Acne refers to pimples, or clogged pores, that occur on the face, neck, shoulders, chest and back. The American Academy of Dermatology (AAD) states that "acne is not caused by dirt or surface skin oil" and that scientific studies have found that food does not cause acne. Acne results when an enlarged hair follicle (called a comedo) becomes plugged with oil, dead cells, tiny hairs and sometimes bacteria, which causes swelling in the follicle and surrounding skin.
Whiteheads and Blackheads
Whiteheads appear as small bumps that result when the plugged follicle stays below the surface of the skin. This is also called a closed comedo. An open comedo, or blackhead, forms when the oil and bacteria from the plugged follicle push up and out to the surface of the skin. The blackhead is not dark due to dirt; it is caused by oxidation of the oil and the dark pigment that naturally occurs in skin.
Papule
This type of acne is only mildly inflammatory. It appears as small bumps that appear just above the skin's surface.
Pustule
Pustules are also small but they are obviously inflamed and contain pus. This type of acne consists of white blood cells, dead skin cells and some bacteria. The inflammation is caused by irritation from the oily secretions of sebaceous glands in the skin.
Nodules
This is a painful, solid, dome-shaped acne. It has inflammation that goes deep into the skin and may destroy tissue. Acne that progresses to this type may require treatment with a prescription medication, such as Accutane.
Cysts
Nodules that are left untreated may progress into a cyst. This is a large lesion that contains semi-liquid material. Cysts are painful and typically result in scarring because the inflammation goes so deep into the skin. The AAD states that some researchers believe that cysts are really just severely inflamed nodules. Nodules and cysts may also appear together, which is called nodulocystic acne. This type of acne is often resistant to treatment.
Other Types
One type of acne that is rare is called acne conglobata. This is a very large acne lesion that is usually accompanied by blackheads and causes permanent scarring. Acne rosacea is different from the other types of acne, causing a red rash on the cheeks, forehead, nose and chin. The most extreme type of acne is called acne inversa. It is defined by very painful, boil-like abscesses that are hard to heal and appear in places where skin touches skin (breasts, groin or armpits), or the "inverse" areas of the body.
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