What are the Types of Acne and How Can You Treat Them?

Types of Acne

If you’ve been living with acne, you’re not alone. In fact, acne is the single most common dermatologic condition in the United States affecting as many as 50 million people, at any given time, with over 85 percent of those between 12 and 24. While the numbers certainly don’t make dealing with the effects acne can have on your skin any easier, rest assured, you’re in good company. Everyone, from celebs on the red carpet to sports icons and your friends, neighbors, and coworkers, has likely dealt with acne in some way, shape, or form.

Acne Doesn’t Discriminate

Of course, the mere knowledge that everyone experiences acne may not seem all that helpful, either, until you begin to consider just how diverse a population acne affects. Acne occurs in every single race and ethnicity, and on each and every skin tone. In addition, acne affects an increasingly diverse portion of the adult population.

While the onset of acne typically begins during puberty, more and more adults are acknowledging their own experiences with acne well past their mid-20s. Women, in particular, can experience bouts with acne well into menopause, influenced by hormonal shifts throughout the menstrual cycle as well as over the course of the body’s maturation. While men are more likely to experience acne as a juvenile and into early adulthood, some men continue to experience acne into later adulthood.

The message here is clear – acne isn’t just for hormonal teenagers, though teens are certainly a demographic that experience disproportionate acne rates. Regardless of age, your experiences with acne are very real, and likely very treatable – especially with the help of extraordinary products like Acne Intelligence. However, to understand why acne occurs across population types – as well as why it’s happening to you and how to treat it – it is important to understand that there are several different types of acne.

How Does Acne Occur?

Regardless of the type of acne you have, acne presents as blemishes on the skin, which form due to clogged pores. In most cases, clogs form when hair follicles step up production of sebum, an oil that prevents the skin from excessive drying. Too much sebum, along with changes in the way your skin sheds dead cells, often results in accumulation of a mixture of excess sebum and dead skin cells in your pores. This environment is very susceptible to clogging and bacterial colonization, which leads to the development of acne blemishes.

Acne blemishes can present in a few different ways, depending on whether the surrounding skin becomes inflamed as a result of bacteria.

Non-Inflammatory Acne Blemishes

This type of acne blemish does not cause swelling of the surrounding skin tissue and is generally limited to the pore itself. Also known as comedones, clogged pores resulting in non-inflammatory blemishes typically are not painful, nor will they usually result in scarring. Non-inflammatory blemishes include:

• Whiteheads, or closed comedones, which consist of a whitish bump that may be surrounded by a slight reddening. The excess sebum and other material inside the pore remains closed to the surrounding environment.
• Blackheads, or open comedones, which appear black in color. Blackheads result from whiteheads that have opened and become exposed to the environment, causing blackening of the contents inside.

Both forms of non-inflammatory acne blemishes can usually be treated by changes in routine – including avoiding sebum buildup by washing twice per day, avoiding over washing, reducing skin irritations, avoiding stress, and using sunscreen – to help prevent breakouts. In addition, customized treatments can be matched to your skin type and acne severity to stop blemishes before they become more severe.

Inflammatory Acne Blemishes

This type of acne blemish is characterized by inflammation and swelling of the surrounding skin tissue. Often, inflammatory acne blemishes are warm to the touch and mildly to moderately painful. In some instances, inflammatory acne blemishes will result in scarring. Common inflammatory blemishes include:

• Papules, which present as bumps under the surface of the skin. Papules are swollen, pink, and raised in appearance, but have no apparent center. These blemishes are caused by blackheads and whiteheads that have begun to affect the surrounding skin.
• Pustules, also known as pimples. Pustules form when a bacterial infection of a pore has gotten severe enough to result in a raised, white blemish with a circular center and red, painful surrounding skin. Pustules are filled with pus, a collection of white blood cells and bacteria that is simply the body’s immune response to the infection.
• Nodules, which present as a centerless lump much harder than a papule, are located deeper within the skin. Nodules occur when an infected pore begins to affect tissue below the surface. Nodules are often painful and can result in scarring or pitting.
• Cysts, known as the most severe acne blemish. Like pustules, bacterial infection has grown to the point at which pus begins to collect under the surface of the skin. However, cysts occur deeper underneath the surface than do pustules, resulting in very large, soft, painful lumps. Cysts can also cause scarring.

