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Types of Acne: Causes and Best Treatments

Kristina Cadwell  
March 24, 2021  

Few things make a teenager’s life more miserable than acne. It isn’t reassuring that many adults also experience this skin condition. Acne can’t be permanently cured, but modern medicine can greatly alleviate its symptoms.

Below, we’ll explain the different types of acne, how to recognize them, and how to treat each acne type.

Acne treatment depends on type of acne and what causes it.

What Are the Different Types of Acne?

Types of acne differ according to severity and how they form. In terms of severity, there is non-inflammatory and inflammatory acne. Non-inflammatory acne doesn’t cause swelling and is easier to treat with over the counter (OTC) medications. Inflammatory acne may need a dermatologist’s evaluation and prescription drugs.

In terms of formation, acne is categorized into the following six types:

Non-inflammatory Inflammatory
  • Blackheads
  • Whiteheads
  • Papules
  • Pustules
  • Nodes
  • Cysts

Let’s take a closer look at each type of acne.

Blackheads (Non-Inflammatory Acne)

Blackheads are small bumps under the skin with a black top on the surface of the skin. They are also called comedones. They don’t cause swelling or inflammation and are considered mild acne.

Blackheads are mild, non-inflammatory acne.

What Causes Blackheads?

Blackheads form when dead skin cells and sebum (oil our body produces) mix and clog a pore, but its top remains open. The air enters the pore and oxidizes pore contents, making the acne look dark.

Blackheads usually form because of excess sebum production caused by hormones (usually during the teenage years or menopause). Comedogenic ingredients in skincare products and certain medications can also cause excess sebum production and lead to blackheads.

How to Treat Blackheads

Don’t squeeze blackheads. Treat them with OTC skincare products that contain salicylic acid or benzoyl peroxide. If blackheads don’t go away after a few weeks, a doctor may prescribe topical retinoids.

Whiteheads (Non-Inflammatory Acne)

Whiteheads are small bumps under the skin. They are just like blackheads, except they don’t have a black top. They are considered mild acne and don’t cause inflammation.

Whiteheads are non-inflammatory acne beneath the skin.

What Causes Whiteheads?

Whiteheads, like blackheads, form when dead skin cells and sebum mix and clog a pore. Unlike blackheads, the top of the pore is closed. They form due to excess oil production caused by hormones, oil-based skincare products, certain medications, and sometimes smoking.

How to Treat Whiteheads?

Whiteheads may be slightly more difficult to treat with OTC medications than blackheads because the pore’s top is closed. Try skincare products (cleansers, toners, lotions) with salicylic acid to unclog the pore or on-the-spot acne treatment products with benzoyl peroxide. If those don’t work, use topical retinoids prescribed by your doctor.

Papules (Inflammatory Acne)

Papules are red, swollen bumps on the skin. They differ in size and shape but are usually smaller than 5 millimeters. They are not filled with pus.

Papules are inflammatory, swollen bumps on the skin.

What Causes Papules

If bacteria that normally live on the skin, Propionibacterium acnes, enters a clogged pore, the walls of the comedone break, causing inflammation of the surrounding area. The resulting red, swollen bump is an acne papule.

How to Treat Papules?

Papules sometimes respond to mild OTC treatments with salicylic acid or benzoyl peroxide. If they don’t, doctors usually prescribe topical medications such as dapsone, retinoids, or antibiotics. More severe papules are treated with oral antibiotics or contraceptive drugs (for women).

Pustules (Inflammatory Acne)

A pustule is a bump on the skin with white or yellow pus in the middle. It is either swollen and red or firm and white. The skin around the pustule is usually inflamed.

Pustules are inflammatory acne filled with pus.

What Causes Pustules?

When sebum and dead skin cells mix and clog a pore, they form a comedone. When bacteria enter the pore, they cause a papule. When white blood cells try to fight the bacteria in a papule, white or yellow pus forms on the pore’s surface, creating an acne pustule. Pustules appear alone or in groups of more pustules and papules.

How to Treat Pustules?

Depending on the severity of the condition, pustules are treated with OTC products or prescription drugs. When OTC products and topical retinoids don’t work, a doctor prescribes topical or oral antibiotics. They are often used with topical benzoyl peroxide to prevent antibiotic resistance.

Don’t pop pustules because the pus may spread the infection further and cause more acne.

Nodules (Inflammatory Acne)

Nodules are red or flesh-colored lumps underneath the skin. They are often painful, hard, and inflamed. Nodular acne is bigger and more severe than comedones, papules, and pustules. Nodules may leave scars.

Nodules are painful, inflamed acne under the skin.

What Causes Nodules?

When dead skin cells, sebum, and bacteria mix and clog a pore, the infection causes the pore’s walls to break. When the infection reaches the skin’s deepest layers, nodular acne forms underneath the skin. Hormones cause the overproduction of sebum that clogs the pore. However, genetics may also contribute to the formation of acne nodules.

How to Treat Nodules?

Nodular acne requires a visit to a dermatologist and intensive treatment. The doctor may prescribe topical retinoids, oral antibiotics with topical benzoyl peroxide, or isotretinoin, a powerful oral retinoid for severe acne. Women with nodular acne may be prescribed birth control pills.

Cysts (Inflammatory Acne)

Acne cysts are red or white painful lumps underneath the skin that are filled with pus. This acne type is the most likely to leave scars.

Cysts are severe, inflammatory acne deep under the skin.

What Causes Cysts?

Like other inflammatory acne, cysts form when sebum, dead skin cells, and bacteria mix and clog a pore. When the pore breaks, the infection spreads deep into the skin resulting in an acne cyst. The cyst is filled with pus, unlike nodular acne.

How to Treat Cysts?

Cysts require intensive treatment prescribed by a dermatologist. The treatment may include topical retinoids, oral antibiotics, oral retinoids, or birth control pills. In more severe cases, the treatment may require corticosteroid injections.

Don't Self Diagnose

The effectiveness of an acne treatment largely depends on accurately diagnosing the acne type. Though you may recognize a type based on our description, you may not evaluate its severity accurately. For that reason, it is essential to seek a doctor’s help before choosing a medication. OTC treatments based on self-diagnosis may worsen the condition.

Conclusion

Most people experience acne. Its severity and type mostly depend on a person’s hormone level and genetics. To minimize the severity of acne and its emotional and physical consequences, it is important to recognize the type of acne accurately. We strongly encourage you to consult your doctor before booking an acne treatment.

Some types of acne are severe and take a long time to heal while cysts and nodules may leave scarring. Check out our article to learn the main types of acne scars, how they form, and how to treat them.

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