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When you have acne, you can develop any (or a combination) of these breakouts on your skin:1

1- WHITEHEAD (CLOSED PLUGGED PORES)1,2

A whitehead forms when excess oil and dead skin cells, or a plugged hair follicle, clog the opening of a pore beneath the skin, forming tiny white bumps that have no obvious opening. Picking at whiteheads can lead to more whiteheads and acne scars, and they will not empty when squeezed.

2- BLACKHEAD (OPEN PORE)1,2

Blackhead acne develops when excess oil and dead skin cells build up inside a pore or when plugged follicles reach the skin’s surface and open up. As the buildup accumulates, it widens the pore’s opening, resulting in a visible blackhead. The black appearance on the skin surface occurs because the air discolors the sebum. Squeezing blackhead can cause an infection or permanent scar.

3- PIMPLE (IF IT CONTAINS PUS, IT’S CALLED A PUSTULE AND WITHOUT PUS IS CALLED A PAPULE)1,2

Excess oil, dead skin cells, and bacteria can clog pores, leading to the rapid multiplication of bacteria. This buildup inside the pore results in pimple formation, characterized by a white-tipped pustule due to pus accumulation. Pimples commonly appear on facial areas and the upper body. In contrast, papules are small, pink, tender-to-touch inflamed bumps on the skin without pus.

4- ACNE NODULE OR CYST1,2

When a pore becomes inflamed due to excess oil, dead skin cells, and bacteria deep within the skin, it can lead to an acne nodule or cyst. Nodules are hard and lack pus, while cysts contain pus and may feel softer to the touch.

Classification of Acne:
Based on the extent and types of lesions, acne may be classified to:

  • Mild Acne:
    Mostly whiteheads and blackheads (non-inflammatory lesions).

  • Moderate Acne:
    With multiple inflammatory papules and pustules, mostly on your face.

  • Severe Nodulocystic Acne:
    With numerous large, painful inflammatory pustules and nodules.

Visit a healthcare provider as soon as you notice pimples so you can start treatment immediately before scarring occurs.⁴

References:
  1. American academy of dermatology association. Acne: Signs And Symptoms. Available at https://www.aad.org/public/diseases/acne /really-acne/symptoms last accessed at 5/6/2024.
  2. What is Acne? Definition & Types | NIAMS. Available at: https://www.niams.nih.gov/healthtopics /acne#:~:text=Acne%20is%20a%20common%20skin,commonly%20called%20pimples %20or%20zits.%20Last. Last access date 3-2024.
  3. Oge LK, Broussard A, Marshall MD. Acne Vulgaris: Diagnosis and Treatment. Am  Fam Physician. 2019 Oct 15;100(8):475-484. 
  4. Acne: Types, Causes, Treatment & Prevention. Clevland Clinic. Available at: https://my.clevelandclinic.org/health/ diseases/12233-acne. Last access date 3-2024.