The Science Behind Breakouts: Why You Get Them And How To Treat Them

The Science Behind Breakouts

Updated 06/14/22. As an esthetician with over 30 years of experience, I’ve seen almost every skin condition and concern out there. From sun damage and melasma to rosacea, wrinkles, and beyond. While none of them are necessarily easy to address, there’s one that can be particularly stubborn, and that’s acne.

Even though it might feel impossible, there are things you can do to help clear and prevent breakouts. To start, it’s helpful to know your specific skin type (breakouts will always be most prevalent for those with excess oil production who are prone to clogged pores, like Skin Types 1-4). It’s also helpful to know the type of breakouts you’re dealing with as well as the science behind them (did you know that the formation of a blemish can begin weeks—even months—before it appears?).

In this post, I’ll explain the life cycle of a blemish from start to finish. I’ll also share expert advice on how to get rid of breakouts, fast. Keep reading for all of this and more.

How Do Blemishes Happen?

Blemishes form in hair follicles, which are also called pores. These are ducts in the skin that are attached to sebaceous glands that produce sebum (oil). Hair grows from the bottom of the follicle to the top, and it’s through the follicle that sebum finds its way to the skin’s surface to keep it moisturized.

There are two main components of hair follicles to know about. The first component is the process of cellular turnover. This is when dead skin cells are shed to make way for new ones. Dead skin, when not shed properly, can end up blocking the follicle. The second component is bacteria. All hair follicles contain bacteria (however, not all bacteria are “bad,” meaning not all bacteria cause breakouts). If the pore is blocked by dead skin or debris, oxygen isn’t able to penetrate and breakout-causing bacteria can thrive. This is because breakout-causing bacteria can’t multiply in the presence of oxygen. 

Most blemishes form from pre-existing whiteheads and blackheads (blocked, hardened sebum deep within pores). They become inflamed from the dead skin cells that block the pore opening, which allow “bad” bacteria to thrive. This is why I always recommend regular deep-pore cleansing facials for breakout-prone skin types. They minimize pore blockages.

In Normal Skin Types:

  • Oil flows smoothly through the follicle
  • Dead skin cells are consistently shed
  • Oxygen can penetrate the pore to keep bacteria at bay
  • The skin looks clear, balanced, and blemish-free

In Blemish-Prone Skin Types:

  • Overactive sebaceous glands produce an excess of oil
  • This oil is thick and sticky, so it clumps together and doesn’t flow easily through the follicle
  • There is an abnormal shedding of dead skin cells causing a build-up inside the follicle
  • Dead skin cells mix with oil, blocking oxygen from entering the follicle
  • C. acnes (formerly called P. acnes) bacteria trigger an infection, forming a visible breakout

The perfect formula for a blemish is oil + dead skin cells + a lack of oxygen. Proper skincare products can help disrupt this process, leading to clearer-looking skin.

The Life Cycle of a Blemish

Did you know blemishes have life cycles? It’s true! Once an infection has started, bacteria increase and irritate the follicle along with the sebaceous gland. This causes a rupture that triggers redness, inflammation, and swelling in the reticular layer of the skin. The reticular layer is located in the dermis, which is the layer of skin where blood vessels and immune cells are located.

When your body recognizes there is an infection, its immune system kicks in to start the healing process. White blood cells (immune cells) rush to the follicle to destroy bacteria. At this stage, the blemish is called a papule—a red, painful bump with no visible whitehead on the surface (this is the stage right before it becomes a full-blown breakout).

Next, white blood cells die off and accumulate, along with other fluid and debris. This forms a pustule, which is when there’s a visible whitehead as a result of white blood cells. (It’s important to note that not all breakouts will transition fully into this stage).

A cyst, on the other hand, is larger than a pustule. It’s considered to be a severe inflammatory breakout, and as a result, can be quite painful. Cysts are typically triggered by a surge of hormones. For some unknown reason, the skin’s sebaceous glands become hypersensitive to this hormone cascade and react by overproducing sebum. So much so, that the sebaceous gland becomes swollen and hardened. Unable to push the extra oil into the lining of the hair follicle, the gland bursts underneath the skin. This causes inflammation and irritation.

How to Get Rid of Blemishes

Now that we know how breakouts happen, let’s talk about how to get rid of them. At any stage of the breakout cycle, if you leave it alone, it will eventually go away assuming your immune system and healing processes are in good working order. If you choose to squeeze a blemish (like when a whitehead appears on the surface), it’s like draining an abscess in that it will remove bacteria. However, the risk you take in squeezing blemishes is that you can displace the infection so instead of coming out the surface, it can go deeper within the pore and cause more inflammation and irritation. This could make a blemish last even longer!

