The Most Common Types of Acne

Acne is a common skin condition that affects millions of people worldwide, causing both physical discomfort and emotional distress. To treat and manage acne well, it’s important to understand its various forms. From mild blackheads to severe cystic acne, customizing treatments for various acne types can significantly improve your chances of achieving clearer skin.

Different Types of Acne

While most people are familiar with acne vulgaris, commonly referred to as “acne”, it’s important to recognize that there are many types of acne that can present unique challenges. By tailoring treatments to the specific type of acne, you can reduce redness, scarring, and the frequency of your breakouts.

Acne Vulgaris (Acne)

Acne vulgaris is the most common type of acne. It’s most commonly linked to teenagers but can affect adults. This type of acne occurs when hair follicles become clogged with oil and dead skin cells. Acne vulgaris can appear on the face, back, chest, and shoulders.

Acne vulgaris symptoms include:

• Blackheads: Small, dark spots that appear when the hair follicles get clogged but stay open at the top.
• Whiteheads: Closed bumps that form when clogged follicles have skin over them.
• Papules: Small, red, and painful bumps.
• Pustules: Similar to papules, but the acne will have a white or yellow center.

Hormonal Acne

Hormonal acne is linked to hormone fluctuations commonly experienced during puberty, menstrual cycles, pregnancy, and menopause. It tends to occur along the jawline, chin, and lower face. While this type of acne is most common in women, it can impact men with fluctuating testosterone levels.

Common hormonal acne symptoms include:

• Cyclical breakouts: Acne flare-ups typically appear a week or two before menstruation and improve once it starts.
• Deep, painful cysts: Deep, painful cysts beneath the skin that take longer to heal than regular acne.
• Resistant to typical treatments: Limited success with over-the-counter acne treatments.
• Increased oiliness: Increased sebum (oil) production in the skin leading to clogged pores and increased acne-causing bacteria.

Cystic Acne

Cystic acne is the most severe form of acne. It occurs when a combination of bacteria, oil, and dry skin cells become trapped deep within the pores, leading to inflammation and infection. Cystic acne is typically caused by hormonal imbalances, genetics, and excessive oil production, making it more common in teenagers, women, and adults with hormonal fluctuations

The key symptoms of cystic acne include:

• Large, painful, pus-filled cysts: Deep lesions can be up to two inches in diameter and are often tender to the touch.
• Redness and swelling: Affected areas are inflamed and may feel warm to the touch due underlying infection.
• Acne scarring: Consistent permanent scars, especially when cysts are left untreated, or picked or squeezed.

Nodular Acne

Nodular acne is a severe form of acne characterized by firm, painful lumps that develop deep under the skin’s surface. It’s often caused by excessive oil production, hormonal imbalances, genetics, and the presence of Cutibacterium acnes bacteria. Stress, certain medications, and skincare products can also contribute to its development.

Common nodular acne symptoms include:

• Firm and painful lumps: These deep-seated nodules can be felt under the skin and are typically red or skin-colored. The deep nature of these nodules often leads to permanent scars.
• Persistency: Nodules can last for weeks or even months, making them more challenging to treat than other forms of acne
• Location-specific occurrence: Nodules usually appear on the face, back, or chest in men, and on the jawline or chin in women.
• Lack of comedones: Unlike regular pimples, nodular acne doesn’t usually have a whitehead or blackhead at the center.

Fungal Acne

Fungal acne, also known as Malassezia folliculitis, is caused by an overgrowth of yeast in hair follicles rather than bacteria leading to infection. It develops in warm and humid environments, and can be worsened by excessive sweating, tight clothing, and a weakened immune system. Certain medications, particularly antibiotics and birth control, also play a role in its development.

The primary symptoms of fungal acne include:

• Uniform appearance: Fungal acne typically presents as small, uniform clusters with bumps that are roughly the same size and shape.
• Itching: Fungal acne often causes itching or a burning sensation in the affected areas.
• Fast onset: Fungal acne develops rapidly, sometimes appearing overnight, especially in tropical environments.

