Skin Concern
Types of acne: a guide to every kind
Acne is not one thing. Blackheads and whiteheads are clogged pores; papules and pustules are inflamed spots; nodules and cysts sit deep and can scar. Knowing which type you have tells you which treatment to reach for, and when to see a dermatologist.
The main types of acne are blackheads and whiteheads (non-inflamed clogged pores, called comedones), papules and pustules (red, inflamed bumps, with or without pus), and nodules and cysts (deep, painful lumps that can scar). Comedones respond best to retinoids and salicylic acid, inflamed spots to benzoyl peroxide, and nodules or cysts usually need a dermatologist. Acne is also described by pattern, such as hormonal acne on the chin and jaw or body acne on the back and chest. Some bumps that look like acne, such as fungal acne or rosacea, need different treatment.
- Identify the lesion type first: clogged, inflamed or deep. It decides the treatment.
- Mild acne with comedones and a few inflamed spots usually responds to over-the-counter care within 6 to 8 weeks.
- Deep nodules or cysts, scarring, or acne with fever or joint pain needs prompt medical assessment.
At a glance
What are the different types of acne?
All acne begins in a hair follicle (pore) that becomes blocked with oil and dead skin cells. The NHS explains that bacteria can then grow inside, causing inflammation and pus. DermNet groups acne lesions into non-inflamed comedones, inflamed papules and pustules, and, in severe acne, nodules and pseudocysts. Many people have several types at once. Our main acne page covers the condition as a whole; this guide helps you put a name to what you see.
| Type | What it looks like | Inflamed? | First treatment to consider |
|---|---|---|---|
| Blackhead (open comedone) | Small dark dot in a pore, flat or slightly raised | No | Salicylic acid or adapalene |
| Whitehead (closed comedone) | Small skin-colored or white bump with no opening | No | Adapalene or salicylic acid |
| Papule | Small, red, tender bump with no visible head | Yes | Benzoyl peroxide |
| Pustule | Red bump with a white or yellow pus-filled top | Yes | Benzoyl peroxide |
| Nodule | Hard, painful lump deep under the skin | Yes, deep | See a dermatologist |
| Cyst | Soft, painful, fluid-filled lump; high scarring risk | Yes, deep | See a dermatologist |
Non-inflamed acne
Blackheads and whiteheads (comedonal acne)
Comedones are the earliest acne lesion. A blackhead is a pore that stays open at the surface; its dark color is not dirt, so scrubbing will not remove it. A whitehead is a pore closed over by skin, so it looks like a tiny pale bump. When these dominate, dermatologists call it comedonal acne.
The American Academy of Dermatology (AAD) says salicylic acid works best on blackheads and whiteheads, and that adapalene, an over-the-counter retinoid, clears and prevents them. Squeezing tends to push material deeper and inflame it.
Not every dark dot is a blackhead: grey, even dots across the nose are often sebaceous filaments, a normal part of pores. Tiny hard white bumps that never come to a head may be milia, which are not acne.
Inflamed acne
Papules and pustules: red pimples and pus spots
When a clogged pore becomes inflamed, it turns into a papule: a small, red, tender bump without a head. As white blood cells collect, it may become a pustule, with a visible white or yellow center. These are what most people mean by “pimples.”
The AAD calls benzoyl peroxide especially effective for mild pimples and suggests starting at 2.5% to limit dryness. A retinoid used alongside helps stop new clogged pores forming. Spots that sit under the skin and hurt without a head are sometimes called blind pimples; they are usually deep papules or small nodules.
Helps
- Benzoyl peroxide wash or gel on the whole area.
- A retinoid at night to prevent new blockages.
- Gentle cleansing and a light moisturizer.
- Patience: 6 to 8 weeks before judging a product.
Makes it worse
- Popping or squeezing, which raises the risk of scars.
- Scrubbing and harsh toners.
- Toothpaste or other home remedies on spots.
- Switching products every few days.
Severe acne
Nodules and cysts: deep, painful acne
Nodules are hard, painful lumps that form deep in the skin when inflammation spreads below the follicle. Cysts, often called cystic acne, are softer, fluid-filled lumps; DermNet describes these deep lesions in severe acne as nodules and pseudocysts. Both can last for weeks and carry a high risk of acne scars.
Over-the-counter products rarely clear this type alone. A dermatologist may offer prescription topical combinations, oral antibiotics such as doxycycline, hormonal treatment for some women, or isotretinoin for severe, scarring or resistant acne, all of which feature in the 2024 AAD guidelines. A single painful lump may be treated with a corticosteroid injection.
| Severity | Typical picture | Usual approach |
|---|---|---|
| Mild | Mostly comedones, a few papules or pustules | Over-the-counter treatment, 6 to 8 weeks |
| Moderate | Many inflamed spots, some on the body | Combination topicals; a doctor may add oral treatment |
| Severe | Nodules, cysts, scarring or widespread lesions | Dermatologist care |
DermNet uses total lesion counts as one guide: fewer than 30 is mild, 30 to 125 moderate and more than 125 severe. In practice, any scarring or deep lumps should be treated as needing professional care.
