Acne is one of the common reasons for dermatological visits. The American Academy of Dermatology (AAD) considers it as “the most common skin condition in the United States, affecting up to 50 million Americans annually.” It is a condition that does not discriminate and can afflict anyone from all ages and all walks of life—although it is more prominent among adolescents at the verge of puberty and women going through hormonal changes.

Make no qualms about it—for something that seems so simple, acne can cause significant psychological and physical problems, such as depression, anxiety, scarring, and low self-worth. It can make sufferers a target for bullying among peers, a problem that is so ingrained in society that it can have hazardous consequences to a person’s mental health.

Thankfully, acne is a condition that can be treated, with proper guidance and care. Here’s a rundown about acne.


Acne, also known as acne vulgaris within the medical community, is a chronic inflammatory skin condition. The majority of Americans have suffered from acne at one point or another. According to the AAD, acne treatment is estimated to be at $3 billion every year.

Acne can grow almost everywhere, but the more common spots for breakouts are the face (particularly the cheeks and forehead), back, chest, and shoulders. It can be improved with over-the-counter treatments, but more severe forms of the condition would require medical intervention.

There are several types of acne. They are:

  • Blackheads – blackheads are clearly visible as they appear as black “dots” on the skin. They are filled with dead skin cells and excess oil. The color black is the result of oxygenation or exposure to oxygen, as well as the reflection of light from the clogged hair follicles. If the blackheads are deep-seated into the skin, they would require extraction to be effectively removed.
  • Cysts – cystic acne are the ones that are clearly visible on the skin surface. They are filled with pus, are large, and oftentimes mimic the appearance of boils. Cystic acne would require the expertise of a doctor, as they can cause severe scarring or darkening of the skin if they are forced open. Having cysts on the face is an indication that the patient is suffering from a severe form of acne.
  • Nobules – This acne is defined by large, solid pimples. They are inflamed pimples that feel firm to the touch and are often very painful for patients. They oftentimes do not respond to over-the-counter drugs and would require intervention before they are cleared from the skin to help prevent scarring.
  • Papules – These are small bumps on the skin, usually pink in appearance. They are easily treated by most over-the-counter acne treatments, as well as by mild extraction. Comedones that are inflamed tend to create papules, which can be sensitive to the touch. If patients have plenty of papules on their face, then it may indicate moderate to severe acne and may require a more potent treatment other than over-the-counter drugs.
  • Pustules – These are bigger than papules and tend to be reddish in color and have white or yellow pus on the top. If removed before they are “mature” enough, pustules can trigger scarring or cause dark spots to appear on the skin.
  • Whiteheads – The opposite of blackheads, whiteheads tend to lurk under the skin surface and will sometimes need extraction to remove. Whiteheads are closed at the surface of the skin since they prevent a clogged follicle from opening.

Most types of acne can be reduced in appearance and/or removed by the use of over-the-counter products or those prescribed by a doctor at a medical spa. Medical spas can also utilize other types of treatments to clear the acne and even clear or prevent scarring.


As could be gleaned from the types of acne, there are several categories to acne which can be indicative of what comprises an effective treatment. These categories are:

  • Acne Mechanica – A lesser-known form of acne, this one usually manifests on the forehead as a straight line. This is often the result of wearing headgear such as sports cap or a helmet.
  • Mild acne – Patients have mild acne if they have fewer than 20 blackheads or whiteheads, less than 15 inflamed bumps, or less than 30 lesions on the face. This is typically treated by over-the-counter ointments and medication, as well as regular facials.
  • Moderate acne – Moderate acne describes patients who have 30 to 125 total lesions on the face. This can be a combination of whiteheads, blackheads, and inflamed bumps. Moderate acne is typically treated with a prescribed medical grade product. In some cases, this can be complemented by an oral medication.
  • Severe nodulocystic acne – On the other hand, patients with over 125 total lesions and the appearance of multiple inflamed nodules and cysts are classified with a severe form of acne. Doctors can inject the lesions with corticosteroids to reduce the size of the acne. Once the inflammation subsides, doctors or estheticians can then usually extract the lesion.
  • Acne Conglobata – One of the more severe forms of acne, this is when the acne is connected under the skin. This usually affects the neck, arms, chest, and buttocks, and can leave severe scarring. This requires immediate intervention from a doctor before it is treated.

This brings us to the question, what causes acne? This is a long topic, but as an overview, here’s what the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH) said: “Acne is a disorder resulting from the action of hormones and other substances on the skin’s oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits.” To break it down, WebMD introduces the concept of “comedone,” which it says is “A comedo, or basic acne lesion, is a hair follicle that has become clogged with oil and dead skin cells. Comedones (the plural of comedo) can develop into bumps called whiteheads and blackheads.”

In layman’s terms, this means that hair follicles that are blocked by sebum, dead skin cells, or oil, can result to pimples. In a next blog, we would discuss the treatment, causes, and prevention tips.