Acne can look deceptively simple: a clogged pore, a blackhead, a few pimples or a breakout that suddenly appears along the jawline. But not all acne develops for the same reason, and that is one reason the treatment that works beautifully for one person may do very little for another.
The first step in treating acne is understanding what type of acne you have, what may be contributing to it, and what your skin actually needs.
Blackheads and clogged pores may benefit from a very different approach than inflamed acne. Persistent hormonal breakouts may require medical evaluation, while the dark marks and scars left behind after acne clears are separate concerns that often require their own treatment plan.
At Agnes Beauty & Wellness in Huntington Beach, I look at acne as part of the overall condition of the skin rather than automatically applying the same facial or treatment to everyone.
This guide explains why acne develops, the different types of acne, what you can do at home, which professional treatments may help, and when acne belongs in the hands of a dermatologist.
What Is Acne?
Acne is a common inflammatory skin condition involving the hair follicles and sebaceous, or oil-producing, glands.
A breakout develops through a combination of factors including:
- excess sebum production
- buildup of dead skin cells inside the follicle
- clogged pores
- bacteria associated with acne
- inflammation
Hormones, genetics, certain medications, cosmetics, stress and other individual factors can influence this process.
This is also why acne is not simply caused by having dirty skin. Washing your face more aggressively will not necessarily solve acne and, in some cases, excessive cleansing and exfoliation can irritate the skin barrier and make an already inflamed complexion more difficult to manage.
What Causes Acne?
There is rarely one single explanation for every breakout.
Excess Oil Production
Sebaceous glands naturally produce sebum to lubricate and protect the skin.
When these glands produce more oil than the skin needs, that excess sebum can combine with dead skin cells and contribute to clogged follicles.
This is particularly common during adolescence, but oily and acne-prone skin certainly does not disappear automatically when you become an adult.
Clogged Pores and Dead Skin Cells
Skin cells are continuously being shed.
When dead cells do not leave the follicle efficiently, they can combine with sebum and create a plug.
If the clogged pore remains open at the surface, it can form a blackhead. If it is closed, it may become a whitehead.
Hormones
Hormones are an important reason acne commonly develops during puberty, around menstrual cycles and during other periods of hormonal change.
Androgens can stimulate sebaceous glands to produce more oil, increasing the likelihood of congestion and breakouts.
Adult women in particular may notice recurring acne around the chin, jawline and lower face.
Inflammation
Once a clogged follicle becomes inflamed, acne can progress from relatively minor congestion into red papules, pustules, nodules or deeper cyst-like lesions.
The more severe and prolonged the inflammation, the greater the concern for persistent discoloration and scarring.
Genetics
Some people simply have a stronger genetic tendency toward acne.
If your parents experienced significant acne, your own likelihood of developing it may be higher.
What Type of Acne Do I Have?
Understanding the type of acne matters because there is no single "best acne treatment" for every breakout.
Blackheads
Blackheads are open comedones. A pore becomes clogged with sebum and dead skin cells while remaining open at the surface.
The dark appearance is caused by oxidation of the material inside the pore—not dirt.
Whiteheads
Whiteheads are closed comedones. Oil and dead cells block the follicle beneath a closed surface.
Blackheads and whiteheads together are commonly referred to as comedonal acne.
Papules
Papules are small, red, inflamed bumps without a visible pus-filled center.
They indicate that inflammation has developed around a clogged follicle.
Pustules
Pustules are the pimples most people immediately associate with acne: inflamed bumps with a visible white or yellow center.
Nodules and Cyst-Like Acne
Deep, painful bumps beneath the skin are much more serious than ordinary surface congestion.
These lesions can persist for weeks and carry a substantially greater risk of scarring.
Deep, painful, recurring or scarring acne should be evaluated by a dermatologist rather than repeatedly extracted or treated aggressively with facials.
What Is the Best Treatment for Acne?
The best acne treatment depends on the type and severity of acne, whether active inflammation is present, the condition of the skin barrier, and whether the main problem is actually active acne or something acne has left behind.
