What are the different types of acne and how do their triggers and symptoms vary?

Acne comes in different types and forms
Acne comes in different types and forms

It’s not just teenagers who get acne. While blemishes are most common during puberty, even babies can be effected and some people develop acne-prone skin in adulthood.

Acne is sometimes labelled according to the age at which it occurs: baby acne, teenage acne, adult acne etc., but it is also described according to the severity of its symptoms (e.g. Acne Conglobata) and, at other times, the various forms of acne are grouped according to the external causes that may have triggered blemishes (e.g. Cosmetic and Mallorcan Acne).
This article looks at all three different ways of grouping acne and explains the names, likely triggers and symptoms of each different type.

We use terms such as comedones, papules and pustules to describe the different forms of acne. If you’re not familiar with these, you can find an explanation of the terms used to describe blemishes in Acne-prone skin in general.

If you’d like to find out more about how blemishes and acne develop, take a look at the development of acne and the causes and triggers of acne. For how to care for skin, read the ideal skincare products and routine for acne-prone skin and acne medication and common treatments.

This article may help you identify the type of acne that you have but, if you are still in doubt after reading it, and if your skin is causing you problems, then you should consult your doctor who will be able to give you the information and advice you need.

 

Acne at different life stages

Our hormones behave differently at different stages of our life. This means that acne, for which the primary internal cause is hormonal, varies depending on our age. You can read more about the relationship between acne and hormones here. Acne is most likely to occur when hormones are fluctuating and is broadly categorised into four different age-related types: 

ACNE INFANTUM

Also known as
Toddler acne, acne infantilis, infantile acne, acne juvenilis

When does it occur?

Between the ages of three and twelve months. Boys are more frequently effected than girls

Where does it occur?
On the face, particularly the cheeks

Symptoms
Most commonly, a few comedones side by side or single papules or pustules. 

Can it scar?
Yes, in rare cases 

Toddler acne normally appears on the cheeks

ACNE NEONATUM

Also known as
Neonatal acne, baby acne

When does it occur?
In around 20% of newborns. Boys are four times more likely to experience baby acne than girls

Where does it occur?
Most frequently on the cheeks. More rarely on the forehead and chin

Symptoms
Normally closed comedones (whiteheads). Occasionally open comedones (blackheads), papules and pustules.

Can it scar?
Unlikely
Newborn boys sometimes experience neonatal acne

ACNE TARDA

Also known as
Adult acne, late acne

When does it occur?
In adulthood (from approximately age 25 onwards)
For 20 to 40% of the population acne either persists beyond the age of 24 or begins after that age
The most common skin disease in industrialised nations

More common among women than men as triggered by stress and the hormone fluctuations of the menstrual cycle, pregnancy and menopause. 

Where does it occur?

On the face (primarily the chin and jaw), neck and upper body

Symptoms
Acne Tarda ranges in severity from light acne (known as Acne Comedonica) through moderate and more severe acne (Acne Papulopustulosa) to severe acne (Acne Conglobata)

Can it scar?

Yes

You can find out the causes, symptoms and possible treatments for Acne Tarda here.

ACNE VULGARIS

Also known as
Teenage acne, puberty acne, normal acne, acne simplex

When does it occur?

During puberty (most likely between the ages of 15 and 18). Between 70%- 95% of adolescents are affected to some degree by acne1 

Where does it occur?
On the face and upper body

Symptoms

Acne Vulgaris ranges in severity from light acne (known as Acne Comedonica) through moderate and sometimes more severe acne (Acne Papulopustulosa) to severe acne (Acne Conglobata). 

Can it scar?
Between 2% and 7% of those who’ve had severe acne experience scarring 1

  1. C.C.Zouboulis, Hautarzt 2014 65: 733-750

The different types of acne in terms of severity of symptoms

Also known as
Mild acne

When does it occur?

Most common during puberty, but can also occur in later life

Where does it occur?
Primarily on the face (forehead, nose and cheeks) and, more rarely, on the back

Symptoms

A number of blemishes which can include blackheads and whiteheads and maybe a few papules. 

Can it scar?
Yes, but scars are unlikely and normally minimal. The risk of pigmentation issues is also low.

Also known as
Moderate acne, Papulopustular Acne

When does it occur?

Most common during puberty, but can also occur in later life

Where does it occur?
Primarily on the face (forehead, nose and cheeks) and, more rarely, on the back

Symptoms

A moderate to severe form of acne. Typically a mixture of papules and pustules. Skin may appear red and inflamed.

Can it scar?
Yes, there is a chance that skin may scar and also be left with hyperpigmentation marks

Also known as
Severe acne, AC

When does it occur?
An uncommon form of acne, it is most likely to happen during puberty although it may also occur in later life

Where does it occur?

Primarily on the face (forehead, nose and cheeks), neck and back.

Symptoms

Multiple visibly inflamed blemishes including papules and pustules. These blemishes may group together and form nodules and cysts and can be painful. 

Can it scar?

Yes, there is a considerable risk of scarring and pigmentation issues

Also known as
Acne Maligna, Acute febrile ulcerative acne

When does it occur?
A very rare form of acne, it effects mostly men between the ages of 13 and 22. It may be triggered by isotretinoin, the most effective medical acne treatment for severe symptoms, and is related to ‘doping acne’ which is acne caused by the overuse of steroids by some bodybuilders and weightlifters.

