Types of Acne Explained: From Blackheads to Cysts

“Acne” is not one single thing. It covers several different types of spots, from tiny blackheads to deep, painful cysts, and each responds best to different treatment. Knowing which type you have is the first step towards treating it properly.

Non-inflammatory acne

Blackheads (open comedones)

Small dark dots in pores, most often on the nose and chin. The pore is blocked with oil and dead skin cells but stays open at the surface, and the plug darkens as it is exposed to air.

Whiteheads (closed comedones)

Small, skin-colored or white bumps where the blocked pore is closed over by skin. They are often more noticeable when you stretch the skin.

Best treatments: salicylic acid and retinoids such as adapalene, which clear and prevent clogged pores.

Inflammatory acne

Papules

Small, red, raised bumps that can feel tender. They form when the wall of a clogged pore breaks down and the surrounding skin becomes inflamed.

Pustules

Red bumps with a white or yellow center of pus. These are what most people think of as a typical pimple.

Best treatments: benzoyl peroxide, retinoids, and for more widespread cases, prescription topical or oral treatments from a doctor.

Severe acne

Nodules

Large, hard, painful lumps that sit deep under the skin and can last for weeks.

Cysts

Deep, soft, pus-filled lumps that are often painful. Nodular and cystic acne carry the highest risk of scarring.

Best treatment: see a dermatologist. Over-the-counter products are rarely enough, and early prescription treatment (for example oral antibiotics, hormonal treatment or isotretinoin) can prevent permanent scars.

Conditions often confused with acne

Rosacea: facial redness, flushing and small bumps, usually in adults, without blackheads.
Fungal folliculitis: small, uniform, itchy bumps, often on the forehead, chest and back, which do not respond to normal acne treatments.
Perioral dermatitis: a rash of small bumps around the mouth and nose, sometimes triggered by steroid creams or heavy products.

If your “acne” does not behave like acne or does not respond to standard treatment, it is worth getting a diagnosis.

How severe is your acne?

Mild: mostly blackheads and whiteheads with a few red spots. Usually responds to over-the-counter care.
Moderate: many papules and pustules across the face or body. Often needs a doctor’s input.
Severe: nodules and cysts, or acne that is leaving scars. Needs a dermatologist.