Why Do I Have Inflamed Acne and How Should I Treat It?

Inflamed acne is a type of breakout that’s red, swollen, and often painful, unlike a blackhead or whitehead that stays beneath the skin's surface. This type of acne can be particularly frustrating because of its noticeable redness and swelling, which make it harder to cover up and treat. While inflamed acne can develop for various reasons, there are several ways to help it calm down and minimize future outbreaks.

Fast Advice for Calming Inflamed Acne

It is important to give your acne treatment several weeks to work. However, if you’re looking to reduce swelling and redness fast, here are some quick tips:

• Avoid squeezing or popping: Although tempting, squeezing or picking at inflamed acne can worsen swelling and lead to scarring.
  
• Try a cold compress: A cold compress will constrict blood vessels to reduce redness and swelling.
  
• Use an anti-inflammatory mask: Clay masks may help to soothe inflamed areas and draw out impurities.
• Use an anti-inflammatory spot treatment: Look for products with benzoyl peroxide or salicylic acid, which can help reduce the size of the breakout and combat bacteria. A topical corticosteroid, like hydrocortisone, can also be used to reduce swelling and inflammation associated with a large pimple.

Why Does Acne Get Inflamed?

Acne becomes inflamed when pores are clogged with oil, dead skin cells, and bacteria, causing the area to swell and turn red. Several factors can trigger this inflammation:

• Bacterial growth: Bacteria get trapped in clogged pores and cause an inflammatory response.
• Excess oil production: When your skin produces too much oil, it can trap dead skin cells and bacteria inside pores, leading to inflammation.
• Hormonal changes: Hormones can play a big role in inflamed acne, particularly during puberty, menstruation, or times of high stress, which can increase oil production.
• Irritants: Using harsh skin care products or touching your face often can irritate the skin, leading to further inflammation.

Other factors that can make acne worse include:

• Pollution or high humidity
• Pressure from helmets or tight clothes
• Stress
• Squeezing or picking at acne

Hormonal vs. Bacterial Acne

Hormonal acne and bacterial acne often look similar but have distinct causes and symptoms.

Hormonal acne often appears on the lower part of the face, including areas like the chin, jawline, and around the mouth in a U-shape pattern. Symptoms include red, inflamed bumps and pus-filled spots, occasional dark spots after the acne heals, and sometimes scarring in severe cases. It may vary in intensity throughout the month, especially in those with menstrual cycles. Hormonal acne is usually deeper and tender to the touch, often forming cysts that don’t come to a head.

Bacterial acne, commonly called Cutibacterium acne is caused by the overgrowth of Propionibacterium acnes (P. acne), a type of bacteria that normally lives on the skin. When pores become clogged with excess oil, dead skin cells, or other debris, this bacterium can multiply within the blocked pores, leading to inflammation. This inflammation results in red pimples, pustules (pus-filled bumps), and sometimes even painful cysts.

Bacterial acne often appears on areas of the skin with more oil glands, like the face, back, and chest. It’s typically treated with topical or oral antibiotics, benzoyl peroxide, or other antimicrobial treatments to reduce the bacteria and inflammation in the affected areas.

Natural Acne Treatment

For those seeking natural methods to reduce inflamed acne, here are some options:

• Aloe vera: The cooling and anti-inflammatory properties of aloe vera may help calm redness and reduce swelling. It is often recommended to be used along with another acne treatment, such as tea tree oil.
• Honey: Studies suggest that raw honey, especially medical-grade varieties like Manuka honey, has antimicrobial properties that can help reduce acne-causing bacteria and soothe inflammation. However, more clinical research is needed to confirm its effectiveness for acne treatment, as honey alone may not be as effective as conventional treatments like benzoyl peroxide or salicylic acid.
• Tea tree oil: Known for its antibacterial properties, it can help reduce skin bacteria. Dilute with a carrier oil before applying to avoid irritation.

These natural treatments can offer relief, but for best results, severe or persistent inflamed acne may require medical treatments.

Medicated Ointments and Washes

Over-the-counter (OTC) products and prescription medications, such as these, are often effective at reducing inflamed acne by killing bacteria, reducing oil, and unclogging pores:

• Benzoyl peroxide: This ingredient is popular in acne spot treatments and washes due to its ability to kill acne-causing bacteria. Start with a low concentration (2.5% to 5%) to avoid irritation and gradually increase if needed.
  
• Retinoids: Derived from vitamin A, retinoids like tretinoin and adapalene help speed up cell turnover, preventing pores from clogging. This treatment exfoliates skin and unclogs pores, and works best on blackheads and whiteheads.
• Salicylic acid: Found in many acne washes and spot treatments, salicylic acid helps exfoliate dead skin cells and unclog pores.

How Antibiotics Treat Acne

For more severe cases, dermatologists may prescribe topical or oral antibiotics to treat inflamed acne. Antibiotics work by reducing the bacteria that cause inflammation and calming the immune response in the skin. However, antibiotics are generally used for short-term treatment to avoid antibiotic resistance (when bacteria mutate and no longer are killed by antibacterial drugs) and they’re often combined with other therapies, like benzoyl peroxide or retinoids.

Antibiotics may help some people with acne. Oral antibiotics may include:

• Amoxicillin
• Doxycycline
• Erythromycin
• Minocycline
• Tetracycline
• Trimethoprim-sulfamethoxazole
  

Topical antibiotics (applied to the skin) such as clindamycin, erythromycin, or dapsone.

Eliminating Triggers

Reducing or eliminating acne triggers can help keep your skin clear in the long term. Here are some common triggers to be mindful of:

• Getting too little sleep
• Having high levels of stress that can cause hormonal changes that worsen existing acne
  
• Touching or picking at skin
• Using oily makeup and skin care products
  

Everyday Skin Care

A gentle, daily skin care routine can help keep acne-prone skin balanced and reduce the chance of inflammation. Here’s a simple routine to follow:

1. Cleanse: Cleanse your skin gently with a mild, non-drying soap or cleanser.
2. Moisturize: Use an oil-free or gel-based moisturizer to hydrate without clogging pores.
3. Spot treatment: Use a spot treatment containing benzoyl peroxide or salicylic acid as needed to target individual pimples.
4. Sun protection: Apply a noncomedogenic (will not clog pores) sunscreen daily to protect the skin from ultraviolet (UV) ray damage, which can worsen acne and cause dark spots.

Additional everyday tips to help you manage acne include:

• Avoid harsh scrubbing or washing your skin too often.
• Avoid touching the face.
• Choose water-based or noncomedogenic products for makeup and skin care, as they are less likely to clog pores and cause breakouts.
• Don't leave makeup on at night.
• Don't pick or scratch pimples.
• Keep hair pulled back or away from your face to prevent oils from transferring to your skin.
  
• Make sure to remove all dirt and makeup by washing your face once or twice daily, especially after exercise.
• Wash your hair daily if it tends to be oily.
  

Summary

Inflamed acne, marked by red, swollen, and sometimes painful pimples, can be frustrating and challenging to treat. Causes can range from hormonal shifts to bacterial growth and lifestyle factors. From natural treatments like tea tree oil and aloe vera to medicated solutions like benzoyl peroxide and retinoids, there are numerous ways to calm inflammation.

For severe cases, antibiotics or prescription treatments may be necessary. Adjusting your skin care routine and identifying your acne triggers can help prevent future outbreaks and support clearer, healthier skin.