Many young adults deal with acne. But if you think it’s only a teenage problem, you’re mistaken. Acne also occurs in adults, and even some infants have acne, too. (1,2) Acne develops when pores or hair follicles become blocked with oil and dead skin cells. (3) Most people complain about acne on their face, but the truth is, you can get acne anywhere on your body. This includes your back, neck, buttocks, shoulders, and chest. (4) Even though many people use the term “acne” to describe all bumps, acne is actually a broad term for different types of bumps. (5) Read on for more information about acne types and symptoms, and learn when it’s time to see a doctor. “Mild acne is the less severe form of acne,” says Yoram Harth, MD, a San Francisco–based dermatologist and chief medical officer of MDacne. “This kind of acne is easier to control and doesn’t usually leave long-term scars.” (6) It’s a different story with moderate and severe acne, though. Moderate acne, continues Dr. Harth, is more noticeable and can leave dark spots and scars, whereas severe acne is the worst form. It’s more difficult to treat and often leaves scars when it heals. (6) It’s important that you learn how to recognize common types of blemishes — as well as their severity — because different types of acne respond to different treatments. Bottom line: If you want clearer skin, you need to know what you’re dealing with. Different types of acne (and their symptoms) include the following:
1. Whiteheads
Whiteheads are a type of acne where bumps develop underneath the skin’s surface. (3) These blemishes are round and small. They’re also covered by a thin layer of skin, resulting in a white or yellowish appearance. (8) Different factors contribute to whiteheads, such as oily skin, hormones, puberty, and the use of cosmetics and moisturizers on your face. (1)
2. Blackheads
Blackheads look similar to whiteheads. But instead of a white bump, blackhead pimples are black or dark. (8) Blackheads aren’t covered by skin like a whitehead. Instead, they rise to the skin’s surface. (3). Exposure to air causes trapped oil inside the pore to turn black, resulting in the bump’s darker appearance. (8) Possible causes of a blackhead include oily skin, an irritated hair follicle, and hormones, as well as skin-care products. Some medications can trigger blackheads. (1)
3. Inflammatory Papules
A papule forms when a pore or hair follicle becomes clogged with bacteria. Your immune system reacts to the bacteria by producing white blood cells, which fight infections. This inflammatory response causes clusters of red, inflamed pimples. (8) Oil and dead skin cells also contribute to inflammatory papules.
4. Inflammatory Pustules
This type of acne is similar to papules. But with a pustule, your body’s inflammatory response causes pimples to fill with pus composed of oil, dead skin cells, and bacteria. These clusters of bumps are red, slightly larger, and sensitive to the touch. (8)
5. Nodules
Nodular acne is a severe form of acne characterized by large, hard bumps underneath the skin’s surface. This type of acne also involves bacteria, and develops when the walls of a pore break down. As a result, bacteria and oil extend deeper into the skin, affecting other pores. Nodules are painful and can cause permanent scarring. (3,8)
6. Cyst
Cystic acne also develops deep underneath the skin, and it’s the worst form of acne, says Harth. It occurs when a severe inflammatory reaction in your pores triggers boil-like, fluid-filled nodules, and is commonly seen in menstruating women. Varying levels of estrogen act at the level of the follicle to cause cysts deep underneath the skin. (3,8) The decision to see a doctor will likely depend on how well you’re able to manage bumps, as well as the severity of your acne. It’s always a good idea to make an appointment for persistent acne that doesn’t clear up. What you think is run-of-the-mill acne could actually be another skin condition like rosacea, keratosis pilaris, or perioral dermatitis. (9) To diagnose acne and determine the type of acne and the treatment you’ll need, your dermatologist will visually examine your skin. (10) For mild-to-moderate acne, start with over-the-counter medicine before you see a doctor. These include topical creams (retinoids) and acne face washes that contain acne-fighting ingredients such as salicylic acid and benzoyl peroxide. (10) Retinoids and retinoid-like drugs prevent clogging of pores, while topical antibiotics kill bacteria on the skin. Salicylic acid facial washes remove dead skin cells by exfoliation. (10) Some of these products may not be safe to use during pregnancy. Check with your doctor to be sure. But what if acne doesn’t respond to self-treatment? According to Harth, you may need something stronger to get rid of stubborn acne. “People with severe acne, and people with moderate acne that doesn’t improve after three months of treatment with an over-the-counter medication, will need to see a dermatologist for oral medication,” he says. Drugs that are powerful enough to treat moderate-to-severe acne include antibiotics, which treat inflammation, kill bacteria, and fight infections. When antibiotics don’t work, your doctor may suggest an anti-androgen agent (a hormonal treatment only available to women and adolescent girls), or isotretinoin, a retinoid used to treat nodular or cystic acne. (10) Depending on the severity of your acne, your doctor may also recommend extraction of a whitehead or blackhead, or a steroid injection. (10) Initially, you might discuss bothersome acne symptoms with your general practitioner — and you doctor might even recommend more effective over-the-counter treatments. If these treatments don’t work and your family doctor suggests seeing a dermatologist, prepare for this visit by writing down any questions or concerns you might have. For example:
What are the side effects of a particular acne treatment?Will medication treat the cause of my acne, or only the symptoms?What are possible causes of acne, and how can I reduce future breakouts?Will the acne medication interact with other medications I take?Are acne medications safe to use while pregnant or breastfeeding?How can I reduce the appearance of acne scars?
If your skin doesn’t improve with self-treatment, don’t hesitate to speak with your doctor. The right treatment not only treats acne, but also protects against new acne.
