Throughout the New Year, Blue Water Spa’s blog focus is an educational series on acne. Join us each week for valuable information that can help you, a loved one or a friend.


Millions of Americans suffer with acne of some severity at some point in their lives. It’s stressful, it’s frustrating, but it CAN be managed. Volume 2 in this four-part series addresses how acne forms, acne grades and how we begin to address it.



We all have hair follicles. Most of us have hair growing from our hair follicles somewhere on our bodies, including our faces, although the hair is fine. The hair in the follicle wicks oil and dead skin up and out of the sebaceous gland. This process works great in people whose follicle (aka, sebaceous gland) works perfectly. In acneic individuals this healthy process has been impeded, allowing extra oil and extra dead skin cells to create a traffic jam. When these two mediums build up, a fantastic environment for bacteria is created. As the follicles function gets more and more backlogged, inflammation sets in. Imagine this happening constantly, to different degrees of severity and you have a face (or back, or shoulder) covered in acne breakouts.


Congestion > micro-comedone > closed comedone > open comedone > papule > pustule > cyst




In Volume 1 we briefly reviewed 4 physiological acne triggers. Here are three more influences that affect your acne.

1. Friction: telephones, sports gear, tight synthetic clothing, excessive exfoliation

2. Cosmetics: comedogenic ingredients in skincare and makeup is huge – dyes, fragrance, heavy sticky oils, insoluble plant oils, polymers. These ingredients cause microcomedomes to form in certain individuals, resulting in various lesions ranging from clogged pores and blackheads to in ammatory pustules. Pore-clogging ingredients include isopropyl myristate, sodium lauryl sulfate, laureth-4, natural Vitamin E, most natural oils and cocoa butter.

3. Environment: excessive UV exposure opens the door to cellular damage. Cellular damage triggers excessive cellular production inside the follicle, which feeds the backlog.

4. Hormone disruptors: Avoid low-estrogen birth control pills, Norplant, Provera, Depo-Provera, and the progesterone hormone replacement Premarin. If you have polycystic ovaries, they will cause hormonal changes and breakouts. Also, birth control pills may delay the onset of acne. Once you stop taking the Pill, you may experience acne that it has thus far prevented

5. Some prescription medications

6. Foods, such as soy, iodines, kelp. Avoid foods containing androgen hormones. Androgens exacerbate acne and are present in peanuts, peanut oil, peanut butter, corn oil, wheat germ, shell sh, organ meats, sweetbreads, beef and liver. Note that other nuts do not contain androgen hormones. Chocolate does not aggravate acne. Greasy foods aggravate acne only because they contain high levels of salt.


There are 4 grades of severity in acne skin. Some individuals have very minor run ins with congested skin, others have to fight their acne tooth and nail without relief.


Grade 1: some mild blackheads, whiteheads, maybe a tiny pustule or two

Grade 2: lots of closed whiteheads and underlying congestion you can feel

Grade 3: whiteheads, underlying congestion you can feel, larger papules and pustules

Grade 4:  papules, pustules and cysts have surpassed all other blemishes



Everything we do to address your acne starts with a thorough consultation to assess the severity of your acne. Once we have established a plan of action, we share a goal with you – clear skin. On our end, we’ll continuously change up your product and treatment to stay on top of breakouts and continually strengthen skin. On your end, it’s critical that you stick to a strict home care regimen and keep regular in office appointments which may be as frequent as once per week. Successful acne management requires a commitment and a partnership.


Through the professional application and recommendation of the most powerful combination of products available to you without a prescription, we can help you start over.  Bring a family member, refer a friend, or finally take a personal step towards clear skin.  516.584.6800