What type of acne do you get?
We’re going back to basics this week as I got a request a while back from someone asking for a post about the different types of acne. Much like my ‘simple dinner recipe‘ that I posted on Wednesday, sometimes the things that you take for granted are revolutionary to someone else!
When I think back though, I have to admit it wasn’t that long ago that even I wasn’t quite sure which type of spot a ‘whitehead’ was… and I’m still not even sure if I’ve ever had cystic acne, or if what I’ve had would be more classified as nodules… or maybe even just bad papules…
Either way! Here is your acne types with plenty of pictures:
We’ll start with whiteheads because whiteheads were always the ones that confused me. To me, it made perfect sense that whiteheads would be the smallish red pimples with the “white” pussy “heads” on them. But apparently those are actually called pustules (I find the names kinda revolting, you?).
Anyway, whiteheads are simply clogged pores that are not inflamed. They are clogged below the surface of the skin, so they remain closed and flesh coloured, but create a little bump on the skin.
Then comes blackheads. Blackheads are basically the same as whiteheads – a non-inflamed clogged pore – but the difference is that the top is open and therefore exposed to the air. The air oxidizes the sebum and keratin that’s stuck there and it turns black.
Note: Many people ask me how to get rid of clogged pores like whiteheads and blackheads… I find that lots of leafy green vegetables works a treat. But sometimes these suckers are stubborn anyway, and that is why I like jojoba oil so much. Jojoba oil is the most molecularly similar thing to our own sebum, so it is the best for going into the pores, dissolving the plug and unclogging your skin. Adding some super finely ground sea salt to your facial routine for mild exfoliation is also a good trick.
Here is one you may never heard of probably because it’s not actually a type of acne at all and isn’t even related to an acne breakout – but I’m including it because it’s so often misunderstood. It’s something called sebaceous filaments.
What are sebaceous filaments?
It’s what you think are the blackheads all over your nose and surrounding area. Guess what? Almost everyone thinks they have a blackhead problem all over these areas when in reality, every single human has these and they aren’t clogged pores at all! They are actually just the oil glands in your skin.. the tiny tubes that supply a pore with sebum. The tips of them are what you see dotted around your nose and they often resemble tiny blackheads, although they’re usually lighter in colour, evenly spaced, and smooth to the touch, unlike blackheads.
They are meant to be there, everyone has them, and you can’t make them go away. If you try, they fill right back up.
I just wanted to bring this to light because many people are needlessly stressing out about their perfectly normal, healthy sebaceous filaments when they shouldn’t be!
And now we get into inflamed acne. Inflamed acne is when a clogged pore – a whitehead or a blackhead – gets irritated and becomes inflamed. This mean it swells, turns red, and begins to hurt. (This is why we want to avoid irritating cleansers + your fingers so that a clogged pore doesn’t get inflamed!)
Papules are tender red bumps … usually fairly small, up to a cm in diameter, and somewhat raised. The defining factor is that they are not filled with pus, although they may go on to fill with pus later on and become a pustule.
Absolutely do not squeeze these!!! It’s only going to make matters worse and encourage scarring.
Pustules are your classic zit. Hard, inflamed, and full of pus that has the defining white or yellow centre. May remind you of a volcano. While it’s ever tempting to pop these, please try to refrain. It may not be as harmful to pop one of these vs squeezing some other varieties, especially if it’s waiting to burst… but I still would really not recommend it (from a former chronic popper – trust me).
Read www.stoppickingonme.com. Right now. Go. Do it.
Nodules and Cysts
And now on to severe acne lesions… nodules and cysts. These are large (much larger than papules and pustules) painful bumps under the skin that take quite a while to go away and can create scarring.
Nodules are generally hard and not filled with pus. Cysts are filled with pus and feel like fluid filled sacs underneath the skin.
