Various Types of Acne, Severity, and Their Treatments

Acne is a common skin condition that occurs due to several factors.⁽¹⁾ Although acne is common in teenagers due to several hormonal changes, it can occur in adults also.⁽²⁾ However, hormonal fluctuation is not the only factor for the occurrence of acne. Several other factors like dirt, bacteria, sebum and dead skin cells that clog the skin pores also cause acne in adults. Let us look at various types of acne and their treatment.

There are various types of acne; hence, it is important to understand about their presentation and their treatments. Acne is categorized into two types:

• Non- inflammatory acne.⁽¹⁾
• Inflammatory acne.⁽¹⁾

Identifying the right type of acne, aids in effective treatment. These two types of acne are further classified into several sub-categories which include:

Non inflammatory acne refers to the clogged pores in the skin which results into acne that stays beneath the surface of the skin.⁽¹⁾ This is one of the commonest of the various types of acne. The non-inflammatory acne has a pebble like appearance. A lot of white bumps are visible when the skin is stretched.

Treatment for Non-Inflammatory Acne: Treatment of non-inflammatory acne includes over the counter products. These OTC products help in removing the oil in the clogged pores, making the skin pores free; and hence help the individual in getting rid of acne. In certain severe cases, these types of acne may need treatment with prescription medicines and topical adapalene gel, as advised by your doctor.⁽⁵⁾

Non-Inflammatory Acne has 2 sub-types:-

These are one of the various types of acne and their treatments largely also includes over-the-counter products and lifestyle changes. These are present as several tiny black dots on the skin that are called blackheads or open comedones. There won’t be any bump on the skin because the top part of the pore is not closed. This type of acne appears due to the clogged skin pores, mostly due to the dead skin cells and sebum.

Treatment for Blackheads (Open Comedones): Over-the-counter salicylic acid help in dissolving the blackheads and clearing the clogged skin pores. If you happen to have sensitive skin, retinoid shall be the first line of treatment for you instead of salicylic acid. Once the acne settles down, use adapalene gel to settle down the skin and avoid relapse of acne. However, for long term relief from acne, it is required to adapt lifestyle changes like oil free food, regular face cleansing etc.

Whiteheads, also known as closed comedones, are one of the subtypes of non-inflammatory acne. In this type of acne, you can find small bumps on the skin, because the peak of the pores is closed. The cause of this acne is same as blackheads. Unlike blackheads, the treatment for whiteheads is quite complicated. Apart from prescribing salicylic acid, your dermatologist shall also prescribe topical retinoid and adapalene.

If your acne looks red and swollen, then out of the various types of acne, this one is probably inflammatory type of acne. It is true that dead skin cells and excess oil cause acne; however, the role of bacteria is also vital in inflammatory type of acne. This type of acne causes painful bumps on the skin and also creates severe infection under the skin.

Treatments for inflammatory acne mainly includes: Benzoyl Peroxide, which gives better results for inflammatory type acne. Sometimes oral or topical antibiotics are also prescribed, as advised by your doctor.⁽³⁾

Here are the various types of acne and their treatments, under the inflammatory category.

Out of the various types of acne that are caused with inflammation, are the papules. Papules are small areas of swelling that usually appear when the skin pores are affected due to an infection. They look reddish and difficult to touch because of their sensitivity. You can usually find that the skin around the swelling is pink. Treatments for papules include Benzoyl peroxide and antibiotics.⁽³⁾

Pustules are also inflamed and swollen areas, caused due to bacterial infection, but unlike papules, you will be able to see pus formation in the swelling. Though the swelling appears red in color, you can notice whitish or yellowing color on the top. Unfortunately, this is one of the various types of acne that leaves back terrible acne scars on the skin. Treatment of pustules also includes benzyl peroxide and antibiotics.

