Acne may be inflamed or noninflamed. Inflamed acne is more severe, and it can cause redness, swelling, and discomfort. Noninflamed acne is usually responsible for blackheads and whiteheads.
Inflamed acne occurs deeper within the skin than noninflamed acne, and it can cause pain and permanent scarring.
A person with inflamed acne may have smaller red pimples or larger, deep cysts. These can form on any area of the skin that has oil glands, but they most often appear on the face, neck, chest, and back.
Inflamed acne can develop in children, adolescents, and adults.
While there is no cure, there are many effective treatments and home care techniques. These can help prevent scarring and any self-consciousness or emotional distress that the acne may cause.
Healthy skin sheds dead skin cells every day. Old skin cells reach the surface of the skin through the pores and fall away.
When a person is prone to acne, part of this process is sped up, causing old cells to collect within the pores and block their openings. These collected cells mix with the skin’s natural oils to form a sticky plug inside the pore.
In a person with noninflamed acne, the plug, also called a comedone, may form a blackhead or a whitehead.
In a person with inflamed acne, the oil and skin cells keep building up, starving the pore of oxygen. This creates a home for bacteria called Propionibacterium acnes.
The bacteria, oil, and skin cells break through the wall of the pore beneath the skin’s surface. The body’s immune system responds, combating the bacteria, which causes inflammation.
The inflammation can lead to redness, swelling, irritation, pain, and itchiness, as well as blemishes. These may be red or swollen pimples, nodules, or cysts.
Inflamed acne can show up in a variety of ways. A person may have one or more of the following types of pimples:
- Papules: These red bumps do not have white centers, and they can range in size.
- Pustules: These are similar to papules but have white or yellow pus centers, and the surrounding skin may be red.
- Nodules: These swollen, painful lumps deep within the skin have no visible pus in their centers.
- Cysts: Like nodules, cysts form deep within the skin and have no white centers, but they are redder than nodules.
Also, cysts are soft and usually painful to the touch. They may look like boils or sores.
Inflamed acne can sometimes be difficult to distinguish from noninflamed acne, especially in milder cases.
A person with inflamed acne may have:
- pimples that are red, swollen, or painful
- pimples with a white or yellow center of pus surrounded by redness
- hard, painful pimples beneath the skin that never reach the surface
- “pitted” scars on the skin from previous inflamed pimples
People with mild inflamed acne may benefit from using over-the-counter (OTC) acne treatments that contain benzoyl peroxide or salicylic acid.
However, OTC treatments are usually not strong enough to treat moderate to severe cases of inflamed acne.
The goal of acne treatment is to minimize future breakouts and help prevent scarring and emotional distress. These can be especially common among people with severe acne, according to the American Academy of Dermatology (AAD).
Doctors may treat inflamed acne with one or more of the following:
- antibiotic pills, creams, gels, or lotions, which can help kill acne bacteria and calm inflammation
- birth control pills, in females, to help balance hormones that cause acne flares
- isotretinoin (Accutane) for severe acne
- laser or light therapy, which dermatologists perform
- drainage of large acne cysts or cortisone injections, to help shrink painful acne cysts
A healthcare professional can best treat severe inflamed acne, though a person can use certain techniques at home to help.
Some studies suggest that tea tree oil can help kill acne bacteria. It is crucial to dilute the oil before applying it to the skin, and stop using it if signs of irritation — such as redness, swelling, or itching — develop.
Also, ice can provide some relief from pain, swelling, and redness caused by inflamed acne.
Try wrapping an ice pack in a clean cloth and applying it to the area for up to 15 minutes at a time. Remove it if the skin gets too cold or uncomfortable.
Zinc supplements may also help treat acne, as a review suggests. The most frequently studied types were zinc gluconate and zinc sulfate.
It is important not to use or take more zinc than recommended, as too much can cause nausea and other adverse effects. Learn more about zinc for acne here.
Overall, it is a good idea to ask a doctor about using home remedies, especially in combination with professional treatment.
Taking steps to keep the pores clear can help prevent inflamed acne.
Also, if OTC or prescribed medications reduce breakouts, it is important to keep taking them as instructed.
To help prevent acne:
- Wash the hair regularly to minimize the amount of oil on the skin.
- Wash the face twice daily with a gentle cleanser that removes oil and any makeup.
- Apply acne products consistently, covering all areas that are prone to breakouts.
- Use skin care products labeled non-comedogenic or non-acnegenic.
- Wear non-comedogenic sunscreen, especially because some acne treatments make the skin more sensitive to the sun.
- Do not pick or pop pimples, to prevent the bacteria from spreading.
- Avoid skin care products that contain alcohol, fragrance, or harsh scrubbing agents, as these can irritate the skin and worsen inflammation.
Many people find that mild inflamed acne responds well to OTC treatments, such as those that contain benzoyl peroxide or salicylic acid.
In general, the AAD recommend giving acne treatments 6–8 weeks to work before seeing a doctor.
However, people who regularly get nodules, cysts, or severe papules or pustules should not wait for OTC treatments to work. These types of acne can cause permanent scarring, so the AAD advise people to see a doctor for treatment without delay.
Inflamed acne can cause physical and emotional discomfort. If acne does not respond to OTC medication, it is important to receive professional care.
A doctor can prescribe more powerful treatments that can help prevent inflamed acne from returning.