By pattern
Hormonal, body and location-based acne
Acne is also named by when and where it appears. These are patterns, not separate lesion types, but they hint at triggers.
Hormonal acne
Deep, tender spots that flare with periods, common in adult women. See hormonal acne and our chin acne plan.
Cheek acne
Often linked to friction, phones, pillowcases and products. See how to get rid of cheek acne.
Forehead acne
Commonly comedonal; hair products and hats can contribute. See forehead acne.
Back and chest acne
Sweat and tight clothing add to it; benzoyl peroxide washes are often used. See back acne.
Teen, adult and baby acne
The AAD notes nearly all teens get some acne, about 20% of newborns get neonatal acne, and some women first develop acne after 25.
Severe variants
DermNet advises urgent referral if severe acne comes with fever, joint or bone pain, or ulcerated, extensive lesions.
Look-alikes
What looks like acne but is not?
| Condition | Clues | Why it matters |
|---|---|---|
| Fungal acne | Many small, uniform, itchy bumps on the forehead, chest or back; no blackheads | Caused by yeast; standard acne treatments may not help |
| Rosacea | Flushing, persistent redness and bumps on the central face; no comedones | Needs gentler, rosacea-specific care; compare in rosacea vs acne |
| Perioral dermatitis | Tiny bumps around the mouth, nose or eyes, often stinging | Steroid creams and heavy products can worsen it |
| Milia | Hard, white, pearl-like bumps that never come to a head | Not inflamed; acne products do little |
| Folliculitis and razor bumps | Itchy pus bumps around hairs, often after shaving | Different triggers and treatments |
Safety and professional-help boundaries
When acne of any type needs a doctor or dermatologist.
- Nodules, cysts or any acne that is leaving scars or dark marks.
- No improvement after 6 to 8 weeks of consistent over-the-counter treatment.
- Sudden severe acne with fever, joint or bone pain, or ulcerated skin, which needs urgent care.
- Acne with irregular periods, extra hair growth or hair thinning.
- Acne affecting your mood, sleep or confidence.
- Pregnant or trying to conceive: avoid retinoids including adapalene, and use benzoyl peroxide and salicylic acid only in limited amounts after checking; see skincare during pregnancy.
Frequently asked questions
Short answers to common questions
What are the different types of acne?
The main types of acne are blackheads and whiteheads (comedones), papules and pustules (inflamed pimples), and nodules and cysts (deep, painful lumps). Many people have more than one type at the same time.
What is the most common type of acne?
Comedones and mild inflamed spots, meaning blackheads, whiteheads, papules and pustules, are the most common. Nodules and cysts are less common but more likely to scar.
What is the worst type of acne?
Nodular and cystic acne are the most severe types, because they are deep, painful and likely to scar. They usually need treatment from a dermatologist.
How do I know what type of acne I have?
Look at the bumps: dark dots or tiny flesh-colored bumps are comedones, red tender bumps are papules, pus-topped spots are pustules, and deep painful lumps are nodules or cysts. If you are unsure, a dermatologist can tell you.
What type of acne is hormonal acne?
Hormonal acne is a pattern rather than a lesion type. It often shows as deep papules, pustules or nodules on the chin and jawline that flare around periods.
What is the difference between a papule and a pustule?
Both are inflamed spots. A papule is a red, tender bump without a head, while a pustule has a visible white or yellow center filled with pus.
Can you pop a cyst or nodule?
No. Squeezing deep acne pushes inflammation further into the skin and raises the risk of scarring. A dermatologist can treat a painful lump quickly, for example with an injection.
Is fungal acne a real type of acne?
Not exactly. So-called fungal acne is an infection of hair follicles by yeast that looks like acne. It is itchy, uniform and often does not respond to standard acne treatments.
Which acne treatment works for which type?
Salicylic acid and retinoids such as adapalene suit blackheads and whiteheads, and benzoyl peroxide suits red pimples and pustules. Nodules and cysts usually need prescription treatment.
How long does acne take to clear?
With consistent treatment, the AAD says fewer breakouts may appear in 4 to 8 weeks and clearing can take about 16 weeks. Deep acne and marks can take longer.
Editorial Record
- Editorial status
- reviewed
- Medical reviewer
- Dr. Abdurrahman Efem
- Practical reviewer
- Merve Akkaya
- Last reviewed
- November 13, 2026
Related pages
Continue from here
Sources reviewed
Evidence behind this page
- DermNet: Acne.
- NHS: Acne.
- American Academy of Dermatology: Acne, who gets and causes.
- American Academy of Dermatology: Adult acne treatment dermatologists recommend.
- Dermatology Times: AAD releases updated guidelines for the management of acne vulgaris, 2024.
Sources support the general editorial guidance shown here. They do not replace personal medical advice from a qualified clinician.