Did you know that there are more than 1 types of acne?
And that your acne type determines which products you should be using to successfully clear up your skin?
As an acne specialist, the most important determining factor when it comes to selecting the right products for my clients is their acne type. This is the basis of my product recommendations. From there I look at severity, oil production, and skin sensitivity, but the foundation is always acne type.
3 Main Acne Types: Inflamed, Non-inflamed, & Combination Acne
There are 2 main acne types, Inflamed and Non-Inflamed. Side note: there is a third type known as Combination Acne which is exactly what it sounds like, a combination of both inflamed and non-inflamed acne, however most people will be dominantly either inflamed or non-inflamed.
Before I explain the 2 acne types, I first want to talk about micro-comedones. All lesions whether inflamed or non-inflamed start out as a micro-comedone.
A micro-comedone is the initial build up of dead skin cells and oil. This comedone is very tiny and starts underneath the skin. It is not visible until it grows into an inflamed or non-inflamed lesion.
Fun fact alert…comedo is Latin for “fat maggot.” You see, back in the day, scientists thought some of these acne lesions were maggots eating oil! Yeah, I know that’s not a pleasant picture.
As these micro-comedones grow in size by collecting more dead skin cells and oil, they will either become inflamed or non-inflamed.
The path they take is mostly pre-determined based on your genetics. What I mean by that is that some acne prone people are genetically pre-disposed to have a higher potential for bacterial build up and inflammation while others don’t.
First let’s talk about inflamed acne because this is the most common acne type. An inflamed pimple starts out as a micro-comedone, which again is just the beginning mass of dead skin cells and oil inside the pore, at this point there is no inflammation.
But then it takes a turn for the worse as bacteria gets added into the mix. This bacteria is found in the skin and it feeds itself on oil. Once the oil is consumed, a waste by-product is created which is highly inflammatory to the skin so the end result is a red, painful and often times pus-filled pimple.
If you haven’t read my previous post on the real cause of acne, I highly recommend that you take a look at it so that you can have a better understanding on how acne forms inside of the pore.
Inflamed lesions also tend to hyperpigment the skin once they are healed. Hyerpigmentation from acne are those leftover dark marks that can be pink, red, purple, or brown.
Inflamed Acne Lesions
Inflamed acne consists of papules, pustules, cysts and nodules.
Papules are small, pus-less red bumps and often times are sore or tender.
Pustules typically start out as a papule and later become inflamed and pus-filled. This happens because the pore wall ruptures closer to the surface of the skin and leukocytes or white blood cells are rushed in to fight off bacteria that is present within the pore. The visible pus you see contains these white blood cells.
Cysts are large pus-filled lesions that appear boil-like. They can be extremely painful.
Nodules are hard, deep lumps that often times do not contain pus. They are very painful and extremely slow to heal.
Non-inflamed acne starts out the exact same way that inflamed acne does, and that is as a micro-comedone. To review, a mico-comedone is the beginning mass of dead skin cells and oil.
Unlike inflamed acne, bacteria isn’t as much an issue to the pores of someone that is prone to non-inflamed acne so this micro-comedone continues on by accumulating mainly just dead skin cells and oil.
Because bacteria isn’t accumulating along with those dead skin cells and oil, that means that the potential for inflammation to occur is very low.
Now on a side note, if you were to improperly pick at non-inflamed lesions then you will most likely cause some unwanted pus and inflammation to occur which basically just means that you’ve now created inflamed acne.
While non-inflamed pimples don’t hyperpigment the skin on their own, if you picked at one more than likely you’ll be left with some hyperpigmentation from the inflammation that you caused.
Lesions of Non-inflamed Acne
Non-Inflamed acne is made of blackheads and closed comedones. These lesions are not red, inflamed nor painful. They just sit on the skin until they are properly extracted.
Blackheads are the most common type of non-inflamed acne and they are a mix of dead skin cells and oil. It is a huge misconception that the top of a blackhead is dark due to accumulation of dirt. What you are seeing is simply oxidized oil (and some melanin).
Think along the lines of what happens to an apple that is sliced and exposed to the air…it starts to oxidize and darken so the same thing is happening with a blackhead.
Closed Comedones are also a mix of dead skin cells and oil, similar to a blackhead, however the pore opening is completely blocked. This prevents oxygen from creating oxidization like with a blackhead, so closed comedones stay flesh colored.
If there was anything positive to say about closed comedones, it would be that the fact that because they are flesh colored that makes them harder to be noticed, especially when comparing them to red, pus-filled inflamed lesions.
Those were the 2 main acne types, inflamed and non-inflamed. Now as I mentioned earlier there is a 3rd type which is known as combination acne and it’s exactly what it sounds like which is acne that presents both inflamed and non-inflamed lesions.
In my next post I will go over the proper way to treat and select the right products for each type of acne because each type requires a different approach.
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- What is your acne type? If you are combination, then are you more dominantly inflamed or non-inflamed?
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