There are many biological factors that cause acne development like your age, hormones, genetics, and medication.
Prescription acne treatments(RX): Some topical acne treatments include tretinoin for acne, clindamycin for acne, oral medication, and laser treatment.
There are 6 main types of acne that accompany acne vulgaris. They are blackheads, whiteheads, papules, nodules, cysts, and pustules.
It is also important to know what kind of acne you have in order to develop the best treatment plan for clear skin. Inflammatory acne and non-inflammatory acne need different treatments. Eliminating acne scarring and achieving clearer skin can take some trial and error, but with a dose of patience and good skincare, it is possible to see an improvement in acne scars in most cases, whether it's with mild acne, moderate acne, or an irritated acne breakout.
What Are the Different Types of Acne?
Acne vulgaris is the most prevalent skin condition in the U.S. However, not everyone who struggles with it is a teenager battling the tell-tale hormones of puberty. The American Academy of Dermatology reports that adult acne is on the rise, with a variety of aggravating factors ranging from haywire hormones to stress.
In the end, acne is caused by inflamed skin and oil glands due to a clogged pore. Like all clinical conditions, developing an effective treatment protocol starts with an accurate diagnosis.
Read on to learn about the different variations of acne and how you can develop the right treatment plan.
Acne 101: What causes acne?
There are four main factors that may contribute to stubborn acne:
Age – You’d be hard-pressed to find a person who didn’t struggle with an acne flare-up now and again during adolescence. Most teenage acne is caused by an influx of androgens during puberty, which can cause the skin’s sebaceous glands to produce extra oil (also known as sebum). Sebum mottles with hair, bacteria, and dead skin cells, resulting in inflammation and (as the teens say) zits.
Hormones – Hormones play a part in the development of acne all throughout a person's life, not just during puberty and adolescence. Sebaceous glands are one of the primary sites that your hormones act on, which means hormonal fluctuations can affect how productive they are throughout your life. The onset of hormonal acne usually occurs between the age of 20 and 50 in adults. It’s especially common in pregnant people and individuals approaching menopause.
Genetics – If you have family members who have had acne at a point in their lives, chances are you will too. Human genetics are highly complex, and researchers aren’t sure why a predilection for acne seems to run in families. However, if both of your parents had acne, you may contend with more persistent acne with early-age onset.
Medications – The use of certain drugs and medications can lead to the development of acne. Individuals who use medication for epilepsy, mental disorders like depression or bipolar, or steroids may experience acne as a side effect.
There has been a lot of skepticism about the role of lifestyle in acne development. However, there is no evidence to suggest that poor lifestyle choices like diet play a causal role in acne.
Certain environmental or behavioral factors may play a role in aggravating pre-existing acne, including:
Since acne can be attributed to a variety of causes, it may be helpful to understand it from a mechanistic perspective: acne is primarily an inflammatory response within the body.
The type of inflammation you have, from whiteheads to cystic acne, differs between individuals. Acne treatments intervene on different stages of the inflammatory response to control outbreaks—which is why it’s essential to learn how to identify the kind you’re dealing with.
Common types of acne & how to treat them
Knowing the cause of acne is step one to treating your acne. Ready for step 2? Let’s dive into the different types of acne you can have.
Blackheads are typically associated with acne vulgaris. As their name suggests, they look like small raised bumps with a black or dark-colored cap. Dermatologists classify blackheads as a type of comedo, and they can be open or closed.
Many people mistakenly assume that the dark color of blackheads is due to the accumulation of dirt. Actually, the “black” part of blackheads is the result of oxidation. During oxidation, the sebum and oils surrounding the hair follicle can appear darker when exposed to air.
Blackheads are caused by:
Blackheads are one of the most routine kinds of acne-related growths. They also tend to be one of the most stubborn forms of acne and can be difficult to keep from forming entirely.
In short, if you have pores, you’ll probably see a blackhead or two (and probably more!) in your lifetime.
Whiteheads are the second type of comedo. They’re characterized by a light-colored cap topping an inflamed, risen bump.
Whiteheads are caused by:
Whiteheads are extremely common to deal with throughout adolescence and adulthood. While they usually appear on the face, you may also see whiteheads on your neck, chest, back, or butt.
