What Exactly Is Acne? Understanding the Types and How It Develops

MW Skin Studio
Nov 24
4 min read

Acne can be an overwhelming experience, whether you’re a teenager or struggling with adult acne too. For teens it arrives just as confidence is forming, and I’ve seen the huge impact it can have on self esteem, mental wellbeing, and even everyday social life.

The first thing that my clients want to hear (and it’s true) is that acne is completely manageable. But understanding what acne actually is and why it shows up is the first step in supporting the skin properly and gently. There are actually many different types of acne, all of which have their own root causes and treatments.

What Is Acne, Really?

Acne is a very common skin condition caused by a buildup of dead skin cells and excess oil (sebum) inside the hair follicles. When this mix becomes trapped, it creates congestion which shows up as anything from blackheads to painful, inflamed breakouts.

Acne can be:

Non-inflammatory, like blackheads and whiteheads
Inflammatory, like red papules, pustules, cysts and nodules

In more severe forms, acne involves Cutibacterium acnes (C. acnes) which is a naturally occurring skin bacteria that thrives in oily, clogged pores and leads to painful breakouts and inflammation.

Why Do So Many Teenagers Get Acne?

It’s estimated that around 90% of teenagers will experience acne of some kind, whether it’s a few breakouts or more persistent issues.

That’s because, during puberty, there’s a natural surge in hormones (particularly androgens) which increase oil production. This extra oil, combined with dead skin cells, stress, and often less than perfect skincare habits, creates the perfect environment for acne to form.

Other contributing factors can include:

Genetics
Poor diet choices (often high in sugar or processed foods)
Stress (which triggers hormonal shifts and inflammation)
Incorrect skincare or poor hygiene habits (like not changing pillowcases regularly)

It’s important to remember that acne isn’t just about cleanliness, in fact you can often strip the skin and encourage acne with aggressive cleaning! What’s more helpful than focussing entirely on cleansing is supporting the skin from the inside and out.

The Four Grades of Acne

Acne presents on a spectrum from mild congestion to severe, painful inflammation. Understanding what grade you're dealing with can help guide appropriate support.

1. Mild Acne

Open or closed comedones (blackheads or whiteheads)
Occasional papules or pustules

2. Moderate Acne

Multiple papules and pustules (small red or pus-filled bumps)

3. Moderate-Severe Acne

Numerous papules and pustules
Occasional cysts or nodules

4. Severe Acne

Widespread cysts, nodules, papules, and pustules
Often painful, can lead to scarring if untreated

Early support matters. Tackling acne before it becomes severe reduces the risk of scarring and long term skin sensitivity.

The Six Types of Acne And What They Look Like

You might be surprised to learn that not all “spots” are the same. Acne can show up in different forms, and each one responds slightly differently to treatment.

Here’s a quick breakdown:

Open Comedones (Blackheads)

Non-inflammatory
Open pores clogged with dead skin cells + oil
Black appearance from oxidation (not dirt!)

Closed Comedones (Whiteheads)

Non-inflammatory
Closed pores clogged beneath the surface
Appear as small, white or skin coloured bumps

Papules

Inflammatory
Red, tender bumps without pus
Can be painful and progress to pustules

Pustules

Inflammatory
Similar to papules but filled with pus
Often appear red with a white or yellow centre

Cysts

Inflammatory
Large, painful, pus-filled lumps
Sit deeper in the skin
Softer than nodules but more likely to scar

Nodules

Inflammatory
Firm, deep, red bumps without pus
The most severe form of acne
Very painful and can lead to permanent scarring

Can Acne Be Cured, Or Just Controlled?

This is a really important conversation. And the honest answer is: acne can be controlled, not always permanently cured.

That’s because acne is often influenced by internal factors like:

Hormonal changes
Stress and cortisol levels
Diet and blood sugar regulation
Sleep and rest
Skin barrier health and skincare habits

While we can’t stop puberty or erase genetics, there’s a lot that can be done to calm the skin and prevent flare ups with the right approach.

When we support the whole body, not just the skin, we see improvements not only in breakouts, but also in mood, energy, and confidence.

Real Support for Real Skin

If you or your teenager are struggling with acne, know that you are not alone and there is help. Acne can be incredibly frustrating, especially when it feels like you’ve “tried everything” and nothing is working.

At MW Skin Studio, I’ve created protocols specifically for teen skin, tried and tested both in clinic and online, including with my own teenage son! My approach looks at lifestyle, diet, hormones, and skincare together to create a clear, calm, and manageable plan.

Whether you're local or further afield, you can book a Virtual Consultation and receive a personalised skin plan with professional skincare access, nutrition and supplement guidance, and clear steps forward.

Book your 1:1 skin consultation here

Or take a look at my Tackling Teen Acne eBook, designed to help teens and parents better understand the skin and support it with confidence.

Take a look at our E-Books here