Where does it occur?
Primarily on the face (forehead, nose and cheeks) and back

Symptoms
Similar in characteristics to Acne Conglobata. Sufferers may also experience fever and joint inflammation

Can it scar?
Yes, there is a considerable risk of scarring and pigmentation issues

You can find out more about the consequences of these different types of acne, as well as what you can do to reduce and remove marks and scars, in Acne and scarring and Acne and pimple marks.

 

ACNE AESTIVALIS

Also known as
Mallorca acne

When does it occur?
It is most common in women aged 25-40, many of whom have had a history of acne in puberty. It appears after exposure to UV radiation, and is likely to be caused by the free radicals (created by exposure to the sun) reacting with the emulsifiers in cosmetic and sun protection products.

Where does it occur?
The most frequently affected areas include the underside of the arms, the chest and, less often, the face

Symptoms
They may include a bumpy rash, skin redness, blisters or pustules, and are nearly always accompanied by intense irritation. In more severe cases larger, haemorrhagic lesions can occur. 

Can it scar?
Yes, but pigmentation issues are a more likely consequence of Acne Aestivalis.

You can read more about these pigmentation issues and how to avoid them in acne and pimple marks and find out how to care for your skin in the sun here.

Constant picking of spots can lead to Acne Excoriée

ACNE COSMETICA

Also known as
Cosmetic acne, make-up acne

When does it occur?
It occurs when skin reacts to the comedogenic substances in some cosmetics. These substances block the sebaceous glands and trigger acne. Symptoms normally subside when you stop using the product.

Where does it occur?
Anywhere on the body, but it is most common on the face, neck, hairline and scalp.

Symptoms
Mild but persistent. Lots of small bumps on the skin that make it feel rough but usually little or no visible inflammation.

Can it scar?

Unlikely

You can find out more about how to choose, and remove, cosmetics if your skin is acne-prone in make-up for acne-prone skin.

ACNE EXCORIEE

Also known as
Picker’s acne, spot picking, spot-picking disorder, neurotic excoriation, psychogenic excoriation, dermatillomania

When does it occur?
More common in women than in men, constant and compulsive scratching, squeezing and picking at blemishes − sometimes even the normal skin − can be triggered by stress or other psychological issues (some people have impulse control disorders and aren’t even aware that they are scratching their skin).

Where does it occur?
Generally on the face (forehead, nose and cheeks) as it’s easily accessible. 

Symptoms

Can exacerbate the symptoms of mild acne and spread bacteria leading to greater inflammation.

Can it scar?
Yes, Acne excoriée often results in scarring, and this risk is exacerbated when people use sharp object to help them pick their blemishes.

 

 

ACNE INVERSA

Also known as
Apocrine acne, hidradenitis suppurativa, sweat gland abscess, pyoderma fistulans significa or acne tetrade

When does it occur?
After puberty. The cause is not entirely clear, but it is thought to be a faulty immune response

Where does it occur?
Primarily effects areas of the body with a high number of apocrine (sweat) glands: armpits, groin and anal folds

Symptoms
A chronic, recurrent, inflammatory disease. Starts with inflamed and painful nodules which can spread 

Can it scar?
Yes, there is a considerable risk of scarring and pigmentation issues

Certain medicines, and the overuse of steroids, can trigger acne

ACNE MECHANICA

Also known as
Sports acne, friction acne, sandpaper acne

When does it occur?

Active people of all ages can experience Acne Mechanica. It is caused by an object holding sweat against the skin and rubbing it causing further sebum production. Most frequently triggered by tight and/or synthetic clothing, helmets, chin straps, jock straps, bras and wetsuits

Where does it occur?

In areas of the body that are in contact with these items.

Symptoms

Blackheads, whiteheads and pimples

Can it scar?
Unlikely. Acne Mechanica is relatively easy to treat and/or prevent and symptoms normally heal well.

You can find out more about how to prevent and care for Acne Mechanica in Acne and sport.

ACNE MEDICAMENTOSA

Also known as
Medicinal acne, anabolic acne, doping acne

When does it occur?
It can be triggered by the use of medications containing barbiturates, lithium or corticosteroids, by overdoses of Vitamin B6, B12 or D2, by steroid abuse and sometimes also by use of the contraceptive pill. Acne normally improves after the medication is discontinued.

Where does it occur?
Primarily on the face, chest, shoulders and back

Symptoms
Painful nodules and pustules

Can it scar?
Yes, there is a risk of scarring and pigmentation issues

ACNE VENERATA

Also known as
Contact acne

When does it occur?
Acne Venerata is triggered by skin being in contact with chemicals that cause it stress. These can include tar, oil, chlorine, toothpastes that contain fluoride and harsh cleansers and grooming products.

Where does it occur?
Blemishes tend to appear in the area that has been in direct contact with the substance.

Symptoms
Usually blackheads

Can it scar?
Yes, but only in severe cases

The different types of acne in terms of severity of symptoms

Acne is frequently classified by the severity of the symptoms − from mild through to severe.

The different forms of acne when grouped by external causes

The primary cause of acne, hormones, is internal but there are several external factors which can cause and exacerbate acne. Acne is sometimes names after, and grouped according to, these external factors. The most common varieties are explained below:

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