Here is a simple way to think about it:
| Your Main Concern | Treatment Approach |
|---|---|
| Blackheads and clogged pores | Appropriate cleansing, exfoliation and professional extractions when suitable |
| Whiteheads / comedonal acne | Pore-clearing home care + appropriate professional facial treatment |
| Mild acne-prone/congested skin | Customized facial treatment and consistent home care |
| Inflamed breakouts | Gentle acne-focused care; avoid unnecessary aggressive treatment |
| Persistent hormonal acne | Professional skin support + medical evaluation when appropriate |
| Deep, painful or cyst-like acne | Dermatologist evaluation |
| Dark marks after acne | Pigmentation-focused treatment once active inflammation is controlled |
| Acne scars / uneven texture | Scar- and texture-specific treatment after active acne is appropriately controlled |
The important point is that treating active acne and treating the damage acne leaves behind are not necessarily the same thing.
Best Treatment for Blackheads and Clogged Pores
Blackheads and clogged pores are primarily a congestion problem.
A good treatment strategy usually focuses on reducing the buildup of excess oil and dead skin cells without repeatedly stripping or irritating the skin.
At home, ingredients such as salicylic acid can be useful because they are oil-soluble and can work within oily pores. Retinoids may also be recommended for some people because they help normalize the way skin cells shed inside the follicle.
Professional treatment can add careful exfoliation and, when appropriate, extractions that remove existing congestion without the repeated squeezing and picking that often happens at home.
At Agnes Beauty & Wellness, the Agnes Customized Facial can be adapted to acne-prone or congested skin and may incorporate appropriate exfoliation, extractions and targeted products based on the condition of the skin.
Explore customized and results-oriented facials
What Is the Best Facial for Acne-Prone Skin?
There isn't one facial that should automatically be performed on everyone with acne.
Someone whose primary concern is blackheads and congestion may need a different approach from someone whose face is covered in inflamed lesions.
For mild acne-prone or congested skin, a customized treatment may focus on:
- thorough cleansing
- appropriate exfoliation
- professional extractions when suitable
- calming inflammation
- supporting hydration and the skin barrier
- identifying products that may be contributing to congestion
Agnes's Customized Facial is particularly useful when the correct treatment is not obvious beforehand because the facial can be adjusted after the skin is assessed.
For congestion accompanied by dehydration or dullness, the Korean 7 Step O2 Flow & Glow Facial is another option designed around cleansing, gentle exfoliation, oxygen therapy and hydration.
Can BioRePeel Help Acne?
BioRePeel is a professional chemical peel that Agnes uses for concerns including acne, congestion, pigmentation, uneven tone and texture.
For appropriate acne-prone skin, controlled chemical exfoliation can help address the buildup of dead skin cells and surface congestion while supporting a smoother-looking complexion.
BioRePeel becomes particularly interesting when acne is accompanied by concerns such as:
- post-acne dark marks
- uneven skin tone
- rough texture
- congestion
- superficial acne-related discoloration
It is not automatically appropriate for every active breakout, however. Skin condition, sensitivity, medications and the severity of inflammation all need to be considered before performing a peel.
For a detailed explanation of how the treatment works, read What Is BioRePeel and Why Is It Called the No-Peel Peel?
View BioRePeel and other facial treatments
Can DMK Enzyme Therapy Help Acne-Prone Skin?
DMK Enzyme Therapy takes a different approach from a conventional cleansing facial or chemical peel.
Rather than simply exfoliating the surface, DMK treatments are customized according to the condition of the skin and can be incorporated into longer-term skin-revision programs for acne-prone and congested skin, uneven texture, post-acne marks and compromised-looking skin.
This can make DMK worth considering when acne is part of a broader pattern involving congestion, inflammation, uneven texture, pigmentation or an imbalanced skin barrier.
Agnes is a DMK-certified practitioner and determines candidacy during consultation rather than treating every acne client with the same protocol.
Read What Is DMK Enzyme Therapy? for a detailed explanation of the treatment and Agnes's approach.
Or explore the DMK Enzyme Therapy treatment page.
What About Hormonal Acne?
Hormonal acne commonly appears on the lower face, chin and jawline and may worsen cyclically.
Professional facials can help address some of the skin consequences of hormonal acne—such as congestion, oil buildup and post-breakout marks—but a facial cannot necessarily correct the hormonal driver behind persistent acne.
This distinction matters.
If breakouts repeatedly return despite good skincare and appropriate professional treatment, particularly when they are deep or painful, it may be time to discuss the problem with a dermatologist or physician.
Skin treatment and medical treatment do not have to compete with each other. For some clients, the most successful approach involves both.
What About Cystic or Severe Acne?
Deep, painful and persistent acne needs to be treated differently from ordinary blackheads and occasional pimples.
