By Dr. oec. Liga Brunina | Biochemist, Clean Beauty Formulator, Founder of LABRAINS

Acne is one of the most misunderstood skin conditions. Often dismissed as a teenage nuisance or targeted with aggressive quick-fix products, acne is in fact a complex inflammatory disorder involving the immune system, hormones, microbiome, environmental triggers, and skin barrier function.

At LABRAINS, we believe in addressing acne at its root—without disrupting the skin’s long-term health. Here’s everything you need to know about acne, based on science, skin biology, and sustainable skincare practices. Please remember: if you have very severe acne with deep inflammation, it’s important to consult a dermatologist. Cosmetics are not medicine—they are part of daily skincare that helps strengthen your skin, improve its tolerance to triggers, and reduce the visible impact of genetic predispositions.

It might seem easy to treat acne quickly using aggressive medical ingredients, but many of these (such as salicylic acid combined with alcohol or benzoyl peroxide) can damage your skin barrier. While they may reduce acne in the short term, they often lead to relapses, scarring, and even long-term issues like post-inflammatory hyperpigmentation years later—which can be even harder to treat. And why is that important? Because not all bacteria cause acne. When we use aggressive ingredients like alcohol-based salicylic acid or benzoyl peroxide, we often destroy both harmful and beneficial bacteria—disrupting the skin's first protective barrier: the microbiome.

For example, Cutibacterium acnes (formerly Propionibacterium acnes) is commonly associated with acne, but only certain strains are inflammatory. Others are actually part of a healthy skin microbiome and play a protective role. When the microbiome is unbalanced, the skin becomes more sensitive, reactive, and prone to recurring breakouts—even if the surface looks “clean”.

That’s why LABRAINS' approach focuses on building long-term skin health, not just fighting symptoms.

Acne begins when pores become clogged by dead skin cells, excess sebum, or external pollutants. But that’s only the surface.

Underneath, there’s a cascade of biochemical events:

• C. acnes bacteria triggers inflammation inside the follicle.
• The immune system releases pro-inflammatory messengers.
• Hormonal fluctuations (especially androgens) increase oil production.
• Stress, dehydrated skin, sugar, dairy, occlusive cosmetics and even over-cleansing (using harsh cleansers strips natural lipids, disrupting the barrier and microbiome. The skin often overcompensates by producing more oil, leading to further breakouts.) can worsen the situation.
• Inappropriate cosmetics or risky ingredient combinations in acne treatments—such as pairing ceramides with occlusive agents or microplastic-like compounds (e.g., PEGs, Acrylates, Dimethicone)—can be counterproductive. These combinations may block pores, interfere with skin renewal, or compromise microbiome balance, especially in acne-prone skin.

Result? Papules, pustules, cysts—and skin in distress.

But don’t worry—once you learn how to manage your triggers and identify your individual thresholds, it becomes much easier to keep your skin under control.

While 85% of teenagers experience acne, up to 50% of adult women also suffer from adult-onset acne, often linked to hormonal fluctuations, stress, or cosmetic use. 

Today, more and more evidence shows that acne is strongly linked to modern lifestyles. Populations living traditional lifestyles (such as some Indigenous groups) report very low to no acne, supporting the theory that diet, environmental pollutants, blue light radiation, AC, dust and urban stress play a key role.

A depleted or insufficient microbial biodiversity—common in urban living—leads to reduced variety of microorganisms on our skin, making it more sensitive and prone to microbiome imbalance.

So please, don’t be harsh on your skin. If you’ve lacked proper hydration, regular movement (to stimulate sweat glands), detox practices, or if your gut is inflamed from poor nutrition or partying, acne may simply be a warning sign of internal imbalance—not a flaw. In fact, it may be your body’s way of preventing more serious conditions from developing later on.

1. Comedonal Acne (Non-inflammatory)

Appearance: Blackheads (open comedones) and whiteheads (closed comedones)

🚨 Main causes:

• Hyperkeratinization: Dead skin cells don’t shed properly, clogging pores
• Excess sebum: Traps dead cells inside follicles
• Poor exfoliation or use of comedogenic cosmetics

⚠️ What to Be Cautious About:

• Over-cleansing strips natural lipids → triggers rebound oiliness
• Using comedogenic “natural” oils (like coconut or cocoa butter)
• Skipping moisturizer just because skin looks oily
• Exfoliating during inflamed phases — can cause long-term barrier damage

💡 Key Insight:

Comedonal acne is often the first visible sign of barrier and renewal imbalance.
Don’t wait for inflammation—support ceramide synthesis, gentle exfoliation, and microbiome balanceearly.

