Cystic Acne and Nodular Acne

Medically reviewed by Carina Fung, PharmD, BCPPS

Cystic acne diagnosis

Acne vulgaris vs. cystic and nodular acne

How do you distinguish between normal, cystic, and nodular acne? Below are some signs to look for unique to each type of acne.

Signs of normal acne

Normal or common acne, which has the Latin name acne vulgaris, is very common and affects more than 3 million people annually in the U.S.

Acne vulgaris takes on the appearance of small, raised, red, tender bumps. These bumps are actually hair follicles that have become clogged with oil and dead skin cells.

The technical term for a single acne bump (papule) is a comedo8 (a clogged hair follicle or pore) and multiple bumps are called comedones.

Cystic vs. nodular acne

The difference between cystic and nodular acne depends on whether you have cysts or nodules on your skin. Cysts are pus-filled bumps that can look like boils, while nodules are solid bumps that feel firm to the touch. Both types of bumps lie beneath the surface of the skin, and both can be painful.

What type of acne do I have?

It is best to speak to a dermatologist to determine what type of acne you have—acne vulgaris, cystic acne, or nodular acne. Sometimes, the three types of acne will overlap, and you might have a combination of the three.

The mildest9 forms of acne are noninflammatory. These include whiteheads and blackheads:

  • Whiteheads (closed clogged pores): Whiteheads appear when oil and skin cells prevent a clogged hair follicle from opening. They are small, whitish, or flesh-colored spots or bumps usually surrounded by a red halo.

    Whiteheads typically do not cause scarring.

  • Blackheads (open clogged pores): Comedones that are open at the surface of the skin. They are filled with excess oil and dead skin cells. These comedones are called “blackheads” because of their black hue, which results from the irregular reflection of light coming from clogged hair follicles.

The skin around a blackhead usually appears normal, while the center of the blackhead is darker than the surrounding area.

Many of the same over-the-counter medicines that treat whiteheads are also effective against blackheads.

  • Inflammatory acne is more severe than noninflammatory acne, and this type is more likely to lead to scarring.

Inflammatory acne develops10 when the bacteria _P. acnes _colonizes within the hair follicle. blemishes include:

  • Papules: Small red or pink bumps on the skin. The skin around a papule is usually slightly swollen and red.

This type of pimple may be sensitive to the touch. Picking or squeezing can make the inflammation worse and may lead to scarring. A large number of papules may indicate moderate to severe acne.

Unlike whiteheads, papules have no visible center. Unlike blackheads, the pores of a papule do not appear to be widened. Papules develop when whiteheads or blackheads cause so much irritation that they damage the wall of the follicle, causing white blood cells to build up.

  • Pustules: Pustules are commonly known as pimples. They are different from papules in that they resemble a whitehead with a red ring around the bump. The bump is typically filled with whitish or yellowish pus, which contains immune cells and bacterial cells.

A pustule forms when white blood cells from a papule reach the surface of the skin.

  • Nodules: Nodules are hard, painful, inflamed lumps located deep within the skin. They look like larger, deeper papules and have no visible center or head.

Nodules develop when an inflamed follicle erupts along the bottom, deep beneath the skin's surface. Nodules are a severe form of acne and can cause skin complications such as dark spots or scarring.

  • Cysts: Cysts are very large, soft, painful, red or white lumps situated deep in the skin. They are filled with pus.

Cysts form deeper within the skin than nodules, and they are the most severe type of acne blemish. Cysts can also cause skin complications, such as scarring.


Disclaimer: The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.

If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.

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