Having acnes can be quite frus trating. These pesky, painful and unpleasant pimples can affect all ages, races and sexes. There are many different types of acne, understanding the root cause and how each are displayed in the skin will help you know which type you are dealing with. It will be clear-cut in some cases, but other times it may be a process of elimination. The primary types are explained here.

Hormonal acne (Acne vulgaris). This is the most common type of acne, primarily among adolescents. It is characterised by comedones, papules, pustules, nodules, cysts, and sequelae, such as pitted or hypertrophic scars. Acne vulgaris is caused by Propionibacterium acnes (P. acnes). It typically allows for good extractions; however, the right enzymes, AHAs and other exfoliating ingredients, can help do most of the work. A quality at-home system and lifestyle changes will be important to remedying this type of acne.

Cystic acne. This type is typically triggered from an excess build-up of sebum and dead skin cells. This combination blocks oxygen from reaching the cells and increases the P. acnes bacteria. Due to the tightness of the keratin in some cases, it will start to grow underneath the skin. Cystic acne can become painful and infected if you are not careful. Typically these lesions are not extractable and forcing this can lead to scarring, which is why using ingredients that help draw bacteria to the surface is recommended. Clays, for instance, are a great partner with cystic acne. Exfoliation and professional treatments are crucial to achieving results.

Acne cosmetica. This type of acne is caused or stimulated by cosmetics. These are usually indicated by small and slightly raised red lesions, whiteheads and occasional pustules. To avoid getting this type of acne look for products labelled as “non-comedogenic”, which means they do not clog the pores. This can usually be corrected by improvising a home regimen focused on cleansing and protecting.

Acn e mechanica. Constant pressure, friction or repetitive physical trauma to the skin such as rubbing from hats, phones, sunglasses, etc, causes this type of acne. Professional enzyme treatments and a home-care regimen that includes a blemish serum and all-purpose cleansing pads will help to restore skin health.

Acne rosacea. This primarily impacts adults and is more likely to occur in women than men. It is characterised by erythema with telangiectasia (small, dilated blood vessels near the surface of the skin). Lesions tend to follow the blood vessel dilation with papules and pustules forming in the centre of the face, cheeks and chin. They are typically large and painful. Acne rosacea is genetic, chronic and progressive. Eliminating irritants such as excessive spicy foods, caffeine, tobacco, alcohol, saunas and stress will support the healing of this type of acne; professional peel treatments and consistent home care are also essential.

Pseudofolliculitis barbae. This is more common in men and occurs when coarse, curved hair penetrates into the skin before it leaves the follicle (also known as ingrown hairs). Salicylic acid is a key ingredient to help prevent the formation of this type of acne. Mandelic acid is also a great alternative for a gentler approach. For treatment, focus on exfoliation — both physical and chemical.

TYPES OF ACNE LESIONS

Along with the different types of acne, there are also varying types of lesions. These will typically fall under one of two categories: in ammatory and non-in ammatory.

Non-in ammatory acne. Non-in ammatory lesions are considered comedones and may be closed or open. Closed comedones, or whiteheads, are small, plugged follicles that are not exposed to the skin. Open comedones, or blackheads, occur when the follicle is dilated and the debris within becomes oxidised. While there is typically no infection or in ammation associated with these lesions, they can enlarge the pores and cause other issues on the surface of the skin if left untreated.

In ammatory acne. Also referred to as cystic acne, in ammatory acne occurs when the cell wall ruptures and bacteria and sebum seep into the surrounding area to cause infection below the surface. Once the pore becomes clogged, the immune system sends white blood cells to the site to get rid of the infection. The types of in ammatory acne includes: pustules, papules, nodules and cysts. Papules and pustules are often referred to as pimples and are the result of increased trapped oil and bacteria inside the pore. Nodules are pockets of sebum that become hardened; they are solid to the touch and can be painful. Cystic nodules are very painful as they occur at the deepest level. This type also has the most potential for scarring.

Michelle Vernon

Medical Aesthetician Phlebotomist CME CLO CLHRP CMA CEO of Body Studio Skincare

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