Different Types Of Acne: Causes, Symptoms, Treatments & Prevention

Acne is the most common skin concern prevalent in men and women of all ages. Most commonly seen in teenagers and young adults, due to hormonal fluctuations, acne can also occur during adulthood, especially in women. Acne, whose medical term is acne vulgaris, manifests in different forms, each with a distinct appearance and symptoms. While some types of acne go away on their own, others require proper medical treatment. In this article, let us dive into the different types of acne and their causes and symptoms. Additionally, let us learn about the various treatments to address each type of acne and some preventative measures.

Acne Types

Call it pimples, bumps, breakouts, or blemishes; all talk about acne. But not all are the same. Acne can be present in various forms, from comedones to cysts. When managing these, it is imperative to know what type of acne you are dealing with. Each type requires a different treatment. Identifying the type of acne is the first step to successful treatment, as it helps the dermatologist customise treatments and treat them accordingly. Based on whether inflammatory or non-inflammatory, we can classify acne as below:

Blackheads
Whiteheads
Papules
Pustules
Nodules
Cysts

Let us examine each type of acne in detail, including its causes, symptoms, and treatment and prevention tips.

Blackheads:

Blackheads are open comedones that look like tiny black spots on the nose, chin, and forehead. They are a grade-1 type of acne that forms when sebum and dead skin cells clog the skin pores. [1] Blackheads are non-inflammatory, as they do not cause swelling

Causes

Most people assume that the trapped causes the comedones to turn black. It is not. The black hues on the skin surface result from the discolouration of sebum because of air. Possible reasons for blackheads include:

Excessive sebum or oil production
Irritated hair follicle
Hormonal fluctuations
Harmful skincare products

Symptoms

Presence of open pores
Dark or black-coloured bumps
Having a raised texture
No associated pain or discomfort

Treatments

Depending on the severity, blackheads are treatable using OTC medications and topical retinoids. The dermatologist may recommend comedone extraction to get rid of them safely. [2]

Prevention

Clean your face twice a day
Use non-comedogenic products in your skincare and makeup routine
Exfoliate gently at least once a week

Whiteheads:

Whiteheads are closed comedones under the skin’s surface. These appear as white or flesh-coloured spots on the skin and are grade-1 type of acne. Slightly raised in appearance, they occur mostly on the neck, back, chest, nose, forehead, and chin.

Causes

Whiteheads are a milder type of acne formed due to increased oil production in the hair follicles by the skin’s sebaceous glands. But unlike blackheads, the top closes up, looking like a small white bump protruding from the skin. Whiteheads are also non-inflammatory acne lesions that do not cause pain or discomfort.

Symptoms

Presence of white or flesh-coloured bumps
Slightly raised
Tender to touch

Treatments

Dermatologists prescribe topical retinoids or OTC products containing salicylic acid or benzoyl peroxide to treat whiteheads and comedone extraction to safely remove them. Depending on the severity, they may also recommend chemical peels and laser skin resurfacing treatments.

Prevention

Wash your face regularly and moisturise it afterwards
Use oil-free and non-comedogenic skincare products
Refrain from squeezing the pimples or touching the skin unnecessarily

Papules:

Papules are inflammatory grade-2 acne that resemble red or pink bumps on the skin. They occur on the face, neck, chest, buttocks, shoulders, and back and can be tender to the touch. They may leave behind hyperpigmentation marks on the skin.

Causes

Papules form when the skin pores clog due to the accumulation of excess oil, dead skin cells, oil and dirt. The increased presence of bacteria on the skin also triggers the formation of papules.

Symptoms

Red bumps
Painful and tender to touch
Presence of pus in some cases
Resemble inflamed whiteheads
Irritation and itching

Treatments

The dermatologist may suggest chemical peel and laser therapies to treat papules effectively.

Prevention

Clean your face regularly with a gentle cleanser, but avoid scrubbing
Use non-comedogenic skincare and makeup products
Remove your makeup before you sleep
Refrain from touching your skin unnecessarily

Pustules:

Pustules are small bumps filled with pus with a white to yellowish appearance and a red halo. They are moderate to severe acne and can occur on the face, neck, back, shoulders and arms. [3]

Causes

Pustules form due to acne or when the blocked skin pores get infected. Other contributing factors include infections, skin disorders, insect bites, and food allergies.

