The Different Types of inflamed Acne Pimples

Did you know that there are many different types of pimples?  Knowing what type of acne pimples you have will help you choose the most effective treatment for your skin.

All pimples begin as a pore blockage or ​comedo.  When bacteria infect a comedo, or it is irritated by squeezing, inflammation occurs. There are four main types of inflamed acne blemishes—papules, pustules, nodules, and cysts.​

1
Acne Papules

Acne Papule - Type of Pimple
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Acne papules are red, inflamed blemishes that appear on the skin's surface. Papules look like red bumps on the skin; they don't have a white head.

Papules can be large or small. They can occur anywhere on the face or body, including the neck, chest, shoulders, and back. They can even appear on the butt.

This is how acne papules develop: Papules result from a high break in the wall of the hair follicle, or what we otherwise call the pore, allowing cellular debris and bacteria to spill into the dermis (the deepest layer of the skin). This break can happen when a pore becomes blocked and engorged with dead skin cells and oil. It can also happen if you squeeze a blackhead or blocked pore.

When this happens, it causes inflammation in and around the follicle. The area turns red and swells, creating that firm red bump we call a pimple.

Here's how you can treat acne papules: First things first, don't squeeze a papule to try to make it come to a head.  You'll likely not extract any debris from the pore, but simply make the blemish become more inflamed. Most papules will heal quickly and without scarring since they are not deep lesions.

Over-the-counter benzoyl peroxide treatments can help heal acne papules and prevent new blemishes from forming.  If OTC products don't improve your breakouts after ten to 12 weeks, though, a prescription acne medication is the next step.

2
Acne Pustules

Acne Pustule - Type of Pimple
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Acne pustules are your "typical" pimple—red and inflamed with an obvious head. Quite often the head is white (that's why these blemishes are also called whiteheads) but it can also be cream to yellow color. Sometimes a brownish spot can be seen in the middle of the blemish's head. This is the comedonal core, or plug of debris within the pore.

Acne pustules range in size from small to fairly large. They develop in the same areas that papules do, namely the face, back, and shoulders.

This is how acne pustules develop: Pustules follow papules. After there is a rupture in the pore, the body rushes to defend against bacteria and help heal the wound. It does this by sending in white blood cells to do the job. The aftermath is the creation of pus.

It's the mixture of pus, dead skin cells, and excess oil that gives a pustule its white cap. And that's what you're squeeze out of the pore when you pop a pimple (Which is never a good idea, by the way. Popping pimples can actually drive the pus mixture deeper into the pore making the blemish much, much worse.)

Here's how you can treat acne pustules: Just like with papules, mild acne or occasional pustules can be treated at home with OTC benzoyl peroxide creams or cleansers.

If you have many pustules, or if they are very inflamed and hard to control with OTC products, see your dermatologist.  Prescription medications, like topical retinoids or combination acne treatments, can help get these breakouts cleared up.

3
Acne Nodules

Acne Nodules on Back - Types of Pimples
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Acne nodules are serious types of acne pimples. Nodules are large, inflamed lesions. They feel like hard, painful lumps under the skin. Where papules and pustules occur at the surface, acne nodules form deeper within the skin.

This is how acne nodules develop: An acne nodule develops when the follicle wall ruptures deep within the dermis. Contaminated debris from the follicle empties into the dermis and infects adjoining follicles. The area swells considerably due to the damage and irritation, so nodules are quite painful.

Just like with pustules, nodules can be filled with pus but because they occur so deeply within the skin you won't see a white head.

Here's how you can treat acne nodules: If you just get an occasional nodule (women are especially prone to them around the time of their monthly cycle) you can typically treat them at home. 

Try ice if your blemish is super painful, to help relieve swelling and make them feel better.  Don't squeeze them!

Because nodules are so large and deep, they can take several weeks to fully heal. Want to banish that big zit fast?  Cortisone injections may helpful, but you'll have to see your dermatologist to get one. 

Speaking of dermatologists, if you're prone to nodular breakouts, you'll definitely want to make an appointment.  These types of blemishes don't respond to over-the-counter acne treatments.  You'll need a prescription acne medication.

4
Acne Cysts

Acne Cysts on Chest - Types of Pimples
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Acne cysts are very large, inflamed lesions. They feel like soft, fluid-filled lumps under the skin's surface. The most severe form of a pimple, cysts are very painful.

This is how acne cysts develop: Like nodules, cysts begin as a deep break in the follicle wall. A membrane develops around the infection in the dermis, as the body tries to wall off the infection and protect the rest of the skin.

As an acne cyst works its way to the surface, it damages healthy skin tissue, destroying the follicle. The likelihood of scarring is very high.

Many dermatologists say the term "cyst" is a bit of a misnomer because these types of blemishes aren't cysts in the true sense of the word.  Instead, they say cysts are actually severe, swollen acne nodules. So, acne cyst and acne nodule is often used interchangeably to describe these serious inflammatory acne breakouts.

Acne cysts are filled with pus and, often, blood. They can take several weeks to several months to fully heal. Never, ever try to extract an acne cyst on your own.

Here's how you treat acne cysts: If you are prone to cystic acne, you must talk to your dermatologist. Acne treatments you get at the drugstore just won't help these blemishes, and there are no home remedies that will successfully treat cystic acne.

You'll most likely need an oral acne medication, like isotretinoin, to get these type of breakouts under control.

Don't wait.  Cystic breakouts easily lead to scarring.  The sooner you see a dermatologist about your acne, the sooner you will start seeing improvement.

5
A Word from Verywell

Who knew there were so many types of acne pimples? This just scratches the surface, too. All of these inflammatory blemishes first started out as a tiny, non-inflammatory breakout.

While getting a pimple every now and again isn't a big deal, if you're constantly battling breakouts and are struggling to get them under control, it's time to make an appointment with a physician. This is especially true if you're prone to larger blemishes like acne nodules. There are medications that will help you clear your skin, so don't wait to make that call.

Sources:

"Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Jan 2006. National Institutes of Health.

Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, et. al. "Guidelines of Care for the Management of Acne Vulgaris." Journal of the American Academy of Dermatology; 2016. 74(5):945-73.

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