Understanding the 6 Main Types of Acne and Their Root Causes

Acne gets lumped into one category, but not all breakouts are the same.

A blackhead on your nose looks and feels different than a painful cyst on your chin. The bumps that appear after trying a new moisturizer can have a completely different cause than the breakouts that show up around your jawline before your period.

That's part of what makes acne so frustrating. You can be doing everything "right" and still not see results because you're treating the wrong type of breakout.

Once you identify the specific type of acne you're dealing with and what's contributing to it, it becomes much easier to choose products, habits, and treatments that actually work to clear your skin.

In this guide, we'll walk through the six main types of acne, the most common causes of acne, and how to build a routine based on the type (or types) that's affecting you most.

Why Not All Acne Is the Same

Acne develops when pores become blocked with oil, dead skin cells, bacteria, inflammation, or a combination of these factors. (1)

What happens after that blockage forms determines the type of acne you see on your skin.

Some clogged pores can remain relatively calm but still cause blackheads or whiteheads. Others become inflamed and develop into red bumps, pus-filled blemishes, or deep, painful cystic lesions. (2)

Because each type of acne has its own unique set of causes, they require different solutions. That's why a one-size-fits-all approach to clearing skin and preventing breakouts rarely works for everyone. (3)

Type 1: Blackheads (Open Comedones)

Blackheads are one of the mildest forms of acne. They develop when a pore becomes clogged but remains open at the surface. The dark color isn't dirt. It's oxidized oil and debris that are exposed to air. (4)

Blackheads usually develop on the:

• Nose

• Chin

• Forehead

• Around enlarged pores

In most cases, blackheads are linked to:

• Excess oil production

• Dead skin buildup

• Pore-clogging skincare products

• Inconsistent exfoliation

What helps to clear blackheads and prevent them from returning? This type of clogged-pore acne tends to respond well to gentle exfoliation and consistent use of acne-safe skincare. 

CLEARITY® Exfoliating Serum was designed specifically for this concern. Its 8% mandelic acid formula helps dissolve congestion inside pores while remaining gentle enough for sensitive and acne-prone skin.

Type 2: Whiteheads (Closed Comedones)

Whiteheads (closed comedones) form when a clogged pore stays closed beneath the skin's surface. Instead of turning dark like a blackhead, the blockage becomes trapped and appears as a small flesh-colored or white bump.

If you've ever felt like your skin looks bumpy even when you don't have obvious pimples, whiteheads might be the culprit. Whiteheads are typically described as:

• Tiny bumps that don't come to a head

• Rough texture under the skin

• Persistent congestion that doesn't seem to disappear even when the skin is cleaned well

White heads/closed comedones are usually caused by some combination of:

• Pore-clogging ingredients that can cause acne

• Heavy moisturizers

• Makeup buildup

• Excess oil production

Type 3: Papules

Papules are small, red, inflamed bumps that develop when a clogged pore becomes irritated. The difference between papules and both whiteheads and blackheads is that the latter contain some amount of visible pus, but papules don't.

Instead, papules can feel:

• Tender when touched

•  Inflamed

• Slightly raised

• Like they're "under the skin"

Papules are a sign that inflammation is becoming a bigger part of the acne process, which can be caused by issues like:

• Hormonal fluctuations

• Stress

• Bacterial overgrowth

• Over-exfoliation

• Skin barrier damage

It can be tempting to try to "pop" papules, dry them out, or prick at them, but this can accidentally make them even worse by irritating the skin and causing even more inflammation.

Type 4: Pustules

Pustules are what most people think of when they picture a pimple. These types of blemishes have visible pus and are usually also red, form visible bumps, and sometimes have a white or yellow center.

Pustules develop when inflammation increases, and immune cells accumulate inside the pore.

Common acne triggers that cause pustules include:

• Excess oil production

• Hormonal acne

• Inflammatory acne

• Bacterial activity

Just like with papules, it's not a good idea to try squeezing pustules, which usually just increases inflammation and raises the risk of post-acne marks.

Type 5: Nodules

Nodules are large, deep, painful acne lesions that develop beneath the skin. Nodules don't usually contain visible pus near the surface, which is what differentiates them from pustules. (5)

Nodules are usually due to more severe inflammation, and in many cases, they're influenced by hormones. They tend to:

• Feel hard

• Develop deep under the skin

• Last for weeks

• Cause discomfort

Because inflammation and hormones are two of the main causes, this type of acne responds best to a combination of topical support and addressing internal factors, such as with hormonal acne supplements.

Type 6: Cysts

Cystic acne is the most severe form of acne.

Cysts are deep, inflamed lesions filled with fluid and inflammatory debris. They can be painful pimples that are persistent and more likely to leave behind acne scars. Common locations where cysts form include the:

• Chin

• Jawline

• Neck

• Lower cheeks

Telling the difference between cystic vs hormonal acne can be confusing because many cystic breakouts are hormonal in nature. However, not all cystic acne is caused by hormones alone.

