How to get rid of six types of acne from cysts to blackheads – after experts find our DNA is to blame

The odd spot here and there is one thing, but when you suffer with acne is an entirely different experience.

Not only are you plagued by near constant pimples, the skin condition leaves many sufferers self-conscious and even depressed.

New research has found people with acne are more likely to have genetic variants which influence hair follicle formation, causing more spots.

Experts believe new drugs could be developed after analysis of the genes of 26,772 people — 5,602 with a severe form of the skin condition — pinpointed a “significant” risk factor.

Acne is a common skin condition that causes spots, oily skin and sometimes skin that is hot or painful to touch.

Most of the time acne is caused by hormonal changes in people between the ages of 11 and 30, it is also genetic.

Spots occur when bacteria enter our pores and mix with dirt and the natural oils in our skin, this can block the pores and cause pimples to appear.

There's a difference between getting the odd spot here and there and constantly battling with pimples.

If you've tried different treatments to clear up your skin with no success then it's a good idea to speak to a doctor, Dr Sweta Rai of the British Association of Dermatologists said.

"You should go and see a doctor if you have a crop of spots appearing all at once and you've tried over-the-counter treatments for four weeks but nothing is working," she told The Sun Online.

"You should also see a doctor if you've noticed scarring as a result of your acne and you should definitely see a GP if you have tried antibiotics or topical treatments but they are not working.

"If you have really sore cysts or nodules you should also see a doctor because it's likely you won't find any relief using over-the-counter treatments.

Here's six different types of acne and how it's treated.

1. Comedonal acne

Comedonal acne is one of the most common forms of acne.

Comedones are small, flesh-coloured bumps usually found on the forehead and chin.

"You may get blackheads or whiteheads but no inflammatory papules, predominantly they just have comedones," Dr Sweta Rai of the British Association of Dermatologists told The Sun Online.

"The best treatment for comedonal acne is a topical retinoid.

"Sometimes this type of acne responds well to different face washes, particularly containing salicylic acid which helps de-grease and unblock pores."

Over the counter creams constaining things like benzoyl peroxide may help, but it's best to speak to a doctor about a prescription for a topical retinoid cream.

"You can get some topical retinoids over the counter but they aren't likely to be strong enough."

If the comedones get quite bad and no other treatment is working then they may need to be treated with Roacutane, Dr Rai said.

2. Inflammatory acne


Inflammatory acne is formed from comedonal acne, but is slightly worse.

It causes red spots and can be more painful than comedonal acne.

"This means you've got a lot of red spots associated with the comedones," Dr Rai said.

"You may get papules which are red spots, or pustules which are yellow spots, and you get white heads and black heads.

"It can be mild, moderate or severe.

"Mild to moderate inflammatory acne can be treated with an oral antibiotic and a topical retinoid.

"If it is leaving scarring or antibiotics are not controlling it then Roaccutane may be suggested."

3. Cystic acne

This type of acne can cause cyst-like lumps to appear.

Usually the skin is very red and inflamed and the spots can leave severe scarring.

"You can get pea-sized or even larger lumps on the skin," Dr Rai said.

"This can be associated with scarring and big cysts that are discharging pus and blood."


Roaccutane can have serious side effects, and must only ever be taken if prescribed by a dermatologist.

The NHS states dry lips and skin are "very common" side effects.

For safety, don't go for any waxing, dermabrasion or laser skin treatment while taking the drugs – or in the six months after stopping it.

Common side effects that occur in one in ten people are:

  • skin becoming more sensitive to sunlight
  • dry eyes
  • dry throat
  • dry nose and nosebleeds
  • headaches and general aches and pains

Serious side effects, that happen in less than one in 1,000 cases include:

  • depression or mood changes
  • stomach problems including severe tummy pain, bloody diarrhoea and feeling sick
  • serious skin rash that peels or blisters
  • muscle weakness and difficulty moving your arms or legs
  • yellow skin or eyes, difficulty peeing or feeling really tired – signs of liver or kidney problems
  • a bad headache that won't go and makes you feel sick
  • sudden changes in eyesight

Tell your doctor straight away if you experience any of these.

In very rare cases, you can suffer a severe allergic reaction. Signs include:

  • getting a skin rash – red, swollen, blistered or peeling skin
  • wheezing
  • tightness in the chest or throat
  • having trouble breathing or talking
  • swelling of the mouth, lips or face

A severe allergic reaction is a medical emergency, dial 999 if you show any of the signs.

As this type of acne is severe an over-the-counter cream or face wash won't do anything to clear it up.

Instead, you will likely need a prescribed form of treatment that works to treat the underlying cause of the acne.

"The treatment for cystic acne is almost always Roacutane."

4. Hormonal acne

Many women experience breakouts due to hormonal changes.

The spots may be small like comedones or they may be red and inflamed.

"Women may often find that the acne is present during the time of their period," Dr Rai added.

"That responds really well to a drug called Spironolactone, which is an anti-androgen drug.

"We do know that people become more sensitive to higher than normal androgen [testosterone] levels in their body at the time they have acne, so suppressing the androgen levels often reduces the acne.

"Particularly, I find, patients tend to notice a pattern in the distribution of their acne, mostly it's on their lower face and they notice it around the time of their period."

5. Acne fulminans

This is the most severe type of acne you can get.

It's similar to cystic acne but more inflamed.

You can also get it on all different areas of your body, not just your face.

"This is basically a really severe cystic, inflammatory acne that leaves scarring," Dr Rai explained.

"With this people often need a course of oral steroid alongside acne treatments.

"Sometimes it is treated with Roacutane and sometimes it's treated with oral antibiotics, but steroids always need to be used because it's so inflamed."

The steroids work to target the inflammation to allow other acne treatments to work.

6. Macro-comedonal acne

Ever noticed a blind spot on your face that just won't go away?

That's macro-comedonal acne.

"This is basically large, closed comedones which are white heads beneath the skin," Dr Rai said.

"Often people will notice they have large bumps underneath their skin, but it's actually macro-comedonal acne.

"It's very hard to control this acne, you usually have to do very low doses of Roacutane or other options like lazer treatment or surgical methods of removing them."

If you are ever worried about the amount of spots or breakouts you get, speak to a doctor about the best way to treat them.


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