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Though all pimples start the same way, they can take many forms and may react differently for different people. All acne begins with one basic lesion: The comedo, an enlarged hair follicle plugged with oil and bacteria. Invisible to the naked eye, the comedo lurks beneath the surface of your skin waiting for the right conditions to grow into an inflamed lesion. As the skin continues to produce more oil, bacteria flourishes within the swollen follicle. The surrounding skin becomes increasingly inflamed as your white blood cells fight against the intruders.
NOTE: The following guide is not intended to be used for conclusive self-diagnosis; it’s best to consult a dermatologist if your acne persists. These definitions may be used to help you decide whether or not you should consider seeking medical attention.
Types of Acne - NON-INFLAMMATORY ACNE
Closed comedo, or whitehead. If the plugged follicle stays below the surface of the skin, the lesion is called a closed comedo, or whitehead. They usually appear on the skin as small, whitish bumps.
Open comedo, or blackhead. If the plug enlarges and pushes through the surface of the skin, it's called an open comedo, or blackhead. The plug's dark appearance is not due to dirt, but rather to a buildup of melanin, the skin's dark pigment.
Types of Acne - INFLAMMATORY ACNE
Papule. The mildest form of inflammatory acne is the papule, which appears on the skin as a small, firm pink bump. These can be tender to the touch, and are often considered an intermediary step between non-inflammatory and clearly inflammatory lesions.
Pustule. Like papules, pustules are small round lesions; unlike papules, they are clearly inflamed and contain visible pus. They may appear red at the base, with a yellowish or whitish center. Pustules do not commonly contain a great deal of bacteria; the inflammation is generally caused by chemical irritation from sebum components such as fatty free acids.
Nodule or Cyst. Large and usually very painful, nodules are inflamed, pus-filled lesions lodged deep within the skin. Nodules develop when the contents of a comedo have spilled into the surrounding skin and the local immune system responds, producing pus. The most severe form of acne lesion, nodules may persist for weeks or months, their contents hardening into a deep cyst. Both nodules and cysts often leave deep scars.
Acne conglobata. This rare but serious form of inflammatory acne develops primarily on the back, buttocks and chest. In addition to the presence of pustules and nodules, there may be severe bacterial infection.
If you’re a teen suffering from acne, you’re certainly not being singled out. At least 90% of adolescents have acne — it affects teens of every size and shape, in every country from America to Zimbabwe. A recent study by the American Medical Association revealed (not surprisingly) that acne is one of today’s teenagers’ biggest worries. “Acne can, without question, affect self-esteem,” says Diane Berson, MD, Assistant Clinical Professor of Dermatology at New York University School of Medicine. “Some kids have it so severely that they don’t even want to go out of their house. They make excuses for not going to social functions.”1
It seems unfair, doesn’t it? Just when you’re beginning to grow up and get some ideas about exactly who’s behind the face in your mirror, you’re staring at a minefield of bumps and blemishes. It can be downright depressing — but since everyone has acne, you’re supposed to suck it up and suffer through it… right? Wrong! Today we know more about fighting acne than ever before. And the best way to stop acne is to find out why it starts when it does — during adolescence.
Why does acne strike teens? At the onset of puberty, the body begins to produce hormones called androgens. These “male” hormones are a natural part of development for both boys and girls, but boys tend to produce more of them — and therefore tend to have more severe breakouts. Why? Our faces and bodies are covered with tiny hairs, each one fitting snugly into a hair follicle, sometimes called a pore. Deep within each follicle, oil glands are hard at work producing sebum, which travels up the hair and out onto the surface of your skin. Sebum’s job is to form a protective layer between your skin and the world, keeping it soft and smooth.
But when androgens enter the picture, your oil glands go into overdrive. They produce extra oil, which can clump together with the dead skin cells on the top layer of your skin. When this sticky mixture finds its way into your pores, it acts just like a cork in a bottle — trapping oil and bacteria inside. Unfortunately, your oil glands just don’t know when to stop; they keep producing oil, and the follicle becomes swollen. Your body’s natural defense system, white blood cells, rush to the area to clean up the mess. The result? Red, painful bumps. Yucky black spots. Zits. Blackheads. Pimples. Acne. It has nothing to do with what you eat, or how often you

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