Different Kinds of Acne
While acne is sometimes seen as a pre-teen and teenage rite of passage, it's actually a skin condition that can be an embarrassing problem well into adulthood. The American Academy of Dermatology estimates that 40 million to 50 million Americans are affected by acne. There are several types of acne, ranging from mild to severe, that have different treatments. All forms of acne start with the same thing, though: an enlarged hair follicle that has become filled with oil, dead skin cells, tiny hairs and sometimes bacteria.
No matter what they look like, blackheads (or "open comedos") are not, in fact, trapped dirt. They're partially obstructed hair follicles caused by an overproduction of oil and trapped dead skin cells. The black color comes from the pigment of the skin cells reacting to the oxygen in the air. Blackheads can last a long time if untreated. Treatments may include benzoyl peroxide, salicylic acid, retinoids, professional extraction by a dermatologist, or antibiotics.
Known as a "closed comedo" in medical terms, this is what happens when a hair follicle becomes completely blocked, and traps the oil, dead skin cells and bacteria. Whiteheads are so named because they look white on the surface. They are not long-lasting and are treated with the same methods as blackheads.
Papules are small (5 millimeters or less), solid, inflamed lesions that usually appear as pink or red bumps on the skin. They can be almost invisible from a distance. They do not contain pus. They may be treated with topical antibiotics, topical retinoids, warm compresses, topical benzoyl peroxide or oral medications.
Pustules are raised lesions filled with pus and have a reddish base. They normally contain white blood cells, bacteria and dead skin cells. If they're left alone to heal (that is, if a person doesn't pick at them or try to "pop" them), they usually don't leave any scars. However, they can develop into cysts. The treatment for pustules is the same as the treatment for papules.
Cystic acne forms when pus runs deep into the skin and begins to infect the tissue around the primary infection. It tends to be painful and can leave permanent scars, more so than other types of acne. Cystic acne can be caused when a person tries to "pop" their pimples and instead makes the infection travel deeper. Treatment may include oral antibiotics and retinoids.
Whereas cysts are filled with liquid or semi-liquid, nodules are hard and solid. They're larger than papules and, like cysts, are usually painful, can cause scarring and can be difficult to treat. Cysts and nodules often appear together, causing a condition called nodulocystic acne. This requires treatment by a doctor, which may include oral antibiotics, retinoids or surgical excision and drainage.
Macules are the sites of healed acne lesions. They can appear flat and red for a few weeks after the acne has healed, and new lesions can form on top of macules.
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