Acne is a common skin condition that causes spots, usually on the face or other parts of the body. The skin can also be oily, painful or hot. There are different types of acne, and depending on the type they require different treatments.
Non-inflammatory
Noninflammatory acne doesn’t cause inflammation or swelling. There are 2 types of noninflammatory acne, open comedones (blackheads) and closed comedones (whiteheads).
Blackheads
Open comedones, more commonly known as blackheads, are open bumps on the skin with a dark tip that fill with dead skin and excess oil. The dark tip is not caused by dirt, but light reflecting the clogged follicle. They most commonly affect adolescents but can affect anyone at any age.
They can develop anywhere on the body since there’s sebaceous glands all over the body which can lead to comedones if the glands or follicles get inflamed.
Sebaceous glands can be inflamed because of hormonal changes, higher sebum production, acne-causing bacteria on the skin and irregular keratin formation.
Salicylic acid can help get rid of blackheads by removing dead skin cells to stop the hair follicles from clogging. It can be found in cleansers, serums and lotions.
Azelaic acid can kill microorganisms to help with the swelling. It can be found in serums, creams and face masks.
Retinoids can prevent clogged pores and break up non inflammatory acne but they can cause the skin to peel or change colour. Using moisturiser can help with this but people under the age of 18 shouldn’t use them because they’re too harsh to skin.
Benzoyl peroxides target bacteria on the surface of the skin which can make acne worse. Low concentrations are less irritating to the skin.
If over the counter treatments don’t work, a dermatologist may prescribe other treatments.
Prescription retinoids that are much stronger than normal retinoids.
Chemical peels strip away layers of skin which can help get rid of acne but they can cause scarring, redness and irritation.
Oral antibiotics kill bacteria that worsen acne
Laser skin resurfacing helps slow down the production of sebum by directing short beams of light at the blackheads.
https://my.clevelandclinic.org/health/diseases/22038-blackheads
Whiteheads
Whiteheads, or closed comedones, appear as small bumps similarly coloured to the skin but sometimes have a white or yellow-ish tip surrounded by redness. They usually affect teenagers sand young adults when there’s more hormonal changes but can continue later on in the person’s life. Whiteheads are closed, so oil or dirt can’t enter.
They mainly affect the chin, nose and forehead where there’s a higher concentration of sebaceous glands but can be found anywhere else. They don’t affect people’s physical health but can make people insecure. They can feel tender but not always.
Whiteheads are treated the same ways as blackheads.
https://my.clevelandclinic.org/health/diseases/22039-whiteheads
Moderate inflammatory
Acne spots that swell and cause redness are referred to as inflammatory acne. Acne is considered moderate when there are lots of whiteheads and blackheads as well as papules and pustules.
Papules
Papules are formed when comedones burst and the bacteria spreads in the skin tissue, causing the body to fight the bacteria which inflames it. It appears as a tiny red bump with a diameter of around 5mm. Most papules become pustules, which is when they fill with pus.
Papules can be formed by bacteria, hormonal changes, specifically androgens, and increased oil production from sebaceous glands.
Papules can be treated with the same methods as non inflammatory acne.
Pustules
Pustules aren’t always caused by acne and are sometimes the result of an allergic reaction or infection. They mainly form on the face, back, or chest, usually in clusters. They appear yellow or white in the centre surrounded by redness, a sign of inflammation.
They can form when the pore cavity of a papule fills with pus due to infection.
Pustules can become more serious and might need emergency medical attention.
Signs of a pustule that immediately needs attention:
- fever
- nausea
- throwing up
- diarrhea
- pain in the affected area
- large pustules that cause pain
- leaking fluid
All these symptoms are contraindications as well and the person shouldn’t have makeup applied.
Use warm water with a mild cleanser if pustules are lasting for a while.Applying that with your hands instead of a cloth can help to avoid scrubbing.
Avoiding oil based products will prevent the build up of oil.
Products with salicylic acid, peroxide and sulfur can help but they can irritate more sensitive skin.
https://www.healthline.com/health/pustules
https://www.healthline.com/health/beauty-skin-care/types-of-acne#inflammatory-acne
https://my.clevelandclinic.org/health/diseases/22905-acne-papules
Severe inflammatory
Severe inflammatory acne is more painful and the lesions are deeper under the skin compared to less severe acne. The main types are nodules and cysts.
Nodules
Nodules are hard, large lumps under the surface of the skin that are often painful. Above the skin, they appear as red bumps.
Nodular acne is caused by the Cutibacterium acnes bacteria becoming trapped under the skin and becoming infected and inflamed, making it very painful. They often form alongside cystic acne.
Nodules can’t be treated by yourself and need a doctor’s attention.
Prescription strength benzoyl peroxide might be prescribed to treat nodular acne.
Cortisone injections can shrink the nodule, as well as reduce inflammation and make it heal faster. It’s a steroid injected with a fine needle.
Oral medications can be prescribed to treat nodules, such as accutane or tetracyclines. Birth controls can also help inflammation and clear up the acne.
https://my.clevelandclinic.org/health/diseases/22888-nodular-acne
Cysts
Cysts are painful, pus-filled pimples deep under the skin. They become inflamed when bacteria gets into the pores. They can appear small or large and usually have aa yellow or white tip due to the pus inside. Cystic acne tends to appear wherever there’s a large number of oil glands.
Opening cystic acne increases the risk of bacterial skin infections.
Once the cysts go away, they can leave discolouration that takes a long time to clear up.
Cystic acne is caused when bacteria gets into clogged pores, causing swelling in the dermis.
Hormonal changes and family history can increase the risk of cystic acne.
Because it’s a severe form of acne like nodular acne, over-the-counter treatments are less effective against cystic acne so you should see a dermatologist to be treated.
Antibiotic topical treatments are often prescribed.
Azelaic or salicylic acid can help because they remove dead skin cells and kill bacteria on the skin.
Benzoyl peroxide also helps kill bacteria on the skin.
Retinoids help by producing new skin cells.
Birth control, accutane and cortisone injections can help cystic acne as well as nodular acne.
Draining the pus removes the cyst faster.
https://my.clevelandclinic.org/health/diseases/21737-cystic-acne