Body and Back Acne

Body acne refers to acne that occurs on parts of the body other than the face, such as the chest, arms, and legs. Back acne, or “bacne,” affects the upper back and shoulders. Both acne types are forms of acne vulgaris but prove harder to treat because these areas are hard to reach. Tight clothes, sweat, hygiene products, and oils from the body often make body and back acne worse.

Symptoms of back acne include:

• Comedones and Pustules: Similar to those found on the face, your back acne may include whiteheads and blackheads, as well as acne with a yellow center.
• Inflammatory Lesions: Red, painful, and inflamed bumps and cysts.

Acne Mechanica

Acne mechanica is caused by friction or pressure on the skin, often from wearing tight clothing or equipment. Athletes face a higher risk due to constant contact with sports equipment like helmets and sweatbands. Sweat and long-term exposure to irritants can make this type of acne worse.

Common acne mechanica symptoms include:

• Gradual onset: Usually develops gradually over time with repeated friction or pressure on the affected areas.
• Small, uniform bumps: Small, consistent-sized bumps on the skin. These bumps are flesh-colored or slightly red and can appear in dense clusters.
• Rough texture: Skin may feel rough to the touch due to the number of small bumps clustered together.

Acne Fulminans

Acne fulminans is a rare and severe form of acne characterized by an abrupt onset of painful, inflammatory, and ulcer-like acne nodules. It typically affects teenage boys and is believed to be caused by a combination of factors including increased androgens, autoimmune reactions, and genetics. Acne fulminans can also be triggered by testosterone or anabolic steroid use. Due to the presence of systemic symptoms, it is a serious condition that requires immediate dermatological attention.

The key signs of acne fulminans include:

• Sudden eruption of acne: Primarily affecting the chest and back, these lesions are extremely painful and can lead to severe scarring when they burst.
• Systemic symptoms: Fluctuating fever, joint pain (particularly in the sacroiliac joints), and general discomfort.
• Bleeding crusts: Open sores heal into crusty scabs that can bleed easily.
• Lab work abnormalities: Blood tests typically reveal anemia, elevated white blood cell count, and increased inflammatory markers (ESR and C-reactive protein).
• Weight loss and organ enlargement: Patients may experience loss of appetite, weight loss, and enlargement of the liver and spleen.

Acne Rosacea

Acne rosacea primarily affects adults with fair skin. Unlike acne vulgaris, acne rosacea does not involve clogged pores but instead symptoms are brought on by inflammation. This leads to the classic red appearance rosacea-related acne.

Common symptoms of acne rosacea include:

• Facial Redness: Persistent redness in the central part of the face include the cheeks.
• Pimples: Small, red, and sore bumps.
• Visible Blood Vessels: Damaged small blood vessels show up as red lines on the skin.

How is Acne Diagnosed?

Acne diagnosis typically involves a thorough skin exam. During this process, your provider will closely inspect the affected areas to assess the type and severity of acne lesions. Most providers can diagnose acne by looking at the skin and examining the face, chest, or back for different types of spots, such as blackheads or sore, red nodules.

The severity of acne is often categorized into three levels:

• Mild: Mostly whiteheads and blackheads, with a few papules and pustules.
• Moderate: More widespread whiteheads and blackheads, with many papules and pustules.
• Severe: Numerous large, painful papules, pustules, nodules, or cysts; possibly accompanied by scarring.

When to Seek a Dermatologist for an Acne Evaluation

While most acne can be managed with over-the-counter skincare products and lifestyle changes, the more severe forms should be treated by a skin specialist. If you are experiencing any of the following symptoms, it’s critical to follow up with a dermatology provider.

• Severe or persistent breakouts
• Scarring
• Pain and discomfort
• Systemic symptoms
• Emotional distress

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Clear Acne Breakouts for Good at Schweiger Dermatology Group

Don’t let acne control your life any longer. At Schweiger Dermatology Group, our expert dermatology specialists are dedicated to helping you achieve clear, healthy skin with personalized treatment plans tailored to your acne type. We offer acne treatment and acne scar treatment through Isotretinoin, platelet rich plasma (PRP) therapy, and more. Whether you’re struggling with persistent breakouts, scarring, or complex skin issues, we offer advanced solutions and compassionate care. Contact us today to schedule your consultation and take the first step towards revitalizing your complexion.