If you've cycled through cleansers, spot treatments, and skincare trends without seeing clear skin, the problem may come down to the types of acne you're dealing with. A blackhead and a cyst form in different ways, so a product that clears one can do nothing for the other (or make it worse).

So, what are the different types of acne, and how do you treat them? Acne falls into two main groups, non-inflammatory and inflammatory, and each type within those groups responds best to its own mix of ingredients and treatments.

At Ethical Esthetics, a corrective skincare clinic in Bedford, NH, acne is the main focus. Founder Molly Schulte is a three-time certified acne expert who builds science-backed treatment plans and teaches clients how to care for their skin between visits.

Let's take a look at what causes acne, the most common types, and how to treat them, so you can start making more sense of your breakouts.

What Causes Acne?

Acne starts inside a pore. Each pore contains a hair follicle and an oil gland, and when everything works smoothly, oil travels up to the surface and dead skin cells shed away on their own. A breakout forms when that process gets backed up.

Four main factors work together to create acne:

• Your oil glands produce more sebum than your pores can clear.
• Dead skin cells shed unevenly and stick together inside the pore.
• The trapped oil feeds C. acnes, a bacteria that lives on everyone's skin.
• Your immune system responds to the bacteria with redness, swelling, and tenderness.

Several triggers can push those factors into motion.

Hormones, especially androgens, increase oil production, which explains why many people break out during puberty, around their period, or after stopping birth control.

Genetics also plays a role, since the tendency for skin cells to clump inside pores often runs in families. Stress, friction from masks or helmets, and certain medications can add to the problem, too.

Skincare and makeup are one of the most overlooked causes. Many popular products contain pore-clogging ingredients, including some marketed for sensitive or acne-prone skin.

Not sure what's in your current products? Run them through our Ingredient Checker to see whether anything on the label is known to clog pores.

What Are the Different Types of Acne and How to Treat Them?

Acne falls into two main categories: non-inflammatory and inflammatory.

Non-inflammatory acne includes blackheads and whiteheads. These are clogged pores that haven't become red or swollen, and they tend to respond well to exfoliation and professional extractions.

Inflammatory acne includes papules, pustules, nodules, and cysts. These breakouts form when a clogged pore ruptures or becomes irritated, and the immune system reacts. Inflammatory acne is more likely to hurt, linger, and leave behind dark marks or scarring.

Most people have more than one type at once, which is why a holistic approach is important.

Blackheads (Open Comedones)

Blackheads are small, dark spots that appear when a pore fills with oil and dead skin but stays open at the surface. The dark color comes from the oil oxidizing as it meets air, so scrubbing harder won't wash it away. They're most common on the nose, chin, and forehead.

Salicylic acid is one of the most effective ingredients for blackheads because it dissolves in oil and can work its way into the pore. Professional extractions and chemical peels help clear stubborn congestion.

Many clients who book a facial for "blackheads" on their nose are looking at sebaceous filaments, which are a normal part of the pore lining and refill on their own. An esthetician can tell you which one you have and save you from over-treating healthy skin.

Whiteheads (Closed Comedones)

Whiteheads are clogged pores covered by a thin layer of skin. They look like small white or flesh-colored bumps and often feel like a rough texture across the forehead or jawline.

Because the pore is closed, whiteheads need consistent exfoliation to loosen the buildup. Mandelic acid, a gentle alpha hydroxy acid, and retinoids help speed up cell turnover so the pore can clear.

Professional extractions remove them safely. Picking at whiteheads at home can rupture the pore wall beneath the skin and turn a simple clog into an inflamed breakout.

Papules

Papules are small, red, tender bumps without a visible white center. They form when a clogged pore becomes inflamed, and the surrounding tissue swells.

Since a papule has nothing to extract yet, squeezing only spreads the inflammation and raises the risk of scarring. Benzoyl peroxide reduces acne-causing bacteria, and calming ingredients help bring down redness.

Pustules

Pustules look like papules with a white or yellow center filled with pus. Most people picture this type when they think of a pimple.

Benzoyl peroxide and salicylic acid help clear pustules and prevent new ones. When a pustule comes to a head, a trained esthetician can extract it with sterile tools and proper technique, which lowers the chance of a lingering dark mark. Popping pustules with your fingers pushes bacteria deeper into the skin and often leads to longer healing time.

Nodules

Nodules are large, hard, painful bumps that form deep under the skin. They can last for weeks and carry a high risk of scarring.

Topical products alone rarely reach deep enough to clear nodules, so they often need a dermatologist's care, sometimes with prescription medication.

Cysts

Cysts are deep, soft, fluid-filled lumps that feel painful to the touch. They're the most severe form of acne and the most likely to leave permanent scars.

Cystic acne typically requires a dermatologist, who may recommend prescription options like oral medication or a cortisone injection to shrink a cyst quickly. Never try to squeeze or extract a cyst at home. An acne specialist can help manage inflammation, build a routine that supports medical treatment, and address marks and texture once active breakouts calm down.

Fungal Acne (Malassezia Folliculitis)

Fungal acne isn't true acne, but it's often mistaken for it. It appears as small, uniform, itchy bumps, usually on the forehead, chest, back, or shoulders, and it's caused by an overgrowth of yeast in the hair follicles.

