Types of Acne on Face: 7 Common Types and Their Treatments

Individuals that experience acne are often worried about its impact on their skin. In order to effectively manage the condition, one must first understand the types of acne and the reasons that cause it.

Acne vulgaris is a common chronic disorder that can affect individuals across all age groups, in both men and women (11-30 years). Hence, it requires a thorough assessment to plan an effective strategy for best results. Allow us to illustrate these markers in the blog below.

Keynotes:

Acne is a chronic inflammatory condition that manifests as bumps or lesions along the skin.
It has several different types like blackheads, whiteheads, papules, pustules, nodules and cysts.
The types of acne and their prospective treatments differ based on severity and the skin’s response to therapy.
If you notice your acne is causing mental stress or is unresponsive to OTC treatment, you must seek a professional diagnosis for targeted treatment.

What Is Acne and How It Forms

Acne is a common skin disorder, inflammatory in nature, manifesting as bumps and subsequent scarring. It arises when there is an irregularity in the oil production, thereby clogging follicles with debris, dirt and dead skin cells. Thus, leading to the occurrence of several types of acne like whiteheads, blackheads, pustules, papules, nodules and cysts.

Being a chronic condition, the pathogenesis of acne is a complex, interconnected process, essentially caused by four factors:

Increased Sebum Production

Our skin naturally produces a serum called sebum in the sebaceous glands to lubricate and protect it from drying out. This organ is heavily regulated by hormones, such as androgens, estrogen, progesterone, as well as insulin. An erratic surge of these can cause an imbalance in sebum regulation. Thus, clogging the pores and leaving the skin oily.
Follicular Keratinization

Our skin follows a routine shedding of the dead skin cells. On account of an imbalance, these cells clog the hair follicle, causing buildup like that of a plug. The blockage may result in whiteheads, blackheads or spots.
Cutibacterium acnes (bacteria)

Cutibacterium acnes (formerly Propionibacterium acnes or P. acnes), is a common bacterium that resides on the skin. An oily environment acts as a nutrient-rich space for this bacteria to multiply. The buildup, debris, and dirt can form into papules and pustules (pus-filled lesions).
Inflammation

Lastly, the aggravated follicles (filled with buildup) trigger an inflammatory response to fight the bacteria. This results in redness, pain and swelling around the infected pore, often seen in types of acne on face like nodules and cysts. It is also important to understand that chronic inflammation can also contribute to scarring and post-inflammatory hyperpigmentation.

Different Types of Acne

Based on the factors, it can be understood that acne can manifest in several different forms, each unique in character. Below are some of the most familiar types of acne you may come across:

Blackheads, Whiteheads, Papules, Pustules

Different forms of acne can be essentially segregated into two parts, inflammatory and non-inflammatory.

The comedones (clogged hair follicles) fall underneath the non-inflammatory (mild) type of acne on the face.

Blackheads

Blackheads are open comedones (pores), which form into tiny black bumps on the surface of the skin due to buildup. The dark color of these comedones is often cast off as dirt, but it is simply melanin (in sebum) oxidized when exposed to air.
Whiteheads

Closed comedones are similar in size to blackheads but fashion a flesh-colored hue as the skin covers the pore. Due to this characteristic, the blocked follicle forms into a bump, holding oil, bacteria, debris and more.

Besides these two, there are inflammatory lesions that are categorized between mild and moderate types of acne:
Papules

With a rise in bacterial growth and inflammation due to unregulated sebum in the skin comes inflammatory acne, or papules. These are small, red (or pink) bumps appearing, surrounded by skin; and painful to touch.
Pustules

The inflammation further aggravates the skin, leading to pus formation in papules as an immune reaction. Pustules, formed from papules, are distinctly red and inflamed, with a yellowish bump containing pus. It is tender and painful.

Nodules and Cystic Acne

Nodules and cysts are also types of inflammatory lesions; however, they range between moderate to severe grades of acne.

