Acne is more than just pimples. Learn the different types of acne and the best ways to treat them so you can get one step closer to clear skin.
It’s time to get down to the nitty gritty about acne and decipher the different types and the best ways to treat them. It’s important to know the different kinds of acne because the most effective way you can treat your pimples is by understanding your skin type and what type of acne you’re suffering from.
So before we begin, let’s answer how acne occurs. Well, beneath the outermost layer of the skin there sebaceous glands and they naturally excrete a waxy substance known as sebum (AKA oil). Over time, the skin sheds itself to get rid of built up dead skin cells, but oftentimes these dead cells can become trapped because of the buildup of sebum (which results in clogged pores/acne).
Another cause of acne is bacteria called Propionibacterium acne. This bacteria is naturally present in the skin but it tends to reproduce because of clogged pores. This happens because the bacteria feeds off of sebum and as a result this can lead to more inflammation and spots.
I reached out to Joshua Zeichner, the director of cosmetic & clinical research in dermatology at Mount Sinai Hospital in New York City, for some clarification on the different types of acne. “Broadly, acne can be divided into inflammatory and comedonal lesions,” he says. “Inflammatory acne includes red angry bumps, pus pimples, and cysts. Comedonal acne is made up of open and closed comedones, which are blackheads and whiteheads, respectively.”
Let’s delve deeper into the different types.
Comedones are hair follicles that get clogged with trapped dirt, sebum, and debris, causing the pore to become infected. Whiteheads are pores that are completely clogged and closed at the surface, which results in their “white” or skin-colored appearance. On the other hand, blackheads are open pores that get their distinct appearance from being exposed to oxygen which creates their “black” or gray color. These types of acne can appear in all skin types, but those with oilier skin are more prone to blackheads.
Through and through, the best treatment for most types of acne are products that exfoliate the skin’s surface. For comedonal acne in particular Zeichner suggests salicylic acid because “it helps remove excess oil from the skin and exfoliate dead cells from the skin’s surface.”
Exfoliating on a regular basis will help to avoid the buildup of dead skin within the pore as well as aid in regulating oil production. Look for chemical exfoliators like BHA or AHA. Paula’s Choice Skin Perfecting 2% Liquid BHA Exfoliant is a salicylic acid-based treatment that works to deep clean the pores. I personally like to alternate my BHA and AHA since BHA is oil soluble and can rid my pores of all the oil so that an AHA can then go in and really deep clean.
Inflammatory acne is just that: lesions that become inflamed and result in red and/or tender bumps which can be filled with pus and bacteria. This type of acne becomes red and inflamed as a result of white blood cells rushing to the infected area and trying to treat it. The most common forms are papules and pustules, which actually originate as comedonal acne. Papules can be identified as red in color and surrounded by inflammation. Pustules are usually the kind of acne you’re referring to when you have a pimple that’s surrounded by a red rim of inflammation and filled with either white or yellow pus.
“If you have red angry pimples, you should be using benzoyl peroxide,” says Zeichner. “It kills acne-causing bacteria that leads to the inflammation that causes these bumps.” But you want to use benzoyl peroxide sparingly as it can be quite harsh on skin and quickly lead to irritation.
For more sensitive skin types, choose products with tea tree oil since its antimicrobial properties help to fight acne and the bacteria that causes it. It also works to soothe inflammation and is known to be gentler on the skin than most other acne-fighting ingredients. Missha’s Speedy Solution Anti Trouble Patch are a great choice as they are essentially a “Band-Aid for zits”. They contain both salicylic acid and tea tree oil to help combat acne and speed up the recovery process. Plus, they keep your spots covered so you can avoid picking and prodding.
Cysts and Nodules
Nodules are larger bumps that are painful to the touch and develop deep within the skin. They feel firm when touched and they occur when the the bacteria within the pore spreads and infects the other follicles near by. They are actually quite similar to papules—just larger and harder to treat. Cysts can look like boils. They are extremely painful and measure up to an inch or more in diameter. This form of acne is lodged deep within the skin and can take anywhere from weeks to months to go away.
Nodules and cysts are the most severe forms of acne, which unfortunately usually result in damage to skin such as permanent scarring. “If you have large, painful, under the skin bumps, known as cysts, you may need more of a treatment than what you can get over-the-counter,” says Zeichner. “A board-certified dermatologist can talk to you about prescription topical or even oral medications that can be effective.” It’s also extremely important to visit your derm as soon as possible because the faster you treat the areas, the less scarring you will incur.
For those who do have leftover acne scars, brightening products like vitamin C and niacinamide are effective at treating them. Try using a high percentage vitamin C, like the Triple C Lightning Liquid, which contains a whopping 20.5% of fresh ascorbic acid (AKA vitamin C) and really helps to lighten any hyperpigmentation. For deeper pitted scars, dermarolling has shown to be effective and you can read our in depth guide here.
Acne is complicated, but when you use the right products you can effectively treat and prevent bumps from occurring. It’s also important to use the proper products for your skin type since using the wrong ones can increase oil production leading to unnecessary breakouts. Now that you’ve educated yourself on the different types and treatments, next time you get an unwelcome visitor, you’ll be able to identify and treat it accordingly.