What Are the Different Types of Acne? Dermatologists Explain All

You may not be able to immediately understand all the types of acne, but you’ll instantly recognize those annoying pimples on your face.

Whether they’re big, red, and painful or small and barely noticeable—if pimples bother you, there’s a reason to treat them. The only problem?

Treating acne is easier said than done. To help us understand the complex world of acne and how to best treat different types of acne, we consulted board-certified dermatologists Dr. Christine Choi Kim, Dr. Devika Icecreamwala, and Curology CEO Dr.

David Lortscher. The skin experts will tell you everything you need to know about pimples.

What is acne?

In short, acne occurs when sebum (the oil that makes our skin naturally soft) mixes with dead skin cells and bacteria and clogs pores.

Kim explains that people with acne have abnormal shedding of hair follicle cells and too much sebum production. Both of these factors lead to clogged pores.

Types of acne

According to Lortscher, acne is generally divided into two main categories: non-inflammatory acne and inflammatory acne. Within these subgroups there are different species with different identifiable characteristics.

Non-inflammatory acne

Also known as comedone acne, this type of acne does not involve large, painful, red papules. Instead, small blackheads and pimples occur, primarily in oily areas of the face, such as the T-zone (but also on the chest and back).

This type of acne is caused by a blockage in the sebaceous units (follicles) of the skin. Differences between whiteheads and blackheads:

Whiteheads: Also known as closed comedones, these pimples appear as small, white bumps due to dead skin cells and sebum trapped inside them. Whiteheads are covered by a thin layer of skin, and their contents are not exposed to the air, Lortscher explains.

Therefore, they appear white or yellowish—the typical colors of oil and dead skin cells.

Blackheads: In contrast, these pimples are open comedones, exposing the trapped oil and dead skin cells to the air. According to Lortscher, oxygen in the air reacts with the trapped material (a process called oxidation), giving the pimples their black color (hence the name).

Inflammatory acne

According to Icecreamwala, inflammatory acne is often caused by an overgrowth of Propionibacterium acnes, a bacterium that lives on the skin and can increase inflammation. This type of acne can appear as papules, pustules, nodules, and cysts.

Papules: These are soft, red, and swollen bumps that have no visible fluid (i.e., no blackheads) and are usually smaller than 5 millimeters (about the size of a pencil eraser). According to Icecreamwala, papules are often caused by dead skin cells clogging pores and increasing inflammation.

Pustules: Pustules are inflamed lesions with visible blackheads that you might be tempted to squeeze (but it’s best not to). They usually range from 1 to 5 millimeters in size, according to Lortscher. Pustules are often caused by an overgrowth of Propionibacterium acnes, Icecreamwala notes.

Bumps: Bumps are larger, firm, red bumps. These spots are deeper than pimples and can be painful, according to Lortscher.

Cysts: Cysts are another painful form of inflammatory acne. They are acne deep in the skin that never seem to go away. Lortscher describes cystic acne as severely inflamed and/or oozing acne nodules. Icecreamwala explains that cysts can be caused by genetics or hormones.

Treatments for Non-Inflammatory Acne

Kim says the most effective way to treat and prevent breakouts is with products that normalize cell shedding, dissolve sebum, and gently exfoliate dead skin cells from the stratum corneum.

However, remember that treating acne is a marathon, not a sprint. In other words, start low (ingredient percentage and frequency) and work your way up. Kim recommends being patient and waiting 6 to 8 weeks for the product to really make a difference in your skin.

Gentle Exfoliation

Exfoliation is essential for treating comedonal acne, but that doesn’t mean the stronger the better. In addition to physical exfoliants, you can try gentle chemical exfoliants, like SkinMedica’s AHA/BHA Exfoliating Cleanser ($48), a Byrdie-approved face wash.

Kim recommends products with alpha hydroxy acids (like glycolic and lactic acids) and beta hydroxy acids (salicylic acid), but warns against overdosing. Using scrubs, toners, masks, and full-body treatments can cause redness, dryness, and flaking, acne, or trigger irritant contact dermatitis.

