Different Types of Spots and How to Treat Acne

Acne is a common condition for many people. 1/4 of people suffer from acne at some point in their life. For those with persistent acne physical discomfort and mental upset is frustrating. However, with the correct treatment, it is possible to relieve the condition.

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Acne Basics

Acne can affect the face, back and less commonly the chest. Acne occurs when oil/sebum from sebaceous glands is produced in excess and, combined with dead skin cells, blocks follicles of hairs on the skin. This can lead to different kinds of spots to appear on the skin’s surface, namely:

Whiteheads - Whiteheads (also known as closed comedones) are small white/yellow bumps on the skin. They may be firm and won’t empty when they are squeeze.
Blackheads - Blackheads (also known as open comedones) are black/yellowish bumps on the surface of the skin. Pigmentation of the lining of the hair follicles gives them their darker appearance.
Papules - Papules are small, red and inflamed bumps that can feel sore or tender.
Pustules - Pustules are similar to papules but also have a white center due to the build-up of pus.
Nodules - Nodules are larger, red and inflamed lumps. They are hard and can be painful.
Cysts - Cysts are larger lumps filled with pus inside. They are more likely to scar. Squeezing them should be avoided for this reason.

Severity of Acne

Acne can be assessed and grouped by severity. This is done by looking at how much and which types of spots are present. As a rough guide:
Mild acne - There are open and closed comedones with or without sparse inflammatory lesions.
Moderate acne - There are more widespread non-inflammatory lesions and some papules and pustules
Severe acne - There are extensive inflammatory lesions which may involve nodules and cysts. There may be pitting and scarring of the skin.

Treating Acne

Treating acne depends on the severity of the problem. It can take some weeks to several months before you start to see results with your treatment. If you have mild acne there are topical treatments available that contain benzoyl peroxide (FDA approved) that you can buy over the counter. However, if your acne is moderate or severe we recommend consulting your doctor about this issue. Your doctor will be able to rule out other causes of skin lesions and diagnose any conditions causing a hormonal imbalance that may be underlying your acne problem if this is present. Treatments can be combination treatments from:

Topical antibiotics
Topical retinoids
Azelaic acid
Oral antibiotics
In women, the combined oral contraceptive pill

There are rules regarding which combinations are permissible. For example, two treatments with the same active ingredient are not usually prescribed at the same time and antibiotics or the pill tend to be used but not both. Treatments often follow a step-up management with single topical preparations to combinations with oral drugs being used last as they have effects throughout the body and some of these may be unwanted. Some treatments will work for some people but not for others. It may be necessary to switch medicines or wait for medicines to take effect. If your skin worsens or does not improve contact your doctor.

Summary

Acne lesions are diverse and some are more troublesome than others. You do not have to fall victim to acne. Take action by contacting your doctor to start a treatment plan. They will be able to discuss the best treatment suitable for you depending on your medical history and acne severity.