

4. Steer away from processed foods.

5. Prevent consumption of spicy and oily foods.

6. Lessen your intake of non-veg foods, especially red meat or foods that are high on fat.

7. Lower your intake of foods that have a high glycemic index.

8. Drink a lot of water to keep yourself hydrated at all times.

Prevention Tips For Different Types Of Acne

 

1. Maintain good skin hygiene and a proper Ayurvedic Dosha balancing skincare routine to prevent acne.

2. Follow a wholesome diet as per your ‘Prakriti’ or body constitution. Stay away from junk, oily and fried foods that trigger acne.

3. Drink a lot of water to keep your skin hydrated and to flush out harmful toxins.

4. Limit your use of make-up products that are comedogenic.

5. Don’t try to self-extract your acne. This can lead to acne scars.

6. Don’t touch the affected area as it may further spread the infection.

7. Wear breathable clothes. Avoid tight accessories if your acne (acne mechanica) is caused by friction, heat or pressure on your skin.

8. Use over the counter acne treatment for mild acne conditions. For moderate to severe acne, consult your doctor.

9. Use sunscreen before stepping out. Keep the affected areas covered, thus limiting sun exposure.

10. Follow a stress-free lifestyle. Include exercise, yoga and meditations to ensure healthy body functions.

When To See A Dermatologist?

Your acne can be triggered by various factors. If it does not heal with homemade therapies, it is advisable to see a dermatologist to prevent severity and even acne scars. Persistent acne may be caused by underlying conditions that may require medical attention. Also, moderate to severe inflammatory acne is best treated by a doctor as there is a high chance of scarring and facial disfigurement.

The Last Word

Acne is a broad skin disorder classification that includes different subtypes of acne that are triggered by various internal and external factors. It is important to know your acne type to diagnose its underlying causes and plan a suitable skincare routine. If precautions are not taken, pimples may cause serious scars on your face leading to psychological stress. Fortunately, the Ayurvedic texts and recent medical research has listed down a number of powerful skin herbs that not only treat persistent acne but also give a holistic boost to your skin’s health.

At Vedix, we evaluate your Doshas and based on the results curate a customized Ayurvedic skincare regimen that addresses your skin concerns.

Know Your Dosha Now