Warning: This post contains images of acne and other skin concerns which some readers might find not too pleasant.

Whilst I review so many products that target acne, spots and blemishes, I thought it would be a good idea to go into a bit more depth as to what causes acne all over the face and over the body. Understanding your acne, spots and blemishes (and making sure you know the difference between those) is key to begin getting rid of them effectively.

What is Acne?

So what is acne? Acne comes from the name of the bacterium p.Acne. This bacteria lives all over our skin and is actually a very good thing. p.Acne eats organisms on the skin’s surface and prevents them from entering our body. We live with p.Acne in a symbiotic relationship – it gets fed and we are protected.

This bacteria is kept at a safe and manageable level because of oxygen. p.Acne doesn’t thrive in oxygen and so it’s kept in check. As soon as oxygen is removed and moisture is added, p.Acne thrives and multiplies, becoming what our body recognises as an infection that needs to be stopped.

When our skin isn’t behaving as it should and the surface is uneven and our pores are blocked, this creates the perfect environment to trap the p.Acne bacteria inside the pore and let it multiply.

Once the bacteria enters the skin, our body’s natural immune processes kick in. Blood is transported to the infection site carrying white blood cells. The white blood cells attack the bacteria to neutralise it and then the skin starts to push the infection out. This explains the redness, white heads, raised surface and even that hard core you find when removing a spot. The majority of the visual symptoms are caused by our own bodies.

What is referred to as Acne or Acne Vulagris is simply down to a matter of size. Larger areas of skin become infected and the bacterial infection travels around under the surface of the skin, causing large areas of often pustulous infection. This can be painful and sore.

Hopefully that explains a little more about what ‘Acne’ actually is.

Psychological Effects of Acne (you’re not alone)

It’s very easy to look at the physical symptoms of acne whilst many people deal with the psychological symptoms. You are not alone.

Depression is a very common and natural response when suffering with Acne because our face is what the world sees. Spots are often and mistakenly associated with bad diet, poor hygiene and puberty. All of these have little merit – eating chocolate really doesn’t give you spots for example.

It’s important to talk about it, to either a friend, family member of doctor. Whilst it’s important to treat the physical symptoms, being able to share and talk about how it affects you is nothing to be embarrassed about. Did you know acne is the most common skin concern? It might feel like it’s only happening to you, and although it might not be comforting to know it’s not, it’s always worth talking about it, particularly to a medical professional who’s seen it many times before.

Forehead Acne

The average person touches their face 3 to 5 times an hour. Not only are you transferring bacteria from other objects, but added grease and pore clogging nasties that can get into your skin.

I often wear a snapback hat when I need to jump out the house, and after a few days of wearing one, I find I get spots here and there on my forehead. Not allowing the skin breath, keeping it sweaty and covered up is not healthy. Skin needs to be unobstructed and as sweat-free as possible otherwise this is a total precursor to forehead acne.

The Forehead is also part of the T-Zone, the oiliest sections of our face, so you’ll also find forehead acne more prominent as well as acne on the nose and chin.

How to treat Acne on the Forehead

I will be repeating the following advice throughout the article because the principles of curing acne are the same.

There are many treatments out there that claim to target acne and blemishes – I would always recommend before jumping in with both feet, to ensure the basics of your skincare regime are solid. If you’re suffering with acne, make sure products are largely fragrance and allergen free as well as oil and alcohol free.

Speak to your GP and seek derma referral

Firstly, speak to your doctor or GP – do not be embarrassed, this is what they’re there for and they want to help. Where possible, seek referral to a specialised skin doctor / dermatologist – more often than not I hear of GPs over prescribing antibiotics and stronger treatments without first addressing skincare. You can treat the infection but if the skins ecosystem is still primed for p.Acne production, then it will most likely return once treatment is discontinued.

Dehydration

The first and most common cause of a p.Acne happy forehead is dehydration. When the skin is dehydrated, skin cells become dry and fall into pores creating blockages.

Gentle, chemical exfoliation

Second is under exfoliation – using gentle chemical exfoliation looking at ingredients such as BHA and AHAs will help to break down the bonds of surface dead skin cells and prevent them from blocking the pores – these will also increase skin cell turnover making sure the cells at the top of the skin are healthier, fresher and more uniform.

Moisturise without oil

Moisture; it’s very common to have acne with oily skin. The trick here is not to strip away the oil, but to restore lost water. When our skin is dehydrated from water, it will seek to overcompensate with excess oil production. You can and should drink lots of water, but only around 60% of the water we drink actually gets to our skin – the rest should come from outside.

Using moisturisers that are water based but free from alcohol will help replenish water, soften the skin, prevent dry surface skin cells and sooth.

Cheek Acne

Acne on the cheek is another one of the most common types of facial acne. There’s nothing particularly special about it, and acne of the cheek is often a sign over all-over skin function breakdown.

Whether you’re a man or a woman, we tend to get more hair on the cheeks than anywhere else on the face. With men the hair is more noticeable and with women not so much, but it’s still there. When the skin malfunctions and pores are blocked, pores with more hair tend to exacerbate the issue with increased blockage and oil production.

