By Erin Lukas
Updated Jan 11, 2019 @ 12:51 pm
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Blackhead, whitehead, or cyst, when I was in high school I treated every pimple the exact same way. Each zit would get covered in whatever spot treatment my mom picked up for me at the drugstore. It didn't matter what ingredients were in these products because I thought my acne would go away once I graduated college and was officially an adult. 

It turns out, acne doesn't have an expiry date. Multiple degrees, full-time jobs, and signed apartment leases later, I still get breakouts. What has changed is my plan of attack for treating acne. All pimples aren't created equal, even though some forms look similar. Each type is unique and requires different treatments to get breakouts under control. 

Still, it can be confusing to know exactly what sets blemishes apart and what products to use on them. That's why I turned to Dr. Melanie Palm, a San Diego, CA-based board-certified dermatologist and cosmetic surgeon, to break down the most common types of pimples, and what acne treatments you need to just make them go away. 

From whiteheads and blackheads, papules and pustules, to nodules and cysts, this is your crash course on how to figure out what type of acne you're dealing with.

WHITEHEADS

Whiteheads are exactly what they sound like: Little pills of white puss that look like they're about to pop out of their pockets. You can get this type of pimple anywhere on your face, but whiteheads are most commonly found on the T-zone, cheeks, and chin.

These pimples form when the hair follicles on the face become sticky, creating buildup of dead skin and early inflammatory cells. Dr. Palm says that latter is what causes the pimple's infamous white color. Unlike more serious forms of acne, whiteheads are considered non-inflammatory because they don't have the pink or red discoloration around the actual pimple. 

And while this type of pimple is the toughest to cover up with concealer, whiteheads can be fairly easy to treat. Dr. Palm says that they usually only last a couple of days, and an over-the-counter spot treatment with acne-fighting ingredients like retinol or benzoyl peroxide can help shrink them down. Incorporating these ingredients into your regular skincare routine can help prevent breakouts, too.

What you should never do is pop a whitehead — even though it can be tempting when your makeup keeps sliding off of it. "Have a professional extract them, or consider effective topical therapy or peels to improve and eliminate whiteheads," Dr. Palm suggests.  

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BLACKHEADS

Blackheads are literally plugs in your pores. Similar to whiteheads, they're not considered inflammatory acne, and they're caused by a buildup of sebum and dead skin cells. They get their dark color when theses cells in the open pore react with the oxygen in the air and turn black. Blackheads are typically found on T-zone, where skin tends to be more oily. 

According to Dr. Palm, topical retinoid creams are the benchmark blackhead treatment. She also suggests using cleansers or peels with chemical exfoliants like glycolic or salicylic acid to deep clean clogged pores. Pore strips can help, but they won't solve your blackhead problem unless you're using them in conjunction with these aforementioned treatments. "Using adhesive strips to take away the blackheads without following up with effective, ongoing therapy to keep pores clean is what can keep them coming back," Dr. Palm says. 

PUSTULES

These inflammatory pimples are those pink, painful bumps with white, pus-filled centers. Adolescents are more prone to pustules, but adults and women suffering from hormonal acne can get them, too. Pustules can also happen when you use an irritating skincare product that's comedogenic. In plain terms, that means pore-blocking. 

"Inflammatory acne such as pustules are best addressed with topical therapy, often in combination with an oral prescription medication, usually an antibiotic," says Dr. Palm. The gold standard products? A combination benzoyl peroxide/clindamycin gel and a topical retinoid.

PAPULES

This type of pimple looks like a grouping of tiny, red, raised bumps on the skin. Yep, kind of like an eczema rash. There's a few different ways to help you figure out the difference between the two skin conditions. Since papules are a form of acne, the inflammation is centered around a hair follicle oil gland, so the bump will always surround a pore. Eczema is more patchy and flaky than bumpy. 

Dr. Palm says that papules can be treated similarly to whiteheads, but an oral antibiotic or therapy may be prescribed if your breakouts are severe and occur often, or they're linked to hormonal changes. Additionally, a face mask that has sulfur in it can help, too. 

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CYSTS

Arguably the worst type of pimple, cysts are painful red bumps that linger deep within the skin until they come to a head with white pus. "Hormonal changes, and difficulties with how the oil gland functions, the skin in the hair follicle sheds, and inflammatory cells around the skin all play a role in the formation of a cyst," Dr. Palm explains. 

To make matters worse, there's no way of really preventing cysts from forming, but they can be treated with the help of a professional. Cortisone injections are one option, or if your cysts are reoccurring or severe, a dermatologist may prescribe an oral antibiotic or perform an excision. 

Just don't try to do surgery on them yourself at home. Squeezing a cyst make it even more swollen, or worse, cause post-breakout scarring. 

NODULES 

A deep cyst that takes longer to heal, nodules are bumps in the fat layer of the skin. And no, you're not getting these pimples because you're doing something wrong in your skincare routine. "It is not a person’s fault that they get nodules," Dr. Palm says. "They can occur in severe forms of teenage and adult acne." 

Since nodule are a severe form of acne, they require professional treatment from a dermatologist. Dr. Palm says that this consists of oral prescription medication, along with topical creams to prevent scarring.