What Is Acne?

Acne is a difficult to treat and often debilitating disease that affects the skin, usually the face. The most common form of acne (acne vulgaris) is an infection within a hair follicle. This infection causes varying degrees of inflammation, which manifest as pimples, nodules and cysts. When the inflammation is severe, it can cause permanent damage to the skin and create acne scars.

Types of Acne

Acne can range from small patches of red skin with tiny bumps to large cysts that are painful to the touch. Different types of acne can have profoundly different underlying causes and understanding precisely what type of acne you have can help you identify what solutions are going to have the best chance of being effective.

Type 1 Acne

  • Minimal inflammation
  • Minimal affected area
  • Not painful
  • Irregular outbreaks

Type 1 Acne is the most mild form of acne and generally is the least damaging and easiest to treat form of the disease. It is characterized by a lack of inflammation and is usually not particularly painful. The area of the body affected by the acne is usually limited.

Type 1 acne is often transient and often resolves on its own after about a week. Non-inflamed blackheads and small red bumps (papules) are common with this form of acne. This form of acne appears to be particularly common in females and often affects the forehead, cheeks, nose and neck. Topical treatments are often effective at resolving the symptoms associated with Type 1 acne.

Type 2 Acne

  • Mild inflammation
  • Some painful pimples
  • Regular outbreaks

Type 2 Acne is similar to Type 1 acne, but is characterized by increased levels of inflammation and more frequent outbreaks. With Type 2 acne, pimples can range from small red bumps to medium sized whiteheads.

Unlike Type 1 acne blemishes, pimples associated with Type 2 acne are often painful to the touch. Over-The-Counter (OTC) topical treatments are often partially effective at decreasing the severity and duration of outbreaks, but are frequently inadequate for Type 2 acne. Topical antibiotics, Topical Retinoids and Light-Based Therapies can be quite effective for this type of acne. In some instances it may be necessary to explore oral antibiotics or oral retinoids, if the acne does not respond completely to topical treatments.

In general, Type 2 acne is minimally scarring if allowed to resolve on its own. However, it is important to practice good hygiene and avoid exacerbating the situation by “”popping”” pimples without cleaning and sterilizing the area before and after.

Type 3 Acne

  • Large, painful pimples
  • Nodular pimples
  • Frequent outbreaks

Type 3 Acne is characterized by the presence of medium to large nodules and pustules that are frequently painful. With Type 3 acne, pimples are often associated with significant amounts of inflammation. Large whiteheads and large, painful red bumps (nodules and cysts) are common. Individual pimples can take a long time to resolve, up to 10-14 days.

In type 3 acne, much of the inflammation and infection originates deeper in the skin tissue than in Acne Types 1 and 2. Because the source of the problem is deep within the skin, Type 3 acne is usually unresponsive to OTC medications, and many other topical treatments.

Topical antibiotics and topical retinoids are often innefective treatments for people with Type 3 acne. In many cases, oral antibiotics, oral retinoids (Isotretinoin) and laser-based therapies are the only effective treatments. The increased inflammation associated with Type 3 acne poses a significant risk of permanent scarring.

Type 4 Acne

  • Large and painful nodules.
  • Abundant Pustules and Cysts.
  • Persistent Outbreak.

Type 4 Acne is the most severe form of the disease. In most cases, Type 4 acne will cause permanent skin damage and scarring. Like Type 3 acne, Type 4 acne is characterized by inflammatory infections deep within the hair follicle and surrounding tissue. Large, painful cysts and nodules are a common feature in Type 4 acne.

Type 4 acne is generally non-responsive to OTC medications. Topical antibiotics, topical retinoids and naturopathic treatments are poorly effective in many cases. Type 4 acne is a serious medical condition that should be evaluated and treated immediately by a dermatologist, if possible. Treating Type 4 acne often requires aggressive treatment regimens that combine topical and oral pharmaceuticals. Type 4 acne is often extremely painful, both physically and psychologically.