ROOT CAUSE | Different Types of Acne

ROOT CAUSE | Different Types of Acne

Acne is complex. It shows up in different places for different people and different treatment modalities work for different people. Like I said, complex. But I think a lot of the complexity stems from the fact that we tend to think of acne as one thing, ignoring the fact that perhaps there are different types.

Recognizing that not all acne is the same, let’s talk about a few of the different categories of acne. 

TYPE ONE: Androgen-Related Acne

This is the category that you are likely the most familiar with and typically looks like what we would consider “classic acne” – oily T-zone with whiteheads and blackheads. When you think androgens, think congestion. Androgens influence both the size of the sebaceous glands and sebum production. (For a full recap on androgens, head here.) Keep in mind that your skin might not necessarily look oily on the surface, but that doesn’t mean that androgens aren’t the culprit. Focus on the congestion. Additionally, blood work showing normal androgen levels is not definitive either. Skin can simply be extra sensitive to androgens.

Stress can exacerbate androgenic acne by causing the adrenals to pump out androgens. Insulin is a big player as well so managing blood sugar is your first line of defense.

Type One Dietary/Lifestyle Adjustments:

  • Eliminate/reduce sugar and dairy (particularly cow’s milk)
  • Minimize your grain intake
  • Supplement with probiotics, Vitamin A, B Complex (plus extra B5), zinc, and omega 3 fatty acids (if stress is a big issue for you, take Vitamin C as well and eliminate caffeine)
  • Drink spearmint or reishi tea
  • Manage your stress with self care

TYPE TWO: Immune-Related Acne

This type of acne typically takes on a rash-like appearance on the cheeks (pimples aren’t quite as well-defined) and ties back to gut health. (If you want a refresher on acne and the immune system, head here.) This is your immune system on overdrive so identifying the cause of this overreaction is going to be key, as well as restoring healthy gut function. There is usually some level of digestive dysfunction at play here too. You will likely see a direct correlation between improvement in digestive function and the skin.

An elimination diet is going to be important with this type. Though I’ve mentioned in the past that I’m not a huge fan of elimination diets, I do think there is a time and place for a therapeutic dietary approach. However, if you are a person that experiences a lot of stress and anxiety around food restriction, do not start with the elimination diet. Stress management, adequate sleep, and movement are just as important for robust immune function. Start there and work through the food sensitivities when you are ready.

Type Two Dietary/Lifestyle Adjustments:

  • Eliminate the GLED (grains, legumes, eggs, dairy) foods for two weeks and then slowly reintroduce one at a time to determine if any are triggering your acne
  • Eliminate/reduce sugar and heavily processed foods
  • Take a probiotic, eat fermented foods, add collagen powder to your smoothies
  • Supplement with zinc, B complex, and omega 3 fatty acids
  • Take baths, get a massage, walk in nature, or anything that helps your body feel safe and relaxed

TYPE THREE: Hormonal Acne, aka Premenstrual Acne

This is where things get a little more complicated because premenstrual acne can simply be an exacerbation of type one or type two acne or its own unique category. The surge in testosterone experienced right around ovulation can make androgenic acne worse and the immune function dip in your luteal phase (to allow for implantation) could exacerbate immune related acne. If either of these scenarios seems to apply, simply follow the above treatment protocols.

However, if breakouts are limited to the days before your period and the acne is cystic and along the jawline, then you could be dealing with incomplete estrogen detoxification. This is where estrogen dominance comes into play. (For more on estrogen dominance, head here.) Your breakouts will likely also be accompanied by other lovely symptoms like PMS and heavy periods.

Type Three Dietary/Lifestyle Adjustments:

  • Eliminate/reduce sugar and dairy
  • Supplement with DIM
  • Reduce exposure to xenoestrogens in the environment
  • Limit alcohol consumption
  • Consider evening primrose oil

Your acne will most likely fall into one the above three categories, BUT it might not. There is also acne related to the thyroid (typically characterized by both dry and oily skin) and acne related to the liver (typically experienced on the body). And there are probably more categories than those too (I told you acne was complex!) This is a great place to start though.

There is also the potential for overlap. You may have congestion and breakouts throughout the month with the addition of cystic breakouts before your period. Don’t feel limited to one set of treatments. Incorporate any treatment elements that resonate with your skin.

Additionally, part of one category may sound like your skin, but another aspect might not. We are all unique individuals. There is bound to be some variation. Go with your gut!

Need one-on-one insight and advice? Book my Radiance Attunement x Breathwork, book a Clear Skin Coaching Consult, or purchase a Skin Session!


The information presented on this web site is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should never disregard medical advice or delay in seeking it because of something you have read here.