Acne. Most of us deal with it at one point or another in our lives, but did you know there's more than just 2,3, or even 5 kinds? That being said- do you know exactly what kind you have? It can be very easy to assume, that’s a white head or I KNOW this is a cyst when indeed it's something else. Though it may seem simple, identifying the type of acne you're dealing with is the first step to properly treating your breakouts. Blackheads, which are very different from cysts, are not treated in the same manner (and they shouldn’t be). And frighteningly enough, sometimes we mistake other skin conditions for acne and start treating them as such- making matters worse!
is it acne?
That being said, the very first step is determining whether or not you're actually dealing with acne. Take a look at the list below and the symptoms or skin concerns that come along with each one, you may be surprised to find out you suffer from these instead of, or, in addition to acne. Some common skin conditions that are mistaken for acne are:
The issue with treating these skin conditions as acne is... That it can actually cause acne looking lesions! Confusing, right? Many times, treating rosacea or milia with acne products can cause redness, irritation, swelling, and even blistery looking bumps that are easily mistaken as acne. These conditions need gentle, effective moisturizers or prescription products from your dermatologist.
the two main types of acne
Acne typically gets broken down into two main categories, inflammatory and noninflammatory.
Non-inflammatory acne refers to blackheads and whiteheads. These are open and closed comedones. A clogged hair follicle is the basic definition of a comedone. When a hair follicle gets clogged with excess skin cells, oil, and debris you have a comedone. A clogged comedone then becomes a visible blackhead or whitehead, with blackheads being an open comedone and whiteheads being a closed one. Non inflammatory acne is the least severe form of acne and the most easily manageable.
Blackheads: One of the most common types of acne, effects a range of ages from teens to people well into their adulthood. Blackheads occur when there is an open, clogged comedone. Because the clog is open, it is exposed to air. Many people falsely believe blackheads are dirt but they're actually the oxidation of oil and sebum, causing it to look black. Blackheads are often caused by the overproduction of oil, skin cells ineffectively shedding, hormonal changes, or taking certain drugs that affect androgens.
Treatment: Luckily blackheads can easily be treated using over the counter creams like salicylic acid and benzoyl peroxide. One of my favorite natural treatments for blackheads is jojoba oil, because it mimicks the skins natural sebum it gently unclogs the pore and removes the blackhead. If you find these are not strong enough for your blackheads, a dermatologist may be able to prescribe tretinoin, tazorac, or adapalene. Blackheads can also be extracted by a licensed professional or at home using the .
Whiteheads: Another common type of acne, whiteheads, occur when a comedone is clogged and closed. Unlike blackheads, whiteheads have a thin layer of skin covering the hair follicle that is plugged with dirt and oil. Many people confused papules and pustules as whiteheads but whiteheads are actually fairly small in size, not painful, nor are they inflammed. Whiteheads appear similar to blackheads as a tiny white bump (or bumps). Whiteheads are caused by hormonal changes, genetics, stress, and lifestyle.
Treatment: One of the most vital things you can do when it comes to whiteheads is maintain a skincare routine (even when your skin is good). One of my personal favorite skincare regimens is the t, great for blackheads, whiteheads, and scarring the starter kit comes with everything you need to get your skin healthy, blemish free, and radiant!
Whiteheads start under the surface months in advance so practicing things like washing your pillowcase twice a week, washing off your makeup every night, making sure you get plenty of sleep, and drinking tons of water can go a long way. Once they sprout their ugly heads, whiteheads are best naturally treated with tea tree oil, aloe vera, witch hazel, and apple cider vinegar. A few over the counter products you can try are benzoyl peroxide, salicylic acid, or retnoid creams. If these are still not strong enough, prescription retinoid creams should be considered with the guidance of a dermatologist.
There are four types of inflammatory acne; nodules, pustules, papules, and cysts. Inflammatory acne is largely due to how the body's immune system responds to "regular" acne. It can also be due to irritation (such as irritating product ingredients), genetics, hormones, diet, lifestyle, and the list goes on! Inflammatory acne is typically defined as moderate to severe acne and will typically need professional treatment to see results.
Nodules: Nodules are large, inflamed, tender breakouts. Nodules are much more serious than your typical blackhead or whitehead. Unlike normal blemishes, they take a long time to heal- anywhere from a few weeks to months. Nodules feel like hard knots under the skin and usually stay under the skins surface though sometimes they will develop a whitehead. Nodular acne can affect your face, back, chest, and even buttock!
Pustules: Pustules are small bumps on the skin that contain white pus, surrounded by redness and inflammation. Pustules are commonly found in clusters within the same area. Typically caused by hormonal imbalances or changes in the body, pustules are common for teens and young adults to experience. Pustules occur from allergic reactions to food, environmental allergens, and acne (the most common cause). The skin around the bump is inflamed, when the infection continues to spread the bump becomes hard and painful, resulting in a cyst.
Papules: Papules are inflamed acne lesions. Unlike pustules, papules are not filled with puss. Papules are hard, clogged pores that are tender to the touch. They are usually pink in color. Papules oftentimes cluster together to form a rash. Papules do not have white or blackheads, instead they're closed red bumps. Papules are usually caused by eczema, dermatitis, and chickenpox.
Cysts: Perhaps the most well-known type of inflammatory acne, cystic acne, is when the skin is clogged with bacteria, sebum, and dead skin cells. These occur the deepest below the surface and are the biggest in size. Cysts are large swollen red and white bumps that don’t have a head and are typically due to a severe infection. Cysts should be treated promptly and aggressively as they're the most likely to scar. You should never try to pop a cyst as it will spread the infection deeper below the surface, and another cyst is likely to pop up in its place or nearby.
Treatment for inflammatory acne: Because severe acne is more closely tied to things like hormonal imbalances, genetics, and food intolerances it's important to seek out treatment from a dermatologist right away. I'm a huge fan for natural and non-toxic skincare treatments, but the truth is a majority of the time over the counter treatments simply won't cut it. Not saying it's impossible but using countless over the counter treatments will leave you feeling exhausted, defeated, and penniless. The longer you put off treatment, the more scarring you risk.
For some its related to diet or digestion issues, others have hormonal problems, and lastly a small group may just be using the wrong products- it could take you a while to determine the deeper root cause. In the meantime, a dermatologist can work with you to decide what the best course of treatment is; a majority of the time prescriptions will be tried first, then antibiotics, then as a last resort Accutane (or roaccutane). Severe inflammatory acne and scarring can lead to depression, social anxiety, and other psychological problems, that’s why it's important to treat it as soon as possible.
more rare types of acne
A few other less common types of acne are acne fulminans, acne mechanica, acne rosacea, pyoderma faciale, and acne conglobata. Those who suffer with these types of acne should seek the care of a dermatologist as soon as possible. These types are rare, can be difficult to treat, and may result in permanent facial scarring if treatment is not sought out immediately.
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Kali Kushner, known as the Instagram alias myfacestory, is a natural beauty advocate in the greater Cincinnati area who is passionate about using organic skincare and holistic remedies to heal acne from the inside out. Her dedication lies in her own chronic acne struggles as she continues to restore herself while helping those around her.