Grade 1 (mild): Mostly whiteheads and blackheads, with a few papules and pustules. Grade 2 (moderate or pustular acne): Multiple papules and pustules, mostly on your face. Grade 3 (moderately severe or nodulocystic acne): Numerous papules and pustules, along with occasionally inflamed nodules.
The four stages of acne (comedones, papules, pustules and cysts) are graded 1 through 4. Exacerbating factors in the etiology of acne include progesterone-containing oral contraceptives, hyperandrogenic states that may manifest as acne, hirsuitism and irregular menses, and oil-based cosmetics.
A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it's exposed to the air. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria.
You can tell if acne is hormonal or bacteria by its severity if flare-ups occur during hormonal imbalances, and whether topical treatments resolve the issues, or if systemic medications are needed.
Acne conglobata is one of the most severe forms of acne. It involves many inflamed nodules that are connected under the skin to other nodules.
Acne is a common issue for many people, especially for teenagers and young adults in their 20s. Some have mild symptoms, while others can have very severe issues. Acne effects around 90% of adolescents with the prime age across all genders being the teenage years of 14-19 years old.
Unfortunately, cystic acne often doesn't go away on its own and requires treatment from a doctor or dermatologist. Cystic acne has psychological effects as well as visible effects on the skin. It is associated with poor self-confidence, anxiety, and depression.
Given the increase in oil production, she says your skin will usually look greasier and slightly more inflamed. Zeichner adds that stress acne can also look like a combination of blackheads, whiteheads, red bumps, and pus pimples.
Fungal acne causes clusters of small, itchy, red bumps (papules) on your skin. Sometimes, the bumps get a bit larger and turn into whiteheads, small pockets of white or yellow pus (pustules).
Hormonal acne causes breakouts. These appear as lesions or bumps on your skin that could become red, inflamed, painful and sore if not treated. Moderate to severe acne and untreated acne can lead to scarring where lesions formed.
Examples include white bread, corn flakes, puffed rice, potato chips, white potatoes or fries, doughnuts or other pastries, sugary drinks such as milkshakes, and white rice. Findings from small studies suggest that following a low-glycemic diet may reduce the amount of acne you have.
Cystic acne is a type of inflammatory acne that causes painful, pus-filled pimples to form deep under the skin. Acne occurs when oil and dead skin cells clog skin pores. With cystic acne, bacteria also gets into the pores, causing swelling or inflammation.
Stage 4: Severe acne
In the most severe stage, acne becomes extremely painful. There will be numerous pustules, cysts, papules and nodules in the affected area or on various parts of the body.
People of all races and ages get acne, but it is most common in teens and young adults. When acne appears during the teenage years, it is more common in males. Acne can continue into adulthood, and when it does, it is more common in women.
Acne is most common in girls from the ages of 14 to 17, and in boys from the ages of 16 to 19. Most people have acne on and off for several years before their symptoms start to improve as they get older. Acne often disappears when a person is in their mid-20s. In some cases, acne can continue into adult life.
One type of acne we'll discuss — comedonal — is non-inflammatory. This type of acne is usually easier to treat than inflammatory acne, so over-the-counter (OTC) treatments may work. The other types — papules, pustules, nodules, and cysts — are inflammatory acne that can be harder to treat.
Although people can pop some noninflamed whiteheads and blackheads if they take the necessary precautions, they should never try to pop or extract inflamed acne. This type of acne is deeper in the skin and may be more likely to cause scarring and infection if a person tries to squeeze it.
Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). A macrolide might be an option for people who can't take tetracyclines, including pregnant women and children under 8 years old.
Hormonal acne can start in the teenage years and continue in to the 20's and 30's. Hormonal acne may also develop for the first time over the age of 20. Hormonal acne can also develop perimenopause and menopause.
Screening tests include serum DHEAS, total and free testosterone, and luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio. These tests should be obtained during the two weeks prior to the onset of menses to avoid the LH surge associated with ovulation.
On the surface, cystic acne can look like large, red boils. Cysts, like nodules, reside deep underneath the skin's surface. But because they're filled with pus, cysts are softer than nodules. The pimples that define cystic acne burst open, often leading to infection.