Because your cheeks tend to be very active when we talk or eat, this area can also feel more painful and inflamed. We also tend to touch objects with our cheeks more than anywhere else, such as on our hands and pillows. The cheek is also a very fleshy part of the skin, pores are often deeper and so primed for greater infection.

Treating Cheek Acne

The steps here are the same as treating the forehead. Foundation skincare is pretty simple and will ensure the promotion of healthy skin functions.

Speak to your GP and seek derma referral

Speak to your doctor or GP – do not be embarrassed, this is what they’re there for and they want to help. Where possible, seek referral to a specialised skin doctor / dermatologist – more often than not I hear of GPs over prescribing antibiotics and stronger treatments without first addressing skincare.

Dehydration

The first and most common cause of p.Acne happy cheeks is dehydration. When the cheeks are dehydrated, skin cells become dry and fall into pores creating blockages.

Gentle, chemical exfoliation

Second is under exfoliation – using gentle chemical exfoliation looking at ingredients such as BHA and AHAs will help to break down the bonds of surface dead skin cells and prevent them from blocking the pores – these will also increase skin cell turnover making sure the cells at the top of the skin are healthier, fresher and more uniform.

Moisturise without oil

Moisture; it’s very common to have acne with oily skin. The trick here is not to strip away the oil, but to restore lost water. When our skin is dehydrated from water, it will seek to overcompensate with excess oil production. You can and should drink lots of water, but only around 60% of the water we drink actually gets to our skin – the rest should come from outside.

Using moisturisers that are water based but free from alcohol will help replenish water, soften the skin, prevent dry surface skin cells and sooth.

Chest Acne

The chest is another area that’s prone to acne, again this is another area prone to sweat, constant contact with clothing and has hair – whether you’re a man or a woman.

It’s worth noting that almost every part of the human body has hair, but some areas are denser than others, particularly the armpits, pubis and legs – these areas have thicker hairs that break through the skin with little problem, it’s the areas where hair is prone to blockage where the problems are most often found.

Chest acne is very often found in men and more often than that, in men who are either overweight or who frequently exercise. This is due to an increased amount of sweat, which dehydrates the skin and subsequently incraeses oil production. Spots on the chest can also ocurr if the chest is shaved, or waved without due care.

Treating Chest Acne

Chest acne, although still acne and is caused by similar principles to acne on the face, it’s a slightly different beast. Firstly, you need to make sure you eliminate sweat from this area by either refreshing the chest when needed or even changing your top.

GP and Derma Referral

Because you’re reading this anonymously, I can’t be sure exactly how severe (or not) your acne on the chest is. For some people, it can be quite severe, so if you’re unsure, particularly if you’re in pain or discomfort – book an appointment with your GP.

Always push for a dermatologist referral and always address your skincare before starting with strong prescription medication – more often than not I hear of GPs over prescribing antibiotics and stronger treatments without first addressing skincare which can lead to the problem returning once treatment has been discontinued.

Avoid close shaving or waxing

If you wax or shave, I’d highly recommend discontinuing until the acne has cleared up. When you do shave, try not to close shave so that the hair is outside the pore thus preventing blockages and ingrowns. If you are prone to acne in this area, I cannot stress enough how much waxing should be avoiding – it dramatically increases the risk of ingrown and causes trauma to the skins surface.

Treatment Products

Whilst you should also cleanse the area (no more than twice a day) look at using an ingrown hair treatment or body spray. Look for products containing ingredients to calm whilst also using chemical exfoliants such as Salicylic Acid. If needed, use a water based, oil-free body moisturiser to sooth the area – but before dressing, ensure the area is dried.

Acne on Back

Acne on the back is one of the most common forms of body acne, particularly on guys – this is also followed by acne on the bum.

The back can be particularly sweaty, you’ll often find your acne on the back is accross the shoulders and upper back. This is due to constant contact with clothing throughout the day which can rub and exacerbate the problem and also lead to ingrown hairs. The back is another area prone to sweat which as discussed under chest acne, makes this problem worse.

It’s worth noting that body builders tend to suffer more with back acne due to increased sweat, but also bodily acne is a common side effect of steroid use. Even if you deal with the skin, as long as you’re continuing steroid use, the problem will likely continue.

Treating Acne on the back

Over the years, I’ve found some brilliant treatment methods for helping to reduce and clear acne on the back.

GP and Derma Referral

Again, I can’t be sure exactly how severe (or not) your acne on the back is. For some people, it can be quite severe, so if you’re unsure, particularly if you’re in pain or discomfort – book an appointment with your GP.

Always push for a dermatologist referral and always address your skincare before starting with strong prescription medication – more often than not I hear of GPs over prescribing antibiotics and stronger treatments without first addressing skincare which can lead to the problem returning once treatment has been discontinued.

Cleansing

It’s important not to overcleanse any area of the skin when dealing with acne. This can dehydrate the skin and make the problem worse. For the back, I recommend using a shower gel that contains salicylic acid (if you’re US based the Neutrogena Skin Clearing Body Wash) or if you’re in the UK, the face wash of the same brand also works well as a body cleanser.

