Skip to main content


Written by Andrew Le, MD

UpdatedMarch 2, 2024

Acne is a common skin condition that affects millions of people worldwide. From hormonal changes to genetics and diet, various factors can contribute to acne.

Understanding the different types of acne, such as whiteheads, blackheads, and cysts—and their symptoms—can help you get the right treatment.

There are several treatment options available, including topical medications, oral medications, and procedures. This article will explore how it can be managed effectively.

What Is Acne?

Acne, a common skin condition, is an umbrella term for all kinds of pimples, including blackheads, whiteheads and cystic acne. It is caused by various factors such as excess oil production, clogged pores, hormonal changes, and bacteria.

Good skin care practices, including gentle cleansing, moisturizing, and avoiding harsh products, may help prevent and manage acne. Many treatments are available including a variety of over-the-counter medicated creams, gels, and toners, and oral medications.

It’s helpful to see a dermatologist, who can advise you on what over-the-counter products to use and whether you need prescription treatments or sometimes procedures.

What Causes Acne?

Acne can be caused by various factors, including hormonal imbalances, inflammation, excess oil production, clogged pores, and bacteria on the skin.

  • Hormonal changes play a significant role in acne, especially during puberty when changes in hormone levels can lead to increased oil (sebum) production.
  • Inflammation further exacerbates acne by causing redness and swelling in the area.
  • Sebaceous (oil) glands can become overactive, contributing to oily skin that is prone to breakouts.
  • Pore blockages can occur when dead skin cells and excess oil build up, creating a perfect environment for bacteria to thrive.

Hormonal Changes

Hormonal changes play a significant role in acne, particularly during puberty in adolescents and sometimes in adults.

During puberty, the body undergoes hormonal changes that can lead to an overproduction of sebum. Sebum, an oily substance produced by the skin's sebaceous glands, can clog pores and create an ideal environment for bacteria to thrive.

In adolescence, the androgen hormones, such as testosterone, often surge, triggering this excess sebum. This hormonal imbalance can result in inflammatory acne that looks like red, swollen blemishes.

Similarly, in adulthood, fluctuating hormones, especially during menstruation or menopause, can lead to breakouts.


Genetic factors can make people more likely to have acne. Research suggests that inherited variations in genes related to sebum production, inflammation, and skin turnover rate can all contribute to the development of acne.


Dietary choices may influence acne development, especially for people with oily skin. A diet high in oily foods can worsen skin conditions, leading to an increase in sebum production and clogged pores. Researchers have found a link between high-glycemic-index (sugars and carbohydrates made from white flour) foods and acne, suggesting that eating more whole grains, fruits, and vegetables may help manage breakouts. Certain nutrients like vitamins A, C, and E, as well as zinc, have been shown to support skin health and reduce inflammation.

What Are the Types of Acne?

There are different types of acne, including whiteheads, blackheads, cysts, and nodules, each with distinct characteristics and treatment approaches.

  1. Whiteheads, also known as closed comedones, appear as small, flesh-colored bumps with a white center. They form when pores become clogged with oil and dead skin cells.
  2. Blackheads, or open comedones, are similar to whiteheads but have a darkened tip.
  3. Cysts are deeper, painful, pus-filled bumps that can cause scarring if not treated promptly.
  4. Nodules are large, solid pimples that develop deep within the skin and can be particularly challenging to treat.

Effective treatments may include topical medications, oral antibiotics, hormonal therapy, or in severe cases, isotretinoin.


Whiteheads, also known as closed comedones, are a type of acne that look like small, white bumps on the skin's surface.

These bumps develop when hair follicles become clogged with oil, dead skin cells, and bacteria, leading to a closed pore that appears as a small protrusion on the skin. They are typically accompanied by a white or yellowish appearance due to the trapped oil and debris.

Treatment options for whiteheads may include over-the-counter topical retinoids, salicylic acid, benzoyl peroxide, prescription retinoids, or professional extraction methods to clear the pores and prevent further breakouts.


Blackheads, or open comedones, look like dark spots on the skin caused by oxidized sebum and debris.

These typically appear on areas with more active sebaceous glands, such as the nose, chin, and forehead. They form when excess oil and dead skin cells clog the pores, creating a plug that reacts with the air, leading to the dark pigment. Regular cleansing, exfoliation, and using products with salicylic acid or retinoids can help clear out the pores and prevent blackheads from forming.