Trying to extract deep lesions or repeatedly applying aggressive exfoliating treatments can increase inflammation and potentially contribute to scarring and post-inflammatory pigmentation.
If you experience:
- deep painful nodules
- widespread inflammatory acne
- recurrent cyst-like lesions
- acne that is leaving scars
- sudden severe acne
- acne that has not responded to appropriate over-the-counter care
a dermatologist should be involved.
Professional esthetic treatments may still have a supportive role depending on your skin and your dermatologist's treatment plan, but severe acne should not be treated as simply a cosmetic cleansing problem.
Acne Scars vs. Dark Spots: They Are Not the Same Thing
This is one of the most common sources of confusion after acne clears.
A flat brown, red or darker mark where a pimple used to be is not necessarily an acne scar.
Post-Inflammatory Hyperpigmentation
Post-inflammatory hyperpigmentation, often abbreviated PIH, is discoloration left behind after inflammation.
The skin remains flat, but the area appears darker than the surrounding complexion.
Pigmentation-focused treatments may be appropriate once active inflammation is under control.
True Acne Scars
True acne scars involve a change in the structure or texture of the skin.
They may appear as:
- shallow depressions
- deeper pits
- rolling or uneven texture
- raised scars
Because structural scarring and pigmentation are different problems, they may require completely different treatment strategies.
If your "acne scars" are actually flat dark marks, our guide to hyperpigmentation and dark spots explains why pigmentation develops and which treatments may be appropriate.
How Do You Treat Dark Spots Left by Acne?
The first priority is controlling the acne that is creating new inflammation.
Otherwise, you may successfully fade one group of dark marks while new ones continue appearing.
Once breakouts are better controlled, treatment can shift toward the remaining pigmentation.
Depending on the skin, options may include professional chemical exfoliation such as BioRePeel, an individualized DMK skin-revision approach, appropriate home care and consistent sun protection.
Sun protection is especially important because UV exposure can make existing pigmentation appear darker and more persistent.
Can You Prevent Acne Scars?
You cannot prevent every acne scar, but reducing prolonged inflammation and avoiding unnecessary trauma can lower the risk.
One of the most important habits is also one of the hardest:
Do not pick or squeeze inflamed acne at home.
Repeated pressure can damage already-inflamed tissue and increase the likelihood of both discoloration and scarring.
Seek appropriate treatment early if acne is becoming deep, painful or persistent rather than waiting until substantial scarring has already developed.
Does Diet Cause Acne?
The relationship between diet and acne is more complicated than claims such as "chocolate causes pimples."
Some research has found associations between acne and certain dietary patterns, particularly high-glycemic diets, while dairy may be associated with acne in some individuals.
That does not mean everyone with acne needs to eliminate dairy, carbohydrates or specific foods.
If you suspect food is affecting your skin, look for a consistent pattern rather than removing multiple food groups based on a breakout that happened once.
For persistent or severe concerns involving diet, hormones or other underlying health factors, discuss them with an appropriate medical professional.
What Should an Acne-Prone Skincare Routine Look Like?
More products do not necessarily produce clearer skin.
In fact, one of the most common problems I see is acne-prone skin being treated too aggressively.
A basic routine may include:
Morning
- Gentle cleanser
- Appropriate acne treatment or active ingredient if needed
- Lightweight, non-comedogenic moisturizer
- Broad-spectrum SPF
Evening
- Remove makeup and sunscreen thoroughly
- Cleanse the skin
- Apply appropriate acne treatment
- Moisturize
The exact products depend on your acne type, sensitivity and any prescription medications you may be using.
If you wear makeup or water-resistant sunscreen regularly, proper cleansing becomes particularly important. You can learn more in What Is a Custom Double Cleanse?
Can Over-Exfoliating Make Acne Worse?
Yes.
When someone sees clogged pores or rough skin, the instinct is often to scrub harder, add another acid, use an exfoliating toner and then apply a strong acne treatment on top.
More is not always better.
Excessive exfoliation can irritate the skin barrier, increase redness and sensitivity, and make it harder to determine which products are actually helping.
Acne treatment should be consistent and targeted, not a nightly attempt to strip the breakout away.
Does Makeup Cause Acne?
Makeup itself does not automatically cause acne, but certain products can contribute to congestion in acne-prone individuals.
Look for products labeled non-comedogenic when possible, clean makeup brushes and applicators regularly, avoid sleeping in makeup and remove sunscreen and cosmetics thoroughly at the end of the day.
