Types Of Acne – Knowing The Best Treatment For The Different Types Of Acne
Most people are not aware that there are different types of acne. They see acne and they assume that it’s all the same. Believe it or not, there are many different kinds of acne, plus there are also other skin conditions that often get mistaken for acne. By knowing the different acne types, you will be able to find the best acne treatment for you.
- There are different types of acne, including whiteheads, blackheads, papules, nodules, and cysts.
- By knowing what type of acne you have, you can be more successful in clearing it up and preventing more from coming back.
- There are some conditions that look like acne, but are not actually acne. These include rosacea and acneiform. It’s important to distinguish them so you can properly treat the conditions.
- Sebum production plays a major role in the development of acne. Too much sebum leads to clogged pores or follicles, which creates acne.
- Around 80 percent of people between the ages of 11 and 30 get acne at some point. It’s a very common condition, especially among teens.
- There are numerous ways to successfully treat acne, regardless of the type. It’s best to decide which treatment options you want to try based on your unique variables.
No matter what type of acne you have, know that you are not alone. Acne is such a common skin condition that just about everyone has had a pimple at some point in their life. In fact, the National Institutes of Health reports that for those between the ages of 11 and 30, around 80 percent of the people have experienced acne¹. It’s something we can all relate to, and together we’re finding ways to reduce all kinds of acne.
Why People Get Acne
It may bring you some comfort to know that you are not alone in having acne, but it certainly doesn’t explain why so many people get it to begin with. Just as there are several types of acne, there are also numerous contributing factors that can cause flare-ups. Some of the most common ones include hormone changes, diet, and hair care and makeup products that clog pores, but the main culprit when it comes to why people get acne is definitely heredity. Our genes play the most significant role in determining whether our skin will be prone to acne breakouts. The good news is that even if your genes are coded for acne, there are still plenty of things you can do to clear it up.
There are many types of acne, and many ways to help clear it up. According to the U.S. Department of Health & Human Services, acne is a disorder that causes outbreaks of skin lesions², which we usually refer to as acne. Regardless of where it appears of what your genetics have to say, acne is caused be three main factors: sebum, bacteria, and inflammation. If you can appropriately treat your skin for these three issues, you can successfully treat your acne.
When learning about the different types of acne, you will hear the term sebum used time and again. That’s because it plays a major role in the production of acne. Sebum is the medical term for the oils that are in the skin. When someone has oily skin, it’s generally because their skin is making a lot of sebum, or oil. That oil is what causes clogs in the pores, which then leads to the emergence of blackheads, whiteheads, or pimple. There are certain things that can increase sebum production, which will in turn lead to more clogged pores.
Luckily, there are countless ways to reduce sebum buildup on your skin, from drugstore creams and serums to innovative dermatology procedures. For example, in a study published3 in the journal Skin Research and Technology, researchers looked at the effectiveness of microdermabrasion in reducing sebum levels. They tested 16 women, giving them the treatment and testing their sebum levels before, just after the treatment, 30 minutes after, and 60 minutes after. They concluded that there was a significant difference, with sebum reduction being noticeable immediately after the procedure and 30 minutes after. However, at the one-hour mark, all participants’ sebum levels had returned to their baseline. If you have consistently oily skin, it is more helpful to find a treatment that reduces sebum production rather than simply getting rid of it temporarily. Some effective treatments include red light therapy, spironolactone, and spearmint tea.
Takeaway: If you have oily skin, you could have an excess of sebum, which is clogging your pores. Take measures to try and reduce the amount of sebum being produced, which will help to clear up your skin. Even making small changes can make big differences with all types of acne.
Understanding Acne-Causing Bacteria, Propionibacterium acnes
Although we typically think of bacteria as a bad thing, propionibacterium acnes, AKA, p. acnes, are a normal part of our skin’s biology, and they can even help reduce acne sometimes. P. acnes always live on the surface of our skin and because their main food source is the sebum we produce4, they can actually help prevent the sebum buildup that leads to certain types of acne. However, p. acnes can become acne-causing bacteria if sebum has a chance to accumulate in the pores. When this happens, the p. acnes simply feast on all the extra food, rapidly reproducing until a minor infection breaks out. This infection can cause pimples, cysts, and other types of acne you’ll read more about below.