Symptoms

Tiny blisters filled with white or yellow pus
Painful to touch
Presence of redness and inflammation

Treatments

The dermatologist may prescribe OTC topical drugs to treat pustules caused by acne. Depending on the severity, they may also recommend other medications, antibiotics, chemical peels, and light therapy.

Prevention

Wash the skin always to keep it oil-free
Use only non-comedogenic products to keep your skin moisturised
Avoid using makeup if you notice lesions
Use sunscreen regularly
Eat a balanced diet rich in fibre, vitamins, minerals and proteins to keep your skin healthy

Nodules:

Nodules are grade-3 to grade-4 acne, characterised by large, inflamed lesions underneath the skin’s surface. They don’t have a visible head. Nodular acne occurs on the face, neck, back, chest, and shoulders and may result in dark spots or scarring.

Causes

Nodules form when the acne-causing bacteria Propionibacterium develops inside the pores and infects them, resulting in swelling from underneath. They are a severe form of acne and take time to heal. Other triggers include hormonal imbalance, side effects of medications, genetics, and exposure to environmental factors.

Symptoms

Deeply seated bumps underneath the skin
Accompanied by redness and inflammation
Have a tough texture
Painful and irritating

Treatments

For fewer nodules, the dermatologist may prescribe OTC medication and oral antibiotics as the first line of treatment. The doctors may recommend advanced acne treatments such as chemical peels, laser, acne extraction, laser therapy, light therapy, acne draining, and direct medicine injections to reduce the bacteria infection and control inflammation.

Prevention

Follow a proper skincare routine
Keep the affected area clean by washing it twice daily
Use a non-abrasive cleanser for your face
Do not scrub
Keep your skin moisturised
Apply SPF sunscreen every day
Avoid touching your skin

Cysts:

Cystic acne is one of the most severe grades of acne. It appears as a large, pus-filled, and painful inflammation. When left untreated or not treated properly, it can lead to scarring. The most prominent area affected by cystic acne is the face, especially the cheeks, chin, and jawline. Cysts can also occur on other areas of the body, like the upper arms, back, and torso.

Causes

Cysts occur when sebum, dead skin cells and bacteria clog the skin pores, resulting in swelling and redness. The infection seeps into the skin’s surface while damaging healthy tissue, taking several months to heal. Genetics, hormonal changes, stress, and side effects of medications also result in cystic acne.

Symptoms

Large, pus-filled cysts under the skin
Painful and tender to the touch
Inflammation and redness
When burst, they infect the surrounding skin

Treatments

Cysts or cystic acne can be challenging to treat. Treatment usually involves a combination of treatments, including intralesional injections, chemical peels, and OTC medications. For cystic acne caused due to hormonal fluctuations, the dermatologist may prescribe oral contraceptives. They may also recommend laser treatment to reduce post-inflammatory hyperpigmentation and alleviate the scars caused by acne.

Prevention

Cleanse your skin thoroughly twice a day using a mild cleanser and lukewarm water
Use oil-free and non-comedogenic skincare products on the skin
Avoid picking or touching the cysts
Maintain your hair hygiene

How To Identify Your Acne?

The signs of acne can vary depending on its severity. Broadly, you can categorise acne into mild, moderate and severe cases. Identifying acne involves understanding the different types, their characteristics, and potential causes. The information mentioned above will help you identify your acne. Accordingly, one can distinguish the type and seek medical intervention for prompt treatment.

When To Visit A Dermatologist?

Some acne may go away on their own, but others could be stubborn and require dedicated treatment. If the acne is persistent or recurring and does not show significant change after using OTC products, it is advisable to visit a dermatologist. Acne, when left untreated, can lead to permanent scars. Consult a dermatologist if you find it challenging to manage acne. Speak to your dermatologist if your acne is:

Filled with pus and getting bigger
Bleeding
Resulting in acne flare-ups covering other parts of the body
Affecting sensitive areas like the eyes and lips

Takeaway

Acne affects people of all ages and may occur for more than one reason. If your acne does not reduce or resolve with OTC treatment, it is best to consult an expert. The dermatologist will help identify the type, severity and underlying cause and recommend a suitable treatment solution customised to your type.