Types of acne
What is acne?
Acne is a common skin condition which causes spots, oily skin and in some cases the skin can become painful and hot to touch. The condition occurs when your hair follicles become clogged up with oil and dead skin cells.
The appearance of acne is usually characterised by a mixture of whiteheads and blackheads (known as comedones) and also some pus-filled spots (known as pustules).
Who is affected by acne?
Acne is particularly common among teenagers, but as many as 95% of us will experience some kind of acne between the ages of 11 and 30. People are likely to experience the symptoms of acne on and off over several years before the condition improves, however, some people experience acne well into later life.
Common places to experience acne
The most common places to experience acne are the face, neck, back and chest.
Face acne
Most people who experience acne would have some acne on the face, typically across the cheeks and forehead.
Neck acne
Some people who experience acne will have some acne develop on their neck.
Back acne
More than half of people who experience acne will be affected by some back acne
Chest acne
Only 15% of people with acne will have some acne on the chest.
Causes of acne
As previously mentioned acne is caused by the hair follicles becoming blocked. The glands attached to the hair follicles, called the sebaceous glands, produce an oil called sebum to keep the skin and hair hydrated. If you have acne the glands begin to produce too much sebum, causing the follicles to get blocked.
Depending on how close to the surface the blockage is and how the surrounding skin reacts with it, you'll either end up with a blackhead or a whitehead. If there are bacteria caught inside the blockage you might get a papule or a pustule, and sometimes this can progress to nodules or cysts.
But what causes this build-up of sebum in the first place?
Testosterone
It is thought that acne in teenagers is caused by increasing levels of testosterone during puberty. This affects both boys and girls.
Sebaceous glands seem to produce more sebum when there are increased levels of testosterone in the body, so this is likely to cause this blockage of the pores.
Female hormonal changes
Women are more susceptible to adult acne than men and this is likely to be caused by the changes in hormone levels due to periods, pregnancy or conditions such as polycystic ovary syndrome.
Genetics
It is thought that acne runs in families - if both your parents had teenage acne, it is more likely that you will develop acne yourself.
Studies have shown that acne in your teenage years is more likely if both your parents had acne. The same goes for adult acne - if one of your parents have or had this, you also have a higher chance of developing adult acne.
Stress
While stress doesn’t necessarily cause acne, if you are acne prone, stress may cause you to break out.
Greasy or oily substances
If your skin regularly comes into contact with oily cosmetics or with grease in a work area, such as a kitchen with fat fryers, you might find this causes acne or makes your condition worse.
Medication
Medications such as steroids - this includes prescription tablets or creams as well as anabolic steroids can cause acne.
Clothes and bags
Regular use of a headband, mask or backpack can cause acne to flareup where the item makes contact with your skin.
Smoking
It's thought that smoking can cause acne in older people
Excessive sweating
Sweating a lot can also block the pores and cause acne. If you sweat a lot during exercise, make sure you shower afterwards and use a fresh towel.
Types of spot caused by acne
There are a variety of different types of spots that people experience with acne. Some people may have a mixture of these spots, while others may only be affected by whiteheads for example.
Blackheads
As we’ve discussed, blocked follicles that are at the skin’s surface will become blackheads. They get their colour because oxygen in the air reacts with the pigment in the oil causing the blockage to turn black.
Whiteheads
Whiteheads are often mistaken for pustules, but there is actually no pus or swelling. Whiteheads develop when there are blocked follicles beneath the skin’s surface and the opening of the hair follicle is forced to close around the blockage.
Papules and pustules
When bacteria multiply within a blocked follicle and oil and dead skin cells begin to build up, there is a chance the follicle wall will tear open. When the wall tears, white blood cells rush to fight off the bacteria causing the inflammation. These white blood cells then cluster and form a pocket of pus, known as a papule.
Pustules are formed when the papule rises to the surface and this is why they are sometimes mistakenly called whiteheads.
Nodules and cysts
Nodules and cysts are common terms for the largest papules and pustules. Nodules are large hard bumps that grow beneath the skin and can be quite painful.
Cysts are often the most severe form of spot caused by acne. They can sometimes be confused for boils, as they look very similar. Cysts are the most likely to cause permanent scarring. Find out more about acne scars and treatments.
How do you know which type of acne you have?
If you look at the type of spot you have, you can compare this with our diagram to work out what kind of spot you have. There are some key things to look out for, for example, if the spots appear like boils or are very sore, this is likely to be cystic acne.
How to treat acne
There are a variety of different options available if you experience acne. If you have mild to moderate acne you might be able to get over the counter treatment, such as gels and creams, from your local pharmacy. Find out more about how to get rid of your own acne.
If your acne is affecting you or it is moderate to severe, you could go see your GP.
Moderate acne treatment
If you experience moderate acne, a GP, or one of our online clinicians may prescribe stronger creams or gels, containing retinoids, antibiotics or prescription strength cleansers. In some cases you may need a longer course of antibiotic tablets. For some women, the combined contraceptive pill, is an option.
Moderate to severe acne treatment
If you have moderate to severe acne, combining a topical (rub-on) treatment with tablets (antibiotics, or hormones if you're a woman) is usually the best option. Antibiotic tablets are thought to work better when combined with a strong skin cleanser such as benzoyl peroxide.
Should you go to a GP for acne treatment
If you're bothered by your acne it's a good idea to see your GP, they will be able to advise on treatment. Your local pharmacist might also be able to help with mild acne.
Our LloydsPharmacy Online Doctor acne clinic offers a wide range of treatment plans, so that our clinicians can tailor treatment to you and your acne. The service is easy to use and involves a free consultation which includes the opportunity to upload photos of your acne. These alongside the answers to the consultation questions will be reviewed by our clinicians, who will then decide, if suitable, what treatment option might be best, depending on your preference, medical history and the severity of your acne.
Sources
https://www.nhs.uk/conditions/acne/treatment/
https://www.nhs.uk/conditions/acne/causes/
https://www.nhs.uk/conditions/acne/
http://www.acnesupport.org.uk/acne-types/
https://patient.info/skin-conditions/acne-leaflet
https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047
https://www.medicalnewstoday.com/articles/322322
