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Types of Acne Problem: Symptoms, Causes & Treatment

With inputs from Dr. Spurti Kattiman

Updated on: January 2024

With inputs from Dr. Spurti Kattiman

Updated on: January 2024

Reviewed by Dr Raja Indana

Read our editorial policy

Table of contents

Key Takeaway:
– Acne problem is a common skin condition that occurs when hair follicles under your skin clog up.
– Dead skin cells and oil block the pores and cause an outbreak of lesions (commonly known as whiteheads, blackheads, zits or pimples. These lesions usually on your face can also turn up on the shoulders, back and chest.
– The problem of acne arises in adolescents and young adults and stays ordinarily till your thirties. However, certain cases might reach your 30s and 40s.
– There are numerous dermatologist and hygienic treatment methods for acne removal. But still, this skin condition can stick with you for a long time.
– Depending on the intensity and individual perspective, acne problems affect your emotional health and are a sign of embarrassment for many.

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Chapter 1: Types Of Acne Problems

There are various types of acne problems. Let us discuss all the types here:

1) Fungal Acne

fungal acne

Fungal acne” is a term used to describe a skin condition known as pityrosporum folliculitis or malassezia folliculitis. It is attributed to an overgrowth of a yeast-like fungus called Malassezia, which is a normal part of the skin’s microbiome. Malassezia is typically harmless, but when it multiplies excessively, it can lead to inflammation of the hair follicles, resulting in small, itchy bumps that resemble acne.

To know more about the causes and treatment of fungal acne, read this detailed article.

2) Nodular Acne

nodular acne MFine

Nodular acne is an intense form of acne vulgaris, a common skin condition that takes place when hair follicles become clogged with oil and and skin cells. In nodular acne, the lesions are larger and more infected than regular pimples or pustules. Nodules are deep, painful, and frequently difficult to touch. They can be red or skin-coloured and might not come to the head like other forms of acne lesions. These nodules develop underneath the surface of the pores and skin and may persist for weeks or months. Nodular acne can result in scarring and have an extensive impact on someone’s vanity due to its visible and painful nature.

To know more about the causes and treatment of nodular acne, read this detailed article.

3) Cystic Acne

cystic acne

Cystic acne is a severe form of acne that occurs when pores in the skin become blocked and infected, leading to the formation of large, painful, and deep-seated cysts or nodules. These cysts are filled with pus and can cause significant inflammation and damage to the skin tissue.

Unlike milder forms of acne, such as whiteheads or blackheads, cystic acne penetrates deep into the skin, often leaving behind scars. It is typically more resistant to over-the-counter treatments and may require medical intervention. Dermatologists often prescribe oral medications, such as antibiotics or isotretinoin, to help manage and control cystic acne.

To know more about the causes and treatment of cystic acne, read this detailed article.

4) Hormonal Acne

hormonal acne

Hormonal acne refers to acne that is primarily impacted by changes in hormone levels in the body. It frequently happens when there is a hormonal imbalance, such as an increase in androgens (male hormones like testosterone) in both males and females. This hormonal imbalance may cause the skin to produce more oil (sebum) than normal, which can block pores and cause acne to appear. During stress, pregnancy, puberty, menstruation, menopause or when diagnosed with PCOS and PCOD, a woman’s body undergoes hormonal changes. These changes can cause hormonal acne.

To know more about the causes and treatment of hormonal acne, read this detailed article.

Chapter 2: Symptoms Of Different Types Of Acne

The acne problem is diverse in nature and has different reasons. Here are the symptoms for different types of acne:

