a guide to the different types of acne

Acne. We’ve all dealt with it, some of us are still dealing with it, and none of us likes it! While acne is typically associated with pimply-faced teenagers in the grip of fluctuating hormones, acne is far from just an adolescent issue. Acne affects many adults due to a variety of reasons including hormones, stress, family history, medication side effects, or medical conditions.

There is more than just one type of acne, and it’s important to know something about the different acne types in order to understand how best to cope with this pesky issue.

What Type of Acne Do I Have?

Acne is divided into two categories: inflammatory acne and non-inflammatory acne. Let’s start with non-inflammatory acne.

1. Non-inflammatory Acne

First things first, you should know that “comedo” is the fancy word for a clogged pore. Comedones result when the hair follicle in the skin is filled with sebum (oil), bacteria, and skin debris, and they can be closed or open. Closed comedones are called whiteheads. Whiteheads occur when the clogged hair follicle is unable to open, trapping the oil and debris inside. They look like small, raised blemishes with whitish “heads.” Open comedones are called blackheads. Blackheads look like small, black dots on the skin. Both whiteheads and blackheads can normally be treated with over the counter medication.

2. Inflammatory Acne

Inflammatory acne occurs when the comedones become inflamed as well as clogged. The blemishes that result from this are usually red and may be tender or painful due to inflammation. There are two types of inflammatory acne, papules and pustules.

A papule is the next evolution of a whitehead—it is a clogged hair follicle accompanied by redness and swelling and is generally medium in size. A pustule is just a papule full of white or yellow pus (hence the name). They are generally larger, painful, and it is extremely tempting to squeeze them to extract the pus. (Resist the urge, as this can result in scarring!)

Another form of inflammatory acne is nodular acne. Nodules are large, inflamed, red, and are hard to the touch. They develop deep under the skin and should be treated by a dermatologist as they may require prescription drugs in order to get rid of them. Nodulocystic acne is characterized by both nodules and cysts—pus-filled lesions. This is also a severe form of acne that requires treatment by a medical professional.

How Serious is My Acne?

As you’ve probably guessed, acne can range from mild to severe. Acne is considered to be “mild” if you have “fewer than 20 whiteheads or blackheads, fewer than 15 inflamed bumps, or fewer than 30 total lesions.” Mild acne, while annoying, isn’t medically worrisome and can usually be treated with over the counter medication.

Moderate acne consists of “20 to 100 whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions.” If you have moderate acne than you could probably benefit from prescription medication, as well as a trip to the dermatologist.

Remember that lovely nodulocystic acne we discussed earlier? If you have this type of acne than your acne is severe and often results in scarring. Intervention by a dermatologist is needed, especially in minimizing scarring and reducing inflammation.

How Do I Treat My Acne?

Luckily, there are many ways to minimize and treat acne, starting with making sure you know how to properly care for you skin type. If you have naturally oily skin, chances are you are also prone to pimples and will need to take extra care to make sure that excess oil doesn’t clog your pores. Over the counter topical medications containing salicylic acid or benzoyl peroxide can help to treat acne, and if your acne is more severe than a doctor may prescribe medication such as topical or oral antibiotics. If you have scarring from acne, don’t despair—there are also many ways to get rid of acne scars or reduce their severity.

Acne can affect your self-esteem and quality of life, so don’t be afraid to seek medical intervention. What is “just pimples” to one person may be a serious concern for another. Acne is one of the top reasons people visit the dermatologist, so don’t be shy! 

By Margaret Durkovic

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