Types of Acne: Pictures, Treatments, and More (2024)

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Acne may be noninflammatory or inflammatory. Subtypes within these categories include whiteheads, blackheads, papules, pustules, nodules, and cysts. Treatment depends on what type you have.

Acne types

You may hear the term “breakout” used to describe all forms of acne, but this isn’t always an accurate description. Not all types of acne spread across the skin.

Clogged pores cause acne itself. These may be attributed to:

  • excess production of oil (sebum)
  • bacteria
  • hormones
  • dead skin cells
  • ingrown hairs

Acne is usually associated with hormonal fluctuations experienced during your teenage years, but adults can experience acne, too. About 17 million Americans have acne, making it one of the most common skin conditions among both children and adults.

Identifying which type of acne you’re experiencing is key to successful treatment. Acne may be noninflammatory or inflammatory. Subtypes of acne within these two categories include:

  • blackheads
  • whiteheads
  • papules
  • pustules
  • nodules
  • cysts

It’s possible to have multiple types of acne at once — some cases may even be severe enough to warrant a visit to the dermatologist. If you’re concerned about your acne and don’t already have a dermatologist, you can view doctors in your area through the Healthline FindCare tool.

Read on to learn more about the subtypes of acne and how you can treat them.

Noninflammatory acne includes blackheads and whiteheads. These normally don’t cause swelling. They also respond relatively well to over-the-counter (OTC) treatments.

Salicylic acid is often marketed for acne in general, but it usually works best on noninflammatory acne. It naturally exfoliates the skin, removing dead skin cells that can lead to blackheads and whiteheads. Look for it in cleansers, toners, and moisturizers.

Shop for products containing salicylic acid.

Blackheads (open comedones)

Blackheads occur when a pore is clogged by a combination of sebum and dead skin cells. The top of the pore stays open, despite the rest of it being clogged. This results in the characteristic black color seen on the surface.

Check out: What are the best essential oils for acne? »

Whiteheads (closed comedones)

Whiteheads can also form when a pore gets clogged by sebum and dead skin cells. But unlike with blackheads, the top of the pore closes up. It looks like a small bump protruding from the skin.

Whiteheads are more difficult to treat because the pores are already closed. Products containing salicylic acid can be helpful. Topical retinoids give the best results for comedonal acne. Currently, adapalene (Differin) is available over the counter as a retinoid. If it does not work for you, stronger topical retinoids are available by prescription from your dermatologist.

Shop for topical retinoids.

Read more: Acne treatments »

Pimples that are red and swollen are referred to as inflammatory acne.

Although sebum and dead skin cells contribute to inflammatory acne, bacteria can also play a role in clogging up pores. Bacteria can cause an infection deep beneath the skin’s surface. This may result in painful acne spots that are hard to get rid of.

Products containing benzoyl-peroxide may help reduce swelling and get rid of bacteria within the skin. These can also remove excess sebum. Your doctor may prescribe either an oral or topical antibiotic along with the benzoyl-peroxide to treat your inflammatory acne. Topical retionoids are also an important part of combatting inflammatory papules and pustules.

Shop for products containing benzoyl-peroxide.

Papules

Papules occur when the walls surrounding your pores break down from severe inflammation. This results in hard, clogged pores that are tender to the touch. The skin around these pores is usually pink.

Pustules

Pustules can also form when the walls around your pores break down. Unlike papules, pustules are filled with pus. These bumps come out from the skin and are usually red in color. They often have yellow or white heads on top.

Nodules

Nodules occur when clogged, swollen pores endure further irritation and grow larger. Unlike pustules and papules, nodules are deeper underneath the skin.

Because nodules are so deep within the skin, you can’t typically treat them at home. Prescription medication is necessary to help clear these up.

Your doctor or dermatologist will likely prescribe the oral medication isotretinoin (Sotret). This is made from a form of vitamin A and is taken daily for four to six months. It can treat and prevent nodules by decreasing oil gland size within the pores.

Cysts

Cysts can develop when pores are clogged by a combination of bacteria, sebum, and dead skin cells. The clogs occur deep within the skin and are further below the surface than nodules.

These large red or white bumps are often painful to the touch. Cysts are the largest form of acne, and their formation usually results from a severe infection. This type of acne is also the most likely to scar.

The prescription medication isotretinoin (Sotret) is commonly used to treat cysts. In severe cases, your dermatologist may surgically remove a cyst.

Check out: Anti-acne diet »

Blackheads and whiteheads are the mildest forms of acne. These can sometimes be cleared up with OTC topical medications, such as salicylic acid-based toners or benzoyl-peroxide spot treatments. If they don’t respond to OTC medications, comedones are easily treated with topical retinoids. There is even one type of retinoid, known as adapalene, which is now available over the counter. It’s very effective in clearing blackheads and whiteheads.

Pustules and papules are more moderate forms of acne. These may or may not clear up with OTC meds. Widespread moderate acne may require an oral or topical prescription from a dermatologist.

Nodules and cysts are the most severe form of acne. You have to see a dermatologist to clear up severe acne. Picking or popping nodules and cysts can lead to scars.

Check out: Can honey and cinnamon treat acne? »

It’s important to be patient with your acne treatment. While some treatments may work immediately, you may not see widespread improvement for several months You should also use caution in using too many acne products at once — this can cause dry skin. In response, your pores can create more sebum, then leading to more acne issues.

