To see clearer skin, it helps to know what types of blemishes you're dealing with. Each type requires different treatment.
What’s that blemish?
Is that a blackhead, papule, or something else? See what the different acne blemishes looks like and how to treat them.
Blackheads and whiteheads
These appear when pores become clogged with excess oil, bacteria, and dead skin cells. If the pore closes up, you’ll see a tiny bump that looks white or flesh colored. These are whiteheads.
Blackheads (dark spots) and pimples
If the pore fills with debris but stays open, you’ll see a blackhead. The black dots aren’t dirt, so resist scrubbing. It will only worsen your acne.
Treating whiteheads and blackheads
To unclog pores, dermatologists recommend using a retinoid. You can buy one retinoid, adapalene, without a prescription. You’ll also want to use a benzoyl peroxide wash. It can help get rid of the excess P. acnes bacteria on your skin.
Stubborn whiteheads and blackheads
Give treatment six to eight weeks to work. If you still see blemishes, you may want to see a dermatologist. A procedure like comedo (medical term for blackheads and whiteheads) extraction may help. Prescription-strength acne treatment is another option.
Early pimples
When excess oil, bacteria, and dead skin cells push deeper into the skin and cause inflammation (redness and swelling), you’ll see small, red bumps. The medical word for this type of acne blemish is a papule. They feel hard. If you have a lot of papules, the area may feel like sandpaper.
Treating papules
To clear this type of acne blemish, try washing your face twice daily with an acne face wash that contains benzoyl peroxide or salicylic acid. If you have a lot of papules, it can be helpful to see a dermatologist.
Pus-filled pimples
The medical term for this type of acne blemish is pustule. These blemishes are a lot like papules, except that pustules contain a yellowish fluid. You’ll often see a yellow- or white-colored center, as shown here.
Treating pustules
To treat, wash your face with an acne product that contains benzoyl peroxide or salicylic acid. Resist the temptation to pop these. It can worsen acne. If you don’t see results from treatment in six to eight weeks, see a dermatologist.
Acne nodules and cysts
These acne blemishes penetrate deep into the skin, and often cause permanent acne scars when they heal. If you have acne that looks like this, you’ll need a dermatologist’s help to treat it. The sooner you start treatment, the fewer permanent scars you’ll have.
Virtually everyone with acne can see clear skin
If you feel discouraged with your acne treatment and believe that nothing will work, you’re not alone. Don’t give up. Effective treatment is available. Sometimes, it requires a dermatologist’s help.
Related AAD resources
Images
Images 1, 4, 5, 7, and 9: Getty Images
Image 2: Image used with permission ofJournal of the American Academy of Dermatology: J Am Acad Dermatol. 1998; 39(2 Pt 3):S34-7.
Images 3, 6, and 8: Images used with permission of theAmerican Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 10 and 11: Images used with permission ofJournal of the American Academy of Dermatology: J Am Acad Dermatol. 2001;45(2):187-95.
References
Habif TP, Campbell, JL,et al. “Comedone acne” and “Pustular acne.” In:Dermatology DDxDeck. Mosby Elsevier, China, 2006: Cards #30,31.
Zaenglein AL and Thiboutot DM. “Acne vulgaris.” In: Bolognia JL,et al.Dermatology. (second edition). Mosby Elsevier, Spain, 2008:495-507.
Zaenglein AL, Pathy AL,et al. “Guidelines of care for the management of acne vulgaris.”J Am Acad Dermatol. 2016;74:945-73.
Last updated: 9/12/23
FAQs
Topical Therapy
Over-the-counter topical products can often help mild acne. They may contain ingredients like benzoyl peroxide, resorcinol, salicylic acid, or sulfur. Prescription products such as antimicrobial or retinoid creams can treat mild to moderately severe acne.
How do I identify what type of acne I have? ›
Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules. Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face. Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules.
