Inflammatory Acne
Understanding Inflammatory Acne
Inflammatory acne is a form of acne in which blocked pores become red, swollen or tender. It commonly presents as papules and pustules, and may occur on its own or alongside blackheads, whiteheads or deeper lesions.
The extent and severity of inflammation can vary between people and over time. Clinical assessment can help clarify how the condition is presenting before management options are discussed.
What is Inflammatory Acne?
Inflammatory acne develops when a blocked pore becomes inflamed. Oil and dead skin cells trapped in the follicle, together with bacteria that normally live on the skin, may trigger an inflammatory response in the surrounding tissue.
This inflammation is what causes the redness, swelling and tenderness that distinguish inflammatory acne from blocked pores alone.
Is Inflammatory Acne an Infection?
Although skin bacteria play a role, inflammatory acne is not simply an infection and is not caused by dirty skin. It involves a combination of blocked pores, oil, bacteria and the skin's own inflammatory response.
How Inflammatory Acne can present?
01
Papules
Papules are small, raised red bumps that may feel tender to the touch. They do not have a visible white or yellow centre.
02
Pustules
Pustules are inflamed spots with a white or yellow centre surrounded by redness. They are often what people describe as pimples.
03
Marks Left Behind
Inflamed spots may leave flat red, pink or brown marks after they settle. These marks are different from scarring and may fade over time, although this can take months.
04
Where Inflammatory Acne Commonly Appears
Inflammatory acne commonly appears on the face, and may also develop on the chest, shoulders and back.
Inflammatory acne often occurs alongside blocked pores, and some inflamed lesions may become deeper and more painful.
WHAT IT CAN LOOK LIKE
