Differentiating Between the Different Types of Acne and How to Treat Each One

Jun 9 2021 - 3:25pm

Portrait of a Young latin girl with acne posing in front of a yellow background

Navigating the world of acne [1] is no easy feat — there are hundreds of products on the market [2] geared toward treating it and endless contradicting advice on what to do if you have it [3]. But before you even get into the nuanced options of treatment [4], you first need to be able to identify the type of acne.

Not all acne is the same, and within one person, multiple different types of pimples can present themselves. They each fall into one of two categories: noninflammatory and inflammatory. Noninflammatory pimples include whiteheads and blackheads, while inflammatory pimples [5] consist of papules, pustules, cysts, and nodules.

To help you distinguish between different types of acne and better understand your skin, we tapped a dermatologist to break down the details of every type of breakout, ahead.

What Are Whiteheads?

Whiteheads, otherwise known as closed comedones, are one of the most well-known types of acne and occur when oil and dead skin cells clog a pore. "They are covered by a thin layer of skin," David Lortscher [6], MD, board-certified dermatologist and CEO and founder of Curology, told POPSUGAR. "Because of this, the contents of the whitehead are not exposed to air, so they appear white or yellowish." Whiteheads are considered to be noninflammatory acne.

Because they're close to the surface, whiteheads typically respond well to topicals, such as over-the-counter treatments. Using a benzoyl-peroxide cleanser, like CeraVe Acne Foaming Cream Cleanser [7] ($15), often improves the issue. The American Academy of Dermatology Association also recommends trying a retinoid [8], like Acne Treatment Differin Gel [9] ($15), which can be bought without a prescription. Extractions are also an option, but they should only be done by a professional like a dermatologist or aesthetician.

It's important to note: "There is no one-size-fits-all treatment for acne," Dr. Lortscher said. "What works for one person might not work for someone else."

What Are Blackheads?

Another form of noninflammatory acne are blackheads, aka closed comedones. They occur the same way as whiteheads — by dead skin cells and oil being trapped under the skin — except they don't present as a raised bump and instead appear as dark dots in the skin. "Oxidation of the trapped substances makes the pimple look black," Dr. Lortscher said.

The treatment for blackheads is the same as whiteheads — try a benzoyl peroxide cleanser and look for other products that will gently exfoliate away dead skin cells to keep them from getting stuck in your pores, like the Tula Deep Exfoliating Blackhead Scrub [10] ($32).

What Are Papules?

When it comes to the inflammatory category of acne, the pimples become a bit harder to differentiate at home. "Papules are tender bumps with redness and swelling caused by inflammation," Dr. Lortscher said. "They are usually less than 5mm." These tiny bumps can feel hard to the touch and can be grouped together in large clusters.

One of the best ways to treat papules is by using a benzoyl-peroxide or salicylic-acid cleanser, like the Neutrogena Oil-Free Salicylic Acid Acne Fighting Face Wash [11] ($7), but if the issue persists, you should see a dermatologist.

What Are Pustules?

Next, you have pustules, another form of inflammatory acne. They are "inflamed lesions with a visible central core of pus and are usually raised about 1-5 mm." They can be mistaken for whiteheads due to their white core, but they're larger in size.

It can be tempting to try to pop a pustule to get rid of it quicker, given that it's filled with white or yellow fluid and near the surface of the skin, but this can potentially cause scarring. It's best to incorporate a benzoyl-peroxide or salicylic-acid cleanser into your skin-care routine twice a day.

"Hydrocolloid bandages, such as Curology's Emergency Spot Patches [12] ($2 as a subscription add-on), are helpful in covering the lesions overnight, or up to 24 hours, and help draw out the contents of the lesion and speed healing," Dr. Lortscher said. Acne patches are also great if you have a habit of picking at your zits.

What Are Cysts?

Cysts, or cystic acne, have a reputation for being particularly stubborn and challenging to treat, not to mention painful. That's because Dr. Lortscher said they're "highly inflamed" and deep under the skin. Cystic pimples also have a tendency to leave behind scarring.

Because cysts are deep under the skin, they typically don't respond well to OTC topical treatments. "You'll do best to see a dermatologist in person or online via telemedicine," Dr. Lortscher said. "For acne that does not respond to the usual treatment, oral antibiotics [13] may be used." Common oral acne medications include spironolactone and Isotretinoin (formerly known as Accutane). If a cystic zit pops up right before an important event, cortisone injections [14] administered by a doctor can also help clear the breakout fast.

What Are Nodules?

The last pimples in the inflammatory category are nodules. "[They're] large, firm, reddish bumps that extend deeper than a papule and are often painful," Dr. Lortscher said. These are the types of pimples that are impossible to pop.

Similar to cysts, nodules don't typically respond well to topical treatments, so seeing a dermatologist is the best route.

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