Traditional acne products won't clear fungal acne, and some rich, oily products can feed the yeast. It usually responds to antifungal ingredients. If your breakouts itch, look the same size, and don't improve with acne care, an esthetician or dermatologist can help you figure out whether yeast is the cause.

Hormonal Acne

Hormonal acne refers to breakouts driven by shifts in hormones like androgens, which increase oil production. It often appears as deep, tender papules or cysts along the jawline, chin, and neck, and tends to flare in a predictable cycle, such as the week before a period.

Hormonal acne responds best to a steady routine with acne-safe products, regular professional treatments, and attention to lifestyle triggers like stress, sleep, and diet.

What Are the Types of Acne on the Face?

Different areas of the face tend to break out in different ways, and the location of your acne can point to what's causing it:

• Forehead: Whiteheads and fungal acne often form here, especially if you wear bangs or use heavy hair products.
• Nose: Blackheads and sebaceous filaments are most common on the nose because it has a high concentration of oil glands.
• Cheeks: Papules and pustules frequently develop on the cheeks, where friction from phones, pillowcases, and hands can irritate the skin.
• Jawline and chin: Deeper papules, nodules, and cysts in this area are often linked to hormones.

Tracking where your breakouts appear, and when, gives your esthetician useful clues for building the right plan. Get started with a virtual consult with Molly to figure out the best treatment plan for your skin.

What Are the Types of Chin Acne?

Chin acne usually includes closed comedones, papules, pustules, and deeper cysts. Breakouts that cluster along the chin and jaw and flare around your menstrual cycle often point to hormonal acne.

Habits can play a part, too. Resting your chin in your hand, wearing a mask for long periods, and pressing a phone against your face all add friction and bacteria to the area.

Some chin bumps aren't acne at all. Perioral dermatitis can look like small red bumps around the mouth and chin, and it often gets worse with typical acne products.

A professional skin analysis helps you get answers and avoid treating the wrong cause of chin acne.

How Do You Treat Acne?

Effective acne treatment starts with identifying your acne type and its triggers. This helps match treatments and ingredients to your skin. Common options include:

• Professional extractions: A trained esthetician safely clears blackheads, whiteheads, and ready pustules without damaging the surrounding skin.
• Chemical peels: Professional-strength acids exfoliate dead skin, loosen congestion, and help fade dark marks left behind by breakouts.
• Facials: Customized acne facials combine deep cleansing, exfoliation, extractions, and calming treatments like LED or high frequency to reduce inflammation and keep pores clear.
• Acne-safe products: Swapping out pore-clogging cleansers, moisturizers, and makeup keeps new breakouts from forming.
• Lifestyle adjustments: Changes to stress, sleep, diet, and habits like touching your face can reduce flares, especially with hormonal acne.
• Prescription medication: A dermatologist may prescribe oral or topical medication for severe or persistent acne (but this shouldn't be your first step).

Consistency with your home care is incredibly important. At Ethical Esthetics, Molly considers home care about 80% of the work, so it's essential to get the right acne products and know how to use them.

Most acne takes around three to six months of steady treatment to clear. For severe nodular or cystic acne, a dermatologist may need to be part of the plan.

FAQs

How Do I Identify My Acne Type?

Look at what your breakouts feel like and where they form. Small, flat clogs without redness are usually blackheads or whiteheads. Red, tender, or pus-filled bumps are inflammatory acne. Deep, painful lumps that last for weeks are likely nodules or cysts. Since most people have a mix of types, a professional skin analysis gives you the clearest answer.

What Is the Hardest Type of Acne to Get Rid Of?

Non-inflamed acne, including blackheads and closed comedones, often takes the longest to fully clear. These clogs build up gradually inside the pore, and many more are usually forming beneath the surface than you can see. Clearing them calls for steady exfoliation and regular extractions over several months, so progress can feel slow even when your routine is working.

Cystic acne is challenging in a different way. It forms deep in the skin, often hurts, and is the most likely to scar, so it typically needs a dermatologist's care alongside support from an acne specialist. Hormonal acne can be stubborn as well, since breakouts return each cycle until the underlying triggers are managed.

How Do I Know If My Acne Is Bacterial or Hormonal?

All acne involves bacteria to some degree, so the better question is whether hormones are driving your breakouts. Hormonal acne tends to appear on the jawline, chin, and neck, flares around your period or during periods of stress, and often feels deep and tender. Breakouts that spread across the forehead, nose, and cheeks are more often tied to congestion, products, or habits.

Acne Treatment in Bedford, NH and Virtually

Ethical Esthetics is a corrective skincare clinic in Bedford, NH, with a focus on acne. Molly is New Hampshire's only Face Reality Level 2 Expert and an MBK Certified Acne Specialist, with experience treating teen breakouts, adult hormonal acne, and everything in between.

Our Acne Program pairs in-clinic treatments with a personalized home care routine.

Your first visit includes a full skin analysis, acne treatment, educational materials, and four to six starting products chosen for your skin. From there, you'll return every two to four weeks while Molly adjusts your protocol as your skin responds.

If you're not local, virtual consults let Molly review your skin history and goals and build a home care routine you can follow from anywhere.

If you want to understand your skin and feel confident in it, learn more about the Acne Program or reach out to Molly to book your consult or treatment!