Our Comprehensive Guide To Acne: Causes + How To Treat Each

Acne, the complex skin condition it is, comes in many, many forms. Each zit is technically born the same way—dead skin, oil, and bacteria stick together and block the pores—but from there, it can develop into various types of blemishes.

Some are large, red, and tender to the touch (like cysts); others are speckled across your skin, causing textural concerns (hello, blackheads and whiteheads). Here, we dive into the seven types of acne, the causes, and how to best treat each spot.  

Each type of acne technically falls into one of two buckets: non-inflammatory or inflammatory. To be clear, all acne stems from some level of inflammation. (This distinction is a bit of a misnomer, but it helps us distinguish the aesthetic differences.)

A few types are more tender, puffy, and angry than others—those are classified as "inflammatory." Papules, pustules, nodules, and cysts fall into this category, as they're all typically red and painful. 

It's typically caused by clogged hair follicles and found where the skin is more oily, like the chest, back, and T-zone area of the face.

Non-inflammatory acne can become inflamed later on when there is an overgrowth of bacteria (specifically Cutibacterium acnes1), which can cause the release of inflammatory cytokines and messengers to create clinical inflammation. So again, all acne is inflammation on some level.

Along acne, there's also other kinds of skin conditions that may appear like acne, such as "fungal acne." fungal acne is not acne, but rather a type of folliculitis (inflammation of the hair follicle) that happens when yeast becomes trapped inside of hair follicles, leading to pimple-like bumps.

"Closed comedones are whiteheads; they look like tiny whitish or flesh-colored bumps on the surface of the skin," board-certified dermatologist Daniel Belkin, M.D., once shared with mbg. 

Now, whiteheads are not the large, tender zits with a big pus-filled center (those are pustules, which we'll get into later). Rather, because whiteheads are not inflamed, they are much subtler.

Blackheads form the same way whiteheads do (i.e., when the pore becomes blocked with gunk and oil) with one caveat: They're considered open comedones.

OK, technically, "subclinical acne" is not a term used in dermatology, but it's used enough in skin care conversations to earn a spot on our list. Essentially, it's a fancy way of saying "congested skin," and it's synonymous with whiteheads. 

Now, let's enter inflammatory acne territory. "Papules look like solid red bumps, while pustules have pus at the top," board-certified dermatologist Zenovia Gabriel, M.D., FAAD, says regarding forehead acne.

Again, papules often turn into pustules: When the red papule forms a white, pus-filled head, you now have a tender pustule. People often mistake this white head as, well, a "whitehead," but in clinical derm-speak, those are two very different things.

"Nodular acne is one of the most severe forms of acne, along with cystic," says board-certified dermatologist Dendy Engelman, M.D., FAAD. Although, she adds that nodules are firmer than cysts and are also more widespread than typical pimples.

Cosmetic and general dermatologist at Marmur Medical Rachel Maiman, M.D., says this type of acne, "often feels like firm knots under the skin and can be found on the face and body."