Whether you’re still dealing with breakouts as an adult or your kids are struggling, acne can leave lasting scars. Luckily, early and effective treatment can reduce the chance of permanent damage. Acne treatments depend on the type and severity of your breakouts. Mild noninflammatory acne, like whiteheads, blackheads, papules, and pustules, can be cleared with OTC products that dry excess oil or prescription retinoids.

Whiteheads and Blackheads:

If you look in the mirror and see small, white, or yellow bumps, you may have a form of acne called whiteheads or blackheads. Both blemishes appear when the pores in your skin become clogged with a combination of natural oil, dead skin cells, and bacteria. Clogged pores can result from overactive glands that produce too much oil or hormone changes (such as those caused by pregnancy, the menstrual cycle, or changes in birth control pill use). 

Other contributing factors are dirty hair and skin, poor hygiene, greasy foods, sweating, tight clothing, and certain medications. Whiteheads are clogged pores that collect dead skin and natural oil under the skin’s surface and appear as firm, white bumps. They are also known as closed comedones because the trapped mixture of sebum, oil, and dead skin doesn’t rupture or leak.

On the other hand, blackheads are clogged pores that remain open to air. This exposes the trapped mixture to the oxygen in the air, which oxidizes it and gives it its characteristic black appearance. Both types of blemishes can be treated with proper facial hygiene, including washing and exfoliating regularly and using over-the-counter products like pore strips. 

Acne treatment in Franklin, TN, includes topical prescription medications and oral antibiotics. But when these treatments are insufficient to clear your skin, a dermatologist may recommend additional options such as chemical peels and deep cleaning treatments.


Pustules are small to medium-sized bumps with a pus-filled center. They are red and tender to the touch. These types of pimples indicate inflammatory acne. They can be found on the face, neck, shoulders and back. In addition, they can also be seen on other parts of the body, like the arms, legs, and feet. 

Like white and blackheads, these inflammatory lesions are caused by the accumulation of excess oil, dead skin cells, and other pore impurities. When this mixture is trapped, follicles become inflamed, and bacteria (Propionibacterium acnes) multiply. This causes noninflammatory acne to degrade into inflammatory acne, resulting in painful pus-filled bumps called pustules. 

Although these pimples are often associated with acne, they can also develop due to other infections and skin conditions. Folliculitis, herpes, shingles, and infectious diseases like scabies and ringworm can all cause these pus-filled lesions.

Moreover, medication-induced acne or psoriasis can also result in pus-filled lesions. Washing the affected skin area twice daily with lukewarm water and mild soap or cleanser can help prevent pus-filled acne. Avoid squeezing or popping these pus-filled acne because it can worsen the condition, drive the infection deeper into the pore, and may lead to scarring. 

Alternatively, laser therapy and chemical peels effectively decrease the amount of bacteria that triggers acne-induced pustules.

In severe cases, doctors prescribe oral medication like Isotretinoin to kill bacteria and reduce inflammation.

Nodules and Cysts:

Severe or nodular acne causes large, inflamed, painful lesions visible underneath the skin. These lesions are called cysts or nodules, and they can lead to permanent scarring if not treated properly. This type of acne often develops from excessive oil production that clogs the opening of a hair follicle. It may also develop from various factors, including diet, hormonal changes, excess sweating, stress and anxiety, certain skincare products or medications, and genetics. 

When a pore gets clogged, natural oils (sebum) and dead skin cells mix with bacteria to create pimples. Papules are red, inflamed bumps that may have a pus-filled top from the body’s reaction to the bacterial infection. A clogged pore that opens deep into the skin can cause nodules, which are hard knots under the skin. These are usually very painful and appear on the face, chest, or shoulders but can also show up in other places of the body. 

Both nodules and cysts are considered inflammatory acne because the inflammation of the follicles causes them. They are often challenging to treat with over-the-counter or prescription creams and treatments as they can be hard to reach under the skin’s surface. A dermatologist can often help remove the lesions without causing more damage to the surrounding tissue.

Acne Scars:

Acne scarring occurs when the skin responds to a blocked pore that gets inflamed. This swelling can lead to permanent scars, known as atrophic scars. Compared to raised scars, these scars are flat and less noticeable. The three main types of atrophic acne scars are ice pick, rolling, and boxcar scars. Ice pick scars are thin and deep with well-defined vertical edges. 

Rolling scars are wider at the top and look like a shallow hill or wave. Boxcar scars are round or oval-shaped depressions more visible than ice-pick scars. The severity of acne can be determined by counting the number of comedones and inflammatory blemishes. Mild acne is less than 20 comedones and 15 inflammatory blemishes. Moderate acne is more than 20 inflammatory blemishes and less than 30 comedones. 

Severe acne is more than 30 inflammatory blemishes and more than 50 comedones. Your genes, hormones, greasy skin, and friction from clothing or accessories like helmets or straps may also influence the severity of your acne. Keeping your pores clear of oil, dead skin cells, and other debris can help prevent clogging. You can also reduce the inflammation and redness of pimples by avoiding picking or squeezing them.