Your guide to the 9 most common types of acne

Whether acne is mild or severe, it can cause stress and affect your self-confidence in a number of ways.

Everyone's skin is different and so are the types of acne that people experience. There are a number of types of acne and naturally, each has specific treatment options.

How you treat your acne is often dependent on the type you commonly experience. Fortunately, science has come a long way when it comes to acne treatment options and there is a solution for breakouts, no matter the severity.

Below, we break down the main types of acne, and how you can go about treating these.

Common types of acne and the causes

While acne is used as an umbrella term, there are actually a number of specific types of breakouts that you might have experienced.

Acne vulgaris

Acne vulgaris is a skin condition identified by skin lesions called pimples, spots or zits [1]. This type of acne most commonly affects teenagers but it's important to note that anyone, at any age, can suffer from acne vulgaris.

Acne is commonly found on the face, neck, chest and back but can appear on other parts of the body.

According to the National Institute of Musculoskeletal and Skin Diseases, acne is caused when sebum (oil) and dead skin cells cause blocked pores and clogged hair follicles, which leads to an outbreak of pimples [2].

Acne mechanica

Acne mechanica is a preventable type of acne that is caused by the pressure of friction on the skin [3]. It is commonly seen in athletes and soldiers as a result of tight clothing like straps and belts that rub against the skin.

In recent years, more people have experienced acne mechanica thanks to the rise in mask-wearing due to the pandemic.

Known as 'maskne', this acne is the result of the mask rubbing against the skin and causing irritation to hair follicles, which causes inflammation and in turn, acne [4].

Pustules

Pimples that are inflamed and pus-filled are known as pustules [5]. These pus-filled pimples can come in different sizes and are a combination of sebum, bacteria and dead skin cells that get trapped under the skin.

This causes an infection that results in redness, swelling and sensitivity around the pustular acne breakout.

Nodules

Nodular acne is considered to be a severe form of acne, that results in large, painful blemishes that appear as hard lumps underneath the surface of the skin [6].

These develop when bacteria is trapped under the skin, causing it to become inflammatory. Nodules are also commonly called 'blind pimples' as they lack the presence of a whitehead.

Whiteheads

Whiteheads are breakouts that occur when hair follicles get plugged or clogged under the skin's surface. The name comes from the white bump that appears on the skin, which can often be tempting to squeeze.

Whiteheads can be caused by oily skin, hormones, puberty as well as lifestyle factors like your diet, the moisturiser you use or your makeup.

Cysts

Cystic acne is considered to be one of the most painful and severe acne forms. Nodules and cysts both develop deep under the surface of the skin, but with cysts, your pores become clogged and develop into pus-filled breakouts.

Cysts are often a common experience during one's period thanks to hormone changes within the body.

Blackheads

Blackheads are small clusters of acne that often look like dirt trapped in the skin. In reality, blackheads are actually caused when trapped sebum inside the pore is exposed to air, causing it to discolour.

This gives the illusion of tiny dark spots dotted across your skin.

Blackheads are often caused by an irritated hair follicle, but can also be a reaction to medication, skincare products, diet and hormones.

Comedones

Comedones are small skin-coloured bumps that are mostly found around the forehead and chin [7]. Blackheads and whiteheads are both comedones; a blackhead is considered an open comedone whilst a whitehead is considered a closed comedone.

Excess sebum production — aka oily skin conditions — can cause clogged hair follicles and inflammation, which in turn, causes comedones.

Papules

Inflamed blemishes or lesions are known as papules. They often appear as small pink bumps on the skin and can feel quite sensitive or tender to touch.

Papules often occur in clusters on the skin and can be caused by bacteria-clogged pores or hair follicles.

Inflammatory acne vs non-inflammatory acne

Inflammatory acne is when a blocked pore becomes infected with bacteria [8]. Our immune systems try to fight bacteria, which leads to inflammation and can cause more severe forms of acne like a cyst.

Inflammatory papules, pustules, nodules and cysts are all classified as inflammatory acne. It's also the most common type of acne and can occur almost anywhere on your body, at any age.

Non-inflammatory acne is when the pores become clogged, leading to acne blemishes like blackheads and whiteheads, which are comedones.

