What Type of Acne Breakout Do You Have?


Any breakout on your face is unwanted. Whether your skin erupts in some kind of bump or is dotted with blackheads, the objective is to get rid of them, and fast! The key to doing this is to figure out exactly what you're dealing with, because different breakouts require different treatments. Once you know, you can start using the best over-the-counter and/or prescription options to improve your skin.
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What's Behind Common Types of Breakouts

Each and every pore on your skin has its own pathway that allows oil (sebum) from your oil glands to flow to the surface of your skin. When oil is being produced at a normal rate, it keeps your skin protected, smooth, and hydrated. But, when hormones cause too much oil to be produced, things can go wrong.

For some people, the excess oil gets backed up and stuck inside the pore. To make matters worse, dead skin cells on the surface cause even more blockage. From there, depending on what else happens inside the pore, you can develop a pimple, whitehead (milia), blackhead, cyst, papule, or pustule.


  • Blackheads form when oil and dead skin cells trapped in the pore lining make their way to the pore opening.
  • When this oil plug makes it to the skin's surface and is exposed to air, it oxidizes, creating black dots, most commonly seen on the nose, chin, or center of the forehead.
  • Blackheads are not related to dirt or general hygiene!
  • Blackheads are not caused by bacteria, so they don't respond to topical disinfectants. such as benzoyl peroxide, sulfur, or topical antibiotics.
  • Treating blackheads involves ongoing use of a well-formulated BHA product to improve the shape of the pore and to exfoliate built-up layers of dead skin cells.
  • Stubborn blackheads that don't respond well to over-the-counter BHA products may benefit from a series of BHA peels from a dermatologist.
  • Scrubs and pore strips are of little use because the problem is not just on the surface.
  • Prescription-only medications such as Retin-A, Renova, or skin-care products with retinol can help improve cell function so the pore can function more normally.

Read more about how to eliminate blackheads.

Whiteheads (also called Milia)

  • Whiteheads are small, hard, white bumps that look similar to pimples but without the redness or swelling, and the contents can't be squeezed out.
  • Whiteheads occur most often on the forehead, cheeks, and in the undereye area, but can occur anywhere.
  • Whiteheads can be stubborn and are difficult to treat. The best skin-care treatment is to use a well-formulated BHA product once or twice a day.
  • In many instances, whiteheads need to be physically removed by an aesthetician or physician.

Regular Pimples (Papules)

  • This is the mildest type of acne lesion. Papules are pink to slightly red bumps with a soft white surface filled with fluid and oil. They can be sore to the touch.
  • Papules occur when a clogged pore ruptures, bacterial growth causes inflammation, and white fluid pushes to the surface.
  • This is the easiest form of acne to manage. Research has shown that over-the-counter products containing benzoyl peroxide and salicylic acid are the absolute best way to treat these kinds of breakouts.
  • Paula's Choice Clear systems work brilliantly for pimples, or you can check out other options on Beautypedia

Large Pimples (Pustules)

  • When pimples become large, engorged, and swollen, a papule has become a pustule.
  • Most teens dealing with acne have a combination of papules and pustules.
  • Managing this type of breakout almost always requires a combination of over-the-counter and prescription-only products.

Read more about acne and how to treat it.

Deep, Painful Pimples (Cysts and Nodules)

  • Cysts and nodules are the largest, most painful, and most difficult type of acne to treat.
  • A cyst does not always look like a pimple; it can be just a large red swollen lump.
  • Cysts reach deep into the sebaceous gland (the gland responsible for producing oil) and the deeper layers of the skin. If left untreated, they almost always lead to scarring.
  • Scarring occurs because the cyst is so large and deep it damages the skin's surrounding support structure.
  • For cysts and nodules, it is critical for you to see a dermatologist because there are no over-the-counter products that can treat this type of acne.

Read more about how to manage cystic acne.

The Best Skin of Your Life Starts Here: The same type of in-depth scientific research used to create this article is also used to formulate Paula’s Choice Skincare products. You’ll find products for all skin types and a range of concerns, from acne and sensitive skin to wrinkles, pores, and sun damage. With Paula’s Choice Skincare, you can get (and keep) the best skin of your life! Learn more at Shop Paula's Choice.

Sources: Experimental Dermatology, October 2009, pages 821–832; Journal of the Indian Medical Association, April 2009, pages 219–222; Expert Opinions in Pharmacotherapy, April 2008, pages 955–971; Cutis, January 2008, pages 81–86; Archives of Pediatrics, September 2007, pages 1152–1156; International Journal of Cosmetic Science, June 2004, pages 129–138; and Medical Electron Microscopy, March 2001, pages 29–40.

About the Experts

Paula Begoun is the best-selling author of 20 books on skin care and makeup. She is known worldwide as the Cosmetics Cop and creator of Paula's Choice. Paula's expertise has led to hundreds of appearances on national and international television including:

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The Paula's Choice Research Team is dedicated to busting beauty myths and helping you solve your skincare frustrations with research-supported expert advice—so you'll have the facts you need to take the best possible care of your skin.

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