Types of Acne

Understanding what acne is and how acne is formed should be the first step in treating acne. When we learn how acne is formed not only can we treat acne, we can also prevent future breakouts.

Acne Defined

Acne is an inflammatory and chronic skin condition that is formed when the pores of the skin becomes clogged with excess oil (sebum) and dead skin cells. These clogged pores will often become infected and inflamed and may develop into any number of acne lesions.

Pilosebaceous Unit

Before we further discuss acne, let’s look at where acne is formed, the pilosebaceous unit. The pilosebaceous unit is composed of the hair follicle, hair shaft and sebaceous glands. A properly functioning pilosebaceous unit does not cause pores to become clogged or inflamed. A malfunctioning pilosebaceous unit will often produce clogged pores.  

Blackheads

Blackheads are a form of comedones. Comedones is the medical term for clogged pores. Blackheads are produced when sebum and dead skin cells are trapped in the pores of the skin. It’s important to note, blackheads are not trapped dirt. Blackheads have an opening on the surface of the skin. When the clogged pore is exposed to air, its contents become darker.

Whiteheads

Whiteheads are another type of comedones. They are formed just like blackheads. They too are trapped sebum and dead skin cells. However, whiteheads do not have an opening on the surface of the skin. Therefore, its color remain white.

Papules

Papules are small and round elevations formed on the skin. They are hard to the touch and they can be tender. Papules do not contain pus. They are caused by a break in the follicle wall that becomes inflamed.

Pustules

Pustules are small raised bumps on the skin. They are about the same size as papules. However, pustules contain pus. Pustules are formed when there is a break in the follicle wall triggering an increase to white blood cells. The pus in the lesion is a mixture of dead white blood cells, skin cells and bacteria. Pustules look similar to whiteheads, but they have a reddish ring at their base indicating inflammation.

Nodules

Nodules are similar to papules. They too are caused by a break in the follicular wall and are hard to the touch and can be tender. The difference between a nodule and a papule is nodules are bigger and penetrate deeper in the skin.

Cysts

Cysts are large painful lumps that contain pus. They form deep within the skin’s layers. Cysts form when there is an infection at the site of inflammation.

Acne Lesions Classification

Acne lesions can be classified as comedonal or inflammatory. Blackheads and whiteheads are comedonal lesions. The remaining acne lesions are inflammatory.

Acne Classification:

Currently, there is not an universal classification for the severity of acne. Here is a commonly used scale. This scale is based on a count of comedonal, inflammatory and nodulocystic lesions.

Mild Acne:

Mild acne is classified as having less than 20 comedonal lesions, less than 15 inflammatory lesions, less than 2 nodulocystic lesions, and less than 30 total lesions.

Moderate Acne:

Moderate acne is classified as having 20 to 100 comedonal lesions, 15 to 50 inflammatory lesions,  3 to 4 nodulocystic lesions, and 30 to 125 total lesions.

Severe Acne:

Severe acne is classified as having more than 100 comedonal lesions, more than 50 inflammatory lesions, more than 4 nodulocystic lesions, and more than 125 total lesions.

Summary

After reviewing the material on this post, you should be able to identify the different types of acne lesions. You should also be able to classify acne lesions. Lastly, you should be able to rate the severity of your acne breakouts.

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Additional Resources

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