Inflammatory Acne

What is inflammatory acne?

Inflammatory acne is a skin condition that causes red, swollen and sore bumps. These pimples contain pus, dead skin cells and excess oil. They’re common on your face, back, chest and shoulders.

What’s the difference: Inflammatory acne vs noninflammatory acne?

The pimples associated with inflammatory acne are deep in your skin and contain pus. They're inflamed (swollen), so they tend to be sore or painful. One type of inflammatory acne is cystic acne.

The blemishes associated with noninflammatory acne are closer to your skin’s surface and usually aren’t swollen or painful. A common type of noninflammatory acne is comedonal acne (whiteheads and blackheads).

How common is inflammatory acne?

Inflammatory acne is very common. It affects all ages, races and genders. It’s most common in teenagers, but it also affects many adults.

Who might get inflammatory acne?

Acne is more common in people who:

• Consume a lot of milk, sugars and fats.
• Live in areas with high humidity.
• Overhydrate their skin or use the wrong moisturizer.
• Pick or squeeze their skin to pop whiteheads or blackheads.
• Smoke.

What causes inflammatory acne?

Inflammatory acne begins when pores or hair follicles get clogged with:

• Dead skin cells.
• Oil in products placed on your skin.
• Sebum, a natural oily substance your body produces.

Clogged pores or follicles cause whiteheads, blackheads and pimples. Eventually, if pimples put enough pressure on the walls of your pores, the walls break. The contents of the pustules can spread into your skin.

Your body’s immune system reacts by sending white blood cells. These cells cause redness, swelling, pus and tenderness common with pimples.

What are the symptoms of inflammatory acne?

Types of inflammatory acne blemishes include:

• Pustules: Bump raised on the surface of your skin that contains pus.
• Nodules: Large, hard bumps buried beneath your skin.
• Cysts: Large, soft, fluid-filled bumps beneath your skin.

The blemishes are usually:

• Painful or tender.
• Red around the outside.
• Swollen.
• Yellow, white or red in the center.

Is inflammatory acne contagious?

Inflammatory acne isn't contagious, so you can’t give it to another person. And it can’t technically spread from one part of your body to another. But whatever causes one breakout of inflammatory acne can cause breakouts in other areas.

How is inflammatory acne diagnosed?

Your healthcare provider can diagnose inflammatory acne by looking at your skin. There are no tests for the condition. You can visit your primary care physician or a dermatologist (skin specialist) for a diagnosis.

How do I get rid of inflammatory acne?

Some over-the-counter cleansers and creams can help reduce inflammatory acne. But many people need treatment from a healthcare provider to clear and prevent these breakouts.

Some inflammatory acne treatments go on your skin (topical), some are oral medications and some are extraction (removal) procedures.

Topical acne anti-inflammatory products include:

• Azelaic acid.
• Benzoyl peroxide.
• Niacinamide, a form of vitamin B3 that has anti-inflammatory, moisturizing and soothing effects.
• Retinoids, which are chemical forms of vitamin A. Examples include tretinoin and adapalene.
• Salicylic acid.
• Topical antibiotics like clindamycin, erythromycin and dapsone.

Oral prescriptions include:

• Antibiotics like doxycycline or tetracycline.
• Dapsone, an anti-infective drug.
• Hormonal therapy, like the birth control pill or spironolactone, an anti-androgen drug.
• Isotretinoin, a form of vitamin A.

Some procedures can help remove inflammatory acne blemishes. They should be performed by a professional, or they might damage the pores and lead to more acne. Procedures include:

• Acne surgery, which uses needles and tiny scalpels to extract blackheads or milia (small cysts).
• Injection of cortisone into a blemish.
• Light therapy, which uses light to kill bacteria.

Can you pop inflammatory acne?

Don’t pick, squeeze or pop inflammatory blemishes. That can cause:

• Acne scars.
• Additional nodules, pustules and cysts as you push more bacteria into your skin.
• Damage to your pores or follicles, which can cause more blemishes.
• Infection.
• More noticeable blemishes.
• Pain.

How can I prevent inflammatory acne?

Many strategies can help you achieve healthier skin with fewer blemishes:

• Avoid touching your face throughout the day, which can transfer oil and dirt to facial pores.
• Choose oil-free, water-based, noncomedogenic cleansers, moisturizers and makeup. If you’re prone to breakouts, select products made for oily to combination skin.
• Don’t pick, pop or squeeze whiteheads, blackheads or pimples, or they may become inflamed.
• Eat a healthy diet with limited sugars and milk.
• Quit smoking.
• Wash and moisturize every morning and every night, plus after you exercise. Don’t go to bed with makeup on.
• When you wash your face, do it gently. Don’t scrub.

How long does inflamed acne last?

Inflammatory acne can be stubborn, but many people achieve clearer skin with several months of skin care and treatment. Many cases require the help of a healthcare professional such as a dermatologist.

However, inflammatory acne may leave permanent scars.

Does inflammatory acne usually come back after treatment?

Inflammatory acne is often a chronic condition, so it can come back during or after treatment. Even after your skin improves, you should continue a skincare regimen to prevent or minimize future blemishes.

How do I take care of myself with inflammatory acne?

Inflammatory acne can be frustrating, stubborn and embarrassing. If your skin doesn’t improve after a few months of good skin care, seek help from a healthcare professional.

In addition to over-the-counter treatments, other at-home products can help calm the skin:

• Masks containing charcoal or clay, which can dry out sebum trapped in pores.
• Sunscreen to protect your skin from sun damage. Many acne treatments remove the outermost layer of skin, putting you at risk for sunburn and sun damage. (Note: Be sure to use sunscreen that’s oil-free and noncomedogenic.)

To prevent scars from inflammatory acne:

• Don’t pick, pop or squeeze blemishes.
• Establish a good skin care routine to prevent blemishes in the first place.
• Follow your healthcare provider’s instructions.
• Use products that contain salicylic acid.

A note from Cleveland Clinic

Inflammatory acne is a skin condition that causes red, swollen and sore pustules, nodules and cysts. Some over-the-counter treatments can help clear the skin and prevent acne. But you might need treatment from a healthcare provider like a dermatologist.