Everything You Need to Know About Acne

Acne is the most common skin disorder in the United States, affecting 40 to 50 million Americans. Nearly 85% of people experience minor acne between the ages of 12 and 24. According to the American Academy of Dermatology, by mid-teens, more than 40% of adolescents have acne or acne scarring that will require treatment by a dermatologist.

Acne is a skin condition that consists of open or closed comedones, papules, pustules, cysts or nodules that occur on the face, neck, chest, back, shoulders and upper arms. It is caused by increased cellular buildup within the hair follicle, inflammation, increased sebum production and multiplication of p. acnes bacteria.

Acne is classified as Acne Simplex (Grades 1-2) or Acne Vulgaris (Grades 3-4):

  1. Acne begins as an excess of keratinocyte cells adhering to the follicle wall while increased sebum produced; this combination forms a plug that blocks the pore creating an open or closed comedone.
  2. Sebum production continues as p. acnes bacteria build and multiply causing inflammation, creating a papule
  3. Inflammation increases as p. acnes bacteria continue to multiply. White blood cells accumulate as part of the immune system response, weakening the hair follicle wall, causing it to rupture. At this stage a pustule is formed.
  4. Nodules and cysts form due to the increased inflammation and tissue destruction incurred by the ruptured follicle wall.

Acne is a very sluggish condition that requires frequent treatment to get under control. A person who has acne often suffers from low self-esteem. Acne comes in many different forms for many different reasons. Here is a breakdown of the most common types of acne and our VI Pro Tips to help combat it.


Most Common Types of Acne:

Asphyxiated Acne is caused by cellular buildup with sebum and debris trapped underneath. Asphyxiated skin cells do not receive enough oxygen, hence skin cell turnover rates are diminished and waste is not properly disposed of. This type of acne is very common in dry and/or polluted environments such as desert regions and metropolitan areas.

  • VI Pro Tip: For people with this type of acne, surface exfoliation such as a chemical peel, Salicylic Acid, scrubs or microdermabrasion are good options. Hydrating, moisturizing, and boosting the skin with antioxidants are essential for promoting healthy skin cell turnover. VI Derm Vitamin C gel is full of antioxidants and works well on asphysxiated acne.


Acne Cosmetica is caused by comediogenic or irritating cosmetic products such as makeup, laundry products, or hair care products. This acne is characterized by small, rash-like bumps usually on the chin, forehead and/or cheeks. Teenage girls frequently struggle with this type of acne because of their makeup brushes.

  • VI Pro Tip: For Acne Cosmetica, it’s important to take a closer look at the products that come into contact with your face including makeup, skin care products, styling products, hair conditioners and laundry detergents. For makeup, we recommend using non-comedogenic, hypoallergenic, or oil-free products and practicing good hygiene habits like cleaning your makeup brushes and sponges. Be careful with haircare products that contain alcohols or oils and keep them away from the skin on your face.  Hypoallergenic laundry detergents may also help the underlying issue.


Acne Mechanica is caused by friction against the skin that is caused by or aggravated by heat, covered skin, repetitive friction against the skin, and/or prolonged pressure of objects such as a cell phone, backpack, bra strap, football helmet or baseball cap. Any objects that traps heat and sweat against the skin can be an offender.

  • VI Pro Tip: The key to addressing this kind of acne is to remove the offending agent that causes friction if at all possible. Replace synthetic clothing with breathable cotton, cleanse skin often and shower directly after exercise to clear sweat and grime. Acne Mechanica responds well to Salicylic Acid and Benzoyl Peroxide and can be found in VI Derm Cleanser and VI Derm Body Wash.


Hormonal Acne is caused by an increase in androgen hormones that stimulate sebaceous glands and increase sebum, or oil, production.  It is characterized by inflamed and cystic nodules, typically found around the jawline and lower half of the face. A high-sugar diet aggravates hormonal acne by triggering an insulin spike in the blood which increases levels of free testosterone in the body. Other factors that change blood-hormone levels can contribute to hormonal acne like puberty, menstruation, pregnancy, menopause and stress.

  • VI Pro Tip:  Over-the-counter (OTC) products are typically not as effective for treating hormonal acne for two reasons. First, topical treatments do not affect blood-hormone levels and second, they do not penetrate hormonal cysts that are buried deep within the skin. Nonetheless, consistency is key for effective treatment for hormonal acne. A daily skin care regimen made of anti-bacterial agents and exfoliants helps with inflammation and clearing surface infection. Salicylic Acid, Vitamin A, AHAs and green tea work particularly well with hormonal acne and are found in the VI Derm Cleanser, VI Derm Complete Cares (Normal to Dry, Oily and Acne Prone) and VI Derm Ultra A.


Cyclical Acne is caused by women’s hormones fluctuating throughout their menstrual cycle and is similar to hormonal acne. Estrogen levels drop during the last two weeks of a woman’s monthly cycle, while progesterone (responsible for tissue swelling) levels ride, creating a hormonal imbalance. High progesterone levels create compressing pores that peak approximately one week prior to menstruation. Due to dropping estrogen levels, testosterone becomes the dominant hormone and increased sebum production.

  • VI Pro Tip: Combat Cyclical Acne by promoting a healthy hormonal balance from the inside-out. Avoid fried, processed, or refined sugar-containing foods and support a healthy liver to detoxify blood. Effective topical treatments for Cyclical Acne include Salicylic Acid, Vitamin A, AHAs and green tea and are found in the VI Derm Cleanser, VI Derm Complete Cares (Normal to Dry, Oily and Acne Prone) and VI Derm Ultra A.


Post Inflammatory Hyperpigmentation (PIH) is discoloration at the site of acne lesions. The inflammation of the acne lesion triggers the melanogenesis response, resulting in the deposit of melanin and darkening of the skin. It is estimated that over 60% of darker skin types suffer from PIH.

  • VI Pro Tip: PIH can be addressed through appropriate treatment plans and home care. While you are able to treat both acne and the resulting hyperpigmentation simultaneously, priority should be given to the acne in order to prevent future discolorations. Many ingredients that fight p. acnes bacteria suppress hyperpigmentation, including Kojic Acid, Azelaic Acid and Lactic Acid. To combat melanogenesis and promote cellular turnover and exfoliation, incorporating topical retinoids (Vitamin A) found in VI Derm Ultra A are essential. To calm inflammation that accompanies PIH, anti-inflammatory ingredients like aloe vera, found in VI Derm Cleanser, should  be used.


Acne is one of the most prevalent skin conditions and varies from person to person. If you suffer from acne, reach out to a professional to find out what are the best steps in reaching your skin goals. If you have any questions regarding information about acne and our VI Peels, please feel free to reach us at social@vipeel.com for general questions.


This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither VI Aesthetics, the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of product which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider. 

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