The Basics
From a small blackhead or whitehead, to large pustules, cysts, and inflamed nodules… acne has many forms. These may be interrelated, for example a pustule can follow a papule after white blood cells invade. In other circumstances, they may be completely independent in origin.
The various types of acne are differentiated by size and whether the lesion is inflammatory or
non-inflammatory. The beginning of acne is the smallest type of lesion, usually called a microcomedo, so small that it’s invisible to the naked eye. Depending on the growth of this microcomedo, it may develop into a closed comedo or whitehead; or into an open comedo, or blackhead. Similar to comedos, but a bit more serious are pustules and nodles.
Types of non-inflammtory acne
Micro – Comedones: Although most acne sufferers have many microcomedones, they are too small to be seen with the naked eye. A microcomedo occurs when the sebaceous duct and pore opening becomes blocked by excess sebum and dead skin cells. Every blemish begins as a microcomedo.
Soft Closed Comedones: Present themselves as bumps on the skin’s surface. They are not painful or red, but develop when a plug of cellular debris and oil becomes trapped within the pore and is covered by a layer of dead skin cells. The oil plug itself remains liquid or soft.
Hard Closed Comedones: Have obvious white heads. They are not red or painful and are especially common in the eye area. They develop just as their soft counterparts; however the plug has hardened and is similar to a grain of sand. The white head is a mass of dead cells and sebum.
Open Comedones: An open comedo or blackhead is easy to identify by its dark brown to black surface coloring. It’s an accumulation of dead skin cells and sebaceous matter within the follicle. As the oil is exposed to air, it darkens. The black coloring is not dirt, like many believe, but a biological reaction to the air.
Types of Inflammtory acne
Papules: A papule is a red and inflamed lesion on the skin’s surface. It contains no pus or white head. Papules result from a lesion and a break in the follicle wall, allowing cellular debris and bacteria to spill into the dermis.
Pustules: A pustule is a typical pimple, red and inflamed with a white head. They range in size from small to fairly large. Pustules follow papules after white blood cells invade. The white cap on a pustule is pus, sebaceous matter and cellular debris.
Nodules: Nodules are large inflamed lesions that occur deep within the dermis. They feel like a hard, painful lump under the skin. A nodule occurs when the follicle wall ruptures deep within the dermis. Contaminated debris from the follicle empties into the dermis and infects adjacent follicles.
Cysts: Cysts are very large, inflamed lesions. They feel like soft, fluid-filled lumps under the skin’s surface and can be very painful. Like nodules, cysts begin as a deep break in the follicle wall. As a cyst works its way to the surface, it damages healthy skin tissue, destroying the follicle.