How to Treat Blackheads, Whiteheads, Cysts, and More

  • The types of acne are blackheads, whiteheads, pustules, papules, nodules, and cysts.
  • A papule is a raised lesion that can fill with pus and become a pustule.
  • Although you can treat most types of acne with commercial remedies, cysts may require injections.
  • Visit Insider’s Health Reference Library for more tips.

Whether you call them blemishes, pimples, or spots, there’s no denying that pimples can be an unsightly and, at times, painful nuisance that roughly affects 50 million Americans annually.

But not all buttons are the same. For example, a black point is different from a pustule which is different from a nodule. And these differences are important in determining the right treatment.

types of acne

Each type of acne requires a different treatment plan.

Ihor Melnyk / Getty Images


1. Black dots

Blackheads, aka open comedones, get their name from the fact that they appear as a black spot on your skin.

Blackheads start like any other pimple: skin debris (aka keratin) mixes with sebum – your skin’s natural oil – clogging your pores.

What makes blackheads different is that the pore is open to air. Oxygen in the air sets off a chemical reaction – oxidation – with the material in your pores, causing it to turn black, says Young McMahan MD, FAAD, certified dermatologist with American partners in dermatology.

How to treat them:

The best solution for blackheads is to wash your face with a beta-hydroxy acid (BHA) such as salicylic acid, which penetrates deep into the pores and can unclog them, says McMahan.

Additionally, you can try over-the-counter retinol such as Differin Gel, said Charles E. Crutchfield III, MD, certified dermatologist and clinical professor of dermatology in the University of Minnesota School of Medicine.

Retinol is a form of vitamin A that works by increasing skin cell turnover, breaking down cells that form clogs, and shrinking future clogged pores, Crutchfield explains.

2. White dots

Whiteheads, aka closed comedones, are similar to blackheads, except instead of being open to air, the pore is closed by a layer of skin, McMahan explains.

How to treat them:

Although it is tempting to try to pop white dots, you should avoid this so as not to delay the healing process.

Similar to blackheads, the best treatment is to wash your face with a BHA such as salicylic acid and use non-comedogenic oil-free products. Again, you can also try over-the-counter retinol, Crutchfield says, to control both blackheads and whiteheads.

3. Pustules

Pustules contain fluid or pus and appear as large, white bumps surrounded by red, inflamed skin. More often than not, bacterial growth in the clogged follicles causes pustules, McMahan says.

How to treat them:

Smaller pustules can go away without treatment, but you can also use topical benzoyl peroxide or sulfur-based facial cleansers, McMahan says. Both of these can reduce inflammation and kill bacteria that grow in the follicle and on the surface of the skin.

In more severe cases, Crutchfield says topical or oral antibiotics may be prescribed by a dermatologist. These included minocycline (oral) and clindamycin (topical).

4. Papules

Papules are solid, raised lesions usually less than an inch in diameter, McMahan explains.

They can be of different shapes, colors and sizes. As they start solid, after a few days they can fill with pus and become a pustule.

How to treat them:

The key is to avoid irritation to the area, McMahan says. Do not rub your skin and be gentle when washing it with lukewarm water. You can wash your face with a salicylic acid or benzoyl peroxide cleanser.

McMahan also recommends that you avoid putting makeup on the papules, so that the affected area can receive as much air as possible.

5. Nodules

A nodule develops when the deeper pores of the skin become clogged with dead cells and sebum, Crutchfield explains. This results in a large, deep lesion which may be visible on the surface if inflamed. If they continue to grow, they can become a lumpy cyst, Crutchfield says, which is usually painful.

How to treat them:

Nodules generally require stronger treatment than what over-the-counter products provide. Oral antibiotics such as minocycline or oral retinoids such as isotretinoin, commonly known as Accutane, can help, Crutchfield says.

Another option is steroid injections directly into the nodule, which can quickly reduce inflammation and pain.

6. Cysts

Cystic acne is considered the most serious type of acne, McMahan says. Similar to nodules, cysts are caused by clogged pores below the skin’s surface. They contain fluid or pus, and they may appear large, red, and are usually painful.

How to treat them:

Like nodules, over-the-counter treatments are not enough to treat cysts. It is important to get the proper treatment from a dermatologist to avoid scarring from these cysts. Crutchfield says prescription options include isotretinoin and antibiotics. Steroid injections are also an option.

Insider takeaways

Although acne can be unsightly and uncomfortable, it is treatable. If your acne is mild, over-the-counter treatments are sufficient to treat it. But if you have something more serious like nodules or cysts, you may need prescription medication.

Be sure to see your dermatologist if your acne is severe or over-the-counter treatments aren’t working.


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