Nodules, out of the various types of acne, are similar to papules and pustules; however, nodules have their infection roots much deeper under the skin. Hence, in case of nodules, the swelling size is bigger, as compared to the other types of acne. Nodules are very painful when touched due to the excessive pus formation and they are difficult to treat with home remedies because of the deep infection. Treatment of nodules mostly requires prescription medicines, as advised by the dermatologist. The common medication for nodules is isotretinoin. This medicine helps in controlling this type of nodular acne by reducing the size of the oil gland.

Cyst is a painful inflamed type of acne that is usually caused due to clogged skin pores. Generally, the clog happens due to various reasons, but the commonest cause is bacteria, dead skin cells and sebum. You may find it difficult to touch the acne because of the severe infection and pus. Treatment of cysts also needs proper evaluation by a dermatologist. Though there are several medications for this type of acne, the common one is isotretinoin, which is generally prescribed by most of the dermatologists. In few severe cases, your doctor may also prefer to remove the cyst by a surgical procedure.

Various types of acne, based on the severity, can be classified into mild, moderate and severe.

Mild Acne ⁽³⁾: Whiteheads and blackheads are one of the mild types of acne.⁽³⁾ Mild forms of acne may not affect your skin much. You will usually find small pimples and mild skin condition. Your skin may experience small blemishes because of blackheads and whiteheads without any inflammation.

Treatment for Mild Acne: The first line of treatment for the mildest of the various types of acne is a combination therapy of oral medicines, topical ointments and soaps. Retinoid or Benzoyl peroxide is the first line of topical treatment options prescribed by the dermatologists for treating acne.⁽⁴⁾ If the acne is severe, the dermatologists may even add dapsone to be applied topically on the skin and this is a relatively new treatment for acne.⁽⁴⁾

Moderate Acne: Papules and pustules fall in the moderate type of acne.⁽³⁾ You may notice few breakouts on the skin and feel little pain while touching the acne. In some cases, you may experience slight inflammation on the skin because of the numerous blackheads and whiteheads, papules and pustules.

Treatment for Moderate Acne: The first line of treatment followed by dermatologists for treating the moderate type of acne is a combination of topical Benzoyl peroxide and retinoid along with oral antibiotics. If there is no response to this prescription regime then the dermatologists may even prescribe spironolactone⁽⁷⁾ along with topical benzoyl peroxide and retinoid.

Severe Acne: The most severe types of acne are nodules and cysts.⁽³⁾ This type of acne appears not only on the face, but also on chest and neck. You can notice that the pimples are filled with pus and are very painful when touched.⁽³⁾ The worst effect of this acne is the scarring left behind on the skin.⁽³⁾ Severe Acne could also affect your skin very badly if left untreated. So, it is advised to visit your dermatologist without any delay to avoid severe damage.

Treatment for Severe Acne: The first line of treatment for treating severe acne is oral antibiotics followed by oral isotretinoin.⁽⁴⁾ Along with the oral medications, topical Benzoyl peroxide and retinoid are also prescribed.⁽³⁾ If the condition worsens, the dermatologist may even add high dose of antibiotics along with oral isotretinoin and spironolactone.

Now that you are aware of the various types of acne, you can deal with this skin monster better. If there is any swelling or pimples on the skin, then it is important to confirm the diagnosis with your dermatologist. Pimple like appearance can also be noted in some other skin conditions like folliculitis, keratosis, pilaris, rosacea, milia, sebaceous filaments and sebaceous hyperplasia. Once the condition is diagnosed, based on the severity of the various types of acne; their treatment can be planned.

Treatment of acne often consists of the use of medicines as deemed appropriate by the dermatologist. In addition to this, it is necessary to maintain good hygiene, keep the face clean by washing with clear water and using a cleanser, if needed. Nutrition and lifestyle too plays an important role in preventing and managing acne. So, drink plenty of water to keep yourself hydrated, eat nutritious foods with lots of fruits and vegetables. Avoid spicy, oily, junk and processed food for clear skin.⁽⁶⁾ Get enough sleep and perform daily exercises for an acne clear skin.

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• Which Female Hormone Causes Acne?
• Does Water Help Acne?
• Can Stress Cause Acne on Your Back?