Types of Acne

DEAR ASK THE DOCTOR: Are there different types of acne and why does it matter?

DEAR JORDON: It is important to know the different types of acne because different types of acne are treated differently. Your doctor will classify the acne into 4 types according to severity:

Type 1- comedonal acne: This category is the mildest of all acne groups and is comprised of what are commonly referred to as whiteheads and blackheads. If the plugged follicle stays below the surface of the skin, the lesion is called a closed comedo, or whitehead. They usually appear on the skin as small, whitish bumps. If the plug enlarges and pushes through the surface of the skin, it's called an open comedo, or blackhead. The plug's dark appearance is not due to dirt, but rather to a buildup of melanin, the skin's dark pigment.

Type 2 – comedonal and papular acne: You will fall into this category if you have a combination of comedones and papules. Papules are tiny red bumps that do not have a visible head on the tip and usually occur in the area where fine, thin hair grows, such as on the cheek or along the hairline. When bacteria is present below the surface, causing a mild infection, the skin turns red and these popular lesions can be tender to the touch and may or may not scar the skin

Type 3 – comedonal, papular and pustular acne: You will fall into this category if you have a combination of all 3 types of acne or acne that is predominantly pustular in appearance. Pustules are small round lesions; unlike papules, they are clearly inflamed and contain visible pus. They may appear red at the base, with a yellowish or whitish center. Pustules do not commonly contain a great deal of bacteria; the inflammation is generally caused by chemical irritation from sebum components such as fatty free acids.

Type 4 – nodulocystic acne: This is the severest form of acne. Nodules are large, hard, and often painful lumps beneath the surface of the skin. Nodules develop when the contents of a comedo have spilled into the surrounding skin. The most nodules may persist for weeks or months and their contents harden into a deep cyst. Both nodules and cysts often leave deep scars.