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Types of Acne

Acne Vulgaris, the most common form of acne, include several forms of lesions, whiteheads, blackheads, papules, pustules, nodules, and cysts.

Mild to Moderate Acne Vulgaris is characterized by Whiteheads, Blackheads, Papules, and Pustules:


Whiteheads are a result of completely blocked pores, trapping sebum (oil), bacteria, and dead skin cells; causing a white appearance on the surface. Whiteheads are the direct result of skin pores becoming clogged with sebum (naturally occurring oil) and dead skin cells. Whiteheads are symptoms of acne vulgaris and consist of pores blocked with sebum.


Blackheads (formally known as open comedo, or plural comedones) are yellowish or blackish bump/plug on the skin. A popular myth about blackheads is that they are caused by dirt collecting in pores and can be washed away. However, the true cause of blackheads is excess oils and make-up, facilitating the multiplication of bacterium (Propionibacterium acnes). Keratin and modified sebum are found within these bumps which darken, causing it to resemble dirt.

No infection is present in whiteheads, infected pores are pustules, papules or nodules- these terms are frequently confused.


Papules are inflamed, red, tender bumps with no head. Do not squeeze a papule. It will do no good, and may exacerbate scarring.


A pustule is similar to a whitehead, but is inflamed, and appears as a red circle with a white or yellow center. Pustules are your garden variety zits.

Severe acne vulgaris is characterized by nodules and cysts:


As opposed to the lesions mentioned above, nodular acne consists of acne spots which are much larger, can be quite painful and can sometimes last for months. Nodules are large, hard bumps under the skin’s surface. Scarring is common. Absolutely do not attempt to squeeze such a lesion. You may cause severe trauma to the skin and the lesion may last for months longer than it normally would.


An acne cyst can appear similar to a nodule, but is pus-filled, and has been described as having a diameter of 5mm or more across. They can be painful. Again, scarring is common with cystic acne. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last much longer than if you had left it alone.

Acne Rosacea can look similar to the aforementioned acne vulgaris, and the two types of acne are sometimes confused for one another. Rosacea affects millions of people, most of whom are over the age of 30. It appears as a red rash which is normally confined to the cheeks, nose, forehead and chin. The redness is often accompanied by bumps, pimples, and skin blemishes. Blood vessels may also become more visible on the skin. Blackheads are not a part of rosacea. It is more prevalent in women, but often more severe when found in men. Left untreated, it can cause swelling of the nose and the growth of excess tissue, a condition called rhinophyma. Treatment is often different for rosacea than for acne, and it is important that you consult a doctor. The doctor can help differentiate whether you are exeriencing acne vulgaris or rosacea.

Acne Conglobata:

This is the most severe form of acne vulgaris and is more common in males. It is characterized by numerous large lesions, which are sometimes interconnected, along with widespread blackheads. It can cause severe, irrevocable damage to the skin, and disfigured scarring. It is found on the face, chest, back, buttocks, upper arms, and thighs. The age of onset for acne conglobata is usually between 18 and 30 years, and the condition can stay active for many years. As with all forms of acne, the cause of acne conglobata is unknown. Treatment usually includes isotretinoin, and although acne conglobata is sometimes resistant to treatment, it can often be controlled through aggressive treatment over time.

Acne Fulminans:

This is an abrupt onset of acne conglobata which normally afflicts young men. Symptoms of severe nodulocystic, often ulcerating acne are apparent. As with acne conglobata, extreme, disfigured scarring is common. Acne fulminans is unique in that it also includes a fever and aching of the joints. Acne fulminans does not respond well to antibiotics. Isotretinoin and oral steroids are normally prescribed.

Gram-Negative Folliculitis:

This condition is a bacterial infection characterized by pustules and cysts, possibly occurring as a complication resulting from a long term antibiotic treatment of acne vulgaris. It is a rare condition, and we do not know if it is more common in males or females at this time. Fortunately, isotretinoin is often effective in combating gram-negative folliculitis.

Pyoderma Faciale:

This type of severe facial acne affects only females, usually between the ages of 20 to 40 years old, and is characterized by painful large nodules, pustules and sores which may leave scarring. It begins abruptly, and may even occur on the skin of a woman who has never had acne before. It is confined to the face, and usually does not last longer than one year, but can wreak havoc in a very short time.

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