What is acne grading?

Acne grading is the classification of breakouts as mild acne, moderate acne or severe acne [1]. The grading of your acne comes down to the number of acne lesions or acne blemishes on your skin.

Mild acne refers to having less than 20 comedones and less than 15 inflammatory acne lesions. Your total acne lesion count should be less than 30. Moderate acne is a total lesion count of 30-125. This includes a range of 20-100 comedones and 15-50 inflammatory acne lesions.

For acne to be classified as severe acne your total acne lesion count exceeds 125 lesions and often includes more than 5 pseudocysts.

How to treat different types of acne

Given each type of acne has different causes, each variety must be also treated differently. Here's how to do it.

Acne vulgaris

Mild forms of acne vulgaris can usually be treated with a combination of products. A good place to start is with a topical benzoyl peroxide product or with a retinoid. Mild and moderate cases can be treated with the help of Software.

We offer personalised acne treatments that cater to your individual skin needs. Our local practitioners are able to create a treatment designed for your acne and will take into consideration the type of acne you're experiencing.

The inclusion of retinoids helps to treat existing acne, while also preventing the formation of new breakouts.

Blackheads and whiteheads

The treatment for blackheads and whiteheads is similar, as you want to try and unclog your pores from excess oil [9].

A good place to start is with a salicylic acid or benzoyl peroxide product to help remove excess sebum and any bacteria on the skin — our Salicylic Acid Foaming Wash works well for this.

To reverse a blocked pore, it's best to try an acne treatment with retinoids, which can help reduce pore size and improve skin texture in the long run.

It's best to avoid using blackhead nose strips as the removal of the blackheads is temporary at best and instead, it often removes all of your sebaceous filaments (comprised of sebum and dead skin cells) leaving your skin exposed to dirt and oil [10].

Acne mechanica

The majority of acne mechanica cases will improve with treatments that include salicylic acid or benzoyl peroxide [11]. These ingredients help to clear away acne-causing bacteria, while also unclogging pores and sloughing away dead skin cells.

Software's Salicylic Acid Foaming Wash is a gentle exfoliator that does all of the above, while also injecting hydration into the skin.

This wash can be used across the body, including on the face, chest and back, and should be used 2-3 times a week for best results.

If you decide to try benzoyl peroxide, be sure to slowly introduce it over a few weeks to minimise any flaking or dryness.

Nodules

Nodules take time to heal because they are often large and deep within the skin. If you're dealing with painful nodules, try applying an ice pack to help reduce swelling and remember to never squeeze a nodule.

As one of the most severe forms of acne, it's best to seek medical help to treat this.

Pustules

Pustules are fairly easy to treat at home with over-the-counter creams or cleansers with benzoyl peroxide. A spot treatment product with salicylic acid may also help.

Software's AHA/BHA Pimple Patches are also handy for treating pustules. These stickers work to remove dead skin cells and unclog the affected pore, control acne-causing bacteria and dry out excess oil in the zit to reveal visibly clearer skin in just two hours.

Plus, they'll stop you from picking at the spot and allow it to heal without being tampered with.

If your pustules are inflamed or hard to treat, it may be time to see a doctor to explore clinical strength options.

Cysts

Acne cysts often contain a mix of pus and blood and can take weeks or months to heal properly. You should never try to extract an acne cyst at home and if it does need to be drained, please pay a visit to your GP for advice on this.

The main treatment methods for cysts are usually oral antibiotics that your doctor can recommend for you.

Papules

Inflamed blemishes or papules should never be squeezed (especially since they don't have a head) and they typically improve with the application of over-the-counter products that contain salicylic acid or benzoyl peroxide.

If you don't see an improvement after a few months and continue to experience papules, you might want to consider a medical treatment to nip the acne in the bud.

Should you squeeze pimples?

The simple answer is no. It might be super tempting to squeeze a big whitehead, but the juice is definitely not worth the squeeze! Not only can squeezing a pimple cause permanent acne scarring but it also heightens your risk of infection from bacteria on your fingers.

Resist the urge and leave the pimple popping to Dr Pimple Popper.

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