Because p. acnes always live on our skin, it’s impossible to get rid of them completely. But you can prevent their numbers from growing large enough to start an infection. One method is to reduce your sebum production or make sure to exfoliate your skin regularly so sebum can’t build up in the pores. Another is to use gentle products that kill p. acnes bacteria. We want to emphasize the word gentle because some antibacterial products are so harsh that they trigger the biggest factor in acne formation: inflammation.
Takeaway: P. acnes bacteria don’t automatically cause acne, but they can contribute to acne under the right conditions. The best way to avoid bacteria-related acne is to reduce sebum production and kill off p. acnes bacteria as gently as possible.
Last, but not least, inflammation plays a critical role in acne formation. In fact, scientists have recently classified acne as an inflammatory condition5, meaning all acne can be traced back to some level of inflammation. Inflammation is basically mild swelling that causes the pores to constrict slightly. This constriction can trap sebum, dead skin cells, and bacteria inside the pore, leading to many different types of acne.
Inflammation can be influenced by all kinds of factors, but one of the most common is irritation. Whenever our skin is irritated, either by our own hands picking and scratching or by a harsh wind or overpowered skin care products, the skin gets slightly damaged. Inflammation is one of our body’s most reliable tools for repairing damage because it involves increasing blood flow to the site of the damage in order to deliver a variety of healing agents like antioxidants, vitamins, and immune system cells to fight off any potential infection.
Although this process is meant to reduce damage, and often does, it is actually a big part of the problem when it comes to acne. This inflammation may heal the damage done by the irritation, but in the process, it constricts the pores and causes a variety of acne lesions to develop. If p. acnes bacteria get trapped in the pore, the inflammation will actually increase in an attempt to kill the bacteria. Typically this added inflammation only makes things worse by making pimples large and painful.
Takeaway: All acne starts with inflammation, which can be caused by even the most minor irritation, like resting your chin in your hand while you work. The best way to prevent acne is to reduce inflammation by using gentler skin care products, refraining from touching your face, and avoiding sources of irritation.
Top-Rated Acne Treatment Products
Throughout this article, we will outline several different types of acne, but we also want to introduce some of our favorite acne treatments. It’s easy to get overwhelmed when looking at all the different ways acne can form, but remember: all acne can be treated and improved. Below, we’ve listed some of the top-rated acne treatment products that contain scientifically-sound ingredients that are very likely to improve your skin, no matter what type of acne you have.
Exposed. If you want a complete acne treatment system, then Exposed Skin Care is the treatment we recommend. It’s gentle but still effective, and they use the best of both natural and scientific ingredients, including benzoyl peroxide, tea tree oil, caffeine, and vitamin E. We recommend the Expanded Kit, which comes with a cleanser, toner, and moisturizer, along with two treatment formulas, one for the morning and one for the evening. It has everything you need to clean, treat, and moisturize your skin, at a relatively affordable price.
Essy. If you’d rather combine your own collection of acne treatment products, we love to recommend Essy’s Acne Cream as a good treatment step, especially for those with dry skin. Its first two ingredients are water and glycerin, which are both great for hydrating the skin, plus it contains a mixture of natural acne-fighting ingredients, like witch hazel, ginseng root, and aloe vera extract.
Keeva. Tea tree oil one of the most effective essential oils for treating acne, and some studies show that it can treat cystic acne as well. In Keeva’s Tea Tree Oil Acne Treatment Cream, the tea tree oil is mixed with a blend of other natural ingredients to create an effective solution to help clear up skin. Users report that it works quickly, and it helps to balance the skin so that it’s not dry or oily. You can also use this product to treat scars from acne.
