Skin Care Tips From Dermatologist
Different Types of Acne
Acne Types

Acne treatment depends upon the clinical type and severity of the pimples. There are many different types of acne classifications available, depending upon the morphology, severity and pathophysiology of the acne.

Why Learn about Different Types of Acne?

 Most people think that all types of acne require same treatment. Nothing can be far from the truth. Each type of acne has to be managed according to its own merit. Most acne natural or home remedies are not effective because they do not pay attention to this important factor.

Your dermatologist will take into account a number of factors while deciding on the best pimple treatment suitable for you; like the type and severity of acne, your age, gender, profession, and; if you are a female, whether you are expecting or breast feeding or have chances of getting pregnant.

Knowing your acne type will also help you decide when to get expert help so as to avoid complications like acne scars and acne skin blemishes.

The most useful and common classifications of acne are as follows:

Morphological Types of Acne

Morphological Types of Acne include

  1. Acne Comedones: Primary lesions during the development of acne; non inflammatory type of acne. Two types: Closed comedone (whitehead) and open comedone (blackhead).
  2. Acne Papules: Papular acne shows minimal inflammation with skin colored or red bumps.
  3. Acne Pustules: Moderate to severe inflammation and pus filled bumps are seen in pustular acne.
  4. Acne Nodules: Deep seated, red, severely inflamed nodules characterise nodular acne. Acne nodules are the result of repeated inflammatory rupture and encapsulation of the hair follicle and sebaceous gland with abscess formation and foreign body reaction.
  5. Acne Cysts: Fluctuant cystic acne lesions are abscesses formed by the breakdown and necrosis of the nodules and contain the debris from infected sebaceous gland, hair duct, inflammatory cells and surrounding dermal tissue.
  6. Acne Conglobata: In very severe acne, the nodules and cysts connect together to form deep, painful sinus like tracts. These are prone for deep scars.

Types of Acne Depending Upon the Severity

The following classification, a very useful one for the patients as well as the treating dermatologist, is modified from “Acne therapy: A methodological review” by Lehmann HP et al. in the August 2002 issue of the Journal of American Academy of Dermatology.

  1. Mild Acne: Up to 20 comedones and less than 15 papules, total acne lesions less than 30 in number.
  2. Moderate Acne: 20-100 comedones and/or 15-50 inflamed papules or pustules, total count of 30-125 acne bumps.
  3. Severe Acne: More than 5 cysts/nodules, more than 100 comedones or inflammatory acne lesions more than 50 with a total acne bumps’ count more than 125
  4. Very Severe Acne: Disfiguring severe nodulocystic acne, covering the major portion of the face, chest and back.

Acne Types Based on the Pathophysiology of Pimples

  1. Inflammatory Acne: Includes acne with papules, pustules, nodules and cysts.
  2. Non-inflammatory acne: Includes comedonal acne.

Acne Grading System

 This grading of acne includes a combination of above classifications.

  1. Grade 1. Mild, comedonal acne; non inflammatory type.
  2. Grade 2: Moderate, papular acne; inflammation is minimal
  3. Grade 3: Severe, pustular acne with moderate to severe inflammation. Chances of acne scar formation present.
  4. Grade 4: Very severe, nodulocystic acne. Deep acne scars possible if not treated promptly.

These different classifications of acne are useful not only in choosing the appropriate treatment modalities for the pimples, but also for conducting acne clinical research and disease surveys. The mild acne is the only type of acne where OTC products and acne home remedy may be tried without much risk of acne complications.

Published by Dr Hanish Babu, MD on 25th May, 2018

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

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