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Demystifying the Different Types of Acne: What You Need to Know.

When we talk about Acne, we usually talk about Acne Vulgaris. This very common skin disease affects hundreds of millions of people worldwide and is caused by the blocking of pores by an overactive oil gland. Causing pustules, papules, blackheads and skin infections. These can happen on the face, neck, shoulders, chest, and back.

It's most important to find out what age group the patient or client is due to how you treat them- Below are the four main groups that we put people into when breaking them down and treating them for Acne.

  • Infant Acne - Under 12 months

  • Childhood Acne- 1-12 years

  • Teenage Acne - 13-19 years

  • Adult Acne - Acne which develops after teenage years

There are two categories that we use to see how to categorise the Acne -

Non-Inflammatory Acne: This acne will contain whiteheads( closed comedones), blackheads (open comedones), and Milia. It doesn't contain anything that causes inflammatory reactions. - Do not cause pain

Inflammatory Acne: This Acne has nodules, papules, pustules and cysts. It will, however, cause inflammatory reactions. - Painful

It is fundamental to know what type of Acne you are looking at, so below I will describe and show you. However, please go to your local salon/qualified beauty therapist for reassurance if you are not sure. To find your nearest qualified beauty therapist, go to

Types of Acne


Tiny whitish keratin cysts around the eye and cheeks in adults and over the cheeks and forehead on babies ( often called milk spots -oil seeds), they can even be found everywhere else on the body in infants.

Treatment of Milia- In adults, firstly, use a good exfoliator with salicylic acid or benzoyl peroxide and some retinoid cream. If qualified to do so, your Beauty Therapist can use cryotherapy, electrolysis or advanced facial techniques to remove them.

Occasionally, if there are large cysts, chemical peels, laser, and surgery will be the only options.

In newborns, the milia will last a few weeks, then go by themselves. They won't scar; if parents are concerned, they can visit their midwife or GP.

Causes of Milia- A build-up of skin cells where the skin hasn't been able to shed itself. It can also be from any skin injuries, burns, or trauma, basically anything that would cause the oil production to increase and the skin cells not to shed.

Blackheads- ( Open Comedones)

Small black dots that can develop almost anywhere over the body but are primarily noticeable on the face, the nose, cheeks, forehead and chin. This is where you will find these cosmetic blemishes; they are not painful but can be highly visible.

Once a mixture of dead skin cells and sebum ( an oily substance found in the oil glands to keep the skin moisturised) blocks one of the skin pores or the hair follicles, then, as the air gets to the surface of the blackhead, oxidisation occurs, turning the top black.

Depending on how many blackheads you have depends on how severe your Acne is.

Mild, moderate or severe. Also, Blackheads are non-inflammatory, so they are non-painful.

Treatment of Blackheads - There are many products out there to dry up the skin and remove blackheads. Some remove the dead skin cells, such as an exfoliator, which works when the blackhead is buried deeply. Occasionally, you will be tempted to purchase a wash, cream or lotion that "dries out the oil from your skin, however, your skin will automatically just read this as it is making a loss and that it needs to produce lot more, thus your skin will become oilier than ever! Manual Removal by a skin therapist or dermatologist, this technique is performed by an expert. Microdermabrasion, Laser Therapy & LED using blue light and laser beam kill and destroy the sebaceous glands, which in turn lowers the oil production. Prescription medications are also available from a dermatologist but carry with them some serious side effects. Please look into this as a last, not a first, resort.

Causes of Blackheads- A lot of the reasons for an increase in blackheads and Acne are due to a change in hormones; of course, there are many other reasons as well. Such as, genetics, using certain fabrics can also cause skin issues, using cosmetics that do not agree with you, as well as medications causing skin problems. Other acneic issues can be ignited by smoking, a poor diet- eating the wrong foods that are high in sugars and low in complex carbohydrates and living under high levels of stress.

Whiteheads ( Closed Comedones)

Whiteheads are basically exactly the same as blackheads in that the top of the spot didn't come into contact with the air, so there is no oxidisation.

Causes of Whiteheads: Whiteheads are mostly found in teenagers and during menstruation, pregnancy and menopause, making them associated with puberty.

Treatment of Whiteheads: Whiteheads, are generally treated with a good skin routine, its important to remember to use your cleanser or skin wash, twice daily, then tone- Not only does your toner just remove your cleanser, it also closes your pores and rebalances the PH of your skin. Then, it is important to use your moisturiser.

You can also use Vitamin A and retinol products. These can help prevent the blocking of the pores of the skin. Benzoyl Peroxide- This is available in many skin products- It helps destroy bacteria on the skin's surface.

