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	The Basics

	From a small blackhead or whitehead, to large pustules, cysts, and inflamed nodules… acne has many forms. These may be interrelated, for example a pustule can follow a papule after white blood cells invade. In other circumstances, they may be completely independent in origin. The various types of acne are differentiated by size and whether the lesion is inflammatory or non-inflammatory. The beginning of acne is the smallest type of lesion, usually called a microcomedo, so small that it’s invisible to the naked eye. Depending on the growth of this microcomedo, it may develop into a closed comedo or whitehead; or into an open comedo, or blackhead. Similar to comedos, but a bit more serious are pustules and nodles.

Types of non-inflammtory acne



		Soft closed comedones develop when a plug of cellular debris and oil becomes trapped within the pore, and is covered by a layer of dead skin cells. The oil plug itself remains liquid or soft.
Soft Closed Comedones	Soft closed comedones present as bumpiness on the skin's surface. They are not painful or red.



		Hard closed comedones develop just as their soft counterparts, however the plug has hardened and is similar to a grain of sand. The white head is a mass of dead cells and sebum.
Hard Closed Comedones	Hard closed comedones have obvious white heads. They are not red or painful, and are especially common in the eye area.




		A blackhead is an accumulation of dead skin cells and sebaceous matter within the follicle. Its top is exposed to air, so the black coloring is not dirt, but oil darkenned by the air.
Open Comedones	An open comedo or blackhead is easy to identify by its dark brown to black surface coloring.



		A microcomedon occurs when the sebaceous duct and pore opening becomes blocked by excess sebum and dead skin cells. Every blemish begins as a microcomedo.
Micro- Comedones	Although most acne sufferers have many microcomedones, they are too small to be seen with the naked eye.

Types of Inflammtory acne



		Papules result from a lesion and a break in the follicle wall, allowing cellular debris and bacteria to spill into the dermis.
Papules	A papule is a red and inflamed lesion on the skin's surface. It contains no pus or white head.



		Pustules follow papules after white blood cells invade. The white cap on a pustule is pus, sebaceous matter and cellular debris.
Pustules	A pustule is a typical pimple, red and inflamed with a white head. They range in size from small to fairly large.




		A nodule occurs when the follicle wall ruptures deep within the dermis. Contaminated debris from the follicle empties into the dermis and infects adjacent follicles.
Nodules	Nodules are large inflamed lesions that occur deep within the dermis. They feel like a hard, painful lump under the skin.



		Like nodules, cysts begin as a deep break in the follicle wall. As a cyst works its way to the surface, it damages healthy skin tissue, destroying the follicle.
Cysts	Cysts are very large, inflamed lesions. They feel like soft, fluid-filled lumps under the skin’s surface, and can be very painful.

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