What are the different types of acne?

Acne is one of the most common dermatological conditions, affecting millions of people worldwide. It is characterized by the appearance of skin lesions, often on the face, but also on the scalp, back, and chest. Its origin is complex and multifactorial, primarily involving the sebaceous glands and sebum secretion. To better understand this condition, it is essential to distinguish between the different types of acne and their specific characteristics.

1. Retentional acne

Retentional acne is often considered the initial form of acne. It is characterized by clogged pores, which lead to the formation of blackheads (open comedones) or whiteheads (closed comedones). These lesions appear when the sebaceous glands produce an excess of sebum, causing a blockage of the hair follicles (hair follicle).

Mechanism of formation

  • Excessive sebum production by the sebaceous glands accumulates, combined with dead skin cells, which clogs the pores.
  • This hydrolipidic film, which normally protects against external aggressors, becomes too thick and loses its barrier function, promoting the appearance of comedones.

Aggravating factors

  • Oily skin is particularly prone to this type of acne due to its abundant sebum secretion.
  • An oily scalp can also be affected, leading to blemishes along the hairline.

2. Inflammatory acne

When comedones become completely blocked, they can get infected, leading to inflammatory acne. This type of acne is characterized by red, painful, and swollen lesions.

The different types of inflammatory lesions

  • Papules: These are small red bumps that form when the walls of the hair follicle become irritated.
  • Pustules: These lesions contain pus, resulting from the body's immune response to a bacterial infection.
  • Nodules and cysts: They develop deep under the skin, causing significant pain. These deep lesions are often a sign of overproduction of gland secretion and can leave scars.

Role of sebum and bacteria

Sebum promotes the proliferation of Propionibacterium acnes, a bacterium naturally present on the skin. When it multiplies excessively, it causes inflammation of the hair follicle.

3. Cystic acne

Cystic acne is the most severe form and can be particularly painful. It is characterized by the formation of deep cysts under the skin. This type of acne can have a significant psychological impact due to the scars it can leave.

Causes of cystic acne

  • Excessive sebum secretion, often linked to hormonal factors.
  • Deep inflammation of the sebaceous glands.

Treatment and Prevention

  • Standard topical treatments are often ineffective against this severe form. A consultation with a dermatologist is essential.
  • Regulating sebum production is crucial to prevent recurrence.

4. Hormonal acne

Hormonal acne primarily affects adult women, especially around the menstrual cycle, during pregnancy, or when stopping contraceptive pills. Androgen hormones stimulate the sebaceous glands, increasing sebum secretion.

Manifestations and location

  • It often appears on the lower face, jawline, and neck.
  • This type of acne is often accompanied by oily skin and excess sebum.

Management and Adapted Care

  • A skincare routine tailored for oily skin can help control excess sebum.
  • Hormonal treatments, such as birth control pills, can be effective in regulating sebum production.

5. Acne Fulminans

Acne fulminans is a rare but severe form of inflammatory acne. It appears suddenly with inflamed nodules, often accompanied by systemic symptoms like fever and joint pain.

Causes and Triggers

  • It is often associated with a severe hormonal imbalance.
  • Excessive sebum secretion plays a key role in triggering this type of acne.

Treatment

Immediate medical treatment is necessary. Oral retinoids, such as isotretinoin, may be prescribed under strict supervision.

6. Cosmetic Acne

This type of acne is caused by using unsuitable beauty products that clog pores. The contents of sebum can interact with cosmetic ingredients, worsening blemishes.

Products to Avoid

  • Comedogenic products that clog pores.
  • Excessive makeup prevents the skin from breathing and promotes clogged pores.

7. Mechanical Acne

Also known as friction acne, it is caused by constant rubbing of the skin against objects like masks, helmets, or tight clothing. This friction irritates the sebaceous glands and increases sebum secretion.

Common Triggers for All Types of Acne

Excess Sebum

Excess sebum is the main factor behind acne. Normally, the hydrolipidic film protects the skin from external aggressions, but in cases of overproduction, it promotes pore obstruction and inflammation.

Role of UV Rays

Contrary to popular belief, UV rays do not treat acne. They can even worsen the condition by thickening the skin and increasing sebum secretion.

Impact of Hormones

Hormonal fluctuations, especially during adolescence, increase sebum production and the activity of sebaceous glands.

Prevention and Treatment: The Importance of an Adapted Routine

Dermatological consultation

A dermatologist can recommend treatments tailored to each type of acne, depending on its severity and underlying cause.

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