Subclinical Acne: How to Identify It, Treat It, and Prevent It

Skincare is rarely straightforward-what works for one person won't necessarily work for another. This can be confusing to understand, especially if two people seemingly have similar skin types, conditions, tones, and are of a similar age. However, there are many sub-categories within skin conditions, and the ever-so-slight variations can completely change the treatment they require.

Take acne, for example. We have whiteheads, blackheads, and cysts. Furthermore, there are some hyper-specific types of breakouts, such as fungal acne, hormonal acne, and subclinical acne. We're here to talk about the latter.

Below, we tapped two leading dermatologists to understand how to get rid of subclinical acne, how to identify it, and how to prevent it before it appears.

What Is Subclinical Acne? 

Green defines subclinical acne as superficial acne that rests right below the skin's surface. "It's also known as comedonal acne," she adds. Comedonal acne refers to comedones—perhaps you’ve heard of them. That’s because, as Chang points out, in dermatology, doctors more often label these skin-colored bumps—which are a form of non-inflammatory acne—as comedones, not subclinical acne. 

Due to the misnomer, people often think that subclinical acne actually refers to deeper, cystic bumps that lie under the skin. In reality, it’s just another term for comedones. 

Causes of Subclinical Acne

Subclinical acne is caused by many of the same triggers as other forms of acne. They are as follows:

• Poor Hygiene: Allowing sweat and bacteria from your workout or the day to settle into your pores can lead to clogs and potential breakouts. “Failing to wash your face after a workout or before going to bed can lead to subclinical acne,” Dr. Green cautions.
• Stress: While stress does not directly cause acne, she admits that it can exacerbate it. “If you are already acne-prone, stress can make your acne worse,” she says. “Acne is an inflammatory disease exacerbated by hormones released during stress which increase inflammation.” For this reason, it’s important to mitigate stress not only for your mind but your complexion.  
• Hormones: Speaking of stress, Dr. Green says that it can cause the body to produce hormones such as cortisol, adrenal androgens, neuropeptides, and cytokines—all of which trigger and inflame the sebaceous glands. “These hormones can cause increased inflammation and histamine release which causes an increase in sebum production, causing acne formation,” she explains.
• Diet: If you regularly consume dairy products or processed foods high in sugar and carbs, Dr. Green says you might be asking for a breakout of any nature—not just subclinical acne. As a result, if you find that your skin is producing more skin-colored bumps than usual or has developed one for the first time ever, it may be time to reevaluate your food choices. 
• Skincare Products: Just because skincare products are designed to help improve your complexion doesn’t mean they’ll work for every person who tries them. The trick to avoiding product-based breakouts is to look for products that are non-comedogenic—meaning they won't clog your pores.
• Over-washing your face: As good as it is to wash your face, it’s important to remember that too much of a good thing can quickly go bad. When it comes to your skin, Chang says that over-washing your face can strip it of its natural oils which can then promote more oil production and, therefore, exacerbate your acne. 
• Genetics: Lastly, your genetics could be the cause of your comedonal, subclinical acne: “Oily skin and acne-prone skin tend to run in families,” Chang explains. While you can’t change your genetic composition, you can implement treatments and strategies to help ward off their effects. More on those, below. 

How to Get Rid of Subclinical Acne

While you can treat the cause of your subclinical acne by addressing the above causes, skincare products can also help get rid of these unwanted bumps. Read on for a list of acne-fighting picks.

Cleanse Your Face With Salicylic Acid

One of the best ways to prevent subclinical acne from forming (and to treat it if it does) is to incorporate a salicylic acid-based cleanser into your daily routine: “Salicylic acid is a beta-hydroxy acid (BHA) that is oil-soluble, so it can go deep inside the pores to remove excess oils and impurities,” Chang explains. 

While you can absolutely seek out any salicylic acid cleanser and give it a whirl, it helps to know what exactly to look for. Typically speaking, acne cleansers are formulated with two percent of salicylic acid. However, if you have super dry or sensitive skin, you may want to opt for less—think: 0.5 to one percent—to try to reduce the risk of irritation. Additionally, if you’re pregnant or breastfeeding, avoid salicylic acid, as it’s related to aspirin and can raise the risk for intracranial bleeding, warns Chang.

Touch-Up With Oil-Free Wipes

If your skin tends to become extra-shiny by mid-day, keep oil-free facial wipes on hand so you dab away excess oil and unwanted debris. While this may slightly interfere with your makeup, it helps keep your complexion clear without having to scrub oil off a napkin or similarly-textured item. Remember: the goal is to avoid any form of inflammation.

Exfoliate Regularly

While it may seem counterintuitive to treat already-inflamed skin with acids, developing a healthy exfoliating routine can help keep your complexion bump-free. Dr. Green explains that exfoliating on the regular can unclog pores, minimize comedones, and even prevent the formation of whiteheads, blackheads, and pustules. However, since alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs) can sensitize the skin, slowly incorporate them into your routine to prevent irritation while you build up your skin's tolerance to them.

Incorporate a Retinoid Into Your Routine

“Retinoids are a first-line treatment for all types of acne, both non-inflammatory and inflammatory,” Chang explains. “Retinoids, like adapalene, normalize skin cell turnover to reduce clogged pores and reduce inflammation.” Adapalene, specifically, can be used to treat both non-inflammatory acne like comedones and blackheads and inflammatory acne like papules and cysts: “This makes adapalene stand out from other acne ingredients, which often only treat certain types of acne,”Chang says. “Like other retinoids, adapalene may cause dry skin, peeling, redness, itching, or burning.” That said, Chang says it’s typically better tolerated than other retinoids. 

Regardless of the type of retinoid you use, Dr. Chang recommends applying them at night, as they can make your skin more sensitive to the sun (and certain retinoids like tretinoin can also be deactivated in the sun). Additionally, she says to start off using retinoids no more than two to three times a week, increasingly only as tolerated.