How to Get Rid of Papules

There are a few ways to deal with a papule (a red bump with no visible whitehead). One suggestion is to apply ice to the spot for 10 minutes every 3-4 hours. Ice may help disrupt the breakout cycle, preventing it from turning into a pustule by decreasing redness and inflammation. You might also consider applying an over-the-counter cortisone cream twice a day. This can also help reduce visible inflammation.

Lastly, you can encourage papules to settle down quickly if you dab on Anti Bump Solution twice per day. I originally developed this product for cystic breakouts only to discover (through customer feedback) that it works really well on all types of blemishes!

When it comes to papules, the key is to avoid picking them or applying traditional drying spot treatments. It might sound counterintuitive but applying a drying spot treatment could actually make things worse. Doing so can dry out the surface of the skin, causing even more of a blockage for the pore. (Read more about this common breakout-fighting mistake.)

How to Get Rid of Pustules

For pustules (a larger red bump with a visible whitehead), the best course of action is to wait. Yes, really! Instead of acting on it immediately, wait a day or two for the infection to appear on the surface. This allows you to control the blemish and avoid damaging your skin.

Once the whitehead is visible, wrap your fingers in tissue and gently squeeze the infection out. Only then should you apply a drying spot treatment like Night Time Spot Lotion. It will work its way into the follicle to help eradicate any infection left over. Remember, if you apply a drying spot treatment before the whitehead is on the surface, it will simply dry out the surface of the skin, creating more dead cells and keeping the infection trapped underneath the skin even longer.

Note: Some people find that spot treating a pustule with benzoyl peroxide can help. You might try experimenting with that. However, if you use too much of it too often, you can get that dryness/dead skin cell build-up, which is what you want to avoid.

How to Get Rid of Cysts

For cysts (large, deep, painful bumps with no visible whitehead), there are several options. Similar to a papule, you can apply ice for 10 minutes every 3-4 hours. While this tends to work better for papules, it’s still certainly worth trying for cysts, too.

Another option is to schedule an appointment with a dermatologist to get a cortisone injection. A third option is to apply the aforementioned Anti Bump Solution the moment it appears. It’s formulated with a purified form of Lactic Acid Ester to calm cysts, Methyl Gluceth 20 to help reduce the appearance of visible redness, and Citric Acid to gently exfoliate and help reduce post-cyst discoloration.

For the most comprehensive topical skincare for breakouts, shop the Zit Care Kit. It comes complete with everything you need to tackle blemishes at every stage.

How to Get Rid of Discolored Marks Leftover from Blemishes

For pustules, once the infection has broken through the skin’s surface, your skin can be left with a scab (especially if you picked it). You’ll likely be left with a red or purple mark, which is known as post-inflammatory hyperpigmentation (PIH). This is an increase of melanocytes (melanin-producing cells) in the epidermis that produce more pigment. Eventually, these discolored cells will settle down and new cells will replace the darkened ones due to natural cellular turnover.

For papules and cysts, which typically do not break through the top layer of the skin, there will still be discoloration. This is because the infection stretched and damaged the surrounding tissue, which resulted in an increase in melanin activity.

So, how do you address this discoloration leftover from blemishes? Exfoliating and skin-brightening products are your best bet. I suggest using the Renée Rouleau Post-Breakout Fading Gel. It’s very effective for doing both of these things. (Read more about how to fade post-breakout marks.)

The Bottom Line

Breakouts can be difficult to deal with but knowing a little bit more about them and how they happen can be helpful in minimizing them. While there is no single reason why some people struggle with breakouts and others don’t, it likely comes down to genetics. It’s not all bad, though. As I’ve always told my clients, people who struggle with breakouts are actually lucky (yes, really! Learn why).

Next, read this complete guide to clearing clogged pores, once and for all.

Disclaimer: Content found on and, including text, images, audio, or other formats were created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website or blog.


Post a comment
  1. Last night I’d applied Toothpaste on a pimple and an in the morning. I shocked my pimple compressed and dark scar appear and condition become worst. Please tell me what will I do now. I want to get rid of that dark spot soon. Please advise me to recover my. Damaged skin.

    Posted By: Mayank  | 


Post a Comment:

Find your
skin type

Great skin starts with knowing your skin type. Take our quiz to get personalized tips and product recommendations.

Take the Quiz