The different types of acne: how to identify and treat them

“Retentional acne”, “inflammatory acne” or “mixed acne”? How can they be differentiated? Which product should you use to treat acne? Knowing how to respond is the first step in implementing the most appropriate treatments.

FEDTET OG UREN HUD

Types of acne: identifying them for better treatment

To get rid of your acne, and before even choosing this or that product (which may not be suitable), you need to determine your type of acne. Who is the best person to ask? Your dermatologist. Their expert opinion is crucial. Based on your type of acne, age, and the severity of your condition, they will provide a personalised approach and an appropriate treatment plan.

Retentional acne

The first type of acne is known as retentional acne. This form of acne presents with different symptoms: oily and shiny skin, enlarged pores, blackheads, or microcysts. Retentional acne results from hyperproduction and accumulation of sebum, along with the skin’s inability to expel it.

This is the initial stage of acne. Since it primarily affects the face (forehead, nose, cheeks, and chin), it is often difficult to live with as it gives the skin a dull and unsightly appearance. Fortunately, skincare solutions exist to restore radiance to your skin and treat imperfections.

Inflammatory acne

The second type of acne is inflammatory acne. It is characterised by raised red pimples, which may be painful (papules). These pimples either subside within a few days, or develop into pustules.

Inflammatory acne is triggered by an imbalance in the skin’s microbiome, which encourages the excessive development of a naturally occurring bacterium: Cutibacterium acnes. Again, this form of acne can be difficult to live with. However, by adapting your daily skincare routine and carefully following your dermatologist’s treatment prescription, you will give it the best chances of success.

Retentional and inflammatory acne

It is sometimes possible to experience both of the first types of acne simultaneously. Often during adolescence, acne is both retentional AND inflammatory. In fact, this is the most common form of acne during puberty.

This type is referred to as “mixed acne” or “polymorphic juvenile acne” as it is characterised by oily skin, retentional lesions (comedones), as well as inflammatory lesions (papules and pustules). It primarily affects the face, chest, and back, and can impact self-confidence at a crucial stage of life. Regular dermatological follow-up, a good understanding of the condition and adherence to treatments are therefore essential. Some forms of acne can develop into severe acne.

→ Teen acne routine

Mild and severe acne

Mild acne, or acne vulgaris, is the most common type of acne, primarily affecting teenagers, but sometimes persisting into adulthood. It includes the retentional, inflammatory and mixed forms mentioned earlier. This is the most widespread form of acne, and its severity is classified on a scale of 0 to 5. The more severe and deep the inflammation, the higher the stage.

There are two severe forms of acne:

Acne conglobata: this type starts at puberty as ordinary acne, but then worsens and spreads to the torso and the roots of the limbs. It is characterised by classic lesions (retentional and inflammatory) along with nodules. The lesions create tunnels under the skin that discharge chronically and leave permanent, unsightly scars.
Acne fulminans: this rare form of acne primarily affects teenagers and young male adults due to high androgens levels. It is an acute form of acne accompanied by a fever (39-40°C) and joint pain. The acne lesions become necrotic and may bleed. This type of acne requires urgent treatment in a hospital.

What tests are used to classify acne?

To correctly diagnose acne, determine its type, and assess its severity, a detailed skin examination is carried out by a dermatologist. This assessment includes a clinical examination to observe the characteristics of skin lesions (such as blackheads, pustules, and cysts). The diagnosis of acne does not require additional laboratory tests.

However, in case of acne if an adult woman (onset or persistence of acne after the age of 25) or when signs of hyperandrogenism (excess male hormones) are present, the doctor might prescribe a blood test to assess sex hormones levels and, in some cases, a pelvic ultrasound to examine the ovaries. Hyperandrogenism can manifest through excessive hair growth, hair loss, irregular menstrual cycles, and weight gain.

Did you know? A woman’s ovaries and adrenal glands also produce male hormones. However, conditions requiring such examinations are rare.

Hormones and age: two key factors in the development of acne

Acne typically begins during puberty, mainly due to the influence of sex hormones, and particularly androgens.

In women, while no direct link has been found between the age of the first menstruation, cycle regularity, and the onset or severity of acne, several studies confirm that acne tends to worsen in the premenstrual phase, just before menstruation.

