Guide: Different Acne Types, And How To Treat ‘Em

There are a ton of options and ways to treat acne, ranging from creams, gels, and washes to prescriptions and procedures. But before you pick a treatment, the first step is to identify the kind of acne and how bad it is.

Ever since this pandemic has transformed me into a certified hermit, I’ve had more time than ever before to fuss over my skin, and if you’re anything like me, someone who loves a good challenge, extracting blackheads, ingrown hairs or popping pimples has become an art form at this point (you can judge, I don’t care). Obviously by now, everyone’s aware there are many different types of acne, and sometimes it can be hard to identify them and henceforth, know how to proceed with treatment. Luckily for you, I’ve already researched and compiled the information, so all you have to do is get your mind ready to receive this information. 


Before we begin, you have most likely heard someone warning you not to pick your pimples at some point in your life (to which you probably didn’t listen), but here I am again to nag you, do not pop your pimples.

It truly is the best thing you can do for your skin, to simply not make it worse. For most people, there are a ton of options and ways to treat acne, ranging from creams, gels, and washes to prescriptions and procedures. But before you pick a treatment, the first step is to identify the kind of acne and how bad it is.

Let’s jump right in…

Comedones (Blackheads & Whiteheads)

Comedones are your regular, run-of-the-mill, non-inflammatory acne caused by hair follicles becoming clogged with oil, dirt, and dead skin cells. Blackheads and whiteheads fall into this category: Blackheads are essentially the top part of a comedone, while the top of the pore is open, the rest of it is clogged, resulting in the black color seen on the surface. Whiteheads are “closed comedones”, where the top of the pore is closed up. It looks like a small white bump on the skin. A lot of times, comedones result from using heavier or thicker makeup products (aka “comedogenic” makeup, which is makeup that cannot penetrate a pore). So, a good prevention tactic is to switch your makeup products with something more breathable (“non-comedogenic”). However, unless you have the proper tools and know-how, blackheads and whiteheads are still best extracted at your go-to facialist, because if you don’t properly clean out the pore, they’ll just grow back with a vengeance. If it’s not a facial day for you, using over-the-counter drugs that contain glycolic or salicylic acid can also do the trick. These acids exfoliate the skin, remove dead skin cells and decongest your pores! But, do not go overboard – using glycolic or salicylic acid two to three times a week is all you need, because you don’t want to overstrip or overdry the skin, doing so only causes more -you guessed it- breakouts. 

Cystic

Cystic acnes are more serious and harder to treat, and oftentimes indicators of hormonal issues. They are usually chronic, where the skin itself looks red, inflamed, and feels painful upon contact. When it comes to cystic acne, we highly recommend booking an appointment with a trusted dermatologist, because performing blood tests are sometimes necessary in order to identify whether hormonal imbalances are at play. Also, you definitely want to make sure you are using non-comedogenic skincare products that promote healing, nurturing, and anti-inflammatory purposes.  

Nodules/Keloidal

Nodule and keloidal acnes are probably the worst, most severe type, and are recognizable from their round appearance under the surface of the skin. They live deep inside the pore and are often painful, with or without touch. You should NEVER, EVER squeeze nodules or keloids as they can burst beneath the skin and cause a bad infection. Because they live below the skin’s surface, using acids to strip and dry out the acne simply won’t work. Much like cystic acne, you need to call your dermatologist, because you will need prescription drugs and anti-inflammatory skin products to treat breakouts of this nature. 

Bacterial

Bacterial acne is mostly found in the T-zone (a.k.a. forehead, chin, nose, and upper lip). This is usually caused by sweat, dirt, and overproduction of oil and sebum. The best treatment is to apply some healing oils, such as argan or tamanu oils, along with hot washcloths every night prior to cleansing. If you popped one of these pimples, use products with benzoyl-peroxide to help reduce swelling, remove excess sebum and get rid of bacteria within the skin. However, make sure you are using non-drying cleansers, and definitely no harsh exfoliators allowed!!! Drying out the skin with an overuse of acids and alcohols can only lead to more bacterial acne. 

Mechanica

Acne mechanica is simply ‘sweat acne.’ They usually pop up after a workout, a hot yoga session, or on teens who aren’t good at cleansing their skin. Treat this acne the same way you would treat the bacterial acne mentioned above. 

Hormonal

Hormonal acne is found on the U-zone of the face (a.k.a. cheeks, chin, and jawline). This type of acne can be triggered by hormonal imbalances, menstrual cycles, stress, or overconsumption of foods such as sugar, dairy, or caffeine. Treatment includes using balancing and nurturing skincare products, using gentle cleansers, and taking care not to over-strip or dry out the skin. Stop using Glycolic acid or AHAs if drying or increased breakouts occur. 

The right treatment…

Treating acne is all about attacking the underlying factors which caused the acne to develop in the first place. Topical over-the-counter medicines are the most common and effective treatments for us regular folk suffering from mild acne. So for those with occasional pimple growth, keep an eye out for these common ingredients when you shop:

Adapalene (Differin).

This medicine is a retinoid, a medicine derived from vitamin A. Retinoids are satisfyingly effective for comedonal acne. It affects the way skin cells grow and prevents clogged pores. Normally, you would apply this medication in the evening, starting with three times a week, and then daily as your skin grows accustomed to it. Side effects of topical retinoids include increase to sun sensitivity, dry skin and redness.

Benzoyl peroxide.

You often find this medicine sold as a gel or lotion. It unclogs pores, dries out pimples, and kills bacteria and prevents new acne from growing. Using benzoyl peroxide and adapalene together is a common starting point for acne treatment. It is recommended to try these treatments for 2-3 months in order to see results. Discontinue use if a problem with the medication arises, such as severe irritation or dryness. 

Azelaic acid and salicylic acid.

Azelaic acid is a naturally occurring acid produced by a yeast. It has antibacterial properties, and manages discolorations. Salicylic acid, on the other hand, clears clogged hair follicles. Side effects of both acids include skin discoloration and minor skin irritation.


Now, when it comes to more severe acne, systemic treatments are required, like taking antibiotics in combination with topical medicines. Isotretinoin is an effective systemic retinoid that is used for severe cystic or nodular acne. Other available treatments include extraction, injection of steroids into inflamed lesions, photodynamic therapy, or chemical peels. However, these treatments require professional help, and therefore you will need to contact your dermatologist for more information. 

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