While blackheads and whiteheads usually form in isolation, papules are a type of acne that tends to form in clusters. They’re small, typically look uniformly red or dark, and have a firmer texture.
Papules are primarily the result of:
The development of papules automatically signals the root cause to be acne inflammation. They may feel sensitive when you touch them, or you might not feel them at all, but they tend to be persistent without consistent treatment.
Acne nodules are firm, dark-colored or red bumps that form under your skin. They tend to cover more surface area, ranging from the size of a thumbtack to a small coin.
Acne nodules are painful and can lead to scarring if left untreated. They may be caused by:
Nodular acne and cystic acne are often conflated, but it’s vital to distinguish between the two if you’re searching for the right course of treatment. In the next section, we will go over how to tell if you have cystic acne.
Acne cysts are a symptom of cystic acne. Compared with nodules, cysts are identifiable by their more pliable texture, which results from being filled with pus.
The fluid in a cyst can tell you what kind of acne has developed. Pus is one of the ways the body fights infection when bacteria combine with oil and dead skin cells. In people with cystic acne, these substances are trapped in the dermis, a deep-set layer of the skin.
Similar to nodular acne, the main causes of cystic acne are:
Acne cysts are often incredibly painful. They are most noticeable when they develop on the face, but they may also be found on the neck, shoulders, chest, back, butt, and arms.
The word “pimple” colloquially refers to what dermatologists know as pustules.
Pustules are a type of acne flare-up most comparable to papules. They also tend to be smaller and clustered, but they’re distinguished by a white or yellowish “cap” signifying the existence of fluid.
Pustules may also be related to hormonal and lifestyle factors. A poor diet full of processed foods can aggravate pustule flare-ups, as can stress, hormonal fluctuations (like your period), and certain medications.
Common treatments for acne
Dermatologists generally use acne type (or morphology) and severity to determine the best course of treatment. The following medications are the most common acne treatments:
Topical medication – Benzoyl peroxide, salicylic acid, and retinoids are all very commonly used chemical acne treatments. These work to mitigate bacteria, oiliness, and decongest the pores (respectively). These substances are available over the counter, and they may be prescribed in higher doses by your dermatologist. Specific types of retinoids, like tretinoin, can be highly effective at fighting acne but require a prescription to use.
Oral medication – Oral medicine may be prescribed for persistent, severe acne. Prescription antibiotics work to dispel bacteria from your skin, while oral retinoids control the amount of sebum your body produces. Birth control is another routinely recommended acne treatment. The estrogens in some birth control can help to offset the influence of androgens in aggravating oil production.
Laser treatment – Laser or light therapy may also be used to reduce the cosmetic effects of acne. You’ll need to use medication to work on the root cause, but laser treatment can help to reduce the appearance of acne and scarring. This type of treatment usually requires several appointments, and it can be highly effective at clearing up skin in the long term.
Your dermatologist may also recommend lifestyle changes to quell factors that can lead to hyper-reactive skin. Quitting smoking or improving your overall health by switching up your diet may support topical, oral, or cosmetic acne treatments.
Developing a workable treatment protocol takes time, effort, and a healthy dose of trial and error, but with patience and consistency, it is possible to see an improvement in your skin.
Types of acne recap
Just because acne is the most common skin condition in the country doesn’t mean it’s any less frustrating to deal with. Diagnosing and treating acne properly can be tremendously beneficial—not just for tackling chronic skin flare-ups, but also for boosting your confidence and overall sense of well-being.
At Favor, it’s our mission to make health care accessible to everyone, from acne medications to birth control. Our subscription service provides:
Our personal care team is filled with clinicians, pharmacists, and care providers who share a single goal: get you the resources and knowledge you need to take care of you. Learn more about insurance coverage and affordable care plans by signing up with us over at heyfavor.com/signup.
Reviewed By: Jessica Barra, FNP - Family Nurse Practitioner
At Favor, our goal is to provide the most up-to-date, objective, and research-based information to help readers make informed decisions. Articles are written by experienced contributors; they are grounded in research and evidence-based practices. All information has been fact-checked and extensively reviewed by our team of experts to ensure content is accurate and on par with current industry standards. Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.