Pregnancy and its associated hormonal changes can also trigger acne flare-ups. It is essential to seek medical advice before using any specific treatment, as some are strictly contraindicated during pregnancy.

Diet, stress, and sun: what is the connection to acne?

The impact of diet on acne, particularly the links between acne and dairy products or carbohydrates (fast sugars), remains a topic of debate. While eliminating these foods from your diet is unnecessary, reducing consumption may help improve your skin. However, the latest clinical guidelines on acne management do not recommend changing diet to improve acne.

Stress does not directly cause acne, but it can exacerbate existing symptoms by stimulating the sebaceous glands to produce excess sebum.

Sun exposure, often perceived as beneficial for acne, can actually worsen symptoms in the long term. Although temporary improvement may occur due to the drying effect on blemishes, acne often returns more severely afterward. This is known as the rebound effect. Sun exposure can also lead to pigmentation of acne scars. Protecting your skin with an appropriate sunscreen is essential, particularly if you are using topical treatments that may increase sun sensitivity.

Dermocosmetic treatments

Dermocosmetic treatments help regulate sebum production, unclog pores, and reduce inflammation caused by acne. It is recommended to choose non-comedogenic products specifically formulated for acne-prone skin to prevent further clogging of the pores. These products may include gentle cleanser, toning lotions, lightweight moisturisers, and targeted treatments containing active ingredients. These ingredients, such as salicylic acid, benzoyl peroxide, or niacinamide, help reduce imperfections and soothe the skin.

Prevention and daily management of acne

Acne is much more than just a skin issue, and can have significant repercussions on mental health. People suffering from acne may experience a decline in self-esteem, anxiety, and even depression, especially when it is visible and persistent. These psychological impacts can interfere with social, professional, and academic life. The solution? Seek medical advice to find the appropriate acne treatment, and do not hesitate to seek help from a psychologist and/or psychiatrist if necessary. Depression requires proper care.

“Washing your face more frequently can prevent acne.”

Reality: Washing your face more than twice a day can irritate your skin and worsen acne. It is recommended to cleanse your face in the morning and the evening with a gentle cleanser suitable for acne-prone skin to remove excess sebum and impurities without drying out the skin. However, you can opt for double cleansing. First, use an oil-based cleanser to dissolve makeup and sun cream. Then, use a water-based cleanser to remove any residual traces and purify the skin. This process helps prevent clogged pores, reduce breakouts, and enhances the absorption of skincare products applied afterward.

Cleanance skincare designed to reconcile you with your skin

Avène Cleanance range is specially formulated to meet the needs of oily, acne-prone skin, even the most sensitive. Designed to prevent and reduce imperfections while respecting the skin’s sensitivity, Cleanance is your ally in achieving healthy, balanced skin.

Cleanance products contain active ingredients that regulate excess sebum, and offer a long-lasting mattifying effect. Avène Thermal Spring Water, at the heart of each product in the range, provides its soothing and anti-irritant properties. It calms inflamed acne irritated skin, providing immediate comfort. Among our brand’s signature products, discover the Cleanance Comedomed Anti-Imperfection Concentrate. The ideal treatment to reduce pimples and blackheads, and prevent their recurrence for up to one year.

Facial cleansing gel, micellar water, serum, mattifying treatment, mask… discover all our Cleanance range products.

Our answers to your questions about acne

Sorting fact from fiction: that is what we are here for.

That is true. Sun exposure can temporarily improve the condition of your skin. UV rays have an anti-inflammatory effect, and the skin thickens… However, by autumn, the skin returns to its initial thickness, and acne reappears, often with an increase in retentional lesions.

Yes, it is true, especially in women. The risk factors are the same as in teenagers, with hormonal variations being a primary cause. However, the clinical presentation is different. Adult acne more commonly affects the lower half of the face (jawline and chin) and is characterised by inflammatory lesions.

Once again, it is true. Thinking that “scrubbing” your skin regularly with exfoliants will eliminate shine and unevenness would be a mistake. In fact, over-exfoliating can intensify inflammation of the epidermis, which will react by producing more sebum.

The different types of acne: how to identify and treat them