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Getting acne....Q&A............(part 3 of 5)

I’ve started getting acne spots. How long do they last? This depends on what type of spots they are and, even then, it can be very difficult to predict what will happen. Some spots will appear and then disappear during the course of a day but others will evolve more gradually through the various stages. Comedones can be very persistent if they don’t get inflamed. Mildly inflamed spots will last 5–10 days before settling down, but can leave a flat red mark (macule) for several weeks. Nodules and cysts may last for weeks or months unless you get some treatment. What is the difference between a whitehead and a yellow- head spot? These two common terms describe quite different types of spot. A whitehead is a closed comedone where the pore is blocked and not open to the air. There is no inflammation (redness). A yellow- head suggests a spot with pus in it. The medical term is a ‘pustule’. Whiteheads may become yellowheads if the blocked pore becomes infected. My daughter is only 9 but she seems
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Classifying Acne

It’s important for us dermatologists to be able to describe acne in
various categories. It helps us to better understand what our
patients have to say and it helps us to communicate with one
another. It also helps us to follow the progress or lack of progress
in our treatments. Here are the basic categories of acne; terms that
you’ll run into later in this book, and likely in your doctor’s office:
 Non-inflammatory acne: This category of acne is identified
when a person’s lesions are primarily whiteheads and black-
heads. It’s sometimes called comedonal acne, because it’s
characterized by comedones.
 Inflammatory acne: In this type of acne, papules or pustules,
red or purple macules, and nodules, often termed “cysts,” are
predominant.
A single patient can have a combination of both non-inflammatory
and inflammatory acne. Typically, this combination is seen in
teenagers rather than adults. Adults more often have inflamma-
tory acne. The way acne is treated often depends on which type
you have:
 For acne that is primarily comedonal with blackheads and
whiteheads, we use agents known as retinoids, such as
Retin-A, Differin, or Tazorac to treat them. These drugs are
comedolytic, which means they break up comedones.
 If you have inflammatory acne, we tend to rely more often on
benzoyl peroxide and/or topical and oral antibiotics.
 If you have a combination of both types of acne, we tend to
use benzoyl peroxide in combination with the retinoids.
You can read more about these treatments, and many others, in
Part III.
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