Understanding the different types of acne and solutions

Acne, a widespread skin condition, affects individuals of all ages but is mostly seen in teenagers.

Acne causes the skin’s pores to clog, resulting in spots of some kind. While acne is most commonly associated with facial outbreaks, you should note that around half of people with acne will also experience symptoms on their back (sometimes called “bacne”).

Acne can have a huge impact on a person’s life. Not only can it be uncomfortable, but it can affect confidence and, in some cases, can scar. The best way to reduce scarring and the psychological impact of acne is to try to find the most suitable treatment as soon as possible.

Types of spots

Everyone is different, and acne will look and feel different for different people. Spots generally have 6 types of appearances:

1. Nodules are hard lumps which build up under the skin and are often painful.
2. Papules, which are sore, red bumps.
3. Pustules, like papules, are sore red bumps but distinguish themselves by having a white, pus-filled tip.
4. Blackheads, which are small black, brown or yellow bumps.
5. Whiteheads, which look like blackheads but are firmer and not possible to squeeze.
6. Cysts are the most severe type of acne spot and most likely to cause scarring. They are large lumps filled with pus.

Understanding different types of acne

Different spot types are the result of different types of acne.

Non-inflammatory acne includes spots that don’t swell, such as blackheads and whiteheads.  These types of spots are caused by pores being clogged by dead skin cells and sebum (the natural oil made by your skin). With blackheads, the top of the pore stays open even though the pore is clogged, which is how it gets its colour. In the case of whiteheads, the pore closes, leaving a small bump on the skin.

Inflammatory acne is the term used for spots that are swollen and red, such as papules, pustules and cysts. Inflammatory acne can be caused by sebum and dead skin cells, but bacteria can also clog pores; these bacteria can also cause infection below the skin’s surface, which can result in painful spots that are difficult to get rid of. 

Causes of acne

Hormonal acne - The reason that acne is most common in teenagers is the reaction between the excess oil produced by teenage skin during puberty and the interaction of that oil with bacteria in the skin’s follicles. 

Acne can also be a sign of hormonal imbalance in women, particularly if it starts suddenly and is accompanied by excessive body heat or irregular or light periods.

Acne Mechanica is a term for acne caused by friction or sweat being trapped next to the skin. This is particularly prevalent in sportspeople who are already prone to acne or have oily skin.

General tips for acne care

If you start to develop acne, there are some simple self-care tips that can help it from worsening.

1. Wash your face regularly – but not too much. As acne can be caused by oil produced by the skin mixing with bacteria in the hair follicles, it can be tempting to keep washing the face to get rid of the offending factors. 
   
   However, washing your face too much can irritate the skin, making things worse. Wash your face twice a day at the most using a mild cleanser and warm water; very cold or very hot water can make it worse. 
   
   If you wear makeup, make sure that it is removed before you go to bed.
    
2. Don’t squeeze! As tempting as it is to squeeze spots, this will mean that they are more likely to scar.
    
3. Avoid oily products, including makeup, oil-based sun cream or moisturiser – even if you suffer from dry skin. Look for water-based products, which are less likely to clog your pores.
    
4. Wash your hair regularly and try to avoid your hair falling across your face.
    
5. Home remedies for treating acne include the use of witch hazel, tea tree oil, or honey. Natural skincare products containing these ingredients are available, or you can buy the oils themselves from wholefood shops.
    
6. Diet and lifestyle can’t improve your acne, but they can improve your physical well-being and boost your mood. Eat well, stay hydrated and exercise regularly.

Treating acne

Acne treatment depends on its severity and requires patience, as it can take months of treatment before an improvement is seen. Several over-the-counter treatments can be used to control acne; if these are not successful, speak to a medical professional.

Non-prescription solutions for Acne. If you have mild acne, speak to a pharmacist. A range of over-the-counter creams can be effective – these will usually contain Benzoyl Peroxide. For ongoing scar treatment and acne prevention, creams containing niacinamide or a retinoid can be effective.

Prescription treatments for acne

If you have severe acne that doesn’t clear up with non-prescription creams and gels, then you may need to consult a medical professional who will advise appropriate prescription treatments. These could include:

Duac Daily Gel is a topical treatment for bacterial acne, which means it is a gel that is applied to the skin rather than a tablet that is taken orally. Duac contains Benzoyl Peroxide, which is an antiseptic that reduces the levels of acne-causing bacteria on the skin, and Clindamycin, which is an antibiotic. Duac Daily should be used once a day alongside regular (water-based) moisturiser.

Treatments containing benzoyl peroxide usually take at least four weeks before they start working and can take 2 to 4 months to have a significant effect.

Lymecycline is a tetracycline antibiotic effective in treating acne, including blackheads and whiteheads. It works by killing the bacteria that causes spots. For acne treatment, a prescribing practitioner usually recommends one 408mg lymecycline capsule a day. Although some improvement will usually be seen within a week of taking the medication, significant improvements are usually not seen for several weeks.

See our Acne page for our full list of available treatments.

Your prescriber will usually review your acne treatment at 4-6 weeks to see if it is working. If it is, they may extend the prescription; if it is not working effectively, they may recommend an alternative treatment or refer you to see a dermatologist.

Conclusion

While acne is most common in teenagers, it can affect adults, too. The most severe kind of acne is usually hormonal or bacterial and, if uncontrolled, could result in scarring. Self-care is important for physical and mental well-being, and while it is a myth that acne is caused by poor hygiene, a good skincare routine can help to treat or prevent mild acne. For moderate or severe acne, it is advisable that you consult a medical practitioner.
A consultation with one of our skilled prescribers is free and the prescription cost is included in the product price. Your acne treatment could be on your doorstep tomorrow, with no queueing for prescriptions and no waiting for an appointment.