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Different acne types - possible causes, and how you might treat it

Acne is one of the most common skincare complaints in the world, affecting approximately 90 per cent of the global population at some point in their lives.

There are three main different types, all with their own causes and treatments. And while acne doesn’t often cause any long-term physical health risks, many people are keen to treat it.

So, what acne might you have and what are the treatment options available?

Acne vulgaris

The most common form of acne is acne vulgaris, caused by clogged hair follicles resulting in a build-up of bacteria and sebum in the pore. This is what’s experienced in 99 per cent of acne cases.

Acne vulgaris usually presents itself as blackheads on top of the skin and whiteheads as acne under the skin - known as comedones. More severe cases of acne vulgaris can cause other types of inflamed elevations such as pustules and cysts.

What causes acne vulgaris?


No specific gene has been identified for acne. However, recent studies have found that those with parents who had or have acne have a higher chance of developing the condition.

Age and hormones

Around 80 per cent of adolescents will get acne due to the surge in testosterone that comes with puberty. Many adults also experience acne. Over the age of 20, women are statistically more likely than men to develop adult acne due to natural hormonal shifts.


Stress cannot cause acne by itself but can make an existing condition worsen or become harder to get rid of. This is because stress triggers the cortisol hormone which then triggers the skins sebaceous glands, mixing with any dead skin cells and bacteria to form more acne.

How to treat acne vulgaris

Creams or solutions

Creams, gels and lotions with benzoyl peroxide can help. It has an antiseptic and anti-inflammatory effect, targeting harmful bacteria and reducing the appearance of spots and inflammations. Other antibacterial ingredients include azelaic acid and salicylic acid which help to break down dead skin cells.


Antibiotics can be used to help treat more severe cases of acne. Where hormones are thought to be a root cause, doctors may also prescribe a hormonal treatment, ranging from the oral contraceptive pill to co-cyprindiol or Roaccutane, which reduce the body’s production of sebum.

Cortisone injections

Dermatologists may offer cortisone injections for severe cases of inflammation or to shrink large cysts caused by acne. Cortisone is a synthetic hormone that can reduce swelling and limit the chances of residual scarring. However, overuse can lead to pitting of the skin. These can be beneficial if you have a special occasion coming up, such as a holiday or a wedding.

Laser treatments

Laser treatment is usually recommended to those who have tried several of the above treatments without success. Non-ablative laser treatment has a high success rate in fading redness and reducing spots but does not remove any scarring or pitting of the skin. For this you’d need to try ablative laser treatments.

Light therapy

Light therapies can also be beneficial for clearing the skin but are often recommended alongside other forms of treatment, such as a topical lotion. Results vary from person to person but most people will see results to a certain extent.

Acne mechanica

Acne mechanica is rarer form of acne and caused by excess friction, pressure and heat. Although much rarer than acne vulgaris, it can be common among athletes, soldiers and students.

You can get acne mechanica on your face, shoulders, back and bum cheeks and it can look different on different people. For some people it may just be small, closed comedones, on others it may show as inflame pustules and papules. It usually starts as rough, bumpy looking skin and develops into red blemishes that are more noticeable.

What causes it?

As the main cause of this type of acne is friction, you’ll usually get it from:

  • Straps of bags
  • Hats and headbands
  • Sports equipment
  • Bra straps
  • Tight fitting clothes and underwear

These items rubbing against the skin cause the sweat and heat to become blocked – clogging pores. As the rubbing continues this causes the pores to become irritated which is what ultimately leads to blemishes forming. It can worsen in hot and humid places – for example in the gym or in warm weather.

What treats it?

Creams or solutions

Like with acne vulgaris creams, gels and lotions with benzoyl peroxide and salicylic acid in can both be beneficial in treating this type of acne. Showering after exercise or getting warm using a surgical scrub like Hibiscrub can also help to clear the skin of any excess bacteria.

Lifestyle changes

Switching synthetic fabrics for natural fibres like cotton can help. A lot of sports uniforms are made from synthetic materials which is why the condition can be worse for athletes.

Getting showered immediately after exercising can also help to keep the area clean, as can making sure there is a layer of clothing between your skin and the bag/equipment you are carrying to lessen the amount of friction directly on your skin.

Acne fulminans

Acne fulminans is a severe form of acne occasionally experienced by adolescent men. Characterised by inflammatory nodules on the back and chest which are often painful, it can lead to scarring, joint pain and other health issues. It can often look very sore, bleed and sometimes lead to a fever.

What cause acne fulminans?

It has been attributed to increased androgens (the male hormones), autoimmune diseases and genetic predisposition. This combination makes the skin more sensitive to surface bacteria. It’s also thought to be aggravated by steroid use and an increase in testosterone.

What treats it?

Topical acne creams won’t work to treat the condition; medication prescribed by your doctor is the only way to treat acne fulminans.

It will usually be either high doses of oral antibiotics, corticosteroids or anti-inflammatory medication. Treatment will need to be taken over the course of a few months in order to see results.


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