Acne—a complex skin condition—has many forms. Although each pimple technically forms in the same way—dead skin, oil, and debris stick together and clog pores—they can then develop into different types of blemishes. Some are large, red, and tender to the touch (like cysts), while others are skin-toned spots that cause texture issues (blackheads and whiteheads). Here, we will take a closer look at seven types of acne, their causes, and how to treat each blemish. Regarding treatments, the advice here is only skin-deep, as acne treatment requires a holistic approach—diet, stress, and sleep can all impact the skin’s condition—but in this article, we will focus on specific ingredients for each type of pimple.
Non-inflammatory and Inflammatory Acne: Each type of acne technically falls into one of two categories: non-inflammatory or inflammatory, although, to be direct, all acne arises from some level of inflammation. Some types are more tender, swollen, and irritated than others—these are classified as “inflammatory.” Papules, pustules, nodules, and cysts fall into this category, as they are all typically red and painful. “Non-inflammatory” acne, on the other hand, results in more subtle bumps—these are whiteheads, blackheads, and subclinical breakouts. Also known as comedonal acne, the bumps are usually flesh-toned, except for blackheads, which have a darker color. They are usually caused by clogged hair follicles and are found where the skin is oilier, such as on the chest, back, and T-zone of the face. Non-inflammatory acne can become inflamed later when there is an overgrowth of bacteria (especially Cutibacterium acnes¹), which can trigger the release of inflammatory cytokines and messengers to create clinical inflammation. Thus, all acne involves inflammation at some level.
Whiteheads How to treat:
- AHAs or BHAs: Removing dead skin will help you avoid clogged pores in the first place. Salicylic acid is an ideal option for oily skin (it’s oil-soluble, allowing it to penetrate pores), while AHAs like lactic acid are generally more hydrating and better suited for those with drier or more sensitive skin types.
- Retinol: Retinol and retinoids promote the normal skin renewal process, preventing the accumulation of dead cells in pores. Osmosis Skincare offers a range of exceptional retinal serums that use pharmaceutical-grade liposomal retinaldehyde and patented nutrients that go beyond the surface to nourish and remodel the skin.
- Exfoliate regularly: Nodular acne can have a genetic component, so if you have a family history, regular in-office chemical peels can help remove excess dead skin and kick-start cell renewal, which, in turn, helps prevent clogged pores and the appearance of nodules over time.
- Pore-cleansing masks: Ingredients like activated charcoal and clay are popular in pore-cleansing masks as they draw out excess oil and dirt from pores, thereby preventing blemishes.
Blackheads How to treat: Blackheads and whiteheads are made of the same material (except for the oxidation of the plug), so they can be treated quite similarly:
- AHAs, BHAs, and clays: Cleansers with salicylic acid, clay masks, and chemical exfoliants with alpha- and beta-hydroxy acids will help exfoliate the skin and make it less prone to blackheads. An excellent option is Deep by Osmosis Skincare, a detoxifying cleanser that removes deep impurities and provides an invigorating clean.
- Blackhead removal products: You can find many products on the market specifically dedicated to this problem—from daily toners to blackhead masks and treatment gels (you won’t find pore strips, as they don’t actually remove plugs at their source).
- DIY masks: Many natural ingredients can gently dissolve dead skin cells and draw debris from pores, including cranberry enzyme, a key ingredient in the Cranberry Enzyme Mask by Osmosis Skincare.
Subclinical Acne How to treat:
- Salicylic acid: BHA is excellent for comedonal acne, as this ingredient penetrates deep into pores and helps break down pore-clogging material.
- Retinol: Again, retinol is “A+” for preventing comedones. Topical retinoids have a comedolytic effect, meaning they help prevent and treat clogged pores. This is due to their ability to increase skin cell turnover and reduce the tendency of cells and keratin debris to stick together.
- Benzoyl peroxide: Benzoyl peroxide kills acne-causing bacteria and helps break down pore-clogging substances like dead skin cells (which can lead to subclinical acne). If you use retinol, stick to a morning benzoyl peroxide face wash to apply retinol at night, as using benzoyl peroxide and retinoids (or retinols) together can cause them to interact, reducing the effectiveness of both.
- Exfoliate regularly: Nodular acne can have a genetic component, so if you have a family history, regular in-office chemical peels can help remove excess dead skin and kick-start cell renewal, which, in turn, helps prevent clogged pores and the appearance of nodules over time.
Papules How to treat:
- Aloe vera: Aloe vera contains many anti-inflammatory vitamins, enzymes, minerals, and amino acids that soothe papules, as well as natural salicylic acids that help remove pimples at their source. Additionally, aloe has some antimicrobial properties: its topical application combined with tretinoin cream (a prescription retinoid) has been found effective in treating inflammatory and non-inflammatory acne³.
- Benzoyl peroxide: It kills acne-causing bacteria, P. acnes, that live in our hair follicles, and also helps break down and remove dead skin cells that clog our pores. This makes benzoyl peroxide particularly useful for angry papules—it can help with comedonal acne, but it’s mainly valued for reducing inflammatory pimples.
- Tea tree oil: Tea tree oil has antimicrobial properties and can reduce the level of acne-causing bacteria on the skin when applied to acne lesions. For instance, one double-blind, placebo-controlled study found that a 5% tea tree oil gel mixture was an effective treatment for mild to moderate acne⁴. Additionally, tea tree oil has anti-inflammatory effects, meaning it can soothe and relieve skin irritation, itching, redness, and swelling. Tea tree oil should always be diluted with a carrier oil—as it’s a potent essential oil, you never want to apply it directly to the skin.
- Blue light therapy: Blue light therapy, using light in the 415 nm range, is absorbed by porphyrin. Acne-causing bacteria, P. acnes, contain a large amount of porphyrin, and when blue light is absorbed, an oxygen free radical is formed, which enters the bacteria,