Types of Acne

Whiteheads result when a pore is completely blocked, trapping sebum, bacteria, and dead skin cells, causing a white appearance on the surface. Whiteheads have a shorter life span than blackheads.

Blackheads result when a pore is only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface. The dark color associated with its appearance is not caused by dirt. Rather, it is a reaction of the skin’s own pigment, melanin, reacting with the oxygen in the air. As a whitehead has a short life cycle, a blackhead is a firmer structure, and can often take a long time to clear.

Papules are inflamed, red, tender bumps with no head.

A pustule is similar to a whitehead, but is inflamed, and appears as a red circle with a white or yellow center. (This is what is commonly called a “zit.”)
Severe acne vulgaris can be distinguished by the presence of nodules and cysts:

As opposed to the lesions mentioned above, nodular acne consists of acne spots which are much larger, can be quite painful and can sometimes last for months. Nodules are large, hard bumps under the skin’s surface. Scarring is common. Absolutely do not attempt to squeeze such a lesion. You may cause severe trauma to the skin and the lesion may last for months longer than it normally would have left untouched.


An acne cyst is often similar in appearance to a nodule, but it is pus-filled, and has been described as having a diameter of 2 inches or more across and is often very painful. Again, scarring is common with cystic acne. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last much longer than if you had left it alone.

Adult Acne

Adult acne is a form of acne vulgaris that can affect adults over 30 years of age. Those who had no problems with acne as a teenager have found that they are having breakouts. But because acne is normally associated with the hormonal fluctuations that occur during puberty, its appearance in an adult should be investigated to determine the underlying causes–especially if it appears for the first time in adulthood.

The following are at least three reasons why acne appears after 30 years of age:

  1. Often the acne that one had as an adolescent resurfaces later in adulthood. It is not always clear why this happens, but it is one reason for its presence in adults.
  2. In women, acne often reappears during pregnancy where there had been no activity for months, if not years. This could also be true in the case of woman during their menstrual period.
  3. Thirdly, acne can appear in adults for the first time who have never had it before. Now with this third reason, it might be more obvious that something unusual is going on and it might be wise to talk to a dermatologist or at least your family physician.

With some reasons established, we can now mention some of the possible causes of adult acne:

  1. Medication. As has been stated previously, some medications can induce acne. Anabolic steroids, anti-epileptic medications, anti-tuberculosis drugs rifampin and isoniazid, lithium and medications that contain iodine.
  2. Chronic physical pressure on the skin. Whether chaffing from wearing a helmet or carrying a backpack, such pressure against the skin can lead breakouts. (See acne mechanica)
  3. Chlorinated industrial chemicals. Working in certain types of industrial environments can cause acne-like symptoms or even chloracne, an occupational skin disorder caused by prolonged exposure to chemicals like chlorinated dioxins.
  4. Metabolic changes. With changes in the body’s hormonal balance, such as those present during pregnancy or menstruation can produce acne in adults.


Though often misdiagnosed as acne, rosacea is, in fact, not acne. Rosacea affects thousands of people in the U.S. alone, mostly those over the age of 30. It generally appears as a red rash confined to the cheeks, nose, forehead and chin. This redness is often accompanied by bumps, pimples, and skin blemishes–the reason it is so commonly mistaken for acne. Further, this redness is also linked to the fact that blood vessels may become more visible on the skin. Rosacea has been shown to be more prevalent in women than in men, but often if found in men it tends to be more severe. If you are seeking treatment and you think it may actually be rosacea, you need to be aware that the treatments differ quite a bit from those used in the care of acne vulgaris.

Acne Mechanica

This form of acne is caused by external mechanical forces like constant pressure, constant and repeated friction, covered skin, and heat. For those involved in sports, in the military or in high-activity jobs, this is nothing new as the condition is common with many athletes and in professions where factors like tight-fitting, even restrictive clothing is worn for extended periods of time. These sort of jobs may include certain kinds of factory work where an employee may be busy with repetitive tasks that may irritate the skin and lead to break outs.

For soldiers who must wear uniforms much of the time and may be carrying backpacks with straps that bite into the skin and cause friction with each step or straps on weapons that can also rub again the body this can become a real issue. Operating in the extremes of temperatures that these soldiers often do can also often complicate existent acne by causing inflammation and further breakouts.

Further examples of possible causes may include:

  1. Wearing head bands that can rub the forehead and irritate the skin
  2. The kind of friction caused by physical contact with musical instruments for extended periods of time
  3. Wearing tight clothing period; whether it is blue jeans or types of undergarments made with synthetic materials
  4. Even bra straps if they happen to fit snuggly against the skin

Things to note:

  1. Family History. Genetics might be a factor in the development of acne in the infant. Do the child’s parents or siblings have acne or did they have it in the past?
  2. Early hormone production. It may be that the infant has a condition that causes early production of sex hormones–especially androgen which is linked to acne. If this is the case, then medical help should be sought to avoid problems with the child’s development.
  3. Growth and developmental abnormalities. Acne at such an early stage in the child’s life could indicate developmental problems that might not show up until later. A pediatrician should be consulted to find out if this might be a possibility.
  4. Drug-induced acne or acneiform eruption. It could be that the child has been exposed to certain medications that can cause acne or acneiform lesions. Examples of such drugs include corticosteroids and those that contain iodine.