Types of Acne, Treatments, and How Your Gut Microbiome Affects Your Skin Health


If you don’t have a crazy acne home-remedy story yourself, you’re sure to know someone who does.

We’ve all seen some wild ideas about what people sometimes consider an effective acne treatment. Some people keep their routines a little more mild with probiotics or... just slathering honey-swirled yogurt onto their face every few days. Others… they turn to cheap sewing kit needles and rubbing alcohol, destroying their skin (DO NOT DO THIS).

If you want to treat your acne effectively, however, you should start with learning what the different types of acne are so that you know what you’re dealing with.

In this article you’ll learn:

  • What the different types of acne are

  • How most popular acne treatments work

  • Why the most popular acne treatments may not address the cause of your acne

  • And how you may be able to stop acne before it starts, addressing the root cause

The Different Types of Acne

Inflammatory acne

These are pimples that are red and swollen. Dead skin cells contribute to inflammatory acne, but more often this is caused by bacteria infections deep beneath the skin’s surface, resulting in painful acne spots that are hard to get rid of.

This includes:


These are hard, clogged pores that are sensitive to the touch. The skin surrounding the pores of papules is often pink. These are caused by the walls surrounding your pores breaking down due to extreme inflammation.


Red, bumpy, and with yellow or white heads on top. Forming when the walls around your pores break down, they differ from papules in that they are filled with pus.


Appearing as swollen pores that continue to grow larger due to irritation, nodules begin deep underneath the skin when your pores are clogged up.


Cysts are large red or white bumps that are usually painful to the touch. As the largest form of acne, their formation is typically due to a severe infection. They form when pores are clogged deep down below your skin’s surface by a combination of sebum (oils), dead skin cells and bacteria.

Noninflammatory Acne

Noninflammatory acne is the more run-of-the-mill daily frustration than inflammatory acne. This includes blackheads and whiteheads.

Blackheads (open comedones)

Acne characterized by the black color on the surface. These occur when your pores are clogged by a combination of dead skin cells and sebum.

Whiteheads (closed comedones)

Acne characterized by a white color on the surface. White heads form the same way as blackheads, but unlike blackheads, the top of the pore closes up. They are often more difficult to treat because the pore is closed.

Common Acne Treatment Methods

The most common treatments for noninflammatory acne are salicylic acid and benzoyl peroxide. Both acne treatment options are available over the counter, and both help clear mild acne while helping to prevent future outbreaks.

That said, all treatments that work to eliminate already existing acne are behind the curve in that they are reactive. They can not prevent the root cause of acne.

Salicylic Acid

Salicylic acid works by drying out the excess sebum in your pores.

However, this comes with five possible side effects:

  • Unusually dry skin

  • Hives

  • Itching

  • Stinging or tingling

  • Peeling skin

Benzoyl Peroxide

Benzoyl peroxide is the most well-known ingredient used for mild to moderate inflammatory acne. It works by both killing bacteria underneath the skin and helping the pores shed dead skin cells and excess sebum.

However, it is often not recommended for sensitive skin due to it being more drying than salicylic acid. This can cause more severe irritation.

Acne Is More Than Skin Deep

As we discussed this past September, your skin health is more than just skin deep, and if you’ve read other articles from Viome, you know we’re all about understanding the body’s microbiomes, beginning in the gut. The skin has a microbiome of its own, made up of trillions of microbes that live on you, helping to keep you healthy. However, this is only one part of a much larger system. Each part of the system affects each of the other parts, all working to keep your body running in tip-top shape.

Your Gut Microbiome Affects Your Skin Health

How your gut microbiome affects your skin health has a lot to do with the state of your gut lining and the balance within your gut microbial ecosystem.

Your gut microbiome is an ecosystem made up of trillions of microbes. That includes bacteria, fungi and more. When your gut microbiome is balanced (more on that later!), it can limit the amount of inflammation in your body and help maintain the health of your intestinal barrier. Your intestinal barrier is responsible for preventing harmful toxins from entering the bloodstream.

When your intestinal barrier is damaged it may allow some molecules from your colon to enter your bloodstream, this is known as leaky gut. Some of these molecules may be pro-inflammatory factors produced by your gut microbiome.

Leaky gut can trigger or contribute to chronic inflammation throughout the body. When this happens it can cause a chain reaction of problems ranging in symptoms from:

  • Increased Acne

  • Bloating

  • Fatigue

  • Gas

  • Increased skin inflammation

  • Joint pain

  • Cramps

  • Headaches

  • Food sensitivities

  • And much, much more...

Leaky gut can contribute to acne, essentially, by distracting your immune system from its normal responsibilities.

Among other things, your immune system is responsible for helping you maintain healthy skin. Your immune system has a type of garbage-disposing cell called a macrophage. These cells use two types of receptors on their surface, called Mer and Axl, to identify dead cells. Dead cells that they find give an “eat me” signal.

The macrophages that “eat” these dead cells, then take the dead cells to lysosomes ( the digestive system of the macrophage cell) where the cellular components are broken down into basic biochemical building blocks: nucleotides, amino acids, fatty acids, and monosaccharides. These cellular components are then recycled, being used as building blocks for new cells.

This takes place on your skin, too.

However, this doesn’t happen when your body is dealing with severe chronic inflammation. The macrophages that would normally remove dead cells from your skin (the same dead cells that clog your pores, causing acne), are busy repairing the overwhelming amount of damage being done by inflammation, allowing dead skin cells to build up on your face. They sink into your pores where they can mix with sebum and/or bacteria, clogging your pores.

Balancing Your Gut Microbiome

A balanced gut microbiome is a happy gut microbiome, one that works efficiently and effectively with the other parts of your body by creating the compounds you need to stay healthy. It is made up of trillions of different bacteria, fungi and archaea (single celled organisms) that all compete for territory and resources, the same as any other ecosystem.

The microbes in your gut microbiome are constantly creating different compounds out of what you eat. Because they eat what you do. Depending on exactly what your gut microbiome environment looks like, these microbes can make different compounds (nutrients or toxins)  out of what you feed them.

Some of those compounds are helpful, like butyrate. Other compounds, like LPS (lipopolysaccharide) can be harmful because of their proinflammatory properties that contribute to leaky gut as we discussed above.

If you eat the foods your unique gut microbiome needs at that particular time, you can help it become “balanced,” a state where it creates more helpful compounds and less harmful ones.

But it’s not as simple as “if you want to get rid of pimples, don’t eat chocolate.” Because while some people’s gut microbiome may react badly to different types of chocolate, it may actually help the gut microbiome of another person become balanced. Just “cleaning up” your diet leaves you in a guessing game where you don’t even know what the options are, much less what the right options are for your gut microbiome at that exact time.

That’s where Viome comes in.

Viome uses a unique technology called metatranscriptomics in combination with an advanced artificial technology system to look at the RNA (gene expression) of the microbes in your gut microbiome. This allows us to identify everything that’s alive inside of your gut and what they are doing. This information, taken from a stool sample and questionnaire, provides a full picture of the environment inside of your gut microbiome. Going a step further, our artificial intelligence system looks at all the countless variables in your gut and uses that information to create your personalized diet recommendations, that when followed, can balance your gut.