• Blackheads
• Whiteheads
• Pustules (pimples)
• Papules (small red, tender bumps)
• Nodules or lumps found directly under the skin
• Cystic lesions (painful, pus-filled lumps)

Acne vulgaris. The most common form of acne. Acne vulgaris usually begins during puberty and can continue through adulthood. The lesions (papules, whiteheads, blackheads, etc.,) can be found all over the body but usually occur on the face, neck, chest, and back.

Acne conglabata. A severe form of acne vulgaris. This type of acne presents as large lesions that may be interconnected found on the face, back, cheeks, upper arms, and thighs. It is common in males between the ages of 18 and 30 years old. May leave permanent scars if left untreated.

Acne fulminans. Occurs when acne conglabata starts suddenly resulting in scarring and ulcerations where lesions are found. Other symptoms that accompany acne fulminans are aching joints and fever.

Gram-negative folliculitis. This rare bacterial infection can occur in some cases of antibiotic treatment with acne vulgaris. It is characterized by cysts and pustules.

Acne rosacea. Similar in appearance to acne vulgaris, this type of acne is usually found only on the nose, cheeks, chin, and forehead and resembles a rash. Rosacea is characterized by small, red pumps and may cause facial swelling.

Pyoderma faciale. This severe form of acne is found only in females and is characterized by nodules that may be painful and develop into sores or pustules. It can come on suddenly and appears only on the face. May cause permanent scarring if left untreated.

Acne can be caused by excessive production of oil or sebum. Hair follicles are connected to the sebaceous glands that produce sebum and when these become plugged with oil or dead skin, acne can develop. Inflammation deep inside the hair follicles can lead to the development of a cyst underneath the surface of the skin. Pimples (raised red bumps with a white center) occur when the blocked hair follicles become infected with bacteria after becoming inflamed.

Acne treatments are based on severity. For mild to moderate acne, benzoyl peroxide and salicylic acid formulas are typically used. In more severe cases of acne, topical and oral antibiotics may be prescribed usually in conjunction with topical retinoids. Topical retinoids contain high doses of vitamin A compounds and possess anti-inflammatory properties while preventing the formation and number of pimples. Other therapies include:

• Laser and light therapies
• Oral contraceptives
• Intralesional steroids (treats large cystic lesions)

Many acne-sufferers have been told that eating greasy foods and chocolate will lead to “break-outs”. This is a myth. Other myths include that cosmetics and bad hygiene cause acne. Remember it is caused by oil-production, inflammation, and bacteria leading to infected pustules. While some cosmetics may clog pores (especially if you do not remove the makeup regularly), there is oil-free makeup available that does not clog pores. Over cleansing the skin can irritate your skin and worsen the condition of the skin.

There are natural treatments that may help improve symptoms of acne. These include:

Tea treeoil. Treats mild to moderate acne. This essential oil derived from the Australian plantMelaleuca alternifoliais a powerful antimicrobial and anti-inflammatory agent. A recent study has shown that using tea tree oil-containing products significantly reduces the number of acne lesions while being well tolerated.

Biofeedback. Used in conjunction with dermatological treatment, biofeedback has been shown to significantly reduce the severity of acne.

Jojoba oil. This natural, waxy substance derived from the seeds of the jojoba shrub contains anti-inflammatory compounds. Using jojoba oil may help to repair skin damage and speed up the healing of acne lesions. You can mix pure jojoba oil with a drop or two of essential oil (like lavender or tea tree oil) and apply it over acne sores.

Aloe vera. Aloe vera gel is anti-bacterial and has anti-inflammatory properties. Using aloe vera may help prevent acne flare-ups, moisturize the skin, and reduce swelling and inflammation.

• Hormonal changes
• Certain medications, such as corticosteroids or testosterone
• Diet, especially carbohydrate-rich foods
• Stress

AADA. Acne: Tips for managing. Retrieved from American Academy of Dermatology Association: https://www.aad.org/public/diseases/acne/skin-care/tips

DSA Dermatology. Six types of acne. Retrieved from: https://www.dsadermatology.com/pdf/Six-Types-of-Acne.pdf

Goulden, V., Stables, G. I., Cunliffe, W. J.  (1999). Prevalence of facial acne in adults. Journal of the American Academy of Dermatology. (pp 577-580). Retrieved from:https://doi.org/10.1016/S0190-9622(99)80056-5

Huizen, J. (2018, July 13). Fifteen home remedies for acne. Retrieved from: https://www.medicalnewstoday.com/articles/322455

Mayo Clinic. (2020, September 12). Acne: Symptoms and causes. Retrieved from Mayo Clinic:https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047

NIH. Acne. What is acne? Retrieved from National Institute of Health:https://www.niams.nih.gov/health-topics/acne

Titus, S. & Hodge, J. (2012, October 15). Diagnosis and treatment of acne. American Family Physician, 86(8).Retrieved from:https://www.aafp.org/afp/2012/1015/afp20121015p734.pdf