Top tip: Apply slowly and gently. For sensitive skin, Kim recommends products with gentle exfoliants, like azelaic acid, mandelic acid, or the plant-based retinol alternative bakuchiol.

Incorporate retinoids into your routine.

Topical retinols and prescription retinoids are not only effective for treating comedonal acne by opening up pores, but they also promote cell turnover, increase collagen production, reduce fine lines and wrinkles, and lighten dark spots.

Start using these products (Kim recommends Differin Adapalene Gel, $15) once or twice a week and slowly increase to nightly use if you can tolerate it without peeling, redness, or burning.

If you’re used to using an over-the-counter retinol at night, ask your dermatologist about a stronger prescription retinoid. As with any acne-fighting product, if you’re pregnant, nursing, or planning to become pregnant, you should consult your doctor before using a retinoid.

Wash your face with a cleansing device

Kim recommends using a facial cleansing device at night to thoroughly remove makeup, sunscreen, oil, and pollution, but don’t just use any cleansing brush. Opt for a brush with ultrasonic technology, which is gentler on the skin than a rotating brush head.

Foreo’s Luna 3 ($219), made from relatively antibacterial silicone, is one of Kim’s top recommendations.

Moisturizing Treatments

People with acne often worry that moisturizers will clog pores and cause acne. But that’s not true. Kim says oil-free or noncomedogenic formulas can make acne products more tolerable and produce results faster.

Even a lightweight hyaluronic acid serum (like Byrdie favorite Rose Ingelton MD Skin Calming Booster, $70) is a good option for summer or oily skin, according to Kim.

Treatments for Inflammatory Acne

The same principles apply as for treating noninflammatory acne: Don’t over-cleanse, scrub, or exfoliate your skin.

Gentle Peels

Kim explains it best: Inflammatory acne lesions stem from noninflammatory acne lesions. Therefore, the initial recommendations for inflammatory acne are the same as standard treatments for noninflammatory acne.

“I try to use a retinol, retinoid, or AHA/BHA product for every acne patient I have to address the root cause of all acne: clogged sebaceous glands,” Kim explains.

Cover your rash with stickers

If you feel a deep cyst forming but can’t make it to your dermatologist for a cortisone shot, Kim suggests covering it with stickers from ZitSticka’s Killa Kit ($29). It contains valuable ingredients like salicylic acid, hyaluronic acid, niacinamide, and oligopeptide-76.

Try topical antibacterial and anti-inflammatory ingredients

“The acne bacteria live at the base of the hair follicle, where they break down sebum into fatty acids, which in turn trigger inflammation in the surrounding skin,” Kim explains.

“Even though acne isn’t a true skin infection, antibacterial products are a big mainstay in the treatment of inflammatory acne.” Icecreamwala recommends benzoyl peroxide because it kills bacteria, which can help soothe inflammation caused by bacteria.

If you hate benzoyl peroxide for bleaching your sheets (we don’t blame you), Kim recommends CLn Acne Cleanser ($32), which contains sodium hypochlorite, as an alternative to benzoyl peroxide. Kim also recommends topical anti-inflammatory ingredients like niacinamide, zinc, and sulfur.

Visit a Dermatologist

Not all acne can or should be treated at home. If cysts and nodules are located deep in the skin, a visit to a dermatologist may be necessary. Sometimes prescription medications, cortisone injections, or even incisions in the skin for drainage are necessary.

For moderate to severe inflammatory acne that can cause scarring, oral antibiotics, prescription medications such as spironolactone and isotretinoin may also be considered.

For those who want to avoid oral medications, Kim recommends light- and energy-based devices that can reduce the number of P. acnes, sebum production, overall redness, and inflammatory lesions, and treat active cystic acne and acne scars.

Despite all of these treatment options in practice, the best way to clear your skin is obviously to visit a dermatologist.