Understanding Different Types of Acne and How to Treat Them Effectively

As for skin problems, acne is among the most common in the US, and you can bet it’s probably on your face, but your neck, chest and shoulders probably also suffer.

The acne scars are the result of lesions like pimples and cysts that heal with scar tissue after swelling and inflammation have subsided. These blemishes happen when the pores and hair follicles get blocked with oil, dead skin cells and bacteria, and your body’s natural reaction, called papules, your immune system comes to the rescue.


Papules are the most common subtype of acne. They are small bumps that are slightly raised from the surface of the skin and are not large or deep. Mild papules are slightly raised red bumps while severe papules are larger and larger than mild ones. Pardon me. Anyway, papules are caused when the hair follicles become clogged with too much oil and dead skin cells (also known as comedone). The oil and cells begin to cause irritation on the skin and their contents push up against the overlying skin. This results in either non-inflammatory lesions (blackheads and whiteheads) or inflammatory lesions (papules, pustules, nodules).

Bacteria that sneak inside the blocked pore are the likely culprits; this infection is indicated by redness and inflammation around the pore, another hallmark of acneic lesions. If you pick or pop pustules, they’ll turn into black or brown heads. Pustules are often irritated by the wrong skincare products — including duct tape — and if you try to pop them, they can leave behind scars, especially if you’re genetically prone to forming them. Pustules often respond well to topical medications; given their swelling, a low-sugar diet, stress reduction and noncomedogenic cleansers can also be helpful.


If a pore gets blocked up on the skin’s surface then the result is blackheads. Actually called open comedones, the pore becomes dark and appears as a tiny, speckled pinhead. Blackheads are forms of acne that may appear on the skin of the face, neck, shoulders, chest or armpits.

The black colour is due to sebum produced in the follicles, which contains leftover oil and dead ‘dust’ shed from our bodies. Our bodies melanin activates and oxidises the sebum, forming black pigment in bumps.

Blackheads could be formed due to hormonal changes, sweating a lot and rubbing, and also using products that promote skin pore clogging like make-up. There are also occurrences of people being genetically prone to having blackheads, along with having oily skin naturally. Lastly, eating food that is too sugary or high in dairy or junk food could contribute to blackheads.

Blackheads can be treated with topical retinoids such as tretinoin ( happens to be the active ingredient in younger-looking – Classic Clear DM formula) and tazarotene; retinoids work by normalising cell turnover and preventing overproduction of oil. Beneficial skincare ingredients that kill acne bacteria and work against blackhead formation include benzoyl peroxide (active ingredient in ), salicylic acid and sulphur. Popping blackheads, however, can lead to infection – and damage the skin far more than intended by resulting in post-inflammatory hyperpigmentation (dark patches).


Whiteheads are small whitish or yellowish bumps that appear as small lesions on the surface of the skin around the hair follicles. Whiteheads are considered as mild type of acne lesions as they are not pustule or papule and do not inflame the skin or have redness and swelling, instead they occur when the oil made by sebaceous gland build up within hair follicle as a result of dead skin cell accumulation in the opening of hair follicle that blocks follicle pores; its cause is more common during adolescent time due to hormones androgen production.

Unlike open comedones (blackheads) that tend to clog with excess oil but can usually be treated with a nose strip and/or a store-bought cleanser, closed comedones stay firmly embedded – paradoxically, they have smaller holes at their surface than blackheads, which allows them to clog with bacteria and skin irritants like dryness and redness. If prevention is the name of the game, keep using noncomedogenic products and don’t binge on greasy foods at your next dinner party, since closed comedones also take preference to settling on nose, chin, areas along your shoulders, and chest, where many of our body’s sebaceous glands that secrete oil are concentrated.


Pustules are another kind of pimple – a pore infected with Propionibacterium acnes bacteria, filled with pus and surrounded by red, swollen papules. Pustular acne is considered moderate acne but, if such blemishes cling together in clusters, they may progress to cysts and nodules, which are both grade 3 acne. Don’t pick at them or pop them: that makes things worse because it ruptures the lesions, which may lead to scarring.

You can actually see the centre of the pustule (the whitehead) through the opening of the pore, as opposed to a blackhead, which typically exists deeper under the surface of the skin. Pustules tend to erupt on the face, neck, back, chest or shoulders, and can often be treated with over-the-counter topical products or prescription medications, and may also benefit from a superficial chemical peel. Sometimes, pustules can heal quickly on their own, or stay for weeks or months, but are not truly a cause for concern.


A nodule is a solid lump of material found under the surface of the skin, sometimes close to an organ. The location and size of the nodule often determines the symptom appearance on the patient, and in some cases creates serious health consequences.

Dermatologists also say that drug treatments might reduce your tendency to get them if you are otherwise conscientious about acne care: prescribing a topical medication such as Clindamycin (Cleocin T, Cleoderm, Duac, Perclincla, Clina-Derm, Clistin, Onzac, Neva-Clind, Acné-Clindan, Taro Clindamycin), or oral antibiotics such as Erythromycin (Akne-Mycin, ATS and Erygel).

Nodules occur when a blunt-ended hair follicle-pore becomes closed with a build-up of sebum, bacteria and dead skin debris, causing a skin reaction inflammation and the formation of a full-blown pimple. If your lesions continue despite these medications, your physician may pierce the inflammatory nodule with a needle, inject a corticosteroid capsule, and then remove it. The inflammation will recede immediately and the risk of scarring from inflammation will be significantly reduced. If your acne is very severe, your physician may prescribe isotretinoin (brand name: Accutane®, isotretinoin, isotropin) for a six- to seven-month course of treatment.

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