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Acne Advice GuideTypes of Acne - Acne Advice Guide - Doctor Fox

Types of Acne

Types of Acne

Acne affects most people at some point in their lives. Here are the most common terms, types and conditions.

Common Terms

  • Blackheads – These are the small black or yellowish bumps that develop on the skin
  • Whiteheads – These spots have a similar appearance to blackheads, although they can be firmer and have a white centre
  • Papules – These are small red bumps that often feel very sore and tender
  • Pustules – These are similar to papules except they have a white tip in the middle that is caused by a build-up of pus
  • Nodules – These are large, hard lumps that build up beneath the surface of the skin and are usually painful
  • Cysts – These are the most serious type of spot which is caused by acne, and are large, pus-filled lumps that look very similar to boils. Cysts post the largest risk of causing permanent scarring.

Adolescent Acne


Acne is the skin condition most associated with teenagers, and research has suggested that almost everyone going through adolescence has suffered from the odd pimple, whitehead or blackhead.

Acne most frequently occurs between the ages of 12 and 20, and is most prevalent in teens because of elevated hormone levels which stimulate the sebaceous glands (attached to hair follicles) and boost production of an oily substance known as sebum. This results in the skin bumps known as whiteheads, blackheads and pimples.

Acne usually starts between the ages of 10 and 13, generally lasts for 5 to 10 years and usually disappears between 20 and 25. In cases of more severe acne – such as nodular or cystic acne – it may not disappear until the age of 30 or beyond.

A tough time for teens

Acne can make teenagers feel socially awkward and isolated, as well as having a detrimental effect on their self-esteem.

A recent survey of British teenagers revealed:

  • 39% of teenagers with acne claimed they avoided going to school because of embarrassment
  • 55% of 11- to 18-year-olds said acne prevented them from having a boyfriend or girlfriend
  • 32% indicated acne stopped them from making friends

Treatment for teenage acne

Mild cases of acne can be treated and controlled by gently washing the affected areas.  Treatments such as benzoyl peroxide are also effective.  More serious acne may need to be looked at by a dermatologist, particularly if it doesn’t clear up within roughly 6 to 8 weeks.

Excoriated Acne

Acne spots

The definition of the word ‘excoritate’ is to damage or remove part of the surface (of the skin), so it’s no wonder this particular type of acne is also sometimes referred to as Picker’s acne.

Excoriated acne may seem mild to the casual observer, but to the sufferer they’re overcome with the uncontrollable compulsion to constantly scratch, pick and squeeze the blemishes. This in itself is a medically recognised condition that should be discussed with a dermatologist, although giving in to the temptation to squeeze acne is not in itself a sign it’s of the excoriated kind.

Infantile Acne


Whilst acne is primarily a condition we associate with teenagers, it can, in fact, occur at a much earlier stage in life in the form of infantile acne.

A newborn baby can suffer from an eruption of acne on the nose and cheeks – and occasionally small pustules – generally the result of hormonal changes that happened as the foetus was developing.

Infantile acne usually clears up within a few weeks without any kind of treatment.

When to consult a physician

If a newborn or infant suffers from a case of acne that lasts for more than several weeks, they should be looked at by the child’s dermatologist or paediatrician. In more extreme cases and if the acne becomes severe, the child should be referred to a paediatric dermatologist or endocrinologist.

Infantile acne is often hereditary or caused by premature hormone production or growth and development abnormalities.


Infantile acne is treated in pretty much the same way you use teenage acne – by cleansing the skin regularly and treating it with topical agents.  Occasionally, and only in rare cases, antibiotics are prescribed.

Pomade Acne

Problems with the skin

Peer pressure is an albatross around the neck of practically every teenager, and they all like to think they’ve got their finger on the pulse of prevailing, hip fashions and trends.

Hair styles are a case in point – and a teen’s predilection for keeping their barnet neatly coiffured often necessitates the application of a thick, oily dressing known as pomade.

Generally used for hair that needs straightening or moulded into various shapes or styles, they can also result in the unfortunate and unsightly side effect of pomade acne. This usually consists of comedones, possibly pustules or fewpapules.

The majority of pomades are categorised as comedogenic – or pore clogging – hair dressings and cosmetics, and some of the chemicals in them can also irritate and inflame the skin.


