6 Different Types of Acne and How to Treat Those Pesky Bumps

What is Acne

Acne, the bane of our lives. Social media, beauty filters, and face editing apps have made us believe that everybody else has clear skin, and that acne isn’t a common issue. Well, this couldn’t be farther from the truth as acne is incredibly common, and it can affect anybody at any age. It’s true that acne is most common among teenagers thanks to changing hormones, but it can affect adults, too. Plus, acne is genetic, so if you have a family history of acne, it’s highly likely that you would have acne, too.

But what exactly is acne? Acne comes in many different forms, and each acne type is treated differently. You may even experience more than one type of acne at a time, so understanding the type of acne that you may be suffering from will help you treat the acne much better.

Acne, in its most basic sense, is when the pores of your skin are clogged. Clogged pores may happen for several reasons, such as:

  • Excess oil production (sebum)
  • Bacteria
  • Dead skin cells
  • Ingrown hairs
  • Hormones

Types of Acne

The acne treatment that you need depends on the type of acne that you may be experiencing. Acne can either be non-inflammatory, or inflammatory. Inflammatory acne is typically red, swollen, and sore, and they’re likely painful, too. These types of acne include papules, pustules, nodules, and cysts.

Non-inflammatory acne:

  • Blackheads (open comedones)
  • Whiteheads (closed comedones)

Non-inflammatory acne:

  • Blackheads (open comedones)
  • Whiteheads (closed comedones)
You may also have heard about fungal acne, but it isn’t really acne. Fungal acne is a skin condition called pityrosporum folliculitis, and is one of many types of folliculitis, which is a skin condition that causes an infection in the hair follicle. It can look like pimples and is often confused with acne. Folliculitis can occur anywhere you have hair, and is typically treated with antifungal pills or cream.

Non-Inflammatory Acne

Non-inflammatory acne is closer to the surface of the skin, and they usually aren’t painful or swollen. These can include blackheads and whiteheads.

Blackheads, also known as open comedones, typically affect the face, neck, back, and chest. This type of acne are pores that are clogged with excess oil and dead skin cells. The top of the pores are open and exposed to the air, which oxidises the melanin and gives it its black colour.

Blackheads occur when a hair follicle/sebaceous gland becomes clogged or inflamed. This can happen for a few reasons, namely:

  • Increased sebum production.
  • Abnormal formation of keratin
  • Increased androgen hormone production
  • Bacteria

Blackheads (open comedones)

Whiteheads (closed comedones)

Whiteheads, also known as closed comedones, also happen when pores are clogged with sebum and dead skin cells. However, unlike blackheads, whiteheads are typically closed on the top. Whiteheads can typically affect the face, neck, back, and chest.
Whiteheads occur when a hair follicle/sebaceous gland becomes clogged or inflamed. This can happen for a few reasons, namely:
  • Increased sebum production.
  • Abnormal formation of keratin
  • Bacteria

Inflammatory Acne

Inflammatory acne occurs when blocked pores are red, swollen, and possibly painful. These types of acne not only contain sebum and dead skin cells, but also bacteria and other inflammatory mediators, which makes it red, swollen, and painful.
Inflammatory acne occurs when pores or hair follicles get blocked with:
  • Dead skin cells
  • Sebum
  • Oil in products placed on your skin
When the pores are clogged, pressure is put onto the walls of the pores. When there is enough pressure on the walls of your pores, the walls break. The contents of the pustules can spread into your skin, which can make the acne appear worse. The immune system then reacts by sending white blood cells, which cause redness, swelling, pus, and painfulness associated with pimples.
There are 4 different types of inflammatory acne, which are papules, pustules, nodules, and cysts. These types of acne typically appear on the face, back, chest, and shoulders.

Papules are comedones on the skin that develop into small, inflamed bumps. Papule acne occurs when the walls surrounding your pores break down from severe inflammation, which results in hard, clogged pores that are tender to the touch.

Pustules are also formed when the walls around your pores break down, but unlike papules, pustule acne is filled with pus, which makes them soft and squishy. Pustule acne is typically red, and they often have yellow or white heads on top.

Nodules are large, inflamed bumps that feel firm and painful to the touch. When the pores are clogged and become swollen pores, they become more irritated and grow larger. Unlike pustules and papules, nodules develop deep underneath the skin. Because of this, dermatologists are typically needed to treat them by using prescription medication.