Also pay attention to hair products, heavy occlusive products and anything else that regularly contacts acne-prone areas.
What About Teen Acne?
Teen acne deserves its own discussion because puberty creates a particularly strong hormonal environment for excess oil production and clogged pores.
The emotional side also matters. Acne during adolescence can affect confidence, and aggressive treatment or constant criticism about a teenager's skin can make an already difficult situation worse.
Parents and teens can read our complete Teen Acne: Why It Happens and How to Actually Treat It guide here:
When Should You See a Dermatologist for Acne?
Professional facials and esthetic skin treatments can be extremely useful for the right type of acne, but there is a point where acne becomes a medical rather than primarily cosmetic concern.
Consider seeing a board-certified dermatologist if:
- acne is deep, painful or cyst-like
- breakouts are widespread or severe
- acne is causing permanent scars
- appropriate over-the-counter treatments have not helped
- acne suddenly becomes significantly worse
- you suspect an underlying hormonal or medical issue
- acne is having a significant effect on your emotional wellbeing
Prescription treatments may include topical retinoids, antimicrobial treatments, hormonal therapies or oral medications depending on the individual.
The goal is not to avoid medical care. The goal is to use the right level of care for the acne you actually have.
Acne Treatment and Facials in Huntington Beach
If you are dealing with acne, the first question shouldn't be:
"Which facial should I book?"
A better question is:
"What is happening with my skin, and what type of treatment makes sense for it?"
At Agnes Beauty & Wellness in Huntington Beach, I assess the condition of your skin, the type of congestion or breakouts present, sensitivity, pigmentation, texture and your current skincare routine before deciding which professional approach is appropriate.
Depending on your skin, that may mean a customized facial with cleansing and extractions, BioRePeel, DMK Enzyme Therapy, a Korean O2 treatment for appropriate congested or dehydrated skin—or a recommendation that you see a dermatologist before proceeding with esthetic treatment.
There is no benefit in performing a treatment simply because it is on a menu.
Explore facial treatments at Agnes Beauty & Wellness
Learn about DMK Enzyme Therapy for acne-prone and congested skin
Frequently Asked Questions About Acne Treatment
What is the best treatment for acne?
There is no single best treatment for every type of acne. Blackheads and clogged pores, inflammatory acne, hormonal acne and severe cyst-like acne can require very different approaches. Identifying the type and severity of acne is the first step toward choosing appropriate treatment.
What is the best facial for acne?
For mild acne-prone or congested skin, a customized facial may include appropriate cleansing, exfoliation and professional extractions. Other treatments such as BioRePeel or DMK Enzyme Therapy may be considered depending on the skin and the concerns accompanying the acne. Deep, painful or severe acne should be evaluated medically.
Are facials good for acne?
They can be when the facial is appropriate for the type and condition of the acne. Professional cleansing and extractions may help certain forms of congestion, while other types of acne should not be aggressively extracted or exfoliated.
How do I get rid of blackheads?
A combination of consistent home care, appropriate exfoliating ingredients such as salicylic acid and professional extractions when needed can help manage blackheads. Avoid repeatedly squeezing them at home.
How do I get rid of acne dark spots?
First control the inflammation that is creating new marks. Once active breakouts are managed, pigmentation-focused treatments and consistent sun protection may help improve post-inflammatory hyperpigmentation.
Are acne scars permanent?
Some true structural acne scars can persist without treatment, although their appearance may be improved with appropriate professional procedures. Flat dark marks after acne are often pigmentation rather than permanent structural scars.
Can acne be caused by hormones?
Yes. Hormonal changes can stimulate oil production and contribute to acne, particularly during puberty and in adults experiencing recurring lower-face or jawline breakouts.
When should I see a dermatologist for acne?
See a dermatologist when acne is deep, painful, cyst-like, widespread, causing scars or failing to respond to appropriate over-the-counter and professional skincare. Severe acne benefits from early medical intervention rather than waiting for permanent scarring to develop.
This article is for general educational purposes and is not a substitute for medical diagnosis or treatment. Persistent, painful, severe or scarring acne should be evaluated by a board-certified dermatologist.
Agnes Grumslys is a California Licensed Cosmetologist (#A330955) and founder of Agnes Beauty & Wellness in Huntington Beach, California. Agnes specializes in customized facial treatments, DMK Enzyme Therapy, BioRePeel and advanced hands-on skin and facial treatments.