Try to avoid squeezing or picking at blackheads as it can cause inflammation and scarring, worsening the condition.


Papules are small, raised bumps on the skin that are typically red and inflamed.

They are often caused by the blockage of hair follicles with excess oil, dead skin cells, and bacteria, which then leads to inflammation. They can be triggered by hormonal changes, stress, and certain medications.

Treatment for papules typically include topical medications containing ingredients such as benzoyl peroxide, salicylic acid, or retinoids to reduce inflammation and promote skin cell turnover. In some cases, dermatologists may also recommend oral antibiotics or in-office procedures like light therapy or extractions to help clear papules.


Pustules are pus-filled bumps on the skin, often appearing as white or yellowish spots surrounded by redness.

They develop when pores become clogged with excess oil, dead skin cells, and bacteria, leading to inflammation and infection. The pus consists of dead white blood cells, bacteria, and debris, which give it its distinctive appearance.

Treating pustules typically includes gentle cleansing, topical medications containing benzoyl peroxide or salicylic acid to reduce bacteria and exfoliate the skin, and in some cases, prescription antibiotics or retinoids for severe cases. Proper skincare routines focusing on keeping pores clear and reducing inflammation can help prevent them.


Nodules are large, solid, and often painful acne lesions that develop deep within the skin. These tend to have significant inflammation and are more challenging to treat than milder forms of acne. Due to their depth within the skin, they can lead to scarring if not managed properly. The specialized treatment for nodular acne may include prescription medications such as isotretinoin. Dermatologists often help manage nodular acne, providing customized treatment plans tailored to the individual's specific needs and skin type.


Cysts are large, pus-filled acne lesions that extend deep into the skin, leading to pronounced inflammation and potential scarring if not managed appropriately.

These lesions can be particularly challenging to treat compared to surface-level acne, as they are often resistant to topical treatments. The risk of scarring with cystic acne is high due to the depth and size of the lesions, which can leave behind hyperpigmentation or pitted scars if not addressed promptly. Dermatologists may recommend a combination of oral medications, such as isotretinoin, and corticosteroid injections to reduce inflammation and prevent further scarring.

In severe cases, surgical procedures like drainage or excision of the cysts may be necessary to relieve discomfort and minimize scarring.

What Are the Symptoms of Acne?

Acne causes redness, swelling, white or blackheads, pain, tenderness, and the potential for scarring.

Redness and Swelling

Redness and swelling are common symptoms of inflamed acne lesions, caused by a buildup of oil and bacteria as well as inflammation. The redness is caused by increased blood flow to the area to combat the infection, leading to inflammation. Swelling is caused by the accumulation of fluid and white blood cells in response to the inflammation.

Whiteheads or Blackheads

Whiteheads or blackheads are caused by the combination of excess sebum production and the accumulation of dead skin cells, trapping bacteria within the pores. Blackheads occur when the pore remains open, allowing the sebum to oxidize and turn black. Whiteheads are formed when the pore is closed by a layer of skin.

Pain and Tenderness

Acne lesions can cause pain and tenderness, especially in inflamed areas or large cystic nodules. Skin sensitivity is heightened, making it challenging to find skincare products that do not exacerbate the pain.

Addressing the pain from acne involves a multifaceted approach, including gentle cleansing routines, topical treatments for inflammation, and potential pain management strategies such as over-the-counter pain relievers or prescription medications.


Acne scarring can result from severe or untreated acne lesions, leading to long-lasting marks on the skin that may impact self-esteem and confidence.

These scars can take various forms, such as ice pick, boxcar, or rolling scars, each with distinct characteristics. Factors like genetics, skin type, and the intensity of the acne can influence the severity of scarring.

Though preventing them by managing the acne is best, there are several treatment options to help improve the appearance of acne scars, including laser therapy, chemical peels, microneedling, and dermal fillers. See a dermatologist to get a treatment that is right for your condition.

How Is Acne Treated?

Acne can be treated through various methods, including topical (applied to the skin) medications, oral prescriptions, laser therapies, and chemical peels, depending on the underlying causes of your acne and how severe it is.