Other contributing factors to cysts can include:

• Hormonal fluctuations

• Genetics

• Chronic inflammation

• Stress

• Certain medications

• Pore-clogging ingredients

Root Causes Behind Each Type

The type of acne you have can offer clues about what's contributing to your breakouts since each type tends to be associated with its own set of underlying triggers. (6)

Blackheads and Whiteheads:

Often caused by:

• Pore-clogging ingredients

• Excess oil

• Dead skin buildup

• Poor exfoliation habits

Papules and Pustules:

Typically associated with:

• Inflammation

• Hormonal fluctuations

• Bacterial imbalance

• Stress

Nodules and Cysts:

Tend to be associated with:

• Hormonal imbalances

• Chronic inflammation

• Elevated stress hormones

• Internal health factors

You can see why using root cause acne treatments is the best way to achieve great results. 

Instead of only treating what's happening on the surface, it's important to understand what's driving breakouts in the first place so you can tailor your routine to address these triggers.

How to Match Your Acne Type to the Right Treatment

If Blackheads and Whiteheads Are Your Main Concern, Focus On: (7)

• Gentle exfoliation

• Non-comedogenic skincare

• Pore-clearing ingredients

CLEARITY® is an excellent place to start because mandelic acid helps dissolve congestion while supporting smoother skin texture.

If Papules and Pustules Are Common, Prioritize: (8)

• Barrier support

• Reducing inflammation

• Consistent skincare

CELLRENEW® Advanced Scar Serum helps support skin renewal while improving the appearance of post-breakout marks.

If You Struggle With Nodules or Hormonal Acne:

Consider supporting your skin internally as well as topically.

The Acne Guru™ developed MINDBODYSKIN® Hormonal Acne Supplement to help address common root contributors including hormonal fluctuations, excess oil production, inflammation, digestive health, and detoxification pathways.

Most find that a combo of internal support with acne-safe skincare creates more noticeable improvements than relying on topical products alone.

Building a Routine Based on Your Acne Type

One mistake that's common among people with acne is throwing everything at their skin at once. 

A simple routine usually works better because it doesn't overwhelm the skin, cause dryness and irritation, and balance oil production while supporting the skin barrier.

In the Morning:

• Cleanse: Use a gentle cleanser to remove overnight buildup.

• Treat: Apply CELLRENEW® Advanced Scar Serum to support skin renewal and improve the appearance of post-breakout marks.

• Moisturize: Use HYDRAGLOW to maintain hydration and support a healthy skin barrier.

• Protect: Finish with mineral SPF daily.

In the Evening:

• Cleanse: Use VITAMINSCRUB® three to five nights per week, alternating with a gentle cleanser on other evenings.

• Treat: Apply CLEARITY®, gradually working toward nightly use as tolerated.

• Hydrate: Finish with HYDRAGLOW.

When to See a Dermatologist for Acne

Many forms of acne respond well to consistent skincare and lifestyle changes. That said, a dermatologist can help identify additional factors contributing to breakouts and recommend appropriate treatment options. 

Professional help might be needed if:

• Acne is painful

• Breakouts leave scars

• Over-the-counter products aren't helping

• Cysts or nodules are becoming frequent

• Acne is affecting your quality of life

Final Thoughts on the Different Types of Acne

Identifying your acne type is one of the most valuable things you can do for your skin.

Blackheads, whiteheads, papules, pustules, nodules, and cysts might all fall under the acne umbrella, but they don't always share the same causes or respond to the same treatments.

The more closely your routine matches your specific acne type, the easier it becomes to make meaningful progress.

Ready to build a routine designed for acne-prone skin? Start with CLEARSTEM's bestselling Clear Skin Routine, an all-in-one solution featuring:

• VITAMINSCRUB® Exfoliating Cleanser

• CLEARITY® "The Blackhead Dissolver"

• CELLRENEW® Advanced Scar Serum

• HYDRAGLOW Plant Stem Cell Moisturizer

For additional root-cause support, add MINDBODYSKIN® Hormonal Acne Supplement to help support hormone balance, digestion, inflammation, and long-term skin clarity from within.*

Together, these products help support brighter, smoother, clearer skin without relying on harsh ingredients.

Shop the Clear Skin Routine, MINDBODYSKIN®, and the full CLEARSTEM collection.

Sources:

Source 1: Acne vulgaris: A review of the pathophysiology, treatment, and recent nanotechnology-based advances

https://pmc.ncbi.nlm.nih.gov/articles/PMC10709101/

Source 2: Acne Vulgaris

https://www.ncbi.nlm.nih.gov/books/NBK459173/

Source 3: Adult female acne: a guide to clinical practice

https://pmc.ncbi.nlm.nih.gov/articles/PMC6360964/

Source 4: Blackheads

https://my.clevelandclinic.org/health/diseases/22038-blackheads

Source 5: Acne Congulbata

https://pubmed.ncbi.nlm.nih.gov/29083736/

Source 6: Adult acne treatment dermatologists recommend

https://www.aad.org/public/diseases/acne/diy/adult-acne-treatment

Source 7: 10 skin care habits that can worsen acne

https://www.aad.org/public/diseases/acne/skin-care/habits-stop

Source 8: Hormonal treatment of acne vulgaris: an update

https://pmc.ncbi.nlm.nih.gov/articles/PMC5015761/