Non inflamed Acne

There are two types of non inflamed acne, open and closed comedones. Commonly known as blackheads and whiteheads respectively.
Whiteheads are closed comedones and are formed from a microcomedone inside the pore. They are skin colored and do not have any type of redness or pus filed tip. The reason these are called closed is because the pore opening is closed (or very tiny) to the outside air. Underneath the skin is a follicle filled with dead skin cells, oils, and other debris. This type of acne is also called maturation arrest acne. Meaning it has not matured or developed into an open comedone. Unfortunately, this type of acne is one of the hardest to treat and a lot of times needs extractions to get the lesion to go away. When you extract these you’ll see white debris squirt out like a little worm.

Open comedones! These are your blackheads and can be identified by them being dark in color and if you look close up, have a mini volcano type opening. The reason they turn black is beside the debris inside the follicle is exposed to air and thus creating a change in color from oxidation. When you extract these, they come out in one hard piece. IMPORTANT to take note that the pores on your nose are most likely NOT blackheads. Pores on your nose tend to be more prominent because those pores tend to produce more oil than other parts of your face and you’re just noticing a larger sized pore not a blackhead.

For some people, this is the only type of acne they will get. For others, they can get inflamed acne as well.

Inflamed Acne

As sebum accumulates, inflammation can develop around the pore. It is here that acne starts to differ. Inflammation is also an inherited tendency. Sebum is the food source for the acne causing bacteria called c. acnes. So an abundance of sebum is a feeding ground for acne bacteria. With all this buildup of skin cells, sebum, and c.acnes, it’s putting pressure on the follicle walls that eventually could erupt and leak to surrounding skin causing an infection and leading to inflammation. This erupted follicle is what is commonly called a pimple, or inflammatory papule, that just looks like a red bump, no white tip.

A pustule is different from a papule in that this lesion contains white blood cells. PUS! When your immune systems starts fighting off the infection, white blood cells accumulate in the follicle making a white tip that you can’t resist to pop. I would not advise you to extract any type of pimple except for this kind but you would have to do in a sanitary manner and resist your urge to pick at it later.

A nodule is less common and often in more moderate to severe type of acne. Nodules are dome shaped and go deeper into the dermis and are more likely to cause atrophic scarring from it deteriorating your dermis layer.

A cyst is a group of pustules that are so close together they create one big lesion. It’s similar to a nodule but contains pus. Scarring is common with cysts as well and can be very painful.

The Face Reality products I use here at HD Esthetics can have your acne under control in about 3-4 months depending on acne type. By combining customized homecare for you along with regular in office treatments such as peels and LED, your skin can begin clearing. To learn more about my acne program click here.