Acne is acne right? Wrong. Even though you couldn’t care less about what type of acne you have and all you want is a new face or a really long fringe to hide your zits, you should be able to classify your own type of acne so that you are aware of all the different treatment options available.
There are nine main types of acne:
Sounds pretty vulgar, but “vulgaris” actually means that this type of acne is the most common type and is found on the faces and bodies of the majority of adolescent acne sufferers. This type of acne may persist in adulthood and could even get worse. Most patients with acne vulgaris have oily skin.
Acne vulgaris is usually a mixture of three different kinds of acne spots, namely non-inflammatory lesions (blackheads and whiteheads and uninflamed nodules), inflammatory lesions (small red bumps, white or yellow “squeezable” spots and large red bumps) and secondary lesions (picked or scratched spots, red marks from recently healed skin, scars and dark marks from old spots).
These are the uninflamed blackheads and whiteheads that dwell on your face. Comedonal acne usually occurs on the forehead and chin.
Blackheads and whiteheads form because plugs of sebum and old skin cells block the pores in your skin.
This type of acne may be aggravated by hormones, humid weather and any oily facial products.
Newborn babies may be born with mild acne on their cheeks, forehead or chin. It is more common in baby boys and normally abates after a few months.
It is caused by exposure to foetal hormones in the mother’s womb.
This is a severe form of nodulocystic acne vulgaris that is found on the face, chest and back. This type of acne is more common in males and is characterised by multiple inflamed and uninflamed nodules and scars.
This rare type of acne is a very severe form of acne conglobata and not only ruins your social life, but causes fever and joint ache too. Other characteristics include an abrupt onset, severe acne scarring, inflammatory and ulcerated nodular acne on chest and back, loss of appetite and weight, raised white blood cell count and a general feeling of illness. It mostly affects males.
This is acne caused by or aggravated by certain medicines. Hormone medications such as oral steroids and anabolic steroids can cause severe acne. In women, oral contraceptives can aggravate acne.
Certain medications have been known to cause or aggravate acne, because they either affect the white blood cells or interfere with the hair follicles. If you are acne prone, if possible stay away from certain halogens, anti-epileptics, antituberculous drugs, antidepressants, Cyclosporin and vitamins B12, and cyanocobalamin.
Acne that has been picked or scratched. Squeezing your zits actually makes acne look worse than it is and by picking at your skin you could be introducing new infections or even worse, scarring yourself for life.
Acne excorie’e is more common in females (must be because of the long nails!). Excessive picking may remove all blackheads, whiteheads and inflammatory lesions, but you will be left with scratch marks, sores and scars.
Acne in pregnancy
During pregnancy, your acne can both clear and get worse. Early on in the pregnancy, acne often gets a bit worse but as your term progresses, acne can often improve, possibly because of increased levels of the female hormone oestrogen.
Not much can be done to treat this acne as it is caused by hormonal changes and expectant mothers cannot take anything involving hormones as it can endanger their baby.
This is what will be left over if you haven’t taken steps to treat acne early. “Scarring” refers to a process in which new collagen is laid down to heal an acne lesion. Thirty percent of people with acne vulgaris do scar, but it is particularly common in acne fulminans and acne conglobata.
The best way to avoid scarring is to seek effective treatment for your acne early on.
Although the list above sounds more like a menu in an Italian restaurant, it needn’t be as confusing as one. If you don’t know what type of acne you have, or maybe you have a mixture of two or three, see a dermatologist for treatment advice.
Revision date: June 18, 2011
Last revised: by Sebastian Scheller, MD, ScD