Diagnosing Acne: What Kind of Acne Do I Have?

Written by Julie Jackson, MD, Board Certified Dermatologist on February 26, 2015 5 Comments

types of acne

All acne is not the same. There are many specific types of acne, each type having its own characteristics and treatment options. Knowing which type of acne you suffer from is the first step to successful treatment and minimization of symptoms.

Acne is generally categorized into two distinct groups, inflammatory acne and non-inflammatory acne:

  • Inflammatory acne manifests as red and painful papules, pustules, cysts, and nodules. This type of acne develops after clogged pores become infected with bacteria. The pain and inflammation is the result of the body’s natural production of white blood cells in order to fight this bacterial infection. Inflammatory acne can last for weeks to months and can leave sufferers with permanent scarring.
  • Non-inflammatory acne includes less severe comedones (blackheads and whiteheads) and seborrhea (scaly red skin). Unlike inflammatory acne, this type of acne is not painful and is often short-lived. Breakouts are cyclical with comedones appearing and diminishing within a couple of days.

Dermatologists use the prevalence and degree of inflammatory acne to categorize the severity of a patient’s acne and determine the proper treatment. Acne is ranked as mild, moderate, and severe.

Mild Acne

When you have several comedones but very few papules and pustules, then you most likely have mild acne. Mild acne is not inflamed, thus it doesn’t have a red appearance and is not painful. This level of acne appears as spots on the lower part of the face, around the mouth, along the jaw, and across the neck. Mild acne commonly appears on areas of the body that have the highest concentration of sebaceous glands including the face, neck, back, and chest.

Mild acne can be treated with a prescription topical retinoid, or over the counter topical medications such as salicylic acid. In addition, there is evidence that a diet with a low glycemic index may be beneficial. Finally, it is advised to practice a proper skincare regimen that includes the use of oil-free and fragrance-free products.

Moderate Acne

This level of acne is similar to mild acne but with visibly more inflammatory spots including papules, pustules, and nodules. Thus there is a mixture of non-inflammatory comedones with defined areas of inflammation.

The use of oral antibiotics and topical treatments may be necessary to treat moderate acne. Common oral antibiotics prescribed by physicians include Doxycycline and Minocycline. Topical treatments including retinoids, topical antibiotics, and over the counter ingredients like salicylic acid, benzoyl peroxide, and glycolic acid can also help to reduce moderate acne.

Severe Acne

Severe acne is characterized by an abundance of inflamed papules, pustules, and nodules combined with the presence of deep and painful cysts, acne scarring, and an irregular (pitted) skin surface. Severe acne is typically very painful with long term ramifications.

The first line treatment option for severe acne is a prescribed medication known as Isotretinoin. Other treatments like oral antibiotics, corticosteroid injections combined with comedone extraction, chemical peels, and photodynamic therapy can also help minimize painful symptoms.

Do you suffer from a form of acne? Contact us today to be seen by a board certified dermatologist or to learn more about our next generation acne treatments. Our professionals will construct an effective treatment plan for your specific individual needs.

Julie Jackson, MD

Dr. Jackson is double board certified by the American Board of Dermatology in the specialty of dermatology and sub-specialty of dermatopathology. She is a member of the American Medical Association, American Academy of Dermatology, American Society of Dermatopathology, Women’s Dermatologic Society, and Texas Medical Association.

5 Responses to “Diagnosing Acne: What Kind of Acne Do I Have?”

  1. Avatar Andrea says:

    I fall somewhere between severe and mild. I have tried so many different things for my face: I wash it everyday and my acne is still awful and it hurts, itches, its irritating. I’ll make an appointment to come in!

  2. Avatar Chloe says:

    Can mild acne be on the forehead, nose, chin and cheeks as well as my back? Because that’s where mine is?

    • WD Staff WD Staff says:

      Hi Chloe, Thanks for reading our blog and asking a great question! Mild acne can manifest within the areas you describe. Rather than location, the biggest factors in the mild classification is severity. So if your symptoms are relatively minor (a few pimples here and there without any redness or irritation) it’s most likely a more mild form.

      Just using quality acne products (oil and fragrance free) should definitely help control mile acne. I would also recommend seeing a board certified dermatologist, they can discuss other lifestyle changes that can help!

      Thanks again for reading!

      –WD Staff

  3. Avatar Claire says:

    @Chloe I have the same issues. Thanks WD for the post and great answer

  4. Avatar Eli says:

    Acne is so unfair!

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