Papules (Bumps on the Skin)

A papule is a hard bump on the skin, about 5mm in size; it is painful- therefore, inflammatory Acne, but it isn't filled with pus (if it were, then it would be called a pustule).

Causes of Papules: this is the same as most of the rest of Acne: migration of dangerous bacteria to the skin, excessive oil production, high levels of androgens and other male hormones, stress, certain medications (antidepressants and corticosteroids), poor diet can contribute to this in some cases.

Treatment of Papules: Using cleansers and exfoliators with salicylic acid and benzoyl peroxide is where you must start. Gently try to remove the dead skin cells. For advice, seek your local skin specialist, but do not try to pick at these. Also, using products such as Hypo21, which ensures the area is sterile and helps keep the skin free from bacteria, is essential.

If you're struggling and the papules are severe, you may need to contact your GP.

Your GP maybe able to put you on a course of topical antibiotics, If this doesn't work for you, they may give you oral antibiotics combined with a hormonal contraceptive to lower the androgens.

If left untreated, severe papules can cause scarring and hyperpigmentation.


Pustules are pus-filled spots that have broken through the skin and contain a yellowish pus. The area is easily recognised as a reddish bump with a whitish centre and a red ring around it. They are usually very painful, and sometimes, they can feel warm to the touch. These are classic signs of inflammation. As they have pus-filled centres ( cysts), this type of Acne is called Cystic Acne. They can be found anywhere on the body, including the hairline and the scalp.

Causes of Pustules: Clogged pores and bacteria on the skin are really the leading cause, and the pustule is generally much more significant than blackheads, whiteheads, and papules. Some diseases can also cause the development of pustules. These include Rosacea, Folliculitis, Chickenpox, Eczema and Psoriasis.

Treatment of Pustules: In most cases, the pustules heal on their own in a matter of days or weeks. Keeping the area clean and washing with a mild and gentle cleanser and lukewarm water is usually all that is required. Try using natural anti-inflammatory essential oil products, such as Eve Taylor.

*Don't be tempted to squeeze or pick a pustule; remember that it is full of bacteria and that bacteria is not only on top of the skin but also underneath it. Therefore, as you press the pustule, the bacteria is not only spread over the skin surface, infecting the rest of the surface of the skin and your hands but deep down below the skin's surface, spreading the bacteria underneath and causing more pustules, papules and other issues.


These are usually found in people either during hormonal changes or in younger or older people. They are usually, but not always, found in people who have oily skin and are the largest and deepest of all types of acne spots. They contain a thin (or thick) liquid and are very sore. They can be anything from a few millimetres to a few centimetres. They don't have a head on them to allow them to be squeezed. However, regarding squeezing any type of cystic Acne- please see my * note above.

Causes of Cysts: The causes of cysts are similar to the other types of Acne, although some predisposed factors may be found. Hormonal changes in females- during periods, pregnancy and menopause or suffering from polycystic ovary syndrome, taking certain medications or drugs, rising male hormone levels, excess sweating, wearing the wrong fabrics or too tight clothing.

Treatment of Cysts: This type of Acne is the hardest to treat. It often means you cannot do it alone, and you will need to start at the Beauty Salon; the best way to treat this type of Acne is by finding a Salon with a medical-grade LED phototherapy Blue and NIR light.

The blue light reduces inflammation and removes bacteria, Whilst the NIR helps with pain and stops scarring. Not all LED machines are the same- make sure the salon you are going to, has a Medical Grade machine, the brands that are recommended are Dermalux or Celluma. Even after these treatments, it may be necessary to receive some oral antibiotics.


Nodules are hard bumps found under the skin that are sore to touch. They start off as a skin colour but change to a reddish or pink colour as the infection and inflammation take hold. There is no head on them, and they can be found anywhere on the face. However, In men, they are also found on the back and chest.

Causes of Nodules - The leading cause is the blocking of the skin pores by dead cells and oil-trapping bacteria; this means that it gets very deep into the lower layers of the skin, causing a deep-rooted infection. Other problems that can cause blocked pores include, excess sweating ( Hyperhidrosis) Increased production of oils( sebum) Chronic anxiety, Certain Skincare Products ( that clog the pores) and the use of certain medications.

Treatments for Nodules- Your Beauty Therapist can prescribe products that have a higher than what you can purchase in the stores topical creams and cleansers with Salicylic acid, benzoyl peroxide and retinoids. Chemical peels, LED lights, and microdermabrasion can all help.

*If necessary, your GP can refer you to a dermatologist who can prescribe oral medications such as isotretinoin, contraceptives or antibiotics.

*Please note all this depends on each individual and is according to their health when reading the article.

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