While most people can treat papules and pustules with a carefully selected topical treatment regimen, nodules and cysts should be examined by a dermatologist before treatment begins. Often, patients present with multiple types of acne blemishes, and a combination of oral medication and a topical treatment regimen can be effective, for the short-term.

What Are the Different Types of Acne?

Most acne appears visually similar, especially since the outward appearance of some blemishes such as pimples, blackheads, and whiteheads are fairly standard across acne types. However, the root causes of each type can affect the way in which acne presents on your skin as well as its severity.

Acne Vulgaris

Commonly referred to as, simply, “acne,” acne vulgaris is a fairly broad term that describes a few different subsets of acne. Since breakouts are usually prefaced by rising and falling hormone levels or significant hormone changes, acne vulgaris is also known as hormonal acne. Most often, acne vulgaris results from a rise in androgen hormones, especially testosterone, that increase the skin’s production of sebum and result in clogged pores.

There are different subtypes of acne vulgaris, including:

• Cystic acne. Usually recognized as the most severe form of acne vulgaris, this type of acne is characterized by an unusually high number of acne cysts. These painful blemishes keep most of the inflammation deep under the surface of the skin, as opposed to very near the surface as in pustules and papules – although both may occur.
• Nodular acne. As you may expect, nodular acne is characterized by a high proportion of nodules underneath the skin. These hard, often painful bumps often occur in conjunction with papules and pustules, but they may scar if not left alone. Nodular acne may increase with the onset of puberty or immediately before a woman’s menstrual cycle begins.

Acne Cosmetica

Unlike acne vulgaris, acne cosmetica is linked to one, specific, root cause that you may have guessed – the cosmetic products people use on a daily basis. Unfortunately, many of the products meant to improve the look of your skin – including makeup, general moisturizers, inexpensive cleansers, and even hair products – can have the opposite effect and cause clogging and infections of the skin. Often, the use of higher-quality cleansers and moisturizers can remedy the effects of acne cosmetica.

Acne Mechanica

Often referred to as exercise induced acne, acne mechanica can be traced to a specific cause much like acne cosmetica. In this case, clogged pores and infection result from sweat, oils, and heat trapped against the skin, as seen in athletes who must wear helmets, sweatbands, or other gear that rubs against the skin. Most acne mechanica can be treated with a combination of reducing exposure to the trigger and a high-quality cleansing regimen after any remaining exposure.

Acne Rosacea

While acne rosacea appears similar to acne vulgaris in some ways, including the appearance of small pustules or papules, acne rosacea is more accurately termed, simply, “rosacea.” Characterized by an overall flushed appearance of the face and several visible blood vessels, rosacea is mostly found in adults over the age of 30. Rosacea affects both men and women, but women more frequently and men often more severely. If you believe your acne symptoms are associated with rosacea, see a dermatologist before undertaking a new skincare regimen, as commonly used over the counter products are often ineffective and can cause rosacea to worsen.

Excoriated Acne

Excoriated acne is, simply put, any of the above types of acne that has been made worse after compulsive squeezing or picking at acne blemishes. While many people have participated in squeezing, frequent manual handling of acne blemishes can begin a cycle that starts with minor scabbing and continues with increased picking and more severe scabbing. It is important to avoid touching acne blemishes, since picking and squeezing introduces excessive bacteria and pressure to blemishes and can result in cysts, nodules, and scarring.

How Severe Is Your Acne?

Besides the level of inflammation of your acne blemishes and their root causes, another way to classify acne is by the level of its severity. While any amount of acne can be distressing and affect your self-esteem and confidence, knowing the severity level of your acne can help you select the appropriate course of treatment. Most often, acne severity is divided into three general categories:

Mild acne typically involves non-inflammatory blemishes like blackheads and whiteheads

Some inflammatory pustules and papules may occasionally arise, but dermatological consultation is usually unnecessary. Mild acne includes fewer than 30 total blemishes, only 15 of which are inflammatory at any given time. Usually, mild acne responds well to an approved skin care regimen.

Moderate acne features more inflamed blemishes than does mild acne

Typically, anywhere from 20 to 100 blackheads or whiteheads appear on the skin, along with 15 to 50 inflammatory blemishes for a total of 125 or fewer blemishes. If you have moderate acne, you may want to seek the attention of a doctor in addition to beginning a responsible cleansing regimen.

Severe acne is characterized by a large number of inflammatory blemishes, including nodules and cysts

Most people with severe acne will seek a personalized skin care routine at the advice of a dermatologist.

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