How to Identify Different Types of Acne and Their Causes

Acne is a common dermatological issue affecting both men and women, impacting not only appearance but also reflecting the health of the skin. Each type of acne has its own causes and treatments, and misidentifying them can lead to mistakes that worsen the skin condition. In this article, HBIO Clinic will help you understand the common types of acne and their causes to guide you in proper skincare.

What is acne? What causes acne?

Acne is a common dermatological issue, formed due to hormonal influences and clogged pores. Acne can vary in size and appear on the face, back, chin, neck, chest, shoulders, and buttocks. Among them, facial acne is the most common and includes blackheads, whiteheads, fungal acne, hidden acne, pustules, inflammatory pimples, etc. Each type has its own distinct characteristics.

Here are some of the main causes of acne:

• Hormonal changes in the body, especially during puberty, pregnancy, or perimenopause.
• Diets high in spicy foods, coffee, and carbohydrates.
• Improper skincare: not cleansing the skin thoroughly, not exfoliating regularly, or skipping moisturizers.
• Frequent makeup use, overuse of cosmetics, and using low-quality products.
• Side effects from certain medications such as corticosteroids, testosterone, lithium, etc.

Non-inflammatory acne types

There are many types of acne, but not all of them cause inflammation or swelling. Below are the most common non-inflammatory acne types, helping you recognize and care for your skin properly.

Blackheads

Blackheads are a type of non-inflammatory acne, appearing as dark spots on the skin’s surface due to open comedones. When the core of the pimple is exposed to oxygen, it oxidizes and turns black.

Signs of blackheads:

• Appear as tiny dots on the skin like pinheads; the core is open and visible to the naked eye.
• Size: 1–2mm.
• Black-colored tips.
• Usually appear in clusters.
• Common areas: nose, forehead, cheeks, shoulders, and back.

Whiteheads (hidden acne, fungal acne)

Whiteheads, also known as hidden acne or fungal acne, form when excess oil, dead skin cells, and bacteria build up and clog the pores. When the pores are blocked, the mixture gets trapped beneath the skin and pushes the skin upward, forming whiteheads. Since the core isn’t exposed to oxygen, it doesn’t oxidize, resulting in white color. This type of acne is usually non-inflammatory and easier to manage.

Signs of whiteheads:

• Small white pimples, 1–2mm in size.
• Often appear in clusters, scattered on the chin, forehead, nose, and cheeks.
• No visible core, lie under the skin surface, causing the skin to feel rough.
• Do not cause pain or inflammation.
• Hard to see visually, mostly felt by touch.
• In some cases, whiteheads may indicate gastrointestinal issues or reproductive disorders.

Inflammatory acne types

Inflammatory acne is often more severe, causing pain and swelling. Below are the common types of inflammatory acne and how to identify them to care for acne-prone skin more effectively.

Nodular acne

Nodular acne is a severe form of acne that damages the skin’s structure, often causing pain and discomfort. Although it may heal on its own, it frequently leaves deep scars.

Signs of nodular acne:

• Starts as small pimples, gradually becoming large, swollen, red, hard, and over 5mm in size.
• Painful to the touch, filled with pus and sometimes blood, but often has no visible core.
• The affected skin becomes tight and may scar after healing.

This condition is caused by inflammation, excess oil, dead skin cells, dirt, and bacteria irritating the pores. It mainly affects people with hormonal imbalances, poor detoxification, prolonged stress, or unhealthy diets and lifestyles.

Red inflammatory pimples (papules)

Red inflammatory pimples often evolve from whiteheads or blackheads. When excess sebum clogs pores and allows P. acnes bacteria to grow, the immune system responds by sending T-cells to fight, resulting in inflammation.

Signs of red inflammatory pimples:

• Red bumps.
• Size: under 5mm.
• Mild pain when touched.
• Commonly appear on both cheeks.

Cystic acne

Cystic acne develops deep beneath the skin, forming red, swollen bumps like lumps. These bumps contain pus and cause intense pain and discomfort. If not treated properly, cystic acne can lead to permanent scarring.

Signs of cystic acne:

• Large, swollen, and raised above the skin.
• May appear singly or in clusters.
• Often filled with pus, causing severe pain.
• Common areas: face, neck, back, and chest.

Pustules

Pustules form when bacteria and sebum accumulate in the pores. They are usually smaller than cystic acne and do not develop deep under the skin.

Signs of pustules:

• Yellowish pimples filled with pus, surrounded by a red ring.
• Mild pain when touched.
• Look like white pimples with a red halo.
• Swollen bumps filled with white or yellow pus.
• Avoid popping pustules to prevent scarring or worsening the inflammation.

Boils

Boils, or furuncle acne, are commonly seen in adults. They can cause serious complications when the infection spreads to the facial sinus area, potentially leading to venous sinus thrombosis or sepsis.

Signs of boils:

• A form of inflamed pimple, usually found around the mouth.
• Starts as a painful, red bump, later develops pus and a blackhead-like core.
• Red, swollen, painful, and hot to the touch.
• May be accompanied by fatigue, high fever over 40°C, and restlessness.

This article has provided detailed information about the different types of facial acne and their causes. We hope these insights help you take better care of your skin and support healthy recovery from within. For professional acne treatment and personalized skincare, visit HBIO Clinic for expert consultation and dedicated care.