Replenix. This brand offers a variety of great acne products, but we’re especially fond of their face wipes. Some nights, you just don’t have the energy to do your full skin care routine, so instead, you can cleanse your face with a Replenix Gly-Sal Acne Pad. They contain both glycolic acid and salicylic acid which both work to remove sebum and dead skin cells clogging pores.
Different Types Of Acne
Chances are you have not taken notice of the characteristics of your acne. You just know that you have it and you want it gone. That makes sense, but it does help to know about the type you have so that you can be more successful in clearing it up. After all, blackheads and pimples are caused by very different factors, and thus, respond best to different types of treatment. Below we’ve listed and described the six main forms of acne: blackheads and whiteheads, papules and pustules, and nodules and cysts.
Comedonal Acne: Blackheads and Whiteheads
Comedonal acne includes blackheads and whiteheads, and it can be defined as acne that involves a clogged pore that is only slightly inflamed. As we just discussed, all acne is inflamed to some degree, but blackheads and whiteheads are on the lower end of the inflammation spectrum for acne.
Blackheads are one of the most common types of acne. They occur when sebum mixes with dead skin cells and gets trapped in an open pore. Once the pore is clogged, it’s called a comedone, and with blackheads specifically, comedones often turn a dark brown color. This is not because of dirt or poor hygiene, it’s simply because the pore is open, which allows the air to oxidize the sebum trapped in the pore. It’s very similar to how an apple turns brown if left out on the counter too long. The air oxidizes our sebum in the same way, making blackheads look like small, dark dots.
Whiteheads form in the exact same way as blackheads, except the pore closes completely, resulting in a closed comedone. This prevents air from oxidizing the sebum and gives whiteheads their pale, white color. Whiteheads sometimes look like very small pimples, but as we’ll read in the next section, they are very different. It’s important to know which type of acne you’re dealing with in order to get rid of it.
Takeaway: Most people have whiteheads and blackheads when they have acne. While they are essentially caused by the same thing, a clogged pore, they look different because one is closed and the other one is open. Both indicate that sebum and skin have mixed to create a clog.
Inflammatory Acne: Papules And Pustules
Inflammatory acne includes papules and pustules, and it differs from comedonal acne because it is doubly inflamed. Inflammatory acne forms through the initial inflammation that causes all acne, but then it becomes even more inflamed due to an infection of p. acnes bacteria. Papules and pustules are small, raised pimples that are solid or appear to be swelling. Papules form when our immune system first recognizes that there are p. acnes trapped in a pore that need to be killed. They don’t have a full “head” and do not contain pus, but they are typically raised and somewhat painful. Pustules, on the other hand, are classic pimples: raised, painful, with a bright white or yellow head filled with pus. Both papules and pustules can be distinguished from whiteheads because whiteheads are typically much smaller and are not painful to the touch.
Papules and pustules are best treated by antibacterial treatments that can help fight the p. acnes infection. Some effective options include benzoyl peroxide, tea tree oil, or even blue light therapy. All of these can help kill p. acnes bacteria, but they don’t address the other factors in pimple formation: inflammation and excess sebum production. These factors can be reduced through other great ingredients, like glycerin, salicylic acid, green tea extract and more. The best way to get rid of pimples is to treat your skin gently and consistently with products that work for you.
Takeaway: If you have papules and pustules, you will likely know it because they are usually inflamed and sore to the touch. There are numerous treatment options that can help clear pimples up and prevent them from coming back.
Nodulocystic Acne: Nodules And Cysts
When it comes to the type of acne that stands out the most, cystic acne (sometimes called nodulocystic acne) usually takes the prize. Cysts and nodules are the largest of the different acne types. They are deep, large, often painful, and can hang around for a long time, often for weeks, sometimes for months. Because they are so deep and long-lasting, they also tend to leave behind acne scars once they do finally heal.