The best ways to deal with pomade acne are threefold:

  • If you’re using pomade, reduce scalp dryness and apply it one inch behind the hairline instead
  • If you’re using pomade to make your hair more manageable, avoid contact with the scalp and hairline and apply it to the ends of the hair instead
  • The third is perhaps the most obvious and most effective solution of all: stop using pomade completely

Pomade acne should soon clear if you stop using pomade, but if it persists regularly cleanse the skin until it subsides.  Contact a dermatologist if it does not completely clear with 6 to 8 weeks.

Acne Mechanica

Acne, scars and keloids in the chest of a young man, isolated on

Acne mechanica is a type of acne or pimple that is caused by skin rubbing, friction, heat, pressure on the skin or when the skin is not exposed to any air. A rash that is caused by constantly rubbed, sweaty skin, for example, can really be a form of acne.

Who gets acne mechanica?

There are often contributing factors that make certain people more likely to suffer from acne mechanica.  It most commonly affects teenagers and adults in their 20s, people who suffer from sandpaper acne, and soldiers stationed in hot, tropical climates.

Treatment and prevention

Acne mechanica generally responds best to treatments that include salicylic acid or benzoyl peroxide, and they are available in various lotions, gels, cleansers and creams.

The nature of acne mechanica means it is triggered by specific causes, so it can be prevented in very specific ways, including taking a shower after exercising, using a cleanser containing salicylic acid, and not wearing clothes which are too tight.

Severe Acne

Acne, scars and keloids in the back of young man.

When it goes beyond the stage of mild or moderate, acne can take on a more severe form. Here are the 4 main types of severe acne.

Acne Conglobata

Acne conglobate is a more severe and chronic form of acne vulgaris, generally characterised by inflammation, deep abscesses, severe skin damage, widespread blackheads and scarring.  The cause of this particular type of acne is not fully understood.

Often preceded by acne cysts, pustules or papules, inflammatory nodules form around multiple comedones, increasing in size until they start discharging pus. This leads to deep ulcers and scarring, with crusts sometimes forming over ulcerated nodules.

Males have a higher chance of suffering from acne conglobate, with the ages between 18 and 30 being the trigger period.


The usual treatment is Isotretinoin, although sometimes antibiotics are prescribed with treatment course that continues over a period of years.  Regular check-ups by a dermatologist are recommended even after a successful course of treatment to minimise the risk of any recurrence.

Acne Fulminans

Acne fulminans is the sudden appearance of highly destructive inflammatory acne, often characterised by fever, inflammation and aching joints (particularly hips and knees), and severe and ulcerating acne.  It can often develop after a course of unsuccessful treatment for acne conglobata.


To treat acne fulminans, corticosteroids or non-steroidal anti-inflammatory medications might be prescribed to reduce the inflammation.  However, it’s quite likely that this type of acne will reoccur and a longer, more intense course of treatment will be necessary.  How

Nodulocystic Acne

Generally, cysts are an uncommon bi-product of acne, but this particular type of acne is characterised by them. In the case of nodulocystic acne, they often measure several centimetres in diameter.

The cysts can be very painful and can occur individually, or take a more widespread form over the face, scalp, neck, back, shoulders and chest. The cysts are filled with a thick, yellow pus that should be drained by a professional physician


Nodulocystic acne generally requires an aggressive treatment programme which can include antibiotics or intralesional corticosteroids that melt the cysts over a 3 to 5 day period. However, some of the cysts may not respond to this kind of medication and may need to be excised surgically.

Gram-negative folliculitis

A bacterial infection that can be the unfortunate side effect of long-term antibiotic treatment, gram-negative folliculitis is an inflammation of follicles caused by a bacterial infection. ‘Gram’ refers to the blue stain used in labs to identify micro-organisms, the bacteria that doesn’t stain blue known as ‘Gram negative’.


Gram negative folliculitis is a bacteria that is resistant to many antibiotics, although Isoterinoin is one that proves the most effective to combat this particular type of acne.

For the people it affects, acne can be a serious problem – but don’t let it hold you back. Don’t let acne put your life on hold. Check out Dr Fox’s acne FAQ and acne information pages and range of medications and antibiotics.