There are numerous systems used to classify acne. The following classification is based upon the severity of the acne:
- Type 1. Identified by less than 10 lesions (plugged pores), usually only on the face. (A lesion is a kind of generic term that simply means injury or wound to the skin. In the case of acne it refers to the plugged oil gland.) These lesions are called “comedones” (”comedo” in the singular) by dermatologists. A comedo can be either a “whitehead” or a “blackhead.” A whitehead is a clogged pore that is closed to the surface; a blackhead is open. (The color of a blackhead is not from dirt. It gets its black color from the follicle.)
Type 1 is also identified sometimes with an occasional “papule” (a small, solid bump on the skin) or “pustule” (a papule that contains pus. “Pus” is simply the body’s white blood cells that attack the plugged pore and fight infection). A pustule usually forms over a follicle with a hair shaft in the center. (Incidentally, it is the pustule that adolescents are so fond of squeezing or “popping.”) With this particular acne problem (Type 1), there is little or no inflammation and no scarring.
- Type 2. Identified by 10 to 25 lesions on face and trunk of the body. Whiteheads and blackheads are more numberous. Some inflammation and mild scarring.
- Type 3. Identified by numbers comedones, papules, and pustules, spreading to back, chest, shoulders. An occasional “cyst” (a sac-like lesion filled with liquid or semi-liquid, larger than the pustule and severely inflamed) or “nodule” (a firm, severe lesion that extends into the deep layers of the skin) may appear. Moderate scarring.
- Type 4. Identified by numerous large cysts and nodules on face, neck, upper trunk. Severe scarring.
