Acne is categorized as either inflammatory or non-inflammatory. As the name suggests, non-inflammatory acne is less severe than inflammatory acne. However, both types of acne begin in the same basic way, with an obstruction in the pore. It's the depth of this obstruction that determines the severity of the acne lesion, notes the American Academy of Dermatology.
Non-Inflammatory Acne
As dead skin and excess oil accumulate in a pore near the surface of your skin, they can form a soft plug, which obstructs the opening of the hair follicle. An affected pore that remains open, yet still obstructed, causes little to no swelling to the surrounding skin and leads to what's known as a blackhead. If the plug forms just below the surface of the skin, the pore can close, but still cause little to no swelling. This results in a whitehead. Both blackheads and whiteheads are forms of non-inflammatory acne, according to Acne.org.
Inflammatory Acne
When the dead skin and excess oil accumulate deeper within the pore, a soft plug still forms and obstructs the opening of the hair follicle. But this deeper obstruction can cause a break in the follicular wall or bacterial buildup, triggering an immune response from the body that sends white blood cells to the injury or infection site. The rush of white blood cells causes inflammation to the surrounding skin, leading to papules, pustules, nodules or cysts. All of these lesions are considered forms of inflammatory acne.
Treating Non-Inflammatory Acne
The severity of the inflammation has great bearing on the treatment options. Blackheads and whiteheads respond favorably to self-care techniques, such as over-the-counter acne medications that contain benzoyl peroxide, salicylic acid, resorcinol, sulfur or even lactic acid. These ingredients dry excess oil and remove dead skin, helping to improve minor lesions.
Treating Inflammatory Acne
Less severe forms of inflammatory acne, like papules or pustules, can sometimes be treated with over-the-counter medications, but may better react to topical prescriptions. Dermatologists often recommend topical antibiotics, retinoids and higher concentrations of benzoyl peroxide to break up the obstruction, which reduces the swelling of the skin.
Treating Nodular/Cystic Acne
Severe forms of inflammatory acne, such as nodules and cysts, won't likely respond as well to topical medications. It's difficult for over-the-counter and prescription creams to penetrate deep within the pores. Most of the time, an intralesional injection of cortisone is used to lessen the inflammation and prevent scarring before any other treatment method is used. Oral antibiotics, oral retinoids and topical medications can then be prescribed to improve the skin.
Prevention
According to the Mayo Clinic, you can sometimes prevent both non-inflammatory and inflammatory acne with self-care measures. Washing the skin twice a day, applying acne creams and using noncomedogenic skin-care products can reduce the chances of obstructions within the pores.
