What is inflamed acne?

When it comes to acne, all forms have one thing in common: clogged pores. It’s the substances and underlying causes of clogged pores that differentiate inflamed acne from non-inflamed acne.

Inflamed acne consists of swelling, redness, and pores that are deeply clogged with bacteria, oil, and dead skin cells. Sometimes, bacteria called Propionibacterium acnes (P. acnes) can cause inflamed acne, too. Non-inflammatory acne, also called comedonal acne, is closer to the surface of the skin and doesn’t have a bacterial basis.

Keep reading to learn about the different types of inflammatory acne and find out which treatments actually work.

What are the different types?

Different types of inflammatory acne require different treatments, so it’s important to start by correctly identifying the kind of inflammatory acne you have.

The main types include:

  • Inflamed comedones. These are swollen blackheads and whiteheads.
  • Papules. These small, pus-filled red bumps appear on your skin’s surface.
  • Pustules. These are similar to papules but larger in size.
  • Nodules. These small, pus-filled bumps lie below the surface of your skin.
  • Cysts. Cysts are the most severe type of inflamed acne. Like nodules, they sit below the surface of your skin. They’re filled with pus and are usually large and painful when touched.

While inflamed acne is common on the face, it can also affect your:

How’s it treated?

Inflamed acne can spread and eventually cause scarring, so it’s best to start treating it as soon as possible. Depending on the type of acne you have, your doctor might suggest starting with over-the-counter (OTC) treatments before moving on to stronger prescription treatments.

Talk to your dermatologist about all of the following options for inflamed acne treatment. Keep in mind that it can take several weeks for each treatment to take full effect.

OTC treatments

There are tons of OTC treatments for inflamed acne, which can make choosing one feel overwhelming. Here are three of the main ingredients you’ll likely find in these products:

  • Benzoyl peroxide. This ingredient works by killing off p. acnes that might be trapped in your pores, and reducing inflammation. It can be drying for your skin, so it’s best to use it as a spot treatment.
  • Salicylic acid. This ingredient has a shedding effect and removes dead skin cells from deep inside your pores. It can also help to break down inflamed acne lesions while preventing them from coming back. You can use it all over your skin, but make sure to follow up with a moisturizer, because it can cause dryness over time.
  • Sulfur. You’ll find this ingredient in many acne-treating products, but it works best for mild, non-inflamed acne. While it won’t make your inflamed acne worse, it probably won’t do much to treat it.

Start by adding a cleanser containing salicylic acid and a benzoyl peroxide spot treatment to your skincare routine. It may be a few months before you start to notice a difference. Keep in mind that inflamed acne doesn’t always respond to OTC treatment, especially if it’s widespread and reoccurring. If you’re not seeing a change after three months, consider seeing a dermatologist or asking your doctor for a referral to one.

Medical treatments

Depending on your symptoms, your dermatologist may recommend one or a combination of prescription medications or topical creams, including:

  • Topical retinoids. Retinoids are powerful vitamin-A derivatives that remove dead skin cells. While you might see them in some OTC anti-aging products, prescription-strength retinoids, such as Differin and Retin-A, are most effective for inflamed acne. Aside from some initial redness and peeling, retinoids also make your skin more sensitive to UV rays, so make sure to wear sunscreen when using them.
  • Isotretinoin. Derived from vitamin A, this oral medication is one of the most powerful treatments prescribed for acne. It can cause a range of side effects, so it’s usually reserved for severe cases, usually those involving inflamed cystic acne, that don’t respond to retinoids. Avoid isotretoinoin if you’re pregnant, breastfeeding, or think you might become pregnant.
  • Oral antibiotics. If your dermatologist suspects that excessive p. acnes are causing your breakouts, they might prescribe a round of antibiotics. These are used temporarily to get the bacteria under control, usually in cases of widespread cystic acne.
  • Topical antibiotics. Unlike oral versions, you can only take for a short period of time, topical antibiotics can be used twice a day for up to two months. However, they aren’t as strong as oral antibiotics, so they’re best for less severe types of inflamed acne, including nodules, pustules, or papules.
  • Hormonal treatments. Some cases of inflamed acne are caused by hormonal imbalances. In these cases, your dermatologist may prescribe hormone-reducing medications. In addition, birth control pills work for some women who experience more inflamed acne before and during their menstrual cycles. Spironolactone, an anti-androgen medication, may also help with nodules and cystic acne caused by unusually high androgen levels.

Skincare tips

No inflamed acne treatment will work if you don’t properly care for your skin. Follow these tips to ensure you get the most out of the treatment options you try:

  • While you shouldn’t try to pop any type of acne lesion, this is especially important for inflamed acne. Doing so can increase inflammation and cause it to spread.
  • Wash your face morning and night with a gentle, gel-based cleanser.
  • Shower immediately after working out.
  • Follow your cleansing routine with an oil-free moisturizer, even if it feels counterintuitive. Skipping this step can deplete natural oils and water from your skin. In response, your sebaceous glands produce more oil, which leads to more acne.
  • Wear a sunscreen-based moisturizer or foundation every single day. While this will help to protect your skin from UV rays, it’s also a must if you’re using retinoids or other treatments that make your skin more sensitive to the sun.
  • If you wear makeup, look for oil-free and non-comedogenic options that won’t clog your pores or make your acne worse. Also, be sure to thoroughly remove your makeup before washing your face at night.

Living with inflamed acne

Treating inflamed acne can sometimes feel like an impossible task. Start by adopting a simple skincare routine that includes an oil-free moisturizer, gel-based cleanser, and benzoyl peroxide spot treatment. If you don’t notice any improvement after a few months, make an appointment with your doctor. There are several prescription treatments that can help when OTC ones don’t.

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