Not All Acne Is the Same! Which One Do You Really Have?

Seeing the first signs of acne on your face can feel frustrating. It’s natural to think, “Oh, it’s just acne. I’ll deal with it later.” Many of us reach for over-the-counter cleansers or spot treatments, assuming that all pimples behave the same way. But the truth is, acne isn’t a one-size-fits-all issue. Each type has unique characteristics and causes, and what works for one person may worsen another’s skin condition¹.

Misidentifying your acne can lead to more harm than good. Using the wrong products or treatments may aggravate your skin, trigger more breakouts, or even leave lasting marks. That’s why understanding exactly what type of acne you have is crucial before attempting any treatment. Correct identification, guided by experts in dermatology in Singapore, allows you to tailor your skincare routine, protect your skin, and effectively reduce breakouts without unnecessary trial and error².

Common types of acne

1. Blackheads and whiteheads

These are perhaps the most familiar forms of acne. Whiteheads occur when pores become clogged with bacteria, oil, and dead skin cells, forming small, flesh-coloured bumps. Blackheads, on the other hand, form when the same material is exposed to air, oxidising and turning black. While they may not be inflamed, they can lead to larger breakouts if not managed properly.

2. Papules and pustules

Papules are small, tender, red bumps, while pustules are similar but filled with pus, appearing white or yellow at the tip. Both types indicate inflammation and often require careful attention. Aggressive scrubbing or picking can worsen the condition, leading to scarring and prolonged healing times.

3. Nodules and cysts

These are the severe forms of acne, presenting as deep, painful lumps under the skin. Nodules are solid and large, while cysts are filled with pus. Both can cause permanent scarring if not treated properly, often requiring medical interventions like prescription medications or dermatological procedures.

4. Hormonal acne

Often concentrated along the jawline, chin, and lower cheeks, hormonal acne is triggered by fluctuations in hormones such as androgens. Common in teenagers, adults, and those experiencing hormonal changes, this type of acne responds well to treatments targeting the endocrine system, in addition to topical solutions.

5. Acne mechanica

This type occurs due to friction, pressure, or heat on the skin. Common culprits include tight clothing, headgear, or even prolonged phone contact with your face. Preventative measures often involve reducing pressure and maintaining good skin hygiene, alongside suitable topical treatments.

6. Acne conglobata and other severe variants

Rare but severe, these forms involve interconnected inflamed nodules, often causing extensive scarring. They are usually addressed under medical supervision, combining systemic and topical therapies.

7. Other causes

Some breakouts can also arise from fungal or bacterial acne, where microorganisms, rather than traditional acne triggers, are responsible. This type often requires professional assessment and tailored treatments to manage effectively.

Why correct identification matters

Using a generic acne treatment without knowing your type can be counterproductive. For example, aggressive acne scrubs may help whiteheads but can worsen papules or cysts. Hormonal acne may not respond to over-the-counter benzoyl peroxide, requiring prescription-strength treatments or hormonal therapy.

Recognising your acne type also helps prevent long-term damage. Scarring, hyperpigmentation, and persistent inflammation are common consequences of mismanaged acne. Additionally, understanding triggers, whether hormonal, lifestyle-related, or environmental, allows for a proactive approach rather than reactive treatments.

Signs you should seek expert advice

Certain indicators suggest that it’s time to see a specialist:

Persistent or severe breakouts not improving with over-the-counter products.
Painful cysts or nodules that may cause scarring.
Sudden outbreaks in adulthood, potentially signalling underlying hormonal or medical issues.
Suspected fungal or bacterial acne, where conventional treatments may fail.

A dermatologist can accurately diagnose the type of acne, recommend investigations and suitable medications or procedures if necessary, and provide guidance on skincare routines tailored to your skin type. They can also address complications such as post-inflammatory hyperpigmentation and scarring, ensuring your skin recovers effectively.

Treatment approaches

Treatment depends on the acne type, severity, and your skin’s unique characteristics. Common approaches include:

Topical treatments: Benzoyl peroxide, AHAs and BHAs (i.e. glycolic acid and salicylic acid), retinoids, and prescription creams.
Oral medications: Antibiotics, hormonal therapy, or isotretinoin for severe cases.
Procedural options: Laser therapy, chemical peels, or extractions performed by professionals.
Lifestyle and skincare adjustments: Gentle cleansing, non-comedogenic moisturisers, and diet considerations can support treatment efficacy³.

Combining these approaches under professional guidance often yields the best results. It’s not just about clearing acne temporarily but managing the underlying causes and preventing recurrence.

Preventive measures

While treatment is important, prevention plays an equally critical role:

Avoid touching or picking at your face.
Use skincare products suited to your acne type.
Maintain a balanced diet and adequate hydration.
Manage stress levels, as stress can exacerbate hormonal acne.
Protect your skin from sun damage with suitable SPF products.

Conclusion

Understanding the type of acne you have is the first step towards clear, healthy skin. With proper identification, treatment, and ongoing care, it’s possible to manage breakouts effectively and prevent long-term skin damage.

If you’re struggling to pinpoint your acne type or have persistent breakouts, consulting a professional is the safest and most effective route. Angeline Yong Dermatology offers comprehensive cosmetic, surgical, and medical treatments in Singapore to help you achieve healthy, radiant skin while addressing the root causes of your acne.

References

Acne: Diagnosis and treatment. American Academy of Dermatology. (n.d.). https://www.aad.org/public/diseases/acne/derm-treat/treat

Zaenglein, A. L., Pathy, A. L., Schlosser, B. J., Alikhan, A., Baldwin, H. E., Berson, D. S., Bowe, W. P., Graber, E. M., Harper, J. C., Kang, S., Keri, J. E., Leyden, J. J., Reynolds, R. V., Silverberg, N. B., Stein Gold, L. F., Tollefson, M. M., Weiss, J. S., Dolan, N. C., Sagan, A. A., Stern, M., … Bhushan, R. (2016). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 74(5), 945–73.e33. https://doi.org/10.1016/j.jaad.2015.12.037

Bhate, K., & Williams, H. C. (2013). Epidemiology of acne vulgaris. The British journal of dermatology, 168(3), 474–485. https://doi.org/10.1111/bjd.12149

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Not All Acne Is the Same! Which One Do You Really Have?