  1. Topical medications, such as retinoids, benzoyl peroxide, and antibiotics, are often used for mild to moderate acne and work by unclogging pores and reducing inflammation.
  2. Oral medications, like antibiotics and isotretinoin, are prescribed for severe cases to target acne-causing bacteria and regulate oil production.
  3. Laser therapies such as photodynamic therapy and fractional laser resurfacing can reduce acne lesions and improve skin texture.
  4. Chemical peels, which is when a chemical solution is applied to your skin to exfoliate the skin, can help with acne scarring and pigmentation issues.

Topical Medications

Topical medications for acne include over-the-counter and prescription creams, gels, or lotions containing medications.

They can treat various types of acne, such as whiteheads, blackheads, pimples, and cysts. Over-the-counter options usually contain common medications like benzoyl peroxide, salicylic acid, or sulfur, which work to unclog pores, reduce inflammation, and kill acne-causing bacteria.

Prescription-strength formulations may include stronger concentrations of these active ingredients or additional components like retinoids or antibiotics for more severe cases of acne. It's important to cleanse the skin gently before applying the product and to follow any specific instructions from your dermatologist.

While these treatments can be effective in managing acne, they may cause side effects such as dryness, irritation, or increased sensitivity to sunlight. It's important to monitor how your skin reacts and adjust your regimen accordingly.

Oral Medications

Oral medications for acne may include antibiotics, hormonal therapies, or isotretinoin, and are usually prescribed in severe cases to address underlying causes and prevent breakouts.

  1. Antibiotics such as tetracycline work by reducing the growth of bacteria on the skin, helping to decrease inflammation and clear acne lesions.
  2. Hormonal therapies like birth control pills or spironolactone regulate hormone levels, which can be particularly effective for women with hormonal acne.
  3. Isotretinoin targets all causes of acne by reducing oil production, cell turnover, and inflammation. This medication can be highly effective, but it may also have side effects such as gastrointestinal issues, skin dryness, mood changes, and potential birth defects.

Laser and Light Therapies

Laser and light therapies target sebaceous glands, bacteria, or inflammation to reduce acne lesions and improve skin clarity.

These treatments work by using specific wavelengths of light energy to either destroy acne-causing bacteria, reduce oil production in the sebaceous glands, or decrease inflammation. Lasers can also help stimulate collagen production, which helps heal acne scars and promotes overall skin rejuvenation. Studies have shown that many patients experience significant improvements in their skin condition.

It is important to note that certain lasers may not be suitable for darker skin tones due to the risk of hyperpigmentation.

Chemical Peels

Chemical peels is when a chemical solution is applied to your skin to exfoliate the skin, unclog pores, and promote skin renewal, offering benefits for acne-prone individuals.

These peels work by removing dead skin cells on the surface layer of the skin, which can help prevent clogged pores and reduce acne breakouts.

There are different types of chemical peels, ranging from superficial to deep peels, each targeting specific skin concerns. Superficial peels are mild and suitable for managing your acne, while deeper peels may be recommended for more severe acne scars.

Talk to a dermatologist to determine the most appropriate peel for your skin type and make sure you’re being treated with safe and effective peels.

Frequently Asked Questions

What is acne?

Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. This leads to the formation of blackheads, whiteheads, and pimples on the face, chest, and back.

What causes acne?

Acne is caused by a combination of factors, including excess oil production, clogged pores, bacteria, and inflammation. Hormonal changes, genetics, and certain medications or products can also contribute to the development of acne.

How can I prevent acne?

To prevent acne, it's important to maintain a good skincare routine that includes cleansing the skin twice a day, using non-comedogenic products, and avoiding touching or picking at the face. It's also important to maintain a healthy diet and manage stress levels.

Can acne be treated?

Yes, acne can be treated. There are various treatment options available, including topical medications, oral medications, and procedures such as chemical peels and laser therapy. It's important to consult with a dermatologist to determine the best treatment plan for your specific type of acne.

How long does it take for acne to clear up?

The length of time it takes for acne to clear up varies. Mild cases may clear up within a few weeks, while more severe cases may take several months to see improvement. It’s important to be consistent with your skincare routine.

Can acne be a sign of a more serious health condition?

In rare cases, acne can be a symptom of a more serious underlying health condition, such as polycystic ovary syndrome or hormonal imbalances. It's important to consult with a dermatologist if your acne is severe or accompanied by other symptoms to rule out any underlying health issues.