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If you are struggling with acne, the best place to start is with topical over-the-counter (OTC) treatment, and some of you may even be able to use at-home treatments.

Today, I will focus on evaluating your own acne to prepare for my next posts on over-the counter-and at home treatments. This will also prepare you to talk to and better understand your dermatologist if it gets to that point.

Acne and acne treatments are big topics. So I need to break them up into segements to really help you understand your acne and do a thorough job helping you.

First, in order to treat acne effectively, you need to understand what type of acne you have. The general categories are comedonal, inflammatory and cystic acne. Most people have a combination of more than one type of acne.

Comedonal acne consists either of tiny skin colored bumps which are called “closed comedones.” There are also “open comedones” that appear as brown to black little bumps, most people refer to as blackheads. These are usually most noticeable on the forehead but are also common on the chin and around, or on, your nose and sometimes scattered on cheeks or even in ears.

Some people mistake pores with dark centers as “black heads.” This mistake is usually made on the nose. Even if you can get something out of these pores it does not make them blackheads. There has to be an actual small bump or plug to be considered a true blackhead or comedone. If there is not, you may not have real blackheads or comedonal acne but just larger pores with normal keratin material in the pores. But because the pores are somewhat larger (such as those on the nose) for some individuals, there is often a shadowing effect in the opening which visually accentuates the opening making it look like a blackhead. What’s even more confusing is that when you use a Biore strip or tape, or when you try to get something out of the pore, you can actually get what looks like a little plug or white stringy material! But, in reality, normal pores are programmed to make this keratin material. The difference is there is no real backing up or plugging of the pore so it doesn’t develop a small bump.

True comedones cause actual plugging of pores and can lead to inflammatory acne or pimples. In fact, comedones are felt to be the first step in the development of inflammatory acne, even if the comedones are not obvious to the naked eye. Sometimes acne is simply comedonal which causes skin to look bumpy.

Inflammatory acne consists of pimples and sometimes pustules. The frustrating part of this type of acne is that it often leaves a discoloration on the skin once the pimple is resolved. Many women refer to this discoloration as scarring when they are talking to me about it. Fortunately, it is not true scarring and will go away, eventually, but usually last for months. There are treatments that will help it go away quicker (I will touch on this too), but there is no magic quick eraser cream. That’s why it’s so important to prevent this type of acne as much as possible. Inflammatory acne is the most common type of acne women struggle with.

Cystic acne consists of hard bumps on the skin which are usually pink or red but can be skin colored too. These cysts can be very tender and can scar even if you leave them alone. Anyone with cystic acne should really make an appointment with a dermatologist because my next advice on the over the counter treatments will probably not help you to the extent you need. And as I stated, cystic acne can often scar and acne scarring (which I will also discuss in a future post) is expensive and difficult to treat.

As I mention above, my next post (which will publish early next week) will cover specific OTC product types and recommendations. But in the meantime, here are some important things to know:

Washing your face is important but will not treat your acne. In fact, excessive washing and scrubbing can actually make acne worse.

Try to keep your hair off your face. Avoid any thick or greasy hair products if you have acne around your hairline.

Avoid wearing tight hats over your acne, and if you still talk on the phone (:)), don’t lean against your hand or phone while you’re talking.

Sun typically helps with acne, but the long term side effects of wrinkling and premature aging of the skin outweigh the benefits of outdoor and indoor tanning! That’s not even mentioning the risk of SKIN CANCER!

You all know not to pinch or pick at your acne. If you do, you are more likely to end up with long lasting discoloration in the areas that are picked at, and it can also cause scarring. So hands off :).