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, mainly involving the sebaceous glands and the secretion of sebum . To better understand this condition, it is essential to distinguish 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 excess sebum , leading to blockage of the hair follicles .

Training mechanism

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

Aggravating factors

• Oily skin is particularly prone to this form of acne due to its abundant sebum secretion .
• Oily scalp can also be affected, promoting blemishes on the hairline.

2. Inflammatory acne

When comedones become completely clogged, they can become infected, leading to inflammatory acne . This form of acne is marked 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 are irritated.
• Pustules : These lesions contain pus, the result of 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 bacteria 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

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

4. Hormonal acne

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

Events and location

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

Management and adapted care

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

5. Fulminant acne

Acne fulminans is a rare but serious form of inflammatory acne. It presents with the sudden onset of inflamed nodules, often accompanied by systemic symptoms such as fever and joint pain.

Causes and triggers

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

Treatment

Immediate medical treatment is necessary. The use of oral retinoids, such as isotretinoin, may be prescribed under strict supervision.

6. Cosmetic acne

This form of acne is caused by the use of unsuitable beauty products that clog the pores . The contents of sebum can interact with the components of cosmetics , aggravating the imperfections.

Products to avoid

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

7. Acne mechanica

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

Triggers Common to All Types of Acne

Excess sebum

Excess sebum is the main factor causing acne. Normally, the hydrolipidic film protects the skin from external aggressions , but in case 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 make the condition worse by thickening the skin and increasing sebum secretion .

Impact of hormones

Hormonal fluctuations, especially during adolescence, increase sebum production and sebaceous gland activity.

Prevention and treatment: the importance of an adapted routine

• Gentle cleansing to regulate excess sebum thanks to care based on probiotics and salicylic acid
• Use of non-comedogenic products to preserve the skin's barrier function .
• Even oily skin needs hydration. Proper hydration helps form a protective barrier and balance sebum secretion .

Dermatological consultation

A dermatologist will be able to recommend treatments tailored to each type of acne, depending on the severity and underlying cause.