Breaking Down the Breakouts: What Type of Pimples Do You Have?

We’re all very intimately acquainted with our own skin. We berate the inflamed, cystic bumps as much as the teeny tiny bumps. We scrutinize obvious things, just as much as we scrutinize things others wouldn’t notice in the slightest (and even we need a 10x magnifying mirror to see!). 

Knowing what type of bump you have can help you put a more targeted plan into action. But unlike most beauty and skincare blogs which will point you only towards topicals, here at Kuma, we take an inside-out approach, knowing that acne is more than skin deep. Of course topicals can be helpful here, but the true heavy-lifting and long-term results will come from addressing acne from the inside out. 

If you’re not sure which type of bumps you’re experiencing, here’s the breakdown.

Different Types of Acne Pimples

Whiteheads

This one is typically obvious because it’s a raised bump and it’s uh, white on the head. These are probably the archetypal depiction of what we think of when we think of a pimple, and likely the most challenging type of breakout to avoid picking at.

Whiteheads form when dead skin, excess sebum, environmental debris, and bacteria get trapped inside the pores, and are covered by a very, very thin layer of skin that looks as though it’s ready to burst. While you may feel the intense urge to pinch, squeeze, pop, or poke at it, do your best not to. 

Picking or popping can aggravate the breakout, causing the whiteheads to become more inflamed or infected increasing the chance of scarring. The ideal practice would be to avoid touching whiteheads (especially with unwashed hands or unsanitized tools). But we get it, sometimes you can’t resist. A steamy shower or hot compress may help encourage its own self-expulsion. If it does pop, apply an anti-bacterial and anti-inflammatory solution (such as a drop of tea tree oil on a cotton swab) to keep the wound clean and help prevent inadvertent spreading (creating nearby clones!). Conversely, and with less risk of scarring, you could use a hydrocolloid patch to absorb the gunk inside.

If the whiteheads keep coming, despite not touching your face, using comedogenic products, or letting sweat linger, it’s time to look within at the internal factors that may be causing your breakouts, which we will discuss in a moment. 

Blackheads

Similar to whiteheads, blackheads are bacteria, dirt, dead skin, and sebum trapped inside of a pore. However, blackheads appear like a small black dot or dilated pore, and can even be flush with the skin; AKA, not raised at all.

Blackheads are most common in areas like the T-zone, especially the nose, or wherever pores appear larger and more visible, but technically they can occur anywhere on the face or body. All pores are susceptible.

So why is it black, rather than a white pustule? Because the pore is open, the “gunk,” (sebum, bacteria, and grime) becomes oxidized, turning it black. 

While blackheads can be extracted delicately and without inflammation by your facialist, it’s best to tackle your blackheads from the inside out…especially if they come back again, and again, and again. 

According to Acne Nutritionist, Maria Marlowe, congested skin may be due to a sluggish liver, which can use a little support from your diet. “In general, the majority of the diet should consist of organic, whole foods, with plenty of vegetables, fruit, nuts, seeds, and high quality protein. Limiting processed and fried foods, and high sugar foods may help. You can give your liver some extra support by consuming more bitter greens or herbs such as arugula, radicchio, and endive, and cruciferous vegetables, such as broccoli, cauliflower, or Brussels sprouts.” 

Papules

Papules are small, hard little domes caused by trapped sebum and inflammation. They may be the same color as your skin, or pink, red, purple, or brown. They don’t have a whitehead and may feel tender, painful, or sore. Sometimes, the pus does eventually come to the surface, creating what’s called a pustule. We will explain how to reduce them in a second, but for now, the key thing to remember is that inflammation is a key factor at play here. 

Pustules

Pustule is a fun phonetic word that conjures the image of the most textbook, almost cartoonish idea of a pimple. “Pus” is in the word— pustules are protruding, bulbous pus sacs caused by excess sebum and dead skin clogging the pores (hello, regular zit). Like other types of blemishes, pustules involve inflammation and an immune response. 

Pustules are deeper than a regular whitehead, and prone to scarring and dark spots (especially if they are popped). Pus itself is a result of an immune reaction, and it’s composed of dead white blood cells, bacteria, and tissue debris. You definitely don’t want to open up a pustule sac of these materials, as that will exacerbate infection and inflammation, and increase your risk of scarring. These babies last long enough on their own, you don’t want to extend it by another couple weeks or months by picking it. 

Hydrocolloid patches are helpful in drawing out the liquid inside the pustule, and they also help protect them from further infection or spreading. 

