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Acne 101: What are the Different Types of Acne?

by | Last updated Jun 25, 2020 | Published on Jun 23, 2020 | FAQ | 0 comments

Growing up for some reason not a lot of people around me were suffering from acne. That made me feel like the odd one out all the time. People would constantly ask about my “condition” and why I don’t do anything about it. Yup.

But as it turns out, acne is not uncommon.

Actually acne is the 8th most common disease of the world[1].

Affecting almost 10% of the planet’s population[2]. That’s a huge number and there is no reason for us to feel odd about it.

Quick Answers

What is Acne?

Acne is a skin condition characterized by blocked and inflamed pores causing pimples. These pimples mostly occur on the face but are also common on the back, chest and arms.

What are the different types of acne?

Acne is mostly determined by it’s appearance. Blackheads and whiteheads represent clogged pores in their initial state. Later on they can form papules or pustules which look like the common acne pimple. Cysts and nodules are formed in sever disease when deeper layers of the skin get involved.

What are the main causes of acne?

Acne can also be classified on the basis of causative factors. Bacterial or fungal infections and hormonal imbalances are commonly found to be the 3 causes behind stubborn acne.

Acne is defined as a chronic inflammatory skin condition.

About 85% of young Americans suffer from some form of acne. It is also a growing concern among adults these days.

Teenage acne is more common in boys. Reasons being the changes around puberty.

Androgens are hormones that are found in both boys and girls but occurs in higher quantity in boys[3].

This hormone hikes up during puberty and causes increased sebum production and acne.  Overtime the skin gets used to the changes and adapts accordingly.

Acne can be classified in two ways:

1. Based on the physical properties of the lesions.

2. Based on the causes of acne.

This classification is important to determine what specific treatment is going to be most beneficial to you.

It will also help you decide if OTC medications are enough or you need to book a dermatology appointment.

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6 Different Types of Acne

Based on Physical Appearance

Acne lesions on the face and body can be classified on the basis of their size, shape and color.[4]

You can have one or a mixture of these lesions on your face at any given time.

So let us see what the most common different types of acne are:

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1. Blackheads

The pores of the skin, called comedones can be clogged with excess oil, dirt or dead skin cells.

The buildup when exposed to air oxidizes and turns dark giving a blackish appearance. This is called a blackhead.

Acne prone skin usually deals with large open pores. They have a greater chance of getting clogged and form a pimple.

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2. Whiteheads

This is a closed comedone with white discharge emerging from the top. When a pore gets blocked and infected it forms a whitehead.

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3. Papules

These are small, circular and palpable lesions. Usually less then 10mm in size. They account for majority of our acne pimples.

The skin surrounding a papule can be red and inflamed. They can occur singly or in clusters.

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4. Pustules

It is an infected papule. Slightly larger in size, swollen, inflamed and usually tender. It is filled with pus which is a product of bacterial activity.

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5. Nodules

They are hard, solid lumps deep within the skin which can be painful. Their depth can reach down to the subcutaneous tissue of the skin.

In the example above, its the deep larger lump that is the nodules. 

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6. Cysts

Similar to nodules but with a fluid (pus) filled center. They feel softer and form in the deeper layers of skin.

Both cysts and nodules represent a severe form of acne. Both have greater tendency of causing complications like scarring and hyperpigmentation.

The causes of different types of acne:

There are many different causes of acne which determines the specific treatment approach.

In almost all these types the root problem is always one, which is excessive oil production. (also why we love clay masks for their superior oil adsorption)

Controlling the amount of sebum on the skin is important in all forms of treatment. But it is also important to target other contributing factors.

Here’s 3 types of acne based on causes:

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1. Bacterial Acne

Many organisms reside normally on our skin and in our pores.

Acne bacteria is called Propionibacterium acnes or P.Acnes for short[4].

They survive in the low oxygen environment of the pores and use oil as food.

You must be wondering if everyone has this bacteria why only a percentage of them develop acne? These bacteria release chemicals which breaks down oil or sebum. They then use it as a source of nutrients to support life.

This is why people with oily skin are more prone to getting breakouts. The bacteria multiplies in number and fills up the pore. It induces inflammation in the surrounding tissue. All this along with dead cell debris causes the pore to block.

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You will also notice whitish discharge from the pimple when it is infected with bacteria. This discharge is called pus, mainly containing dead bacterial matter[5].

If your doctor suspects you have bacterial acne he will prescribe you antibiotics to fight off the infection.

We have found success with the natural route, with clay.  The superior adsorption properties of clay are effective on excess oil.  If you haven’t tried clay, try out 4 types of clay with our facial clay mask assortment.

2. Hormonal Acne

Better called as Cyclical or Premenstrual acne[6]. Most girls and boys will get acne at the time of puberty.

The shifting hormone levels regulating oil production on the skin are generally to blame.

But women with polycystic ovarian syndrome or PCOs are likely to have acne through their 20s as well[7].

So ladies, ask yourself this:

Do you notice new breakouts just before your periods?

If yes, there’s a good chance that your hormones are responsible for this.

Hint: These pimple mostly appear on your jawline and chin area.

Just before your new menstrual cycle, the levels of a hormone called progesterone surges in the blood. This progesterone causes water retention in the body and skin, giving you a bloated puffy appearance.

The water retention increases pressure around the pores as well. This hormone also plays a role in thickening of sebum produced by the skin. Both effects increases tendency of the pore to get block and form a pimple.

If you’re an adult female with this pattern of acne, it’ll be a good idea to get checked for PCOs. Your doctor might want to try birth control pills to better regulate the hormones and control acne.

3. Fungal Acne

Along with bacteria occurring normally on the skin, some fungi are also present alongside. They constitute what we call the normal flora of the skin.

Yeast is one such fungi which lives near the oil glands in the pore. It also uses fatty acids from sebum as a source of food.

Overgrowth of this fungus can occur due to many reasons. Blockage of the pore by sweat or excessive oil, overuse of antibiotics can cause proliferation of the fungus.

It blocks the pore and gives rise to fungal acne also called Malassezia folliculitis[8].

The condition mimics normal acne pimples caused by bacteria and is often misdiagnosed. Usual acne treatments are not effective in this case.

Oral or topical antifungal drugs are used to eliminate the fungus along with lifestyle modifications. 

Controlling oil production is also helpful in cutting off the food supply of the organism.

Again, clay is also a useful tool for this. Here’s some of my favorite clay mask recipes: 

 

In Summary

Acne is a complex condition with varied morphology and etiological factors.

At any given time, you can have multiple types of lesions on your face. You can also have hormonal or fungal acne with superimposed bacterial infection.

This makes the treatment rather difficult and frustrating. But understanding the different types can help you take a more targeted approach for better long term results.

Disclaimer: Our content does not constitute a dermatologist or medical advice. Always spot test new products before applying to your face.

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