Blackheads (also called open plugged pores)- These open comedones are little bumps on your skin that occur because hair follicles or pores are filled with debris with open pores and contents exposed to air. They are the moderate category of acne and often found in people with extremely oily and greasy skin.
Whiteheads (also called closed plugged pores)- These closed comedones are witnessed after pores on your skin turn out clogged due to oil, bacteria and dead skin cells and pores are closed. Nevertheless, both the head category acne problems cause a different effect on the skin. The pores in blackheads stay open. Whereas, when it comes to whiteheads, the pores are blocked and closed, so we need to treat them differently. This acne problem does affect your skin.
Papules– Papules in layman’s terms, are little red bumps that are raised on your skin and swell up due to inflammation. Like the previous different types of acne, papules exist due to excess oil, bacteria and dead skin cells inside your pores and end up getting clogged. Apart from that whenever papules occur, the clogging results in hair follicles becoming inflamed and bulged.
Pustule– A pustule occurs on your skin whenever a pore becomes excessively clogged. Your skin begins to swell with yellowish-pus, and that is how a pustule is formed. In this type of acne, the infected pores appear with a white or yellow colored centre blemish that swells up into a bump with red skin around it. This type of acne can also cause some amount of pain and discomfort.
Cyst– One of the critical types of acne, cysts or cystic breakouts are centred within your skin and appear when your pores are either severely blocked or seriously infected. They appear similar to the pustules but usually have nowhere to go and cause a lot of pain. These cysts are ingrained in your skin tissue, and even when removed, they may end up leaving marks or scars on your face.
Nodules– Similar to cystic breakouts, nodules or nodular pimples come under the most serious types of acne. They hold similar properties as a cyst, but it’s just that they do not contain pus. In fact, it looks like a strong hard bump on your skin, and it is the most painful type of acne. To find an Acne problem solution, dermatologists describe nodules as a lump that is 1cm in size and beneath your skin.Read the detailed guide on the difference between acne and pimples.

Have you come across these symptoms before? Reach out to a dermatologist nearby on MFine to learn more!

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Chapter 3: What Are The Causes For Acne Problems?

Acne problems appear on your skin when the pores are inflamed and blocked with bacteria, oil and dead skin. As explained by a dermatologist, the pores of your skin open to a follicle, which consist of sebum (excreted from the sebaceous oil gland) and hair. As mentioned gland releases sebum and flows into the follicle to the pore and finally on your skin surface. The sebum is meant to keep your skin soft and frictionless. However, the same gland can also be a leading acne problem that individuals face.

The sebaceous gland ends up producing excess sebum that causes your skin to become extremely oily. A leading cause for acne.
Due to inflammation an excess amount of dead skin cells is restricted in your pores.
Your pores get clogged by the excess dead cells and sebum, and bacteria begin to grow.

These causes lead to acne problems and pimples on the skin surface. Similar to acne, pimples occur when your skin has clogged pores, and the oil is restricted. An acne problem can also be caused due to daily habits and we should treat the same in its early stages.

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Chapter 4: What are the treatments for the Acne problem?

Acne problem solutions depend on the severity and the type of acne.

Mild acne are generally treated at home or using and over-the-counter (OTC) medications, such as gels, soaps, creams, and more that are applied to the skin and pimples on face
Home Remedies
The basic self care and home remedies that are the perfect cure for acne include:

Wash your skin twice a day with a mild soap to remove dirt along with excess oil
Keeping your hair clean and washing it regularly also plays an important role
Use gentle products that are alcohol free. Avoid products that can irritate the skin like toners, astringents and exfoliants.
Avoid Applying DIY masks which will cause flare-ups
Water based make-up or products labeled “non-comedogenic” (not pore-clogging)
A big no to squeezing or picking pimples, which cause the acne to spread further
not touching your face as the bacteria present in your fingers can cause flare ups

OTC Medication remedies
OTC cure for acne include:

Resorcinol: helps the breaking of blackheads and whiteheads and pimples on the face
Benzoyl peroxide: accelerates the replacement of skin, kills bacteria and slows down the production of sebum and unnecessary pimples on the face
Salicylic acid: Reduces inflammation and swelling while assisting the breaking down of blackheads and whiteheads
Sulfur: works best for breakouts that are formed with a combination of dead skin cells and excess sebum
Retinol: Unblock pores and prevents clogging of pores with dead cells
Azelaic acid: Helps reduce sebum eruptions, and stops bacterial growth.

It is suggested to start with lower strengths of products as some solutions can cause skin irritation, redness, or burning on first use.

All of the mentioned below needs to be taken after consulting a skin specialist, or a dermatologist at MFine if the acne problems persist at a larger scale. Treating acne the right way needs patience and also expert advice.