Nodules

Nodules can be hard, have no visible head for weeks or even months, and can even be quite painful. They are considered a severe form of acne, and are related to cysts. These aren’t just annoying, but can totally affect a person’s self-esteem. It can be hard to resist performing some kind of home surgery, but nodules run the risk of major scarring, and of course, further infection spreading to the face. So fight that urge with all of your being!

Cysts

Similar to nodules (and some cystic acne does contain nodules within a larger breakout) cystic acne is painful, deep breakouts under the skin. While nodules can be pretty solid and hard, cystic acne bumps are softer and often come to head.

While less painful than nodules, cystic acne is considered the most severe. The source of cystic acne is a buildup of sebum and dead skin, not just within a pore but deep in a hair follicle. This typically stems from hormonal imbalance due to poor diet, gut dysbiosis, and stress.

You want to avoid bursting them at all costs, because the bacterial infection typically spreads quickly to the surrounding areas, worsening the breakout and exacerbating inflammation. They can leave deep, crater-like scars.

When a breakout like this occurs, we have to fight every urge to deploy all our methods at once and commence to “kill it with fire.” Instead of attacking it with every active, which may make the skin more sensitive and irritated, simply icing it may help to bring down the size of the bump. 

The Root Cause of All Breakouts

Ok, so now that you’ve identified the type of pimples you have, the more important question is, how do you get rid of them?

The solution comes with understanding the root cause of breakouts: Inflammation. 

Although most people think bacteria is the primary trigger for acne, the truth is, science has shown us that acne is actually caused by inflammation. (Yes, even in so-called, non-inflammatory acne). 

There are various causes of inflammation, such as nutrient deficiencies, a pro-inflammatory Western diet, blood sugar imbalance (or excessive intake of sugar), gut dysbiosis, hormone imbalance, or stress. 

And while that may seem like a lot of factors, the truth is, our diet and lifestyle habits heavily influence all of these factors, and are powerful enough to both cause and reduce inflammation from the inside out. 

For example, if you don’t eat seafood or seeds on a regular basis, you’re probably not getting enough of acne-fighting, inflammation-busting omega-3. 

If you eat lots of sweets - or no sweets but lots of savory refined carbs (think bread, cereal, and pasta) - your blood sugar is probably on a roller coaster taking you straight to breakout-ville. 

If you’re constipated, the associated gut dysbiosis can contribute to hormone imbalance, since the way we remove excess hormones is through the stool. When the train doesn’t depart the station daily, so to speak, those excess hormones can get reabsorbed back into the bloodstream, contributing to hormonal imbalance that can lead to breakouts. (One of the many reasons our motto at Kuma is “Glowing Skin Starts in the Gut”) 

How to Stop Breakouts Before They Start?

The key to reducing and preventing breakouts is to reduce inflammation through your diet and lifestyle. 

Try An Anti-Inflammatory, Low Glycemic Load Diet 

So, take an honest look at your habits. If it’s filled with more soda than water and cookies than carrots, adopting an anti-inflammatory, low glycemic load diet, will be a good place to start. 

Support Your Gut Health

The clearest, healthiest skin starts with a healthy gut. 

Research shows acne patients may have less gut microbial diversity, may lack certain beneficial strains including lactobacillus and bifidobacteria, and may have an impaired intestinal barrier.

Including probiotics, particularly certain lactobacillus strains, can help. For example, a randomized, double-blind, placebo controlled study found that the strain L. rhamnosus SP1 improved adult acne in 12 weeks.

L. acidophilus has also been found to support skin clarity, while L. plantarum strengthens the intestinal barrier, which may indirectly support healthier skin. 

Glow Biome is a once a day skin probiotic supplement formulated with 6 probiotic strains (including those listed above!) that support the gut-skin connection. Glow Biome has been clinically proven to reduce breakouts, increase skin hydration, and support healthy digestion in 12 weeks or less.  

Manage Your Stress

Studies show stress can indeed break you out. For example a recent study on female medical students found that an increase in stress severity strongly correlated with acne severity. A similar study found that acne increased during exam time for college students. 

But why? When we feel stressed, our bodies produce more of the stress hormone cortisol, which stimulates oil production. Excess oil can clog your pores and lead to acne.

Stress also increases inflammation in the body  - by first disrupting the gut! 

So, in addition to supporting the gut with probiotics, get your stress under control by incorporating stress-busting activities into your daily routine, such as meditation, breathwork, yoga, or spending time in nature.