Forms of Acne

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There are several forms of acne but by far the most common and widely recognised type is acne vulgaris. This is the kind of acne associated with teenage outbreaks. There are five further forms of acne some of which are very similar to ‘normal’ acne and others which are only distantly related. The less common types include acne conglobata, acne fulminans, gram-negative folliculitis, pyoderma faciale (rosacea fulminans) and acne rosacea.

Acne Vulgaris

This is the kind of acne generally referred to when people talk about ‘acne’. It affects around four out of five people at some point during their lifetimes although it is most common during puberty. It mostly clears up around the late teens and early twenties but can occur at almost any time of life and last well into middle age. It is also possible for acne vulgaris to affect children. The condition can range from extremely mild to very severe. It manifests itself in the form of whiteheads, blackheads, papules (minor, raised red bumps) and pustules (raised lumps with a yellow or white head). More severe cases also include nodules (large, sore, red lumps) and cysts (large, inflamed, pus filled lumps).

Acne Conglobata

Acne conglobata is a more serious strain of acne vulgaris. It includes whiteheads, blackheads, papules, pustules, nodules and cysts which can become seriously inflamed and join together to form large, painful lesions. These lesions often leave bad scars if they are not properly treated. This form of acne is more common in men between 18 and 30 and appears on the face, the upper torso, the buttocks, the upper arms and the thighs. Treatment for this type of acne normally has to be aggressive as the condition is often resistant to treatment. For this reason the oral medication Isotretinoin (Roaccutane or Accutane) is often used.

Acne Fulminans

This form of acne is identical to acne conglobata except for a few key facts. Firstly, it appears very suddenly, generally affecting younger men. Secondly, the lesions seen in acne conglobata ulcerate. This means that the skin is entirely broken, forming an infected crater and causing skin damage. Thirdly, and uniquely to any kind of acne, acne fulminans causes fever and aching joints. This acne can be worsened by antibiotics and is most effectively treated by Isotretinoin (Roaccutane or Accutane) or oral steroids.

Gram-Negative Folliculitis

This form of acne is rare and mostly affects men. It can occur naturally or as a result of treating acne vulgaris with antibiotics for too long. It is a bacterial infection cysts and pustules but can usually be effectively treated with Isotretinoin.

Acne Rosacea

This is the most distant relative of acne vulgaris, although it looks similar it is an entirely separate skin condition. The most obvious difference is that acne rosacea does not include blackheads. Acne rosacea mostly affects women but the most serious cases are present in men. The complaint includes a red rash, pimples and bumps, which appear on the nose, the forehead, the chin and the cheeks while the blood vessels in the face, appear more obvious. It is important that this condition is not confused with acne vulgaris, as it requires completely different treatment and urgent consultation with a dermatologist. Without the correct treatment acne rosacea can cause Rhinophyma, which causes swelling of the nose and the overproduction of skin tissue.

Pyoderma Faciale (Rosacea Fulminans)

This rare form of acne appears in women between the ages of 20 and 40. Like acne fulminans it has an abrupt onset. Pyoderma Faciale only affects the face and includes sores, nodules and pustules that last around a year. It can affect women who have never had acne before and can cause a lot of scarring in a short time. The usual treatment is Isotretinoin, sometimes accompanied by the use of systemic corticosteroids.

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