Types Of Acne

Acne can affect the skin on your face, neck, back and chest. Skin blemishes that are not inflamed are called comedones, or whiteheads and blackheads. In the inflammatory stage, there are more than a few whiteheads and blackheads on the face.

Inflammation of whiteheads produces pimples and pustules and these can develop into cysts that contain pus.

Variations of acne range from mild forms to more severe and scarring conditions.

Acne Vulgaris – mild or moderate

This is the most common form and lesions that are considered acne vulgaris take the form of blackheads, whiteheads, pustules, nodules and cysts. Acne vulgaris is always associated with the presence of comedones. Acne spots characteristic of acne vulgaris are:

Pustules

A red circle with a white or yellow center is considered an inflamed pustule. These are the most frequent types of spots on the skin of people affected by acne.

Whiteheads

A pore that is blocked and has trapped sebum, dead skin cells and bacteria has a white appearance, hence the name whiteheads. The trapped sebum and bacteria remain below the skin surface. Whiteheads develop more rapidly than blackheads. They look like tiny white spots that can be so small that are practically invisible to the naked eye.

Blackheads

If the pore is partially blocked and part of the sebum, bacteria together with dead skin cells can slowly drain towards the surface of the skin, and the result is blackheads. They are called blackheads because of the pigment of the skin, called melanin that reacts with the oxygen in the air. Blackheads take longer to clear as they are more stable. They last longer as the contents slowly drains towards the surface of the skin.

Blackheads or whiteheads will release their contents to the surface and eventually heal. If the follicle wall ruptures, inflammatory acne can develop. Ruptures occur naturally or when you pick or touch your skin.

Papules

Papules appear when there is a break of the follicular wall. The white blood cells gather inside and the pore is inflamed. Papules are bumps that appear red and inflamed and have no head. It is not advisable to squeeze such a papule, as they may leave scars. By squeezing it, you add to the inflammation and can cause an infection. When white blood cells reach the surface of the skin, a pustule is formed. This is what people usually call a pimple.

Acne Vulgaris – Severe

Inflamed lesions can affect the surrounding skin, engulfing other follicles in their neighbourhood. When such lesions occur, they are called nodules or cysts. Nodules and cysts are present in the severe forms of acne vulgaris.

Nodules

Acne spots that are larger and more painful are called nodular acne and take a long time to cure. These nodules form under the skin surface and can result in scarring. Nodules can flare from time to time, so squeezing lesions of this type is the worst thing you can do. The tissue of the skin is traumatized and it takes months for it to be cured.

A dermatologist can lessen the swelling associated with such nodules and use treatments that prevent scarring, usually in the form of injections with cortisone.

Cysts

Even though it may look like a nodule, an acne cyst is filled with pus and usually has a diameter of at least 5 mm. Such cysts can appear in other areas, such as the arm pit, groin or buttocks. Deeper skin tissue is affected by such cysts. They are also quite painful. Cystic acne commonly produces scarring. A deeper infection may be cause by squeezing such a cyst. The inflammation will also last longer. Again, a dermatologist can use cortisone injections to treat such cysts.

Acne Rosacea

Acne Rosacea may be confused with Acne vulgaris because of the common appearance. Rosacea usually affects people over 30. Looking like a red rash, Acne Rosacea is present on the cheeks, nose, forehead and chin. Not only is the skin reddish, but there are also bumps, pimples and blemishes. The redness is intensified by the presence of blood vessels that become visible on the surface of the skin.

Some persons have no acne comedones associated with Rosacea. Rosacea does not include blackheads. The more severe forms are usually associated with men, while Rosacea is quite frequent in women. This type of acne needs special treatment as it may develop into a condition called rhinophyma, which implies swelling of the nose and growth of excess tissue.

The type of treatment for this form of acne differs from the most common type of acne spots and only a dermatologist can offer expert advice on how to deal with this condition.

Severe Forms of Acne

Acne Conglobata

The most severe form of acne vulgaris is called Acne Conglobata and is prevalent in men. Numerous lesions, sometimes interconnected form at the surface of the skin, which is also covered with blackheads. Severe damage to the skin and even disfiguring scarring are often associated with this type of acne. It can be present on the face, but also on the chest, back and even on buttocks, upper arms and thighs. Acne conglobata can appear between 18 and 30 years of age and it can last for several years. The cause is not known.

Acne conglobata can be treated with isotretinoin (Accutane) but aggressive treatment over a longer period of time might be necessary to control this condition.

Acne Fulminans

Young men may be experiencing an abrupt onset of acne conglobata, with severe nodulocystic and ulcerating acne. Scarring can be disfiguring, but this condition is also associated with fever and aching of the joints. It does not respond well to antibiotics, so oral steroids and isotretinoin (Accutane) are normally prescribed.

Gram-Negative Folliculitis

Treatment of acne vulgaris with antibiotics on a long term basis sometimes results in a bacterial infection manifest in pustules and cysts. Although it is a rare condition, gram-negative folliculitis is present in both men and women. The good news is that is effectively treated with isotretinoin (Accutane).

Pyoderma Faciale (Rosacea Fulminans)

Only females are affected by this severe form of facial acne, usually between 20 and 40 years old. Large painful nodules, pustules and sores are present and can cause scarring. Usually it has abrupt onset, even affecting women who had not suffered from acne before, and it only appears on the face. Although it does not last more than one year, it can be quite destructive. Isotretinoin (Accutane) is prescribed in such cases and even systemic corticosteroids have to be used in more severe situations.