We’ve all been there. It’s the night before a big presentation, the morning before a first date, the week we’re supposed to be enjoying our vacation, and suddenly, seemingly out of nowhere, a break-out strikes.

Our skin, irritated by something, revolts and refuses to cooperate, no matter how many tips and tricks we try to soothe the irritation. When we look at our skin as a detailed map of our bodies’ health, we can recognize when something is off and try to zero in on the cause, whether it be a hormonal imbalance, incorrect products, a bad diet, the buildup of dead skin, or an imbalanced pH level.

Typically, acne is classified as either Noninflammatory or Inflammatory, and both types present a unique challenge when it comes to treating them. Noninflammatory acne includes blackheads and whiteheads, which normally do not cause swelling, and the difference in the coloring depends on whether the blemish stays closed at the surface (whiteheads) or becomes exposed to air (blackheads). Blackheads and whiteheads are typically caused when dead skin cells and excess oils clog the hair follicles, and in most cases, can be remedied with over-the-counter treatments, salicylic acid, or the use of facials. Inflammatory acne, on the other hand, is characterized by swelling and redness, with pores that are deeply clogged with dead skin cells, body oils, and/or bacteria.

When a blackhead or a whitehead becomes inflamed, they may turn into papules which present themselves as small red or pink bumps on the surface of the skin. They may become sensitive to touch and picking the blemishes may lead to worse inflammation or scarring. The presence of many papules generally indicates moderate to severe acne.

Common acne, or Acne Vulgaris, includes blackheads, whiteheads, and other surface-level pimples on the skin, with the most common areas for breakouts being the face, chest, shoulders, and back. Success in treating common acne can be found in choosing the proper products and creating a focused skincare routine, or – in more severe cases – seeking help from a dermatologist or a licensed esthetician. Acne Mechanica, another common form of acne, is caused by heat, friction, and pressure against the skin, and is commonly experienced by athletes and people who frequently wear helmets and hats. Acne Mechanica can be treated with cleansers and prevented by wearing moisture-wicking materials under headgear.

When a pimple becomes inflamed, it can develop into a pustule, which resemble whiteheads, but have a reddish ring around the bump. The pustules are usually filled with pus, and picking them must be avoided, as doing so can cause scarring and discoloration to the skin. Pustules are primarily caused by hormonal imbalances and can be treated with mild facial cleansers.

Nodules and cysts are both inflamed bumps that feel firm to the touch. They develop deep within the skin and can be accompanied by pain. Over-the-counter treatments will generally not work in combatting them and seeking help from skincare professionals is highly recommended.

Now that we have established a basic understanding of the different types of acne, it’s important to note that there are different grades as well. The severity of acne can be measured by taking into account the location, type, and number of blemishes, coupled with the presence or absence of scarring.

Grade I acne is considered mild in severity and characterized by either opened or closed blemishes, with a low number of inflamed papules and pustules.

Grade II acne is considered moderate in severity and consists of papules and pustules, primarily on the face, or concentrated in areas on the back, shoulders or chest.

Grade III acne is moderately severe, with numerous papules, pustules, and inflamed nodules. The acne is also considered Grade III if it is present in high concentrations on the back, chest, or shoulders.
Grade IV acne, the most severe, is characterized by large, painful nodules and pustules, in a large number on the face, back, chest, or shoulders.

Just like the best way to care for your skin is to curate a routine for your specific type, the best way to care for acne is to build the treatment regimen that focuses on the type of acne you are experiencing. Once again, there is no “one size fits all!” For noninflammatory blackheads and whiteheads, as well as mild inflammatory acne, over-the counter treatments, mild facial cleansers, and regular consultation with your esthetician can yield the desired results. If you are experiencing more severe acne, such as nodules, cysts, and painful inflammatory acne, seeking professional treatment from a dermatologist may be the most beneficial route, as they are able to prescribe medicinal treatments or conduct surgery as necessary.

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