Understanding the 5 Types of Acne: A Functional View on Internal Causes
If you've tried every serum, switched out your pillowcase 100 times, and still wake up with breakouts—you’re not alone. And the problem might be that you’re not looking at acne from all angles—especially the internal ones. When most people hear “types of acne,” they think about the dermatology textbook list: blackheads, whiteheads, papules, pustules, nodules, and cysts. That’s helpful for figuring out what’s happening on the skin—but it doesn’t tell you why it’s happening in the first place.
Today, we’re flipping that idea on its head. Let’s talk about the five functional types of acne—plus a bonus 6th type for the overachievers (hi, chronic combo skin). These types are based on what’s driving the breakouts underneath the surface. Spoiler alert: there’s almost always more going on than clogged pores.
The 5 Functional Types of Acne (Plus The Extra-Spicy Combo Type)
These are the categories we use at Clear Skin Lab to figure out what’s triggering breakouts and how to treat them from the inside out:
Hormonal Acne
Infection-Driven Acne
Inflammation Acne
Irritant Acne
Stress-Triggered Acne The Combo Type (because of course your skin is a multitasker)
Let’s break them down.
1. Hormonal Acne
Types of acne explained: hormone edition
When people say “hormonal acne,” they usually mean breakouts linked to PMS or PCOS. But there’s more to it than estrogen and testosterone.
Here’s the deeper dive:
High testosterone or DHEA can drive excess oil and cystic breakouts.
Low progesterone or estrogen imbalances can disrupt skin homeostasis.
Insulin resistance is a big one—too much insulin = more sebum = more breakouts.
Thyroid hormone issues (especially low thyroid) can slow cellular turnover and trigger congestion.
Hormonal acne often shows up on the chin and jawline, flares around your cycle, and tends to respond to hormonal birth control, spironolactone, or Accutane—which is a clue.
🚨 Hot tip: Hormones don’t go rogue for no reason. If your hormones are imbalanced, we dig deeper: is it poor mineral status? Liver congestion? Blood sugar chaos? That’s where functional testing comes in.
2. Infection-Driven Acne
AKA: Acne from the gut, scalp, or skin microbiome gone rogue
This is one of the most under-discussed types of acne—and it can fly totally under the radar if you don’t have gut symptoms.
Clues it might be infection-related:
Acne on the forehead, shoulders, chest, back, or butt
Acne that flares with heat, sweat, or workouts
Breakouts that are itchy, red, or slow to heal
History of gut issues (but not always!)
This can be due to:
Gut infections (like parasites, H. pylori, or bacterial overgrowth)
Topical fungal overgrowth (like Malassezia, which mimics acne)
Low microbial diversity—too little of the good bugs = overgrowth of the bad ones
🧪 This is where tests like the GI-MAP stool test shine. We don’t just kill bugs—we fix the terrain so it doesn’t happen again. That’s the functional difference.
3. Inflammation Acne
The “silent driver” behind most breakouts
Let’s be clear: almost all acne has some inflammation component. But some people’s skin is stuck in a high-alert, inflamed state all the time.
Signs you’re dealing with inflammation acne:
Red or purple breakouts (often not pustular)
Random, all-month-long acne with no clear cycle
Reactions to a long list of foods (but food may not be the real problem)
Skin feels hot, reactive, or overly sensitive
Causes can include:
Iron overload or poor iron recycling (even in anemic people)
Mitochondrial dysfunction or poor antioxidant status
Chronic low-grade infections (see above)
Toxic burden (think mold, metals, or liver sluggishness)
We look at the whole picture here—yes, reduce the inflammation, but also repair the system that should calm it down in the first place.
4. Irritant Acne
When your skin says “no thanks” to products, detergents, or fabrics
This is less internal and more “what’s touching your face.” But it’s still real, and we see it often.
Triggers might include:
Harsh skincare ingredients
Detergents or fabric softeners
Hats, helmets, or clothing friction
Allergic reactions to materials or preservatives
For some people, this is as simple as eliminating the irritant. But for others—especially if they have full-body rashes or autoimmune issues—it may signal deeper immune dysregulation. If your skin reacts to everything, we may need to investigate your immune function and look at long-term immune modulators and skin barrier repair.
5. Stress Acne
No, we’re not telling you to “just relax”
This isn’t about being too busy or needing a spa day. Stress acne is about how well your cells handle stress.
If your stress response is poor, your body’s inflammation, hormones, and immune system all get out of whack. And guess where that shows up? Your skin.
Clues it might be stress-driven:
You’re not sleeping well
You feel wired-but-tired
Acne flares during emotional stress, big deadlines, or after travel
You’re type A but your labs show burnout
At Clear Skin Lab, we support cellular stress resiliency through:
Minerals (sodium, potassium, magnesium)
Mitochondrial nutrients (like CoQ10, carnitine, DHA)
Nervous system support (adaptogens, breathwork, lifestyle tweaks)
6. Combo Acne: The Overachiever
Let’s be honest—this is most of us. It’s rare to have just one type of acne. More often, it’s a mix: hormonal + inflammation, or infection + stress + mystery rash. A little spice, a little chaos.
That’s why cookie-cutter skincare doesn’t work. If you’ve been dealing with acne for years and feel like you’ve tried everything—it’s probably because your root causes haven’t been fully identified.
That’s where we come in.
Types of Acne Meaning Something More: Why Functional Care Matters
You deserve more than a topical fix or another supplement stack.
Understanding the types of acne from a functional perspective means:
We stop chasing symptoms
We identify what your body is trying to say
We rebuild your skin health from the inside out
And no—this doesn’t mean you need to be perfect or eat liver every day. But it does mean we need to understand your internal terrain and what it needs to rebalance.
Your Next Steps: Find Out What Type You Have
Ready to stop guessing?
👉 Option 1: Start with our Acne Lab Panel – get answers without committing to a full program
👉 Option 2: Apply for 1:1 coaching – full support, custom protocols, real progress
👉 Option 3: Book a free discovery call – we’ll help you decide the best next step
You’re not broken. You’re just missing the full picture. Let’s change that. 💛