Different Types of Acne

Acne excoreé

The changes of acne are often minimal but the patient, often a young girl, picks at the skin producing disfiguring erosions. It is often very difficult to help the patient break this habit.

Baby acne

Also known as acne neonatorum, is condition that affects roughly 20% of newborn babies. Lesions appear at around 2 weeks postpartum and commonly disappear after 3 months. Lesions include small, red, papules, which mainly affect the cheeks, as well as the nasal bridge of infants. They clear spontaneously but may last for some years. There is said to be an associated increased tendency to severe adolescent acne.

Baby acne has recently been described to be caused by saprophytic yeast of the Malassezia species, which cause a primary skin infection leading to the appearance of acne-like pustules. Initially it was believed to be the common yeast species, Malassezia furfur, which also causes ‘cradle-cap’ in infants. However, new publications have pointed to another species, Malassezia sympolais. Treatment options are still the same for both species, which includes low dose topical antifungals.

Acne vulgaris

Acne vulgaris is an inflammatory disease of the skin, the most common form of acne, occurs during puberty and affects the comedogenic areas of the face, back, and chest. There may be a familial tendency to acne. Acne vulgaris is slightly more common in boys, 30–40% of whom have acne between the ages of 18 and 19. In girls the peak incidence is between 16 and 18 years. Adult acne is a variant affecting 1% of men and 5% of women aged 40. Acne keloidalis is a type of scarring acne seen on the neck in men.

Patients with acne often complain of excessive greasiness of the skin, with “blackheads”, “pimples”, or “plukes” developing. These may be associated with inflammatory papules and pustules developing into larger cysts and nodules. Resolving lesions leave inflammatory macules and scarring. Scars may be atrophic, sometimes with “ice pick” lesions or keloid formation. Keloids consist of hypertrophic scar tissue and occur predominantly on the neck, upper back, and shoulders and over the sternum.

Acne conglobata (Hidradenitis suppurativa)

This is a severe form of acne, more common in boys and in tropical climates. It is extensive, affecting the trunk, face, and limbs. In “acne fulminans” there is associated systemic illness with malaise, fever, and joint pains. It appears to be associated with a hypersensitivity to P. acnes. Another variant is pyoderma faciale, which produces erythematous and necrotic lesions and occurs mainly in adult women. Gram negative folliculitis occurs with a proliferation of organisms such as klebsiella, proteus, pseudomonas, and Escherichia coli.

Occupational

Acne-like lesions occur as a result of long term contact with oils or tar as mentioned above. This usually results from lubricating, cutting, or crude oil soaking through clothing. In chloracne there are prominent comedones on the face and neck. It is caused by exposure to polychlortriphenyl and related compounds and also to weedkiller and dicophane.

Acne cosmetica

Acne cosmetica is a term refering to acne caused by or made worse by cosmetics. The mechanism was presumably a chemically induced plugging of the pilosebaceous orifice. This was a significant problem for dermatologists in the 1970s and 1980s, but with the improved formulations produced by cosmetic chemists over the past thirty years, this is now a relatively rare diagnosis in daily practice.

Acne Rosacea

A variant that typically causes a red nose and is more common in older people than in young people, mostly affecting those who are aged 30 and above.  It commonly appears as a red rash, which are normally confined to the cheeks, nose, forehead, and chin. The redness is often accompanied by bumps and pimples. Blood vessels may also become more visible on the skin. People with this kind of acne rarely have pimples.  These flashes can be triggered by certain foods like spicy foods and alcohol.