Understanding and Treating Different Types of Acne

Cysts are pus-filled bumps that are generally considered to be the most severe type of acne. According to Dr. Marchbein, cysts are characterized by deep, painful bumps that can occur anywhere on the face, chest, or back. Acne cysts are caused by clogs that occur deeper underneath the skin’s surface than other acne types. When the walls of your pores eventually burst open from inflammation-induced pressure, bacteria and debris are left to spread within your skin—causing your immune system to produce pus in response to this perceived attack on your body. Similar to nodules, acne cysts are also more likely to leave long-lasting post-acne marks—which is why it’s crucial to avoid picking or popping this type of blemish.

Papules occur when comedones (blackheads or whiteheads) become so inflamed that the walls of the pores break. According to Dr. Marchbein, this type of acne is characterized by redness and tender bumps on the skin. These hard, clogged pores usually look similar to a whitehead, but with a pink or red ring around them. The main indicator of acne papules is that they do not contain a yellow or white center filled with pus, as this would make them pustules. Papules can eventually become pustules, but it’s important to remember that they are two different types of acne.

The type of acne that most people imagine when they think of a “pimple” is actually known as a pustule. Pustules may look like whiteheads to the naked eye, but they have a few key differences. These acne blemishes form when a papule becomes filled with pus that contains dead white blood cells sent by your body to fight an infection. They often include a white or yellow hue at the center and are accompanied by soreness and redness. Similar to papules in many ways, pustules also form when the walls surrounding your pores break down from pressure from inflammation.

Blackheads are blemishes that are formally known as “open comedones”—meaning that the clogged pore remains open at the surface of the skin. Most frequently seen on and around the nose area, as well as on the chin, blackheads are characterized by small, black bumps. Contrary to popular belief, these dark-colored spots are not caused by dirt, but by oil and debris within the pores that darken when exposed to oxygen in the air.

Considered one of the more severe types of acne, nodules are hard, inflamed bumps that form deep within the skin. These bumps are usually larger in size and more painful compared to other types of acne, and form when bacteria become trapped in the skin—resulting in an infection. Nodules can differ in color, from a flesh-colored hue to a more reddish appearance, and are likely to leave post-acne marks if left untreated. This is due to the fact that the inflammation associated with acne nodules can damage the surrounding skin cells. Nodules typically take more time to heal than papules and may require prescription medication.

Benzoyl-peroxide is one of the most common ingredients for treating acne, and according to Dr. Marchbein, “it’s one of the most powerful acne ingredients that we have.” This ingredient is effective, generally well-tolerated, and may help kill acne-causing bacteria. That’s why CeraVe recommends a gentle and non-irritating cleanser with benzoyl peroxide, like CeraVe Acne Foaming Cream Cleanser. This foaming cleanser helps clear up whiteheads, blackheads, and acne pimples, and helps prevent new acne blemishes from forming.

"Acne, like other skin conditions, is a deficiency in the skin barrier,” says Dr. Marchbein, who also advises that “products that contain ceramides can actually help to restore the skin barrier.” Since research has found that people with acne have reduced levels of these essential skin barrier lipids, CeraVe recommends including ceramides in any skincare routine for healthy-looking skin.²

Retinol is a derivative of vitamin A that may help improve the appearance of post-acne marks once blemishes have cleared and the skin has healed. A resurfacing retinol serum, such as CeraVe Resurfacing Retinol Serum, is an effective option to help reduce the appearance of post-acne marks and pores, and support smoother skin texture. Apply your retinol serum evenly to your face daily for enhanced skin texture and radiance.

“Salicylic acid is a beta-hydroxy acid, which means that it goes deep down into the pores to help unclog them, and can gently exfoliate the skin,” says Dr. Marchbein. By effectively penetrating deep into pores, it can help to eliminate pore-clogging materials, like dead skin cells. Keeping pores free from debris, oils, and bacteria is an essential part of minimizing acne, especially blackheads and whiteheads.

1. “Skin Conditions by the Numbers.” American Academy of Dermatology, 2021: www.aad.org/media/stats-numbers.
2. Lynde, Chuck W et al. “Moisturizers and Ceramide-containing Moisturizers May Offer Concomitant Therapy with Benefits.” The Journal of clinical and aesthetic dermatology vol. 7,3 (2014): 18-26.