Just like other types of acne, nodules form when pores get clogged. But the difference here is that the problem spreads beyond that one small pore. A nodule forms when the p. acnes infection breaks down enough skin cells to make its way into other nearby pores, spreading deeper into the skin. Before you know it, multiple pores have been plugged together, which creates a nodule, which looks like a very large, hard pimple that’s often very painful to touch. Cysts are similar to nodules, although they are even larger and often softer than nodules. They are the biggest, deepest, and most damaging of the different types, often leaving deep scars on those who have them. If you have cystic acne, there are over-the-counter and natural remedies available, but you will likely receive the best treatment from a dermatologist.
Takeaway: Nodules and cysts are the larger, more noticeable and painful types of acne. They often leave scars and can take a toll on one’s confidence. Getting treatment for them right away is the best way to minimize their impact.
What’s Different About Chin Acne?
Chin acne is regular acne that forms because of a unique combination of acne-causing factors that come together in the chin area. Acne starts when the skin becomes inflamed, and our chins are very prone to inflammation. This makes chin acne more likely and more persistent than acne on other areas of the face.
The chin is in an area of the face called the U-zone which also includes the jawline and cheeks. Unlike the T-zone, which covers the forehead and nose and is generally very oily, the skin in the U-zone is usually much drier than the rest of the face. This dryness makes the skin more susceptible to irritation because it doesn’t have a layer of oil to protect it. Because of this, even small irritations like scratching your chin or resting it in your palm while you work can cause inflammation and lead to acne.
Because chin acne tends to be caused by irritation, it typically responds best to gentle treatment approach. Instead of using harsh acne treatment products that may only further irritate the skin and lead to more inflammation and acne, try treating chin acne with a good moisturizer. This will help protect your skin from irritation and prevent chin acne from forming in the first place.
Takeaway: Chin acne is different from acne on the rest of the face because of how it forms: through dry skin, irritation, and inflammation. The best way to treat it is to prevent it by protecting the skin with a good moisturizer.
Although most people experience acne on their face, body acne is another common form of acne to look out for. Body acne can be more difficult to get rid of than facial acne because of the differences between the skin on our face and the skin on our body. First, our bodies are constantly exposed to potential irritation from the rubbing of our clothing, unlike our faces. Second, the pores on your face might seem large, but the pores on your body are much larger, making it easy for sebum and dead skin cells to build up inside and cause large blockages. Together, these factors make body acne a reality for many.
Back acne and butt acne are two common types of body acne, and they are usually more stubborn than typical facial acne. This is because the skin on your back and butt is much thicker than the skin on your face. If you try to treat your back and butt acne using your facial acne treatment products, you likely won’t see very good results because those products are designed for skin that is much more fragile. To successfully get rid of body acne, you’ll need stronger acne treatment products that you wouldn’t normally buy because they’d be too harsh for your face.
Takeaway: Body acne is almost as common as facial acne, but it’s typically treated best by much stronger products than you would typically use for your face. If you have sensitive skin though, try wearing looser clothing or switching up your laundry detergent.
A Brief Introduction to Hormonal Acne
Hormonal acne is a common type of acne that appears whenever our hormones shift and fluctuate. Stress hormones can cause hormonal acne, but generally, it’s the sex hormones like testosterone and estrogen that cause the biggest problems. One of the main reasons teenagers have acne more than many other age groups is because these hormones are undergoing massive changes during the teen years.
Everyone, regardless of sex or gender, produces both testosterone and estrogen in varying amounts, and neither hormone is directly responsible for increased acne. Instead, it is the fluctuations in these hormone levels that causes skin issues. For instance, many men and intersex folks produce high levels of testosterone and low levels of estrogen, but these levels can shift and change, often rapidly during puberty. Whenever these changes occur, the skin reacts by producing excess sebum, which then clogs pores and leads to what is known as hormonal acne.
Hormonal acne can occur in people of any sex or gender, but it is definitely more likely for those who menstruate. The menstrual cycle involves large hormonal swings each month and for some, this can lead to massive breakouts. Combined oral contraceptives are often a good way to treat hormonal acne, but they aren’t perfect for everyone. Birth control can increase feminine features which may be undesirable for some, plus it’s obviously not a good idea if you’re trying to get pregnant. If birth control isn’t a good option for treating your hormonal acne, focus on treatments that reduce sebum buildup, like exfoliators containing salicylic acid or sulfur.
