Symptoms
There are two major categories of acne: non-inflammatory and inflammatory. The non- inflammatory lesions are either closed comedones (“whiteheads”) or open comedones (“blackheads”). Closed comedones are small, flesh-colored or slightly red bumps that are caused by follicles containing a plug of sebum and keratinous debris. The pore is closed or small and difficult to see. In contrast, open comedones appear black on the surface of the skin because the pore is open and distended which makes the plug visible. The exposed black surface of the plug is caused by the skin’s natural dark pigment melanin and should not be confused with dirt. In inflammatory acne, comedones develop in the same way as in non-inflammatory acne, but they then become infected with bacteria which triggers an inflammatory response by the body’s immune system. As white blood cells swarm to the infected area, the comedone swells to produce a larger bump called a papule that can be tender. As more inflammation occurs, pus accumulates at the surface of the skin to form a pustule. The most severe inflammatory acne causes nodules and “cystic” lesions which can be very prominent, painful, and permanently scarring.

Last updated: 04-May-07