There are different types of acne each with its’ own unique characteristics and treatment and here is a brief description about each one of them is as follows.
Blackheads are self limiting and are easy to treat as it is the mildest form of acne. Usually they do not last long and disappear after sometime. There are also severe cases of blackheads that require medical attention. Blackheads are follicles with wider openings. They are known as open comedones in medical terms. Blackheads can appear in the form of plugs or blocks anywhere in the body. Generally blackheads appear on forehead or nose and it is easy to remove them.
Whiteheads are called closed comedones which are sebum filled follicles, having a very small opening at the skin surface. Though acne can occur in any hair bearing skin area, certain areas are more prone to acne formation such as nose, cheeks, lower jaws, forehead and chin. These acne prone skin areas have larger oil producing sebaceous glands. For those with severe acne, it can occur in other areas too such as thighs, buttocks, chest, back and sometimes even in upper arms.
Papules come in different shapes and sizes. They come in different colors too such as red, pink, brown and purple. Sometimes they have other features such as crusts or scales. They form an elevation on the skin without any visible accumulation of fluid. They may become infected due to scratching or rubbing.
Pustules look like small puss filled inflamed blister like lesions on the skin surface. Mostly they are due to bacterial infection and need medical attention. They can occur anywhere in the body but are common on face, back, shoulders, armpit and groin.
Sebaceous Filaments are harmless after effects of natural sebum production. There is absolutely no need to worry your head over them. They have thread like appearance and are different from blackheads. They appear filament like and their sizes vary according to the size of pores that again vary from individual to individual due to genetic reasons.
Acne nodules or nodular acne is a severe form of acne that is formed in the deeper parts of skin and they usually leave behind a scar. They are larger than the usual blackheads, whiteheads, and pustules. They do not respond to over the counter medications and need medical attention. They can remain active for long period and it is aggravated by squeezing or picking them.
Acne Cysts or cystic acne
This is also a severe form of acne that occur in the deeper part of skin and it can be painful.. Cystic acne is larger than nodular acne and does not respond to the usual over the counter medications hence need medical care. Some dermatologists claim that Cystic acne is nothing but a severe form of nodular acne with severely inflamed nodules but many disagree. Cystic acne is known to leave behind a scar as its’ legacy. This type of acne needs expert medical advice, not self medication.
This skin condition occurs mostly in men as it is associated with testosterone. Acne conglobata is a highly inflammatory skin condition that starts with blackheads in neck, face, chest, buttocks, and upper arms. Pimples form around blackheads and gradually the pimples become larger filled with pus until they rupture. After rupture new pimples start growing on the same spot till they rupture again. When these new ones rupture, several pimples fuse together to become a cluster of many pimples and thus keep spreading outwards. After sometime these lesions heal and leave behind scars or skin bumps. This type of acne need medical attention.
Gram Negative Folliculitis
Gram-negative folliculitis is a type of acne that occurs in patients who had been acne patients earlier and were treated continuously for long periods with antibiotic tetracycline. It is an infection caused by gram negative bacteria such as, Escherichia coli and Enterobacter. The medication Isotretinoin is very effective in treating gram-negative folliculitis. The treatment involves use of isotretinoin along with systemic antibiotics.
Acne Fulminans usually begins during puberty. It all starts with joint pain and inflammation that usually leads to swelling of lymph nodes situated at the base of neck that eventually decreases but is followed by joint inflammation and loss of appetite. If these symptoms are ignored, it is followed by weight loss and muscle atrophy and extreme physical weakness. Open sores, some even large develop by this time that stick to fabric that come in contact with it which is very painful to remove. This is a severe form of acne that needs medical care and sometimes even hospitalization.
Acne Rosacea is characterized by redness on the nose, cheeks, forehead, ears, chest, neck, and scalp. Symptoms include appearance of red domed pustules, papules and red eyes with burning, itching and stinging sensations. It mainly affects people of Caucasians origin especially women. It has four sub types, three affecting skin and one affecting the eyes. It gets worse over a period of time if left untreated. Treatment varies as per the severity and sub type of this skin condition. Acne Rosacea is not curable but can be managed at the most. If it is mild it is not treated at all but covered with the help of cosmetics. Other sub types may need prolonged treatment with topical and oral antibiotics.
Pyoderma faciale also known as Rosacea fulminans is women specific as it does not affect males but affects younger women. It begins abruptly and does not persist more than a year. Unlike Acne Rosacea, it does not affect eyes. It is characterized by large painful red pustules, nodules and sores in chin, cheeks and forehead that may result in scars. The treatment involves antibiotics and Isotretinoin.
Infantile acne affects infants aged between 3 to 12 months but it is rare. Such infants are prone to severe acne during their teen years.
Excoriated acne occurs to those who are in the habit of picking or squeezing acne spots leading to more inflamed acne spots. In fact manual intervention aggravates the situation further.
Acne inversa is the most misdiagnosed type of acne compared to other types. In this type, lesions appear in neck, scalp, genitals, mammary folds, buttocks and anal region. The foul smelling discharge of pus from the lesions is most disconcerting. The main feature of this type is that even long time medication does not seem to help. It is believed that genetic predisposition may be a factor. The outcome of this type of acne can be very devastating leading to psychological issues.
When patients consume drugs that contain androgen producing agents, drug acne occurs as a side effect. This happens because when patients consume these drugs, it triggers androgen production in the patients leading to excess sebum production hence acne. Anti-tuberculosis and anti epileptic drugs contain androgen enhancing agents and so when patients consume these drugs, they experience acne flare ups or aggravation of existing acne.
Chemical acne also known as oil acne occurs when workers in chemical industry accidentally come into contact with certain chemicals or oil containing hydrocarbons which has the quality to trigger acne like skin eruptions at the point of contact. Some skin ointments and cosmetics can create acne like eruptions on the skin surface where it is applied.
Chloracne can persist for long periods before healing and can be highly disfiguring hence dangerous. When people come into contact with certain substances containing dioxin or chlorinated hydrocarbons, whiteheads and inflamed cysts appear at the point of contact which is known as chloracne. Even a transient accidental contact with these substances can cause cysts that take a long time to heal. There are instances of chloracne epidemics due to factory accidents when thousands of people had to suffer acne cysts due to accidental contact with these substances containing acne inducing agents.
Tropical acne occurs due to environmental reasons. Humid conditions obtaining in tropics can trigger acne eruptions in some people especially Caucasians who are not used to humid climate. Tropical acne appears in the trunk area of the body and does not respond to medication. The only way out is to move out to a moderate climate.
Treatments can vary depending upon the type of acne. Knowing the type of acne will go a long way in choosing the right type of treatment, medication and also whether you can be treated at your home or need hospitalization.