Which acne is hardest to treat? ›
Nodules and cysts are the most severe form of acne. You have to see a dermatologist to clear up severe acne. Picking or popping nodules and cysts can lead to scars.
What are the 4 levels of acne? ›
Table 1:
| Grade | Severity | Clinical findings |
|---|
| I | Mild | Open and closed comedones with few inflammatory papules and pustules |
| II | Moderate | Papules and pustules, mainly on face |
| III | Moderately severe | Numerous papules and pustules, and occasional inflamed nodules, also on chest and back |
| IV | Severe | Many large, painful nodules and pustules |
Acne effects around 90% of adolescents with the prime age across all genders being the teenage years of 14-19 years old. For people who have widespread acne that is classed as moderate to severe, more intervention in the form of acne treatments is often required.
What does hormonal acne look like? ›
Hormonal acne skin lesions may take the form of whiteheads, blackheads, papules, pustules and, in more severe cases, nodules and cysts. These can appear along the jawline, or on the chest and back. The skin will be bumpy, congested, and present with an overall dull appearance.
How do I know if my acne is bacterial or hormonal? ›
Other signs of hormonal imbalances like irregular periods, excessive hair growth, or hair loss may also be present in addition to this one. On the other hand, bacterial acne is characterized by the presence of red, tender, and frequently inflamed cysts, pustules, and pimples.
How do I know if my acne is hormonal or cystic? ›
Hormonal acne resembles usual acne but may cause more deeper nodules and cysts, that last for long periods. Hormonal acne causes spots on the chin and jaw line & also around the mouth. Hormonal acne can also cause acne over the whole face and back. More information on acne and other treatments for acne.
How to tell the difference between stress acne and hormonal acne? ›
Period pimples, or other more consistent breakouts are usually not stress related,” explains Dr Gohara. Stress pimples will usually pop up in the oiliest areas of the face, like the forehead, nose and chin. Your T-zone might look greasier and more congested too.
What is triggering my acne? ›
Some things that may trigger acne include: Hormonal changes that make the skin oilier. These may be related to puberty, menstrual periods, pregnancy, birth control pills, or stress. Greasy or oily cosmetic and hair products.
Bacteria can inflame the hair follicle and cause lesions that are red, swollen, and filled with pus. Bacterial acne has the potential to scar or cause pigmentation.
What's the difference between acne and pimples? ›
The clearest way to distinguish between acne and pimples is to understand that pimples are a symptom of a condition, whereas acne is the condition itself. Someone who has acne-prone skin will experience pimples as a part of their condition, however not everyone who gets the occasional pimple has acne-prone skin.
What does stage 1 acne look like? ›
Grade 1 Acne is the mildest of 4 acne types hence it also most commonly know as mild acne. This Acne consists of comedones (blackheads) mostly on the nose, and a few papules which are small, red breakouts typically found on the cheeks. These breakouts are minimal and tend to be occasional.
Does itchy acne mean its healing? ›
On a positive note, itchiness can be a sign indicating that the acne is getting better. When acne is healing, the red, pustular skin needs to be replaced with new, healthy skin. During this process, your body exfoliates, or sheds old layers of skin to uncover new layers of skin.
Is it possible to get rid of all acne? ›
While severe acne can be stubborn, it's not impossible to get clearing. Thanks to advances in treatment, virtually all acne can clear with a dermatologist's help.
What causes all over acne? ›
Some things that may trigger acne include: Hormonal changes that make the skin oilier. These may be related to puberty, menstrual periods, pregnancy, birth control pills, or stress. Greasy or oily cosmetic and hair products.
Why is my acne so bad everywhere? ›
Acne is the result of pores being clogged by excess oil, dirt, and bacteria. It can be caused by many things, including skin-care products, picking, hormones, stress, medical issues, smoking, diet, and more. Some areas of your body are prone to certain types of acne, as well.
Why do I always have so much acne? ›
Four main factors cause acne: Excess oil (sebum) production. Hair follicles clogged by oil and dead skin cells. Bacteria.
