All acne is not created equal. This makes perfect sense, seeing as there are so many factors — i.e. hygiene, hormones, and genetics — that can both lead to and exacerbate your breakouts. But knowledge is power, and just knowing that there are different types and that each kind requires its own plan of attack puts you ahead of the clear-skin curve.
Symptoms, treatment options, and personal experiences for various physical, mental, and health conditions and concerns.
Once you figure out what you're working with, it gets far easier to treat. From there, you can determine what kinds of ingredients and products will work most efficiently to clear up breakouts and prevent new zits from popping up (and tempting you to pop them). This is the ultimate guide to identifying and then taking down every type of acne out there, according to board-certified dermatologists. Find out how to identify and deal with the different kinds of acne, including blackheads, whiteheads, blind pimples, and cystic zits — because not all purported acne-fighting formulas effectively fight all types of acne.
Now, let's clarify a few things about different types of acne, so you can get to work clarifying your skin.
What You're Seeing: A sudden sprinkling of zits around your chin and jawline.
What's Going On: Do you tend to get these at the same time every month — say, just before you get your period? Because these are the work of fluctuating hormones, says Joshua Zeichner, a board-certified dermatologist and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Hormones can put oil production into overdrive, and having an excess of it means that it's more likely to settle in your pores and cause zits.
How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($8), with a benzoyl peroxide spot treatment such as Glossier Zit Stick ($14). If you're still seeing zits, "Visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.
What You're Seeing: A typical zit with a white dot in the center.
What's Going On: Blame it on your clogged pores. "Skin cells stick together inside your pores, blocking the opening," explains Zeichner. The white you see at the top — hence "whitehead" — is the blocked pore. Oil trapped beneath it mingles with grime and bacteria, causing inflammation and the red, swollen bump that ultimately makes a pimple.
How to Handle It: Consider salicylic acid your secret weapon. "This beta-hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel ($27), a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.
Inflammatory Acne: Papules
What You're Seeing: Patches of small, red zits that don't come to a head.
What's Going On: Meet papules. No, they're not things you'd find growing on the grounds of Hogwarts (though they sound like it). These are a type of inflammatory acne, and they're the work of bacteria. "Growth of the bacteria p. acnes on the skin promotes inflammation, causing acne bumps to become red and tender," says Zeichner.
How to Handle It: Your best bet is benzoyl peroxide. "Benzoyl peroxide can kill acne-causing bacteria and reduce inflammation," says Zeichner. Try a cream like the La Roche-Posay Effaclar Duo Dual-Action Acne Treatment ($30), which also exfoliates with lipo-hydroxy acid. Be aware, however, that it can seriously dry out skin so moisturize well after you use it.
Inflammatory Acne: Pustules
What You're Seeing: Red, angry-looking pimples filled with white or yellow liquid. What's Going On: These may vaguely resemble whiteheads, but they're actually in the inflammatory acne family, says Zeichner. Pustules, which are filled with — you guessed it — pus, are the result of inflammation caused by bacteria.
How to Handle It: Think of these as bigger, pissed-off whiteheads. Your best bet, says Zeichner, is to stock up on benzoyl peroxide, which kills the bacteria. A spot treatment like Kate Somerville Anti Bac Acne Clearing Lotion ($42) should do the trick. Also, try not to pop them — as tempting as that may be. Since they're inflamed, they're more likely to scar if you go the DIY route.
What You're Seeing: Huge, angry pimples — and there are usually multiple.
What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.
How to Handle It: If you've tried the usual anti-acne ingredients, like salicylic acid and benzoyl peroxide (which, we should warn you, rarely work for this kind of acne), you should consider paying your dermatologist a visit. "You may need a cortisone injection or an oral medication, like an antibiotic, in addition to topical formulas," says Zeichner. He's also a fan of a prescription topical medication called Epiduo Forte Gel, since, he says, it's been shown to be effective at controlling severe acne without the help of oral treatments.
What You're Seeing: Dark, tiny dots plugging your pores.
What's Going On: You might be all too familiar with these, which tend to make their debut when you’re in high school. "Blackheads, like whiteheads, are blocked pores," says Zeichner. What gives them their namesake color, though, is the oil. It's already dark, but blackheads also have a larger opening at the surface than whiteheads do, meaning air can enter and oxidize that oil sitting inside the pore, turning it even darker.
How to Handle It: Exfoliation is a step you just cannot skip if you're experiencing blackheads. Zeichner recommends pairing a salicylic acid-packed wash with pore strips; Bioré Deep Cleansing Pore Strips ($8) are tried and true.
What You're Seeing: Just a subtle — but incredibly painful — bump under your skin.
What's Going On: You don't actually see these so much as feel them — which is why they're called blind pimples. "A blind pimple is like a balloon under the skin with no connection to the skin's surface, so there's nowhere for it to go," explains Zeichner. The pressure just builds beneath the skin, which is what makes it sensitive to the touch.
How to Handle It: Speaking of touching, don't! Picking it, squeezing it, or poking at it will only worsen the situation. These may disappear on their own after a few days. Otherwise, Zeichner suggests visiting your dermatologist for a shot of cortisone, which will reduce inflammation and shrink it in just 24 to 48 hours. But if a last-minute appointment isn't in the cards, go ahead and play mad scientist. First, ice the area, and then apply salicylic acid gel, benzoyl peroxide gel, and one-percent hydrocortisone cream. The combo will calm skin, kill bacteria, and draw out excess oil from the pimple — all things necessary to take this down, says Zeichner.