Cysts can develop when pores are clogged by bacteria, sebum, and dead skin cells. Also known as cystic acne, this type of acne occurs deep underneath the skin and are even further below the surface than nodules. Cystic acne is typically large, and red with white bumps, and are often painful to the touch. Cysts are the largest form of acne, and they usually develop from a severe infection. This type of acne is also the most likely to scar. Prescription medication is needed to treat cysts, and in severe cases, minor surgery may be required to remove it.

How Severe is Each Type of Acne?

Dermatologists rank acne by severity:
Grade Severity Description
Grade 1
Mild
Mostly whiteheads and blackheads, with a few papules and pustules.
Grade 2
Moderate or pustular acne
Multiple papules and pustules
Grade 3
Moderately severe or nodulocystic acne
Numerous papules and pustules, along with occasionally inflamed nodules. Your back and chest may also be affected.
Grade 4
Severe nodulocystic acne
Numerous large, painful and inflamed pustules and nodules.

How is Acne Treated?

There are many ways to treat acne, which include topical or non-prescription treatments, and oral acne medications:

Topical Acne Medications

A dermatologist in Singapore  may recommend using a topical acne medication to treat your acne. You can apply these medications directly onto your skin, just like a moisturiser. These could include products that contain one of the following ingredients:

Topical or non-prescription treatments include:
  • Salicylic acid: Available in many products, like toners or cleansers. Salicylic acid dissolves dead skin cells to prevent your hair follicles from clogging, and helps remove the top layer of damaged skin.
  • Azelaic acid: Naturally contained in barley, wheat, rye and other various. It kills microorganisms on your skin and reduces swelling.
  • Benzoyl peroxide: Available in different forms, such as as acne leave-on treatment or cleanser. It targets surface bacteria, but may dry out the skin.
  • Retinoids (vitamin A derivatives): These promote skin cell turnover and help to prevent clogged pores. However, retinoids also may worsen blackheads at the beginning of the treatment.
  • Antibiotics: Topical antibiotics like clindamycin and erythromycin control surface bacteria that aggravate and cause acne. Antibiotics tend to be more effective when combined with benzoyl peroxide.
  • Dapsone: Dapsone (Aczone®) is a topical gel, which also has antibacterial properties that can treat inflamed acne.

Oral Acne Medications

Oral acne medications are pills that are taken by the mouth to clear your acne.

Different types of oral acne medication include:
  • Antibiotics: Antibiotics treat acne that is caused by bacteria, and are typically prescribed for moderate to severe acne. Common antibiotics for acne include tetracycline, minocycline and doxycycline.
  • Isotretinoin: A form of oral retinoid, isotretinoin reduces the size of oil glands, which contributes to acne formation.
  • Contraceptives: Birth control pills contain a combination of oestrogen and progesterone, which lowers the amount of androgen in the body.
  • Hormone therapy: Hormone therapy can be helpful for those who experience acne flare-ups during menstruation or irregular periods caused by excess androgen, also known as hormonal acne. Hormone therapy consists of low-dose oestrogen and progesterone, or a medication called spironolactone, which blocks the effect of certain hormones that affect the hair follicles and oil glands.

Additional Acne Therapies

If topical or oral medications don’t seem to reduce your acne or if you have acne scars, your dermatologist may recommend different types of acne therapies to clear your skin, including:
  • Steroids: Best for severe acne, steroids are injected into large nodules to reduce inflammation.
  • Lasers: Lasers and light therapy treat acne scars by delivering heat to the scarred collagen under your skin, which stimulates the body’s wound-healing response to create new, healthy collagen. This then encourages growth of new skin to replace it.
  • Chemical peels: Chemicals are used to remove the top layer of old skin, after which new skin grows, and reduces acne scars.
  • Microdermabrasion: This treatment removes the top layers of the skin, which releases the clogs that cause acne.

Conclusion

Acne is a super common skin condition which can affect people of all ages. It’s caused by pores that are clogged by dead skin cells, sebum, and in some cases, bacteria. There are 2 main types of acne; non-inflammatory acne which include blackheads and whiteheads, and inflammatory acne, which include papules, pustules, nodules, and cysts. There are also many different types of acne removal treatment, including topical acne medications, oral acne medications, and other acne therapies, such as laser treatments and chemical peels.

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