Nodules

Compared to the above types, nodules are larger in size (about 5 mm) and seated deep under the skin (dermis). Nodules are painful and firm, resulting from inflammation, infection or other hormonal factors. These can be difficult to treat with over-the-counter products and will need a professional intervention.
Cysts

While nodules are solid, cysts can be easily identified by their larger size and yellow sac-like structure filled with pus. These are softer yet much painful than the others. The lesions are infected deep within the skin and carry the risk of scarring.
Acne Conglobata

This is a rare type of skin disorder, often graded as severe nodulocystic acne. Acne conglobata results in large, interconnected nodules, foul-smelling abscesses, and cysts often leading to dramatic scarring and disfigurement.

In addition to the above 7 types of acne, one can also experience fungal acne (malassezia folliculitis), hormonal acne, acne mechanica (caused by friction) and acne rosacea.

Cystic and nodular acne requires immediate professional diagnosis and treatment to curb the risk of rupture, which can potentially spread the inflammation in surrounding tissues. Please do not pick at your skin or it may lead to infection and hyperpigmentation.

Read more: Treatment Options for Hyperpigmentation

Best Treatments Based on Acne Type

Based on the types of acne we saw above, here are some their respective acne treatments which may be suggested by your GP:

Blackheads, Whiteheads and Mild Acne

Non-inflammatory lesions such as blackheads, whiteheads and mild lesions are often treated with over-the-counter topical solutions. These include salicylic acid (regulates sebum buildup), benzoyl peroxide (inhibits bacteria), and retinol to increase cell turnover and unclog pores.
Papules and Pustules

Mild papules and pustules are spot treated with benzyl peroxide or azelaic acid. These not only exfoliate the region but also help reduce inflammation and redness. In terms of moderate to severe forms of acne, professional topical antibiotics and topical retinoids are prescribed.
Nodules and Cysts

Nodules, cysts and severe nodulocystic acne all require prescription treatment by a board-certified dermatologist. They may prescribe isotretinoin for persistent lesions which do not respond to therapy. Or they might induce drainage procedures to reduce the inflammation and extract pus out of deep-seated cysts.
Fungal Acne

This type of acne is found on the face, chest, back, etc, brought upon by the growth of yeast rather than bacteria. Its treatment includes antifungal creams, oral medicines or medicated shampoos (anti-dandruff shampoo).
Hormonal Acne

Hormonal acne is caused due to the body’s reaction to inconsistent fluctuations in hormones. Hence, its treatment includes oral contraceptives, anti-androgen drugs, as well as hormone therapy in some cases.

When these types of acne and their respective treatments fail to perform optimally, your dermatologist may also recommend laser therapy, chemical peels, microneedling, hyaluronic fillers or even surgery.

When to See a Dermatologist

Dermatologist-proven acne products can be game changers to treat mild acne; however, below are some situations that may warrant professional attention:

If you develop moderately severe acne or nodulocystic acne, you will want to get a professional diagnosis to minimize scarring.
Acne that doesn’t improve after several weeks with OTC products.
Lesions with deep scarring or hyperpigmentation will warrant a check-up.
If you suspect fungal acne or other skin disorders.

Conclusion

Acne, being a skin condition can also deeply affect one’s self-esteem. Hence, understanding different types of acne and strategies to manage them can help you boost not only your skin health but also your mental well-being as well. Start small and remain consistent with your skincare routine. At times when OTC remedies do not deliver success, consult a dermatologist for advanced diagnosis and treatment.

FAQs:

What are the 7 types of acne?

According to studies, there are more than seven types of acne. Some of these include blackheads, whiteheads, pustules, papules, cysts, nodules, fungal acne, acne conglobata and more.
Which type of acne is the worst?

While the term “worst” is subjective, nodules, cysts and severe nodulocystic acne are some of the most pronounced and difficult types of acne to treat. These are deemed severe due to their large size, depth of injury, associated pain, inflammation, and possibility of scarring.
Can one person have multiple acne types?

Yes, it is generally quite common to see an individual with multiple types of acne on face, neck, chest, back and shoulders. As acne is a multifaceted disorder, it can manifest in different types along the body.
Do all types of acne leave scars?

No, not all types of acne may leave scars; however, comedone for example, are non-inflammatory and typically will not scar the skin. However, pustules, nodules and cysts may rupture and cause long-term effects like texture changes, pigmentation or spots.