Acne vulgaris is the
medical name for common acne -- the presence of blackheads, whiteheads, and
other types of pimples on the skin. The most common spots for breakouts are the
face, chest, shoulders, and back. Although mild acne may improve with
over-the-counter treatments, more severe forms should be treated by a
A comedo, or basic acne
lesion, is a hair follicle that has become clogged with oil and dead skin
cells. Comedones (the plural of comedo) can develop into bumps called
whiteheads and blackheads. Products that may trigger comedones are called
"comedogenic." Makeup labeled "noncomedogenic" is less
likely to clog pores and contribute to acne.
Blackheads are comedones
that are open at the surface of the skin. They are filled with excess oil and
dead skin cells. It's not dirt that causes the comedone to turn black. The
oil's reaction to air causes the black color. Blackheads can frequently be
treated with over-the-counter medications.
Comedones that stay closed
at the surface of the skin are called whiteheads. This happens when oil and
skin cells prevent a clogged hair follicle from opening. Many of the same
over-the-counter medicines that treat blackheads are also effective against
Papules are comedones that
become inflamed, forming small red or pink bumps on the skin. This type of
pimple may be sensitive to the touch. Picking or squeezing can make the
inflammation worse and may lead to scarring. A large number of papules may
indicate moderate to severe acne.
Pustules are another kind
of inflamed pimple. They resemble a whitehead with a red ring around the bump.
The bump is typically filled with white or yellow pus. Avoid picking or
squeezing pustules. Picking can cause scars or dark spots to develop on the
Nodules are large, inflamed
bumps that feel firm to the touch. They develop deep within the skin and are
often painful. Nodules should be treated by a dermatologist. Over-the-counter
treatments may not be powerful enough to clear them up, but prescription drugs
can be effective.
Cysts are large, pus-filled
lesions that look similar to boils. Like nodules, cysts can be painful and
should be treated by a dermatologist. People who develop nodules and cysts are
usually considered to have a more severe form of acne.
Acne falls into the
"mild" category if you have fewer than 20 whiteheads or blackheads,
fewer than 15 inflamed bumps, or fewer than 30 total lesions. Mild acne is
usually treated with over-the-counter topical medicine. It may take up to eight
weeks to see a significant improvement.
If you have 20 to 100
whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions,
your acne is considered moderate. Dermatologists usually recommend prescription
medication for moderate to severe acne. It may take several weeks to notice an
improvement, and your acne may appear to get worse before it gets better.
Severe Nodulocystic Acne
People with severe
nodulocystic acne have multiple inflamed cysts and nodules. The acne may turn
deep red or purple. It often leaves scars. Prompt treatment by a dermatologist
can minimize scarring. In some cases, a doctor may inject corticosteroids
directly into nodules and cysts to reduce the size and painful inflammation.
Acne conglobata is one of
the most severe forms of acne. It involves many inflamed nodules that are
connected under the skin to other nodules. It can affect the neck, chest, arms,
and buttocks. It often leaves scars. This type of acne is more common in men
and is sometimes caused by taking steroids or testosterone. Timely treatment by
a dermatologist is essential.
Acne mechanica is caused by
heat, friction, and pressure against the skin, often the result of wearing
sports gear such as a helmet or baseball cap. It is sometimes called
"sports-induced acne" because it occurs frequently in athletes.
Preventive measures include wearing an absorbent material under sports
equipment and showering immediately after activity.
Topical therapy is acne
medication that is applied directly to the skin, like gels or creams.
Over-the-counter topical products can often help mild acne. They may contain
ingredients like benzoyl peroxide, resorcinol, salicylic acid, or sulfur.
Prescription products such as antimicrobial or retinoid creams can treat mild
to moderately severe acne. These can be prescribed alone or in combination with
Systemic therapy refers to
acne medication that is taken by mouth. Antibiotics like tetracycline,
minocycline, doxycycline, or erythromycin may treat moderate to severe acne by
targeting bacteria and reducing inflammation. Other systemic therapies include
oral contraceptives, which can reduce acne in some women, spironolactone, an
anti-androgen hormone pill, and isotretinoin (high-dose prescription vitamin
A). Isotretinoin is used only in certain severe, cystic acne cases, or in cases
where other treatments don't work. A course of isotretinoin treatment requires
regular appointments with your dermatologist.