This series of illustrations shows how different types of acne develop and how to treat each specific kind. This first illustration depicts a normal pore so you can compare the other pictures of acne against it.
Corneocytes, or skin cells, become more sticky as they are shed and accumulate in the pore instead of flowing out onto the skin. More skin cells are shed at the top of the pore than the bottom. Sebum production is increased.
During this stage, the pore looks normal on the outside, but there are distinct changes in the cells surrounding the pore. As the material in the pore builds up, it creates a bottleneck that prevents sloughing. The medical term for this stage is a microcomedone.
These are some medications that may help at this stage:
Over-the-counter benzoyl peroxide kills bacteria and helps prevent C. acnes from overgrowing. Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. There is insufficient evidence to support some over-the-counter treatments, such as salicylic acid lotion.
As sebaceous material builds up, inflammation develops in the cells surrounding the pore. Whiteheads can be infected or not infected, depending on whether the C. acnes bacteria have been able to infect the cells around the pore.
These are some medications that may help at this stage:
Over-the-counter benzoyl peroxide kills bacteria and helps prevent C. acnes from overgrowing. Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. Prescription topical antibiotics kill the C. acnes bacteria and might be used if some of the whiteheads are infected. Prescription oral antibiotics also kill the C. acnes bacteria and might be used if many whiteheads are infected or if there are infected papules or pustules. There is insufficient evidence to support some over-the-counter treatments, such as salicylic acid lotion.
These are some medications that may help at this stage.
Over-the-counter benzoyl peroxide kills bacteria and helps prevent C. acnes from overgrowing. Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. Prescription topical antibiotics kill the C. acnes bacteria and might be used if some of the blackheads are infected. Prescription oral antibiotics also kill the C. acnes bacteria and might be used if many blackheads are infected or if there are infected papules or pustules. There is insufficient evidence to support some over-the-counter treatments, such as salicylic acid lotion.
These are some medications that may help at this stage:
Over-the-counter benzoyl peroxide kills bacteria and helps prevent C. acnes from overgrowing. Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. There is very limited evidence to support some over-the-counter treatments, such as salicylic acid lotion. Prescription topical antibiotics kill the C. acnes bacteria and are often used if a person has some inflammatory papules. Prescription oral antibiotics also kill the C. acnes bacteria and are often used if a person has a lot of inflammatory papules. There is insufficient evidence to support some over-the-counter treatments, such as salicylic acid lotion.
These are some medications that may help at this stage:
Over-the-counter benzoyl peroxide kills bacteria and helps prevent C. acnes from overgrowing. Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. Prescription topical antibiotics kill the C. acnes bacteria and are often used if a person has some pustules. Prescription oral antibiotics also kill the C. acnes bacteria and are often used if a person has a lot of pustules. There is insufficient evidence to support some over-the-counter treatments, such as salicylic acid lotion.
These are some medications that may help at this stage:
Topical retinoids like tretinoin, adapalene, and tazarotene reverse the stickiness of the skin cells, allowing them to slough normally. Prescription oral antibiotics also kill the C. acnes bacteria and are often used to calm down the infection with cystic acne. Isotretinoin (formerly marketed as Accutane) may be prescribed to treat moderate to severe cystic acne. This drug does have serious side effects and needs to be monitored closely if it is used.
