What are some common types of acne?
Acne is one of the common skin conditions that are seen in individuals of all age groups. The determination of the different types of acne is done on the basis of appearance, age of the individual and other causative or aggravating agents.
Below is a brief introduction of different types of acne and how you can identify each type, followed by some popular acne treatments available.
Mild to Moderate Acne
Mild to moderate acne includes skin conditions in which the risk of extensive skin damage is moderate as compared to severe acne that leads to widespread areas of skin damage, leading to disfiguring and scarring. Below are the most common types of moderate acne:
Acne Vulgaris – The commonest and mildest form of acne that constitutes a variety of lesions like whiteheads, blackheads that may get inflamed to give rise to papules, pustules or in some rare cases nodules or cysts. The primary pathology is the increased oil or sebum production by oil producing glands of skin that clog the pores. Clogging of skin pores leads to entrapment of dead cells, bacteria and cellular debris that elicit an inflammatory response which eventually leads to papules or pustules.
The lesions of acne vulgaris are:
- Whiteheads appear when skin pores are clogged due to excessive oil secretion from the sebaceous glands. The dead cells get infected under the influence of bacteria that forms a white spot on the skin surface.
- Blackheads are similar in structure and pathophysiology to whiteheads with the only difference that the pore is not fully clogged. Due to stable structure, these tend to last longer than white heads and over-time turn brown to black as a result of melanin formation.
- Papules are comparatively larger in size as compared to whiteheads/ blackheads and become tender due to inflammatory reactions.
- Pustules are the later and much more inflamed form of a papule that has a red tender margin and yellow/white center that contain pus (or cellular debris). The difference in management of a papule and a pustule is that you can pop the latter but not the former due to risk of scarring.
Severe Acne Vulgaris -It follows the same pathophysiology as that of moderate acne vulgaris with the difference that inflammatory process in acne vulgaris goes far beyond the boundaries of normal control and leads to development of nodules or cysts.
- Nodular acne is marked by the presence of prominent and painful nodules that can even last for months. These nodules are hard and tender on palpation and don’t reduce or dissolve on squeezing the top (as opposed to papules and pustules). Such skin lesions normally leave unsightly scars and indentations that may also be associated with recurrent nodular acne flares.
- Same is true for acne cysts that are similar in size and appearance to nodular acne with the difference of cystic collection of pus that is produced as a result of dissolution of dying skin cells.
Both nodular acne and cystic acne leave behind scars and require some sort of intervention for treatment.
Acne Rosacea is another type of deforming and disfiguring acne that affects individuals in their thirties. It may be similar in its clinical presentation to acne vulgaris but manifests more severe and disfiguring manifestations if left untreated. The hallmark lesions of Acne Rosacea include a pinkish rash on the prominent parts of face like nose, forehead and chin. The rash constitutes all types of acne including papules, pustules, nodules and cysts along with blemishes.
The more horrifying aspect associated with Acne Rosacea is the growth of superficial skin tissues in areas of chronic acne that may lead to disfiguring tissue growth (especially prominent around nose leading to rhinophyma).
Severe Types of Acne
All aforementioned types of acne are troubling and affecting the emotional and social aspects of human personality, but the severe forms of acne like Acne Conglobata can affect the overall quality of life.
Acne Conglobata cases are seen more frequently in male population and are marked by the presence of severe and deep-seated nodular acne lesions which are numerous and are inter-connected, leading to severe disfiguring damage to skin and widespread areas of skin scarring. The most commonly involved areas are buttock, thigh, face and shoulders.
Acne Fulminans – It is another severe type of acne that affects adult males more frequently. The appearance and occurrence of lesions are fairly similar to acne Conglobata. The two conditions are differentiated on the basis of systemic symptoms that include fever and joint aches in Acne Fulminans and no systemic symptoms in Conglobata.
Gram-Negative Folliculitis – Another severe form of acne is gram-negative folliculitis that refers to inflammation or infection of skin pores, seen in the setting of long term antibiotic therapy of acne conditions. The hallmark lesions are the pustules and papules that may transform into cystic lesions.
Pyoderma Faciale, which is also known as Rosacea Fulminans is seen in young adults (with most cases reported between 20 to 40 years of age) and marked by the presence of papules, pustules, nodules and cystic lesions that are prone to scarring. The lesions are very annoying and may appear in females with no prior history of acne at the time of puberty. These lesions are more common in females as compared to males.
What is the best acne treatment available today?
The treatment of acne is largely dependent on the severity and nature of lesions and response to the therapies. The most common approach of treating acne is by the use of oral antibiotics, topical ointments and lotions, diet and behavioral modification and certain cosmetological procedures.
What are some best acne scar treatments available today?
All moderate to severe types of acne leave behind disfiguring and unsightly scars, indentations and pigmentations that are not only cosmetically unappealing but also serve as the source of new acne lesions. There are a number of treatment modalities available that serve at:
- Decreasing the pigmentation of skin
- Enhancing the tissue regeneration to fill in the gaps and indentations produced by extensive tissue damage (hallmark of nodular and cystic acne lesions).
- Enhancing the rejuvenation of skin cells to improve the cosmetic appearance of skin.
Different treatments are available that include acne scar removal creams, dermabrasion, chemical peeling of skin and laser acne treatment options. The type of treatment is chosen after assessing the skin damage, but laser acne treatment is perhaps the most advanced and best acne treatment that is available today. It deals with the removal of superficial layers of skin with the help of sharp laser beam so that the layer of dead and damaged cells is shredded and the active tissue exposed can heal in a period of weeks to produce a bright and smooth skin. Dermabrasion and chemical peels also follow the principle of laser acne treatment but are less accurate in removing damaged skin layers.