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In a spot of bother? Or just want to be clear when it comes to dealing with potential flare ups? Many of us spend years trapped in a difficult relationship with spots or acne and want to make a clean break for good. The challenge? Not all spots are equal. Here, we take a deeper dive into different types of spots, what causes them and how to manage spots and acne for an allround calmer, more settled outlook on our skin.

Types of spots/acne

Blackheads and whiteheads

The most common type of spot, most of us will be familiar with. Caused by a buildup of dirt and/or sebum that blocks the hair follicle. Blackheads are black or yellowish bumps that are ‘open’ and whiteheads are blocked pores that are ‘closed’. The spots react differently depending on how exposed they are. Unlike a blackhead, a whitehead can sometimes be difficult to empty when squeezed.

Papules and Pustules

Papules are small red bumps that can feel tender. Pustules are bumps on the skin with a white tip at the centre – a build-up of pus and fluid. They can appear in clusters across the T-zone, cheeks, chin, forehead or temples, chest, back and neck and can be surrounded by inflamed red skin. They can be triggered by hormones, stress, poor sleep or pores blocked by sebum, skin cells, bacteria and makeup.


Cysts are red, hard pus-filled lumps that sit under the skin. They can be painful and you can’t squeeze them. They’re the most severe type of spot caused by acne and are caused by blocked pores and other factors mentioned above.

To squeeze or not to squeeze?

Most of us know the answer is to resist squeezing your spots! If you feel the urge take a deep breath, step away from the mirror and distract yourself. 

If you squeeze spots (especially cystic spots) you can push infection deeper and risk scarring. 

A note on fungal acne

Malassezia folliculitis – more commonly known as ‘fungal acne’ is a persistent acne-like condition that doesn’t respond well to regular acne-treatment methods. Bacteria is the cause of most cases of acne, but yeast (together with a suppressed immune response) is the cause here. Malassezia folliculitis can be misdiagnosed as acne but the condition differs to acne as it does not lead to comedones and is often itchy whereas acne is not. Certain groups of ingredients have been linked to the condition and in particular, previous antibiotic use commonly given to treat acne.

Causes of spots

Teen acne is generally triggered by hormones and puberty, but the causes of adult acne can vary greatly. Lifestyle factors, monthly hormone cycles and genetics can all play a role. Lifestyle factors that can trigger a flare up of acne including stress, anxiety, poor sleep and use of specific cosmetics that can irritate the skin or block pores.

While we can make lifestyle changes, there are some factors that cause acne which we can’t control. Genetics and an exaggerated activation of the immune system are thought to play a part in the underlying cause of acne. Many women will be familiar with menstrual-related flare ups too. While the exact reasons are not fully understood, it’s thought menstrual flare ups are linked to an increased sensitivity of the oil-producing cells (sebocytes) to hormonal stimulation. 

During menopause in later years, levels of the hormone oestrogen drop dramatically which – together with hormone replacement therapy, can trigger acne. HRT, a common menopause treatment, can also trigger acne. As skin feels dry due to loss of collagen, there is a tendency to reach for heavy moisturisers or facial oils, but combined with hormones these can cause even more problems with breakouts. Focus on replenishing and soothing your skin barrier with non-comedogenic products that don’t clog your pores.

Product sensitivity and irritation

Sometimes a product may be irritating your skin rather than causing skin renewal, leading to spots. If this seems to be the case with your Daily Doser, keep your skin well hydrated, contact our Support Team ( and stop any additional over the counter ingredients that may irritate your skin further such as harsh cleansers and exfoliant acids such as AHA and BHAs. 

If you’ve been using an over the counter product for a while, remember that cosmetics and skincare can go off, so check the Period After Opening symbol which looks like a pot with a lid, for the product’s shelf life after opening. 

Time flies by and many of us are surprised to learn that some products on our shelves are months or even years out of date, and could easily be contributing to irritated skin or acne.

A note on purging

If you suffer a breakout of spots or a worsening of existing acne in the first few weeks of adjusting to new prescription skin treatment, this is known as purging. Purging can result from your skin adjusting to the actives in your Daily Doser or any acne or anti-ageing treatment that contains prescription strength or in some cases, over the counter active ingredients. 

Not everyone goes through purging, but for those who do, it rarely lasts longer than eight weeks. If your purging lasts longer than this, contact the Support Team ( at Skin + Me. It’s likely another issue that needs to be addressed, and we can clear it up.

How often should I cleanse my face? 

It’s tempting to over cleanse skin when you have acne but cleansing more than twice a day (unless you’re recovering from a sweaty exercise session) can be counterproductive and irritate skin, making it worse.

You want a gentle cleanser that protects the skin barrier whilst removing makeup, dead skin cells, dirt and oil, unclogging pores and discouraging spots.

Freshly cleansed skin should feel comfortable. Revitalised and clean and without irritation or feeling tight and gasping for moisture.  Check out our Dermatologist’s picks of the best cleansers.

Double cleanse in the evening using lukewarm water to remove all makeup, dirt and pollutants. A single cleanse in the morning should be all you need to clean away overnight oil and prep your skin for your regular routine.

Ways to manage spots

Treating teenage spots starts with proper cleansing and controlling oil production before identifying treatment needed. Identifying the causes of adult acne can be more complex. 

Adult acne can have multiple causes, and needs a targeted approach to match. 

A successful treatment for adult acne needs to consist of effective, evidence-based treatments (hello, acne-fighting Daily Doser) that get to work – yet are gentle enough to respect adult skin that’s likely to be more sensitive and prone to dryness.

If your moisture barrier has been compromised by aggressive acne treatments and natural ageing, it’s important to focus on soothing and repair, as well as targeting spots. When looking at your current skincare routine, choose products that hydrate, moisturise and support your barrier – think hyaluronic acid and ceramides. Avoid excessive use of actives (even though it’s tempting to pile on the products) and harsh exfoliating cleansers that can do more harm than good. 

Treatment ingredients that target adult acne include clindamycin, retinoids and azelaic acid. All have good evidence in treating acne, while retinoids and azelaic acid also have incredible anti-ageing properties. It’s useful to note that ingredients like retinoids can damage your moisture barrier, so remember to protect your skin after using them. Daily use of SPF, a gentle cleanser and a moisturiser will help to protect your skin while allowing powerful active ingredients to get to work on your acne. 

Working to identify and manage known trigger factors, such as stress and the menstrual cycle, are also important in giving your treatments the best chance of working. If you’re able to recognise known triggers, you’ll be better equipped to adapt your routine and lifestyle to support your skin and help your skincare to work most effectively.

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