2. Papular Acne (Mild Inflammatory)

Appearance: Small, red, inflamed bumps (papules) without pus

🚨 Main causes:

• Blocked pores with inflammation
• Immune system reaction to C. acnes bacteria in the follicle
• Hormonal triggers that increase oil production

⚠️ What to Be Cautious About:

• Scrubbing inflamed skin — this spreads bacteria and worsens micro-tears
• Drying alcohol-based products or spot treatments
• Skipping hydration – even oily skin needs ceramide support during inflammation
• Switching products too frequently — destabilizes healing progress

💡 Key Insight:

Papular acne is a signal of immune activation. Calm the skin, support the barrier, and don’t exfoliate blindly. Building up skin strength is more effective than chasing short-term drying.

3. Pustular Acne

Appearance: Red, inflamed lesions with a white or yellow center (pus)

🚨 Main causes:

• Inflammation + immune response
• Bacterial overgrowth (especially virulent strains of C. acnes)
• Stress, poor diet, or hormonal fluctuations can worsen it

⚠️ What to Be Cautious About:

• Spot treatments with benzoyl peroxide – they may break the barrier, worsen PIH
• Picking or squeezing – risk of scarring and deeper infection
• Overusing acids or harsh cleansers – leads to rebound pustules

💡 Key Insight:

Pustular acne is an immune and microbial dysregulation, not just “clogged pores.” You must work with your skin—not against it—by reducing triggers, respecting its microbiome, and prioritizing barrier-first care.

4. Nodular Acne

Appearance: Deep, painful, firm lumps under the skin

🚨 Main causes:

• Severe inflammation deep in the skin layers
• Often hormone-driven, particularly androgens
• Genetic predisposition and chronic follicular blockage

⚠️ What to Be Cautious About:

• Relying solely on retinoids or drying agents—they thin the barrier and increase long-term sensitivity
• Not moisturizing! Dehydrated skin overproduces sebum as compensation
• Overloading active treatments without repair phase—leads to chronic inflammation cycles

💡 Key Insight:

Nodular acne is not superficial—it’s a sign of internal dysregulation (hormonal + genetic + inflammatory).
Treat it with deep respect, calming the skin and nourishing the lipid barrier to regain harmony.

5. Cystic Acne

Appearance: Soft, pus-filled lumps under the skin; can scar.

🚨 Main causes:

• Excessive immune response
• Hormonal imbalances (often during puberty, PCOS, or stress)
• Often exacerbated by occlusive cosmetics, poor skincare, or high sugar/whey diets

⚠️ What to Be Cautious About:

• Excessive dryness caused by stripping ingredients (acids, alcohols, retinoids)
• Unrealistic expectations for fast results—cystic acne takes time to resolve
• Picking or squeezing cysts—leads to permanent textural damage

💡 Key Insight:

You don’t fight cystic acne with aggression.
You calm it with strategy, restore your skin’s defensive intelligence, and let the barrier take the lead.

6. Acne Mechanica

Appearance: Acne in areas of friction or pressure (e.g., under mask, helmet, or tight clothing)

🚨 Main causes:

• Mechanical friction and sweat
• Trapped moisture and heat disrupt the skin barrier
• Often seen in athletes or in humid environments (e.g., “maskne”)

⚠️ What to Be Cautious About:

• Over-washing or harsh exfoliation: may worsen barrier damage from friction
• Occlusive ingredients under pressure: avoid silicones, PEGs, dimethicone during mask wear
• Comedogenic sunscreens or makeup: switch to breathable, mineral-based formulas
• Peeling masks: avoid if the area is raw, cracked, or freshly irritated

💡 Key Insight:

Acne Mechanica is a mechanical and environmental condition, not a hormonal one.
Managing friction, fabric, and moisture, combined with microbiome support, leads to long-term stability.

Some cases require a phased approach:

• an initial stage (to calm inflammation and/or to break biofilm),
• an intermediate stage (to support healing), and
• a reparative or supplementation stage (to restore and rebalance the skin).