Use a gentle, nylon bristle body brush will also help to exfoliate the area during cleansing. Make sure this is done gently and do not scrub – scrubbing will increase blood flow to the area and risk bursting acne spots which can cause them to spread and worsen.

Treatment Products

Using a salicylic acid based body spray will dramatically help back acne by removing the skin-blocking dead skin cells. Also by applying a water-based oil-free gel moisturiser will hydrate the area and prevent surface dead skin cells from drying out. Many fake tanning companies have a back-applicator to apply product, this can also be used to apply a gel moisturiser. Don’t use too much and ensure the back is dry before dressing.

Things to avoid

Make sure your bed sheets are changed very, very regularly as they are breeders of bacteria if left unwashed. Be sure to wear loose fitting clothes with breathable natural fabrics like cotton and hemp – avoid synthetic fabrics at all cost! Finally when washing your hair, stop washing your shampoo and conditioner out over your back – these are a really easy way to worsen inflamed back acne.

Adult Acne

So it’s just kids and teenagers that get acne, right? Wrong. Despite what adverts and marketing would have you believe, adult acne is very common. It’s true that teenagers have a greater propensity for acne, due to the increased oil production and changes in skin function all occurring in a relatively short space of time. However, if your skin is the perfect ecosystem for acne production – it’s doesn’t matter if you’re 15 or 50, it can develop.

Key Advice for Adult Acne

Don’t over-cleanse the skin. If you’re finding your skin is becoming very oily, stripping the oil is a bad (albeit seemingly obvious) move to make. By stripping oil, your skin will only produce more. The key is to realise why your skin is producing so much oil and slow it down. This is often due to dehydration and so when the skin is lacking in water, it overcompensates by producing more oil. Use oil-free, hydrating and nourishing products to add water and help restore skins natural, healthy functions.

Use gentle chemical exfoliation to help unblock the pores. Aim to use products that are alcohol free as this can further irritate and dehydrate the skin. Targeted ingredients such as Salicylic Acid (BHA) and AHAs will unblock pores. Also seek calming ingredients such as Tamanu Oil (no blocking or greasy) and algae and seaweed complexes to calm the skin – topical caffeine is also great for this.

Acne Rosacea

Two skin concerns that are often confused are acne/rosacea. Roscaea is still relatively misunderstood but symptoms include elevated blood flow to the surface of the skin, giving a bright flushed appearance. Skin also dehydrates leaving it dry and flakey. This in turn can cause spots and white pustules under the skin called Millia (these are not ‘spots’, but pockets of white blood cells).

With Rosacea it’s important to use very hydrating ingredients that are absolutely, 100% oil-free. Raised blood vessels and raised capillaries react badly to oil, and this can cause further irritation, pain and discomfort. Clinique’s Redness solutions, launched almost 10 years ago, has been a staple of Redness skincare treatment featuring very nourishing, calming products that are oil free. Reducing alcohol intake will also help.

By balancing healthy skincare function, you can reduce the overall appearance of rosacea and therefore any resulting acne. However, if there’s even a chance you might be dealing with Rosacea, consult your GP and push for a dermatologist referral. Just remember, it’s key to avoid oil-rich ingredients and from anecdotal experience, it seems many GPs don’t quite understand the importance of this – aqueous cream is not oil free.

Getting Rid of Acne Scars

Finally I wanted to touch on Acne scars. Now I’ve had quite a bit of experience with this from having Chris and also an ex that had deep acne scars that through regular treatment and good skincare, were massively reduced.

Good Skincare

Firstly, as I’ve mentioned through this whole page, getting a good solid skincare regime is important. Make sure that now your acne has gone, that it doesn’t come back and that your skin is kept calm and happy. Use regular exfoliation, oil-free but water-rich nourishing moisturisers and lots of SPF (with UVA and UVB protection).

Professional Skin Treatments

There are a wide number of professional skin treatments available such as chemical peels, derma-needling and laser treatment. These are effective in kick starting the skin into repairing the elastin and collage production to ‘fill’ out the acne scars or ‘pot marks’. Do your research and if possible, visit a dermatologist for these treatments.

Andy Millward, who used to blog as Pampered Prince, and is now an aesthetician is worth contacting for advice and treatment plans, here.

Acne Scar Serums and Treatments

There are a whole number of acne scar treatments available. The best I’ve found in a long time has been the Clinique Smart Serum. Chris has been using this and his few acne scars but moreso his enlarged pores have been completely transformed. A great skincare range and although not cheap, has given brillaint results.

Next would be the La Mer concentrate. This ultimate skin regenerating complex can be used on acne scars new and fresh. From my beauty hall days, I remember talking with customers who had used it on breast cancer scars and seen incredible results. I haven’t seen a beauty treatment restore skin’s collagen and elastin quite in the way this does with real noticeable differences. Be sure to get a sample first to see that your skin responds well to it and doesn’t react – this can be a problem due to how active the serum is. Most La Mer counters will offer a sample and advice.