Takeaway: Hormonal acne is most common among teenagers, though it can occur in anyone of any age, and is caused by fluctuations in testosterone and estrogen levels. Combined oral contraceptives and gentle exfoliators are typically the best treatment options.
Adult Acne: How it Differs From Teenage Acne
We tend to talk about acne like it’s a teenage problem, but the truth is, adult acne is also very common. For some, teenage acne will simply continue into adulthood, which is called persistent adult acne, but for others, acne can appear suddenly in their mid-20s, which is called adult-onset acne.
Even if you have persistent adult acne, you shouldn’t continue treating your adult acne the same way you did your teenage acne, because adult skin is different from teenage skin and has different needs. Teenage skin cells regenerate rapidly and sebum production glands are consistently in overdrive due to all the hormonal fluctuations of puberty. In adult skin, however, skin cells regenerate much more slowly, and sebum production glands are typically far less active. This means adult skin is typically drier than teenage skin, so those harsh drying creams that worked wonders for the acne in your youth could actually make your adult acne worse.
One of the best ways to treat adult acne is to get a good moisturizer. Many people with acne avoid moisturizer for fear of clogging their pores, but the right moisturizer will help your skin retain moisture without trapping anything in your pores. You just need to check the ingredient label. Keep your eyes peeled for water, glycerin, and vitamin E (sometimes listed as tocopherol). These ingredients deposit and retain moisture, and the vitamin E is a great source of antioxidants6 essential for adult skin. On the other hand, you definitely want to avoid ingredients like coconut oil, laureth-4, and denatured alcohol. These ingredients clog pores, irritate skin, and usually lead to more breakouts, not less.
Takeaway: Adult acne tends to be caused more by the irritation and inflammation associated with dry skin rather than excess oil, so one of the best treatments is a good moisturizer.
What is Acne Mechanica?
Acne mechanica is technically everyday acne, but it has a very specific cause: friction. Sometimes called “sports acne,” acne mechanica forms whenever the skin is irritated by the consistent rubbing and pressure of many sports uniforms or pads. However, it can be caused by so much more than sports. Regular everyday chafing can cause acne mechanica7, and many flutists and violinists experience acne mechanica on their chins.
Here’s what happens: whenever something like a tight uniform or sports bra rubs against the skin, it causes some minor irritation. When this rubbing goes on for a long time, however, the irritation becomes less minor and can quickly lead to inflammation, which we know often leads to acne. When a violinist plays a two hour concert, they experience a lot of friction on their chin and jawline, and the skin there becomes inflamed. The pores constrict, and for some people, acne can quickly form.
Usually, we advise people to avoid the things that are causing their acne, but sports and music are wonderful things. If you have acne mechanica, we recommend something else instead: take good care of your body and your equipment. Right after a practice or game, immediately take a cool shower to reduce any potential swelling, and be sure to wash your pads or uniform as often as possible to prevent the buildup of bacteria. If you have acne mechanica related to playing an instrument, be sure to clean your instrument before playing each time, and be sure to wash your face with cool water right after a practice or performance.
Takeaway: Because friction causes irritation and inflammation, it can also cause a particular type of acne called acne mechanica. The best way to reduce acne mechanica is by keeping your body and your equipment clean.
When It’s Not Acne
There are a couple of conditions that tend to mimic acne, but they are not actually acne and require very different treatment to improve. Two of these are rosacea and acneiform. According to the Mayo Clinic, rosacea is a skin condition where the skin is red and there are visible blood vessels8. Rosacea can also sometimes cause small, pus-filled bumps, which are what people tend to assume are pimples. While anyone can get rosacea, it’s most common in fair-skinned middle-aged women. Those who suspect their bumps may be rosacea should consult with a dermatologist so they can be properly diagnosed and prescribed the right treatment.
