Acne is a disease of the skin that is most common where the sebaceous glands are. Mostly they are in the face, upper back, and chest. This condition seems to result from thickening of the follicular opening, increased sebum production, the presence of bacteria, and the inflammatory response of the body.



Characteristic lesions include open (blackhead) and closed (whitehead) comedones or blemishes. Moreover, there are four major types of inflammatory acne blemishes, which are the (1) papules, (2) pustules, (3) nodules, and (4) cysts. Each type will be further discussed to guide you in differentiating the acne blemishes.

(1) Papules are red and inflamed lesions on the surface of the skin. They are small, solid, raised skin lesions, that are less than 1 centimeter in diameter and do not contain white head or pus. Papules are brought about by a high break of the follicular wall, allowing the bacteria and cellular debris to leak into the dermal layer of the skin. Papules should not be squeezed to avoid the worsening of the breakout. Papules usually heal rapidly and do not leave any scar because they are only superficial lesions. Using Benzoyl Peroxide may aid in preventing the occurrence of the papules.

(2) Pustules are typical pimples which are red and are inflamed with a white head or pus. They are small, circumscribed elevations of the skin containing fluid like substance. However, the size of a pustule may also vary from small to relatively large. At times, the brownish core of the comedone is seen to cap the white head or pus. Pustules usually follow papules once the white blood cells attack. The combined pus, cellular debris, and sebaceous matter make up the white-colored cap over a pustule. It is better not to pop the pustules. Benzoyl Peroxide can also be used to treat occasional pustules or mild acne. However, if the pustules become highly inflamed, or numerous, or hard to control, it is best to consult a dermatologist.

(3) Nodules are larger inflamed lesions, which occur deeper within the dermal layer of the skin. Nodules are felt like hard, tender lumps beneath the skin. They occur as the follicular walls break and the contaminated debris empties deep within the skin, infecting the adjacent follicles. Nodules are severe acne lesions, which necessitates dermatologic consultation.

(4) Cysts are very large inflamed closed sacs in or under the skin lined with epithelium containing fluid or semisolid material. Because they are lumps beneath the surface of the skin and are filled with fluids, they would be felt as soft and very tender. This is the most severe form of pimple. A cysts start as a rupture of the follicular wall deep within the dermis, resulting to the development of a membrane surrounding the infection. As the cysts make their way to the surface of the skin, they destroy skin tissues and damage the follicles, hence, scarring is most likely to occur. Individuals who are at risk of having cystic outbreaks must consult a dermatologist for proper topical, as well as systemic medications or treatment.

Knowing these different types of acne lesions is really helpful in identifying the interventions or treatment appropriate for the particular acne blemishes on your skin.