You should also confirm whether any bumps or swelling are actually the result of acne. There are several skin conditions that cause symptoms similar to those with acne, though they are something entirely different. These include:

  • folliculitis
  • keratosis pilaris
  • milia
  • rosacea
  • sebaceous filaments
  • sebaceous hyperplasia

Seeing a dermatologist is the only way you can receive a full and accurate diagnosis. In some cases, expert treatment may be the only way to fully clear and control your acne.

Shop for OTC acne treatments.

Keep reading: A guide to taking care of your skin »

Types of Acne: Pictures, Treatments, and More (2024)

FAQs

What is the hardest type of acne to treat? ›

Acne conglobata is one of the most severe forms of acne. It involves many inflamed nodules that are connected under the skin to other nodules. It can affect the neck, chest, arms, and buttocks. It often leaves scars.

How do I identify what type of acne I have? ›

Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules. Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face. Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules.

What are the different types of acne and how to treat them? ›

The bottom line

Acne can appear as blackheads and whiteheads, papules and pustules, or nodules and cysts. Comedonal acne and mild-inflammatory acne can be treated with topicals. People with more severe cases of inflammatory acne and almost all people with nodulocystic acne will need pills to clear up their acne.

What is the most severe acne treatment? ›

Isotretinoin is a treatment for severe acne that comes in capsules. It has a number of beneficial effects: it helps normalise sebum and reduce how much is produced. it helps prevent follicles becoming clogged.

What kills acne bacteria fast? ›

Benzoyl peroxide.

This ingredient kills bacteria that cause acne, helps remove excess oil from the skin and removes dead skin cells, which can clog pores. Benzoyl peroxide products that you can buy without a prescription are available in strengths from 2.5% to 10%.

What is the rarest acne? ›

Acne fulminans or acne maligna is a rare skin disorder presenting as an acute, painful, ulcerating, and hemorrhagic clinical form of acne. It may or may not be associated with systemic symptoms such as fever and polyarthritis.

How to tell if acne is hormonal or bacterial? ›

Hormonal acne and bacterial acne look similar, but there are some key differences that can help determine which type of acne is present: Location: Bacterial acne is more frequently found on oily skin regions like the forehead, nose, and chin, while hormonal acne is typically found on the lower face and jawline.

What does bacterial acne look like? ›

Bacteria can inflame the hair follicle and cause lesions that are red, swollen, and filled with pus. Bacterial acne has the potential to scar or cause pigmentation.

How does fungal acne look like? ›

In fungal acne, the spots are red bumps (papules) or pustules (white heads) of a similar size, usually between 1 to 2 mm. They occur in waves and they can be pretty itchy – much more itchy that usual acne spots. Fungal acne can occur anywhere on the body but common locations are: Forehead, temples and frontal hair line.

What is the white stringy stuff that comes out of a pimple? ›

When you squeeze your nose or squeeze a pimple on your nose, there are white substances coming out of the pores, looking like thin strings. It's called the sebaceous filament, which is made up of sebum and dead skin cells that accumulate around hair follicles.

What is the best medicine for all type of acne? ›

Oral medications

For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin).

What is the easiest type of acne to get rid of? ›

Blackheads and whiteheads are the mildest forms of acne. These can sometimes be cleared up with OTC topical medications, such as salicylic acid-based toners or benzoyl-peroxide spot treatments. If they don't respond to OTC medications, comedones are easily treated with topical retinoids.

What do dermatologists recommend for bad acne? ›

How dermatologists treat severe acne
  • Antibiotic + medicine you apply to the acne: This is often the first treatment recommended for severe acne. ...
  • Isotretinoin: This is a potent medicine that attacks all four causes of acne—bacteria, clogged pores, excess oil, and inflammation (redness and swelling).

What is the new treatment for acne? ›

A laser treatment targeting acne at its source

The 1726 nanometer AviClear laser offers patients a safe, drug-free approach to the treatment of acne. This FDA-cleared device targets one of the leading causes of acne by suppressing sebum production from sebaceous glands.

What is the last resort treatment for acne? ›

Isotretinoin Is the Acne Drug of Last Resort

The condition causes hard lumps or nodules to form deep under the skin and manifest on the surface as angry red bumps.

Which is the most severe form of acne? ›

Acne conglobata (AC) is a rare but severe form of nodulocystic acne. It usually presents with tender, disfiguring, double or triple interconnecting comedones, cysts, inflammatory nodules, and deep burrowing abscesses on the face, shoulders, back, chest, upper arms, buttocks, and thighs.

What type of acne is hard? ›

Nodules are hard, inflamed lumps located deep within the skin. Like papules, nodules have no visible head. Nodules are a severe form of acne blemish and can cause skin complications such as dark spots or scarring.

What is the most painful type of acne? ›

Cystic acne is a type of inflammatory acne that causes painful, pus-filled pimples to form deep under the skin. Acne occurs when oil and dead skin cells clog skin pores. With cystic acne, bacteria also gets into the pores, causing swelling or inflammation. Cystic acne is the most severe type of acne.

What is the highest grade of acne? ›

Table 1:
GradeSeverityClinical findings
IMildOpen and closed comedones with few inflammatory papules and pustules
IIModeratePapules and pustules, mainly on face
IIIModerately severeNumerous papules and pustules, and occasional inflamed nodules, also on chest and back
IVSevereMany large, painful nodules and pustules

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