Inflamed acne happens when a plug ruptures a follicle wall and leaks fluid into the skin, which your immune system then responds to with inflammation. if this rupture happens near the surface of the skin, the result is usually a minor papule or a pustule. If it happens deep within the skin, it’s much more likely to become a serious nodule or a cyst (another great reason to never squeeze your skin… you push the bacteria further into your pores, making it more likely for you to get nodules and cysts. And if you do get them, don’t ever, ever, EVER even dare THINK of squeezing this type of acne, although I hope that goes without saying by now).
Nodules is where I’ve gotten confused about my own acne… in the past, whenever my acne started taking a turn for the worst, I would begin getting a lot of big, hard inflamed spots that don’t have heads on them, mostly around my chin. I have never really known if these are actual nodules or just bad papules, because I’ve never had a ginormous one that has lasted for months. I still don’t know the answer.
Either way, I’ve never gotten one of these since I cleaned up my lifestyle!
Other Types of Acne
There are other types of acne too. The ones I was describing above fall under the name of “acne vulgaris”, which is resoundingly the most common form of it, and the one with the worst name in my opinion! Other types include:
The spots in acne rosacea are basically the same as with acne vulgaris (although usually no blackheads), except it’s also accompanied by a red rash that usually covers the nose, cheeks, forehead, and chin. It primarily affects women over 30 and is probably the most common type of acne after vulgaris.
This is the most severe type of acne with large lesions interconnected across the face and body with lots and lots of blackheads. It is known to cause severe scarring and damage and usually only affects males. It’s rare, don’t worry.
This type of acne can come on very suddenly and usually affects young men, and it different than the others because it is usually accompanied by fever and aching joints. It usually occurs after unsuccessful treatment for acne congolobata.
This type of acne that consists of large nodules and pustules that can be very damaging. It is basically the same as acne fulminans but usually only affects women between ages 20 to 40, comes on suddenly, only affects the face, and usually disappears within a year.
Gram Negative Folliculitis
This is a rare type of acne that consists of pustules and cysts and it usually is a consequence of long term antibiotic use for regular acne, particularly tetracyclines. The cysts usually contain a specific species of bacteria.
Note: Don’t let these scare you. Most of them are very rare.
Mild, Moderate, or Severe?
And then comes the question of what classifies your acne as mild, moderate, or severe. Most people don’t really know what theirs would be classified as, and how they describe their acne tends to be a matter of perspective – the more upset you are about it, the more likely you are to classify your acne as worse than it really is.
So is there a standard grading system?
Well, some classify it according to type of lesion. In other words, if you only have whiteheads and blackheads, that counts as mild. If you have those plus pustules and papules, then you have moderate. If you have those plus cysts and nodules, then you have severe.
I guess that system works, but I don’t think it’s that accurate, personally. I think it’s the sheer volume of inflammation that should classify it.
For example, if you have a few whiteheads and blackheads and one or two inflamed spots, to me that is not moderate – it’s mild. There is hardly any inflammation so moderate seems like a bit of an extreme rating.
On the other hand, like I said before, when my acne was bad, I’m not even sure if I had cysts or nodules. They might have been nodules, but maybe they were just big papules. If they weren’t nodules, I find it ridiculous to say that my acne was merely moderate. The volume of inflammation on my face was far beyond that.
Here is a proposed global acne rating system from the US FDA that seems to work well enough in my opinion:
- Clear, indicating no inflammatory or noninflammatory lesions;
- Almost clear, rare noninflammatory lesions with no more than one papules/pustule;
- Mild, some noninflammatory lesions, no more than a few papules/pustules but no nodules;
- Moderate, up to many noninflammatory lesions, may have some inflammatory lesions, but no more than one small nodule;
- Severe, up to many noninflammatory and inflammatory lesions, but no more than a few nodules.
Okay! So there you go – I hope that cleared up any confusion about what’s what with the different types of acne.
Remember that all types of acne (and all sorts of other health complaints you may have) can be treated with holistic treatment instead of drugs – and this is beautiful because there is far less chance of it coming back in the future, since you are working with your body to heal instead of harming it further.
If you need more more help with this, don’t forget I have my book available – Ultimate Secrets to Acne Freedom.
PS – It doesn’t matter whether you have mild, moderate or severe acne, you’re still beautiful! ♥