Different Types of Acne & Ways to Treat Them

Hey All!

Acne is generally caused by the same things: oil, dirt, dead skin cells trapped in pores. Depending on whether it gets infected, or how deep the acne occurs into the skin, changes the type of acne. There are a total of 6 different types of acne:

  • Whiteheads
  • Blackheads
  • Pustules (Pimples)
  • Papules
  • Cysts 
  • Nodules

Different Types of Acne

Acne falls under 2 different categories: noninflammatory and inflammatory. 

Noninflammatory (comedonal acne) means that the acne does not cause inflammation of the surrounding skin. These are the least severe type of acne and generally, do not hurt. They are not caused by bacteria and are closer to the surface of the skin. 

Noninflammatory Acne Types:

  • Whiteheads: Whiteheads are generally small with a white center. It is known as closed comedones. They develop when dead skin, oil, or dirt gets trapped inside your pores. They affect the top layer of your skin and generally will not leave behind scars. 
  • Blackheads: Blackheads are similar to whiteheads with the exception that they are open comedones. The oils exposure to air causes oxidation which causes the sebum to darken, giving it the name blackhead.  
Treatments: Treatment for both whiteheads and blackheads are quite similar. The use of AHA such as glycolic acid will help with exfoliating dead skin cells and the use of a BHA such as salicylic acid will help to exfoliate deeper into the pores. AHA will help open up closed comedones and keep the surface layer clean. BHA will help clear out the comedones. You may also use benzoyl peroxide or sulfur to help absorb excess oils and dry out dead skin cells to clear out your pores.  
  1. Use both AHA and BHA to exfoliate the skin.
  2. Use benzoyl peroxide or sulfur as spot treatments. 

Inflammatory acne is acne that consists of swelling and pores that are clogged with bacteria ( Propionibacterium or p acne), dirt, oil, and dead skin cells. Inflammatory acne affects the surrounding skin and affects deeper into the pore. Generally causing redness and raised acne. 

Inflammatory Acne (Mild-Moderate)

  • Papules: Do not have a white/yellow center. They are raised and sometimes can come in clusters. They are typically small, pink and raised, making them very apparent on the skin. It is generally caused by a blockage in the pores causing it to become inflamed. Dermatitis, allergic reactions, and eczema can also cause papules. Papules can start forming pus, which happens when white blood cells are sent to help fight the infection in the area. Once the pus is collected, forming a white center this will turn the papule into a pustule. Papules should never be popped, as this would push the infection further into the pores
  • Pustules: Pustules are known as your typical pimple. It is a raised red bump with a white/yellow center. It is filled with fluid/pus and can be painful to touch. Pustules are generally formed when the pores are clogged with excess dirt, dead skin cells, and oil. When pus occurs, there is an infection in the pore cavity which can then cause a more severe form of acne called cystic. Pustules can also be caused due to allergic reactions (environmental or food) or insect bites. Pustules are also the type of acne that people generally "pop" although not recommended to pop yourself. 

Treatments: Luckily, papules and pustules respond quite well to over the counter treatments. Along with good exfoliation with the use of AHA and BHA, applying benzoyl peroxide as a spot treatment, will not only absorb excess oil and dry out dead skin cells, but also kill acne-causing bacteria (p acne). This will help significantly with inflammation and infection. You can also use pimple stickers or sulfur spot treatments to help with the excess oils. If using over the counter treatments do not help your conditions or you believe the cause of your acne might be due to other factors such as an infectious bug bit or new medication, then see your doctor for further evaluations and treatments. 

Inflammatory Acne (Severe)

  • Cystic: Cystic acne is one of the most serious types of acne. Cystic acne occurs from a combination of bacteria, oil, and dry skin cells that get trapped in your pores resulting in a rupture and infected with bacteria deep within the skin. Cystic acne is known to be caused by hormones and mainly affects ages 11-30. Cystic acne is red, inflamed, looks like a boil, and is painful. 
  • Nodules: Nodules are also formed deep beneath the skin. However, nodules are not filled with pus and actually an extremely hard bump and generally are skin-colored. Redness might occur when inflammation occurs in the surrounding skin and are painful to touch. Nodules are actually one of the hardest acne to treat and considered as one of the most severe types of acne. 

Treatments: Unfortunately, cystic acne and nodules occur so deep within the skin that over the counter medications generally do not work. Generally, it is still best to keep the area clean with good exfoliation and not to irritate the acne further by physically picking or touching it. Cystic acne and nodules have a high chance of leaving behind a scar, which means DO NOT TOUCH THEM. With cystic acne, you can ice the area to help restrict the blood vessels to reduce inflammation. With nodules and cystic acne, it may take a long time such as weeks or even months before it will go away on its own. However, it is recommended to see a dermatologist for treatment because these types of acne may still leave a scar even after going away. A dermatologist may prescribe a combination of antibiotics (orally) to help fight off infection, birth control pills (for cystic acne), prescription-strength spot treatments, and Retin A to apply topically or orally, depending on severity. With these treatments, it will still take time before your acne disappears completely. A quick fix to cystic acne, your dermatologist may decide to give you a shot of cortisone in the infected area, and this will make the acne disappear overnight. However, remember that with severe acne, treatments are more intense, which means there are pros and cons to each type of treatment. Discuss with your dermatologist to determine the best type of treatment for you.  

Acne Treatments Must Haves:

To combat acne make sure to always have the following in your home to defeat acne as soon as you get them!

1) Benzoyl Peroxide: Kills acne-causing bacteria and absorbs excess oil

2) Salicylic Acid: Exfoliates deep into the pores and help clear out blackheads

3) Glycolic Acid: Exfoliates surface layer of skin to prevent new acne from forming

4) Sulfur: Absorbs excess oil from acne

5) Prescription Strength Retin-A: Helps with hormonal acne such as cystic by unblocking clogged follicles that causes cystic acne

All the best,

Sara

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