Understand my skin
We can all agree that we’d like to get rid of our acne. But the strategies will often be different depending on the acne specificities.
Acne can take on a variety of forms based on its severity, the person’s age, the stage of progression, or the context (pregnancy, for example). Teenage acne, inflammatory acne in adults, cystic acne, hormonal acne, acne during pregnancy... dermatologists always classify acne according to its severity to determine the appropriate treatment.
In this article, you will find a handy chart that will help you improve your knowledge and easily identify the different types of acne.
This common condition affecting adolescents is triggered during puberty. It is polymorphic in nature, i.e. characterised by pimples taking on a variety of forms. It typically starts as comedonal acne, with the appearance of blackheads and microcysts or closed comedones that are limited to the face at first. There may also be some inflammatory red spots.
Inflammatory acne often coexists with comedonal acne. It is the second stage of acne, characterised mainly by painful red spots in the form of papules and pustules. The colonisation of these pimples by the Cutibacterium acnes bacterium (previously known as Propionibacterium acnes) induces an inflammatory reaction. The pimples are located on the face (especially the T-zone and jawline) as well as on the cleavage and back, in men in particular.
Here, red spots (papules and pustules) progress to form deeper lesions called nodules and cysts. Larger in size, these lesions appear as small hard lumps under the skin and can also be inflamed. Since cystic acne is very hard to treat, it is important that patients consult a dermatologist. The pimples are inaccessible and can cause significant scarring.
It’s true, acne is always hormonal since sebum secretion is controlled by hormones. But there are cases when the condition is caused by a hormonal imbalance, for example the over-production of male hormones.
Not all of the hormonal mechanisms at play in acne are completely understood, and researchers are currently working to improve knowledge of the persistence of acne in adult women in particular.
There are also some rarer forms of acne that can be very severe:
Acne is often described as being mild, moderate or severe. Here is how the various acne severity levels are assessed according to the French Dermatology Society (SFD).
No lesions
There may be residual pigmentation and erythema
Practically no lesions
Very few scattered open or closed comedones and very few papules
Mild
Easy to recognise; less than half of the face is affected. A few open or closed comedones and a few papulo-pustules
Moderate
Over half of the face is affected. Several papulo-pustules and several open or closed comedones. There may be a nodule.
Severe
The entire face is affected. It is covered with numerous papulo-pustules and open or closed comedones and very few nodules
Very severe
Highly inflammatory acne covering the face with nodules
A major risk associated with acne, scarring can be especially distressing since it primarily affects the face. Scarring is defined as marks that are still visible one year after a lesion heals. Inflammatory and comedonal acne can leave various types of scars:
atrophic sunken scars that appear as small craters giving the skin a pockmarked appearance
deep and narrow ice-pick scars
raised keloid scars causing the skin to become bumpy and fibrous
Obviously, when you pick at your blemishes in front of the mirror, you increase the risk of scarring, even with comedonal pimples such as blackheads and white bumps. It is therefore essential that you resist the temptation of popping your pimples.
Lastly, if you have acne and expose yourself to the sun, your lesions may become strongly pigmented during the healing process. These hyperpigmentation marks may persist for years at best or be permanent at worst.
