Acne types : Acne Treatment Guide

This is a follow on from the acne symptoms section which looks at these different types in more detail.

Types of acne include:

• Blackheads
• Whiteheads
• Papules
• Pustules
• Nodules
• Cysts
• Scars

Acne scars are discussed in a separate section.

Blackheads

The medical term for these is ‘open comedones’. They have a wide opening and are comprised of sebum plugs (ball of sebum) and dead skin cells. Air is able to access the hair follicle due to the wide opening which together with the sebum plugs and skin cells results in a chemical reaction. This reaction changes the colour within the hair follicle to black - hence the name ‘blackhead’.

Whiteheads

The medical term for these is ‘closed comedones’. They are similar to blackheads except that they only have a tiny opening which stops air from getting to the follicle. The follicle cannot change colour which means that this type of spot remains a white colour.

Papules

Another name for a lesion (skin growth or cyst). These pink, inflamed lesions do not contain pus and form when excess oil and dead skin cells block and then rupture a hair follicle.

Squeezing or rubbing the inflamed pore will also damage the hair follicle, resulting in a papule. Papules occur on the surface of the skin.

Pustules

These are an advanced form of papules. They appear as a small red and inflamed pimple with a white top which contains pus and oil from the sebaceous glands.

Nodules

A nodule is a much larger type of lesion which develops underneath the skin –usually in the dermis (middle layer). This hard, painful lump is comprised of oil, dead skin cells and infection from the ruptured hair follicle which has spread beneath the skin.

Damage to this nodule can result in acne scarring.

Cysts

This is also a large type of lesion which is soft to the touch and filled with a fluid, e.g. pus. These are swollen and painful to touch and carry a high risk of scarring. They are formed when a hair follicle has ruptured, causing an infection in the middle layer of the skin.

This cyst gradually makes its way to the surface of the skin but damages healthy skin cells whilst it does so. This results in total destruction of the hair follicle.

Cysts are not to be messed with and require medical treatment.

Scars

This refers to acne scars. These can develop following an outbreak of cysts or nodules and can remain even after the acne has cleared up. Scarring can also occur if you squeeze or pick at your acne.

If you have a severe form of acne then you are at higher risk of acne scars.

This is discussed in greater detail in our acne scars section.

You may find that you have one type or a combination of these different types of acne.

You may have a mild form of acne but this can worsen as a result of several factors. These are discussed in the acne complications section.

These are all characteristics of acne vulgaris the most popular form of acne but did you know that there are other forms of acne?

Other types of acne

The acne we most commonly associate with is ‘acne vulgaris’. This type of acne is divided into three groups: mild, moderate and severe and particularly affects teenagers.

This guide is dedicated to acne vulgaris as this is the most common type of acne. However, we have included short paragraphs if information about the less well-known types.

These include:

• Smoker’s acne
• Cosmetic acne
• Acne rosacea

Smoker’s acne It has been argued that smoking can cause acne, in particular, the non-inflamed variety which consists of whiteheads and clogged pores. This appears to be a bigger problem for women who smoke compared to men.

Why is that?

We know that smoking has an ageing affect on the skin but it seems to be the case that chemicals within tobacco smoke also trigger an outbreak of acne. These chemicals are responsible for a wide range of effects on the body.

However, there have been counter-arguments put forward which suggest that there is no link between the two.

Cosmetic acne

This is also known as ‘acne cosmetica’: a type of acne which is caused by using make up that contains ingredients which are ‘comedogenic’. This means that they are likely to cause blocked skin pores. An example of these ingredients includes mineral oil or cocoa butter.

This type of make up can clog the pores, leading to the formation of whiteheads (non-inflammatory acne).

This does not mean that every type of make up will cause acne and in most cases it doesn’t. It is more likely to aggravate an existing outbreak of acne or trigger it in someone who is predisposed to developing acne.

Acne rosacea Often called ‘adult acne’: this skin condition presents itself in an outbreak of small red spots and cysts which appear very similar to acne. However, it is different to the acne that often develops in puberty (common acne).

Other symptoms include a flushed face, a thickened skin, dry eyes and prominent blood vessels on the face. This is usually a mild form of acne that affects people in middle age, usually women more than men. But it is more severe in men than women. It is difficult to pinpoint the exact causes of acne rosacea but there are a few possible causes which include:

• Faulty immune system
• Hereditary
• Damage from excess sun exposure

Acne rosacea is not painful and complications are rare. People who develop this condition report a feeling of burning skin –similar to sunburn, and dry or itchy eyes. There is no cure for this condition but there are treatments available which can reduce these symptoms. These include topical medicines which are used to treat common acne, antibiotics, camouflage creams and light/laser therapy. Other things which can help are using a sun cream with a high sun protection factor (SPF); avoiding spicy foods, alcohol and hot drinks; avoiding steroid creams and using an oil-free moisturiser.