Corticosteroid injection– If an acne cyst gets highly inflamed, it might burst. This leads to scarring. It may be treated by injecting a diluted corticosteroid. This helps prevent scarring, reduce inflammation, and speed up healing of the acne problem that you are facing.
Oral antibiotics-They are generally prescribed for up to 6 months for patients with moderate to severe acne. Acne is more likely to get used to topical rather than oral antibiotics. Antibiotics can fight bacterial growth and stop inflammation. Doxycycline and Erythromycin are a few antibiotics suggested for pimples and acne.
Topical antimicrobials– Topical antimicrobials aim to reduce Cutibacterium acnes in patients with moderate to severe acne. Like clindamycin and sodium sulfacetamide. One may be prescribed a topical retinoid. Topical retinoids are byproducts of vitamin A. They cleanse the pores and prevent blackheads and whiteheads from forming under the skin.
Isotretinoin- A strong oral retinoid, used for the treatment of severe cystic acne which has not responded to other medications and treatments. It is a strictly controlled medication with potentially serious side effects. And must only be taken after the recommendation from a dermatologist for your acne problems

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Chapter 5: What are the complications due to Acne?

We need to be sure and aware that these acne problems might result in a short and long term complication. Following are the list of complications that one can face due to acne problems.

Excoriated Acne- Excoriated acne which is a result of scratching or picking at your acne lesions to the point of harming the skin area. This may be due to compulsive/obsessive excoriation disorder.Constant picking of skin leads to angry red bumps, open red sores, crusts, scratches and scabs. All this can result in the formation of a cyst or nodule and permanent scarring.
Post-Inflammatory Hyperpigmentation– It is the clinical term that describes discoloured, dark and uneven spots left behind after an acne blemish has recovered. Fortunately, Most of the post-inflammatory hyperpigmentation fades over time.
Scarring– Acne break-outs may lead to pitted scarring also known as ice pick scar. In certain cases, acne blemishes may also cause raised scars or hypertrophic.
Acne in People With Diabetes– Inflammatory acne breakouts are of rising concern for diabetic patients as they have little tolerance to skin and soft tissue infections. Certain prescription treatments for acne consisting of a vitamin A byproduct, may change sugar levels of blood and the doctor may have to monitor closely to prevent further complications.
Acne during Pregnancy– Due to the hormonal changes during pregnancy, a woman may develop acne or have breakouts. Certain prescription acne drugs are not recommended during pregnancy as they can cross the placenta and lead to further complications such as birth defects, miscarriage and stillbirth.

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Chapter 6: When should you consult a doctor?

With the severity of acne chances of scarring increases, so it’s vital to treat inflammatory acne at the earliest. This often means getting professional help
Older adults witnessing a sudden outbreak might be a symptom of an underlying disease. This should be immediately taken to a doctor for a full check-up or discussion of how ongoing conditions are being managed
If there is a sudden break out of red bumps on the face, back, chest or elsewhere for the first time.
The acne condition worsens despite regularly using the OTC products and healing is out of the sight
There is serious inflammatory acne, nodules or cystic Breakouts
If one feels the acne can be caused by certain medication
One can get extremely upset about their skin as acne is not just a physical aspect on the skin but also has a psychological impact on the mind.

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Chapter 7: Are there any risk factors involved?

Age Diversity: A wide age group falls victim to acne, but it’s most common in adolescents.
Hormonal changes: Hormonal changes are common during puberty, pregnancy or medical conditions like PCOS.
Heredity: Genetics plays a vital role in acne and the type skin inherited by the offspring
Excess grease and oil. You may develop acne where your skin comes into contact with excess oily products.
Skin Interaction: Often caused by pillow covers, tight collars, telephonic friction and even backpacks (back acne).

Consult the best dermatologist to learn more about the risk of acne problems and get personalised treatment!

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References

Q. How can I stop acne problems?

Ans: Wash your skin twice a day with a mild soap to remove dirt along with excess oil. Use gentle products that are alcohol-free. Avoid products that can irritate the skin like toners, astringents and exfoliants.

Q. Why do I have acne at 25?

Ans: Excess skin oil and germs are the same culprits that cause acne in teens and adults. Excess oil can be caused by hormonal changes of any kind, including those brought on by menstruation and pregnancy. Acne appears to be more common among women who smoke.

Q. What age does acne stop?

Ans: Girls between the ages of 14 and 17 and boys between the ages of 16 and 19 are more likely to get acne. Before their symptoms start to get better as they age, the majority of people have acne intermittently for several years. Acne frequently vanishes when a person is in their mid-20s. However, adult acne also persists.

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