Acne vulgaris is the medical name for common (vulgaris) acne — the presence of blackheads, whiteheads, and other types of pimples on the skin. There are many causes or types of Acne identified to date. The most common spots for breakouts are the face, chest, shoulders, and back. Although mild acne may improve with over-the-counter treatments, more severe forms should be treated by a doctor experienced and equipped to offer clinically effective options to achieve and maintain clear skin and more importantly to exclude the one of many Acne Imposters which if misdiagnosed and improperly treated may lead to disfigurement, deformity or even significant compromise of health.
Comedones: A comedo, or basic acne lesion, is a hair follicle that has become clogged with oil and dead skin cells. Comedones (the plural of comedo) can develop into bumps called whiteheads and blackheads. Products that may trigger comedones are called “comedogenic.” Makeup labeled “noncomedogenic” is less likely to clog pores and contribute to acne.
Whiteheads: Comedones that stay closed at the surface of the skin are called whiteheads. This happens when oil and skin cells prevent a clogged hair follicle from opening. Many of the same over-the-counter medicines that treat blackheads are also effective against whiteheads.
Blackheads: are comedones that are open at the surface of the skin. They are filled with excess oil and dead skin cells. It’s not dirt that causes the comedone to turn black. The oil’s reaction to air causes the black color. Blackheads can frequently be treated with over-the-counter medications.
Papules: are comedones that become inflamedand tender, forming small red or pink bumps on the skin without head. This type of pimple may be sensitive to the touch. Picking or squeezing can make the inflammation worse and may lead to scarring, and these papules do not contain pus; therefore, you should never pop them as it will irritate the skin and can leave a permanent scar. Sometimes you can find papules under eyes. A large number of papules may indicate moderate to severe acne.
Pustules: are another kind of inflamed pimple. They resemble a whitehead with a red ring around the bump. The bump is typically filled with white or yellow pus. Avoid picking or squeezing pustules. Picking can cause scars or dark spots to develop on the skin.
Nodules: are large, inflamed bumps that feel firm to the touch. They develop deep within the skin and are often painful. Nodules should be treated by a dermatologist. Over-the-counter treatments may not be powerful enough to clear them up, but prescription drugs can be effective.
Cysts: are large, pus-filled lesions that look similar to boils. Like nodules, cysts can be painful and should be treated by a dermatologist. People who develop nodules and cysts are usually considered to have a more severe form of acne.
Ranges of Acne Severity
Mild Acne: Acne falls into the “mild” category if you have fewer than 20 whiteheads or blackheads, fewer than 15 inflamed bumps, or fewer than 30 total lesions. Mild acne is usually treated with over-the- counter topical medicine. It may take up to eight weeks to see a significant improvement.
Moderate Acne: If you have 20 to 100 whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions, your acne is considered moderate. Dermatologists usually recommend prescription medication for moderate to severe acne. It may take several weeks to notice an improvement, and your acne may appear to get worse before it gets better.
Severe Nodulocystic Acne: People with severe nodulocystic acne have multiple inflamed cysts and nodules. The acne may turn deep red or purple. It often leaves scars. Prompt treatment by a dermatologist can minimize scarring. In some cases, a doctor may inject corticosteroids directly into nodules and cysts to reduce the size and painful inflammation.