According to the National Center for Biotechnology Information, acneiform are eruptions that resemble acne9. They can happen at any age, and the lesions appear to look like a nodule, papule, pustule, or a cyst, but the main difference is that they do not have comedones. Like acne, they can be caused by a variety of reasons, but they often form due to exposure to a specific product. Treatment often involves stopping the use of the product that caused them. For example, if they are being caused by using a particular chemical in a new face wash, stop using the face wash (and check your other products for the chemical) and they should clear up. Many people find these itch, so they may be able to use an anti-itch substance to help find relief.
Takeaway: Not everything that looks like acne really is acne. There are some things that look like acne, but they are other skin conditions. If you are unsure if your blemishes are acne or an acne-like condition, consult with a dermatologist. To effectively treat the problem, you need to know for sure what it is.
Tips For Treating Acne
While there are different types of acne, there are also multiple ways to treat it. There’s no one type of treatment that is right for everyone. In order to find the right treatment for your acne, you need to determine what kind you have, what type of skin you have, what will fit into your budget, and what you are comfortable doing. Acne treatment options include everything from using essential oils and creating homemade acne masks to getting microdermabrasion and taking prescription medications. Evaluate your particular variables to determine which is going to be the right option for you to try.
The good news is that there is an acne treatment option for everyone, it’s just a matter of finding the one that will work for you and your skin type. One of the most effective treatments is a gentle, consistent skin care routine, but dietary changes, hormone therapy, and microdermabrasion could also help as well. You will be more successful at clearing up acne if you know what type you have and what is causing it. You may need to try more than one treatment option to see what works best for your skin, but it’s best to give each treatment a six-week trial period where you use it exactly as directed every day. Jumping from product to product will only aggravate you and your skin.
Frequently Asked Questions
Q. Are there different types of acne?
A. Yes, not all acne is the same. There are whiteheads, blackheads, papules, nodules, and cysts. They are all acne, but all different kinds.
Q. Why does it help to know about the different kinds of acne that there are?
A. When you know what type of acne you have then you will be better able to address it with the right treatment option. You may also know why you are getting it and be able to help prevent getting more.
Q. Are there any types of acne that require seeing a dermatologist?
A. You don’t need to see a dermatologist for most acne, but if you have severe or cystic acne then seeing a dermatologist might be the best way to find an effective treatment. A dermatologist can help treat acne and address scarring. Due to the negative way our society treats acne, those with severe acne sometimes have a lower quality of life and diminished level of confidence, making it that much more important to find effective treatment options.
Q. What is the difference between a whitehead and a blackhead?
A. Both involve a clogged pore, but a blackhead is open. With it being open, the air turns it black, which makes it appear darker. A whitehead is closed and is underneath the skin.
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- Acne. U.S. Department of Health and Human Services (Website). Accessed 2019..
- Fąk M., Rotsztejn H., Erkiert-Polguj A. The early effect of microdermabrasion on hydration and sebum level. Skin Research and Technology. 2018;24(4):650-655.
- Platsidaki E., Dessinioti C. Recent advances in understanding Propionibacterium acnes (Cutibacterium acnes) in acne. F1000Research. 2018;7.
- Antiga E., Verdelli A., Bonciani D., Bonciolini V., Caproni M., Fabbri P. Acne: A new model of immune-related chronic inflammatory skin disease. Giornale Italiano di Dermatologia e Venereologia.2015;150(2):247-254.
- Rizvi S., Raza S.T., Ahmed F., Ahmad A., Abbas S., Mahdi F. The role of vitamin E in human health and some diseases. Sultan Qaboos University Medical Journal. 2014;14(2):e157-e165.
- Mills. O.H., Kligman A. Acne mechanica. Archives of Dermatology. 1975;111(4):481-483.
- Rosacea. Mayo Clinic (Website). Accessed 2019.
- Nair P.A., Salazar F. Acneiform eruptions. StatPearls. 2018.
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