Different Types of Acne: 6 Types & How To Treat Them

Non-inflammatory acne is a milder form of acne that does not involve redness, swelling, or pain. The pimples that form do not contain any pus. It is commonly called comedonal acne as it is characterised by the presence of ‘comedones’, also known as blackheads and whiteheads.

1. Blackheads (open comedones)

Blackheads, also known as open comedones, form on the skin when oil plugs the opening of a pore. They turn a dark brown colour when melanin, the natural pigment in the skin, reacts with oxygen, giving them their distinctive blackhead appearance.

Blackheads commonly occur on and around the nose, chin, and back.

Keratin plugs

Sometimes blackheads can be confused with keratin plugs, which also cause bumps on your skin. Keratin plugs are usually white, pink, or skin colour rather than black. They develop when your hair follicles get clogged with dead skin cells and a protein called keratin.

Keratin plugs are not spots and do not require treatment. You should not try to pop them but if you’re unsure whether your spots are keratin plugs or something else, and they do not go away on their own, speak to your doctor for a diagnosis.

2. Whiteheads (closed comedones)

Whiteheads, or closed comedones, occur when an oil and dead skin cell plug develops below the opening of a hair follicle. They can range in colour from flesh-coloured to creamy white, but they cannot be easily popped.

Whiteheads are commonly found on the forehead, chin, and cheeks.

How to treat non-inflammatory acne

The most effective way to treat non-inflammatory acne is to treat the root cause which is an overproduction of sebum (oil) by the sebaceous glands. Treatments range from over-the-counter and prescription medications to medical procedures depending on the severity.

Over-the-counter treatments

Over-the-counter treatments can be bought from most UK pharmacies without a prescription. Treatments for non-inflammatory acne include:

• salicylic acid cleansers – exfoliates and penetrates pores to reduce blockages and prevents comedone formation
• benzoyl peroxide like Acnecide – often available as a gel or cream that works by unclogging pores, clearing comedones
• topical retinol – promotes cell turnover to stop pores becoming clogged and commonly available as creams and serums

Prescription medications

Although over-the-counter treatments are often a good place to start, they are not always effective, especially in more severe non-inflammatory acne cases.

If you have moderate to severe comedonal acne, you may need to see a doctor to discuss prescription-strength topical medications.

At Superdrug Online Doctor, we can provide the following treatments for non-inflammatory acne:

• Differin Gel or Differin Cream – these contain adapalene, a type of topical retinoid that increases the rate at which cells are produced, reducing inflammation and oiliness to prevent spots from forming and reducing existing symptoms
• Acnecide – a benzoyl peroxide containing gel that is applied a maximum twice a day to kill acne-causing bacteria and reduce sebum production
• Finacea gel or Skinoren cream – gels and creams that contain azelaic acid, a topical treatment that reduces keratin production, exfoliates skin, and unblocks comedones and prevents new ones forming

Surgical treatments

For severe cases of non-inflammatory acne, surgical treatments may be needed if topical and prescription medications are not effective.

Some of the surgical treatments that can benefit comedonal acne include:

• chemical peels – a chemical solution is applied to the skin to remove the top layers, encouraging the growth of smooth skin and reducing comedone growth
• microdermabrasion – physically exfoliates the skin to remove dead skin cells to unclog pores and remove comedones
• cryotherapy – liquid nitrogen is applied to the comedones, freezing them for removal
• comedone extraction – a comedone extractor is used to physically remove blackheads and whiteheads from the skin

Lifestyle changes to prevent non-inflammatory acne

The best way to approach comedonal acne is to prevent it completely. Some of the lifestyle changes you can make include:

✓ a good skincare routine, washing your face once in the morning and once in the evening, using non-comedogenic products that will not block pores (and making sure not to overwash)

✓ a skin-friendly diet, lowering your intake of high-sugar and dairy foods while increasing your intake of fruit and vegetables

✓ relaxation techniques to manage stress

✓ regular exercise to promote healthy skin and regulate hormonal balance

✓ drinking plenty of water to stay hydrated

✓ applying sunscreen to your face whenever you’re exposed to the sun

Inflammatory acne causes red, swollen, painful lesions, often on the face, but can also affect the neck, back, chest, and shoulders.

Inflammatory acne is characterised by deep lesions called pustules and papules. It’s caused when pores become blocked with excess sebum, dead skin cells, and bacteria, triggering inflammation.

3. Papules

Papules are small, raised, red bumps that are caused by an infected hair follicle. They’re usually 2 to 5mm in diameter and feel solid with the skin surrounding them appearing swollen, red, and tender to touch.

Papules are commonly found close to comedones (blackheads and whiteheads) where the skin has previously been irritated.

4. Pustules

Pustules are small, red, pus-filled pimples that are similar in size to papules. They look and feel inflamed.

How to treat inflammatory acne

Inflammatory acne can be managed with a combination of over-the-counter and prescription medications, and lifestyle changes. Treating inflammatory acne will reduce its severity and lower the risk of complications.

The table below shows some of the common treatments available:

Some of the natural things you can do to manage inflammatory acne, include:

• dietary changes – choose foods that have a low glycaemic index (GI) like apples, lentils, chickpeas, oranges, and barley over high GI foods that can increase the risk of acne outbreaks
• skincare routines – adopt a healthy skincare routine that means you wash your face no more than twice a day, avoid harsh products and scrubs, and use non-comedogenic products that can prevent pores getting blocked
• manage stress – stress increases acne severity, so practicing mindfulness and relaxation techniques can help prevent acne outbreaks getting worse
• avoid squeezing and picking spots – squeezing and picking spots can spread acne-causing bacteria around your face and body and lead to complications such as acne scarring

Severe acne is characterised by many large, painful papules, pustules, nodules, or cysts, which often cause acne scarring.

Some research shows that severe acne is less common, affecting 1% of adult women and teens, and 3% of adult men.

5. Nodules

Nodules are large, hard lumps that appear under the skin’s surface and are tender, inflamed, and painful. Nodules can cause dark blemishes and scarring.

6. Cystic acne

Cystic acne is a severe, inflammatory form of acne that develops when cysts form under the skin. These can look like boils, can be red or white, and are filled with pus. Cystic acne can be painful and is prone to causing scars.

How to treat severe acne

Because this type of acne can cause severe symptoms, over-the-counter treatments are not usually effective. Instead, prescription treatments are the preferred treatment for severe acne, including: