Types of acne


All types of acne have two things in common. Firstly: they start with a lesion: the comedo, a hair follicle plugged with oil and bacteria. And secondly: they’re all annoying, at the very least.

Whiteheads vs. blackheads. Papules, pustules and nodules.  Why learn all these names when all you really want is clear skin? Because the best way to fight back is by arming yourself with knowledge.


Whiteheads are one of the most common types of acne. Unfortunately, it’s a part of how your skin works, but it doesn’t mean that we have to live with them!

Understanding what whiteheads are (and are not) makes eliminating them faster and easier.  In medical journals whiteheads are called closed comedones and mostly appear on the skin as small, whitish bumps.

So what causes them? When the pores of your skin accumulate oils or sebum, you get whiteheads. This plugs your skin’s follicles, creating lesions. The reason these lesions turn into whiteheads (versus blackheads) is because the clogged areas are not exposed to air.

So what are blackheads?

A blackhead is created when a follicle in your skin becomes plugged and pushes through the surface. These are called open comedones and are typically caused by your skin producing too much oil. This oil, when exposed to air, turns black in color (and sometimes yellow) because of a buildup of melanin, your skin’s dark pigment. Therefore blackheads are not caused by dirt as a lot of people think.

If you’ve gone through or are going through puberty, you’re a good candidate for blackheads. That’s because your body generates a significant amount of hormones during puberty, and these hormones in turn stimulate your skin’s oil glands. This is 100% normal and means your body is doing what it’s supposed to do. But blackheads are an unfortunate byproduct of this process.

There are other reasons you might get blackheads. If your skin isn’t cleaned properly, dead skin cells accumulate within the pores, your pores become clogged, and these clogs lead to oil buildup. Using oil-based cosmetics or moisturizers can also stimulate blackhead development, so talk to your doctor about the cosmetics that will work best for your skin. Likewise, pollution, humidity and grease in your work environment (like if you work in a kitchen near a deep-fryer) can also cause breakouts.
One more thing to keep in mind. Many people wonder why they still get blackheads even though they scrub the affected areas. Well, your skin is supposed to be naturally oily. Excessive scrubbing and/or other irritations will actually cause your skin to produce more oil to compensate, thus creating even more blackheads. So clean your skin thoroughly but gently and not excessively.

What are Papules?

Papules are small, hard cone-shaped bumps that are pinkish in colour. It’s basically a fancy name for an inflamed whitehead. That’s why they’re tender to touch unlike other forms of acne. Not to be gross, but they contain no pus. Since they don’t contain pus you should never pop or poke them. If you do you might seriously irritate your skin and aggravate your existing pimples, and possibly end up with a permanent scar.

What are Pustules?

Pustules are small, round lesions. They’re red in color with yellow or whitish centers (caused by visible pus). While inflamed, pustules are generally painless and do not contain a great deal of bacteria. The inflammation is actually the result of a chemical irritation from things like free fatty acids, which are substances that circulate in the bloodstream and are common in everyone’s skin, although it’s possible there are other causes.
While it may be tempting to pop a pustule – don’t do it. You could end up with a permanent scar. If you got one that’s particularly bothersome, see your dermatologist to have it expressed properly.

What are Nodules?

Nodules are severely inflamed, hard lesions deep within the skin. Cysts are similar and are also pus-filled lesions, also deep under the skin. They develop when the contents of your comedones (a medical term for whiteheads or blackheads) have spilled into the surrounding areas. Your body’s local immune system responds to this ‘attack’ by producing pus.

Unlike other forms of acne, nodules may persist for weeks or even months, the result of their contents hardening into deep (and stubborn) cysts. Cystic acne is the most serious type of skin acne, although nodules do not always develop into cysts.  Both cysts and nodules, although similar, can exist independently as either nodular or cystic acne. They occur together, too, as nodularcystic (or nodulocystic) acne. Left untreated, they are likely to cause scarring, so if you think you have this condition, you should see a dermatologist for treatment.

Like most acne, nodular and cystic outbreaks can affect anyone but are more common in teenage boys and young men. Unfortunately, these types of acne often have genetic causes.  So if one of your parents had such outbreaks there is a good chance you’ll have them, too.

What is back acne?

While ‘bacne’ isn’t a word you’ll find in the dictionary, if you’ve got it you know the term. It refers to back acne, those annoying acne outbreaks on your back. Back acne usually first appears during puberty and is often outgrown by your early twenties, but can, unfortunately, persist beyond these years.

So what’s the deal with back acne? Well, your back has a very large area of oil secretions. Your back pores become clogged with skin cells and the oil is unable to escape as normal. This causes inflammation which in turn becomes back acne.

Back acne can also be triggered when heat and sweat is trapped against the body, and when your skin is irritated by friction. If you’re frequently wearing athletic equipment, tight-fitting clothing, backpacks or anything similar, you might be prone to back acne.

Back acne can be stubborn to get rid of and if left unchecked, some people may get cysts that can lead to scarring.  Thankfully, there are many treatments available. As with most acne conditions, the best approach is to find a skin care routine that works well for you – and then stick with it.  If your acne doesn’t start to improve within a few weeks, you should speak to your dermatologist about other treatment options.
What is Acne Conglobata?

Acne conglobata (AC) is an uncommon and very severe form of acne that can affect your back, buttocks, chest, shoulders, upper arms, thighs, and even your face. AC is characterized by abscesses and scars. Medically speaking, this condition is essentially a combination of acne pustules and nodules, though you might have bacterial infections as well. No one really knows what causes AC (unlike other acne conditions), but it often develops if your existing acne deteriorates or some dormant acne you have (even if you don’t know it) suddenly erupts.

You’re probably most acquainted with Acne conglobata because of the media frenzy over steroids. Anabolic steroid abuse is a sure way to contract AC.  AC affects younger male adults more than females, although even infants have been known to develop the condition.  This is a medical condition, obviously a physically and emotionally destructive one, so if you think you have AC, see a dermatologist as soon as possible.


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