Even though all acne spots and blemishes start to develop in
the same way, they can acquire many different appearances and
may react differently
different people, leading to different types of acne. All acne
originates with one basic lesion: the comedo, an enlarged hair
follicle blocked with sebum made from oil, dead skin cells and
bacteria. The comedo stays below the surface of the skin
to develop into a swollen lesion. As more sebum keeps on being
produced, bacteria thrive within the swollen follicle. The neighboring
skin becomes gradually more inflamed as the white blood cells
fight against the trespasser. The way the comedo develops and the
way the immune system responds detemrine the nature of the acne
and the type of lesion that is seen.
There is a list below with a brief
classification and definition of each feature that can be seen
in acne. Acne lesions extend
in severity from comedones (mild) to nodules and cysts (nasty).
Comedo is a type of acne in which a sebaceous follicle is blocked
with sebum, dead cells from inside the sebaceous follicle, and
sometiems small hairs, and bacteria. If a comedo is open,
it is usually
called a blackhead since the outside of the plug in the follicle
has a blackish outward appearance. A closed comedo is commonly
known as a whitehead. Its appearance is that of a skin-colored,
or a somewhat swollen, “bump” in the skin. The difference
in color between the whitehead and the blackhead lies on the fact
that the aperture of the plugged sebaceous follicle to the skin’s
surface is closed or very narrow, unlike the expanded follicular
opening of the blackhead.
Another type of acne feature presentation is a papule. A papule
is a tiny (5 millimeters or less), solid lesion vaguely prominent
the skin. A group of very small papules and comedones may be practically
undetectable but have "a sandpaper" feel to the touch.
A papule results from a limited local cellular response to the
process of acne.
Pustule: a pustule is a frail type of acne lesion with the figure
of a dome. It contains some pus, which in general consists of
a concoction of white blood cells, dead skin cells, bacteria,
and plasma fluid. A pustule
that develops over a sebaceous gland may or may not have a hair
in the center. Acne pustules that cure devoid of continuing to
form usually leave no scars.
Macule: a macule is the short-term red spot that is left by a
healed acne lesion. It is flat, usually red or reddish, with a
distinct border. A macule is a type of acne feature that may endure
for a long time, maybe weeks, before vanishing. Macules can contribute
to the “red face” appearance of acne if a number of
them are present together at one time.
Nodule: a nodule is like a papule in that it is a solid, dome-shaped
lesion. However, unlike a papule, a nodule may be very painful.
This type of acne is characterized by swelling. The nodule reaches
into deeper levels of the skin and may produce tissue damage,
in scarring. Nodular acne is one of the most severe types of acne
An even more severe type of acne is a cyst. A cyst is a lesion
that resembles a sac, containing liquid substances composed of
blood cells, dead cells, and bacteria. It is reminiscent
of a pustule; it can become really inflamed, reaches deep skin
layers, can be very painful, and may result in scarring. The
main difference is that cysts outsize pustules. Cysts and nodules
usually occur together in severe types of acne.
The features above are the main characteristics of acne that
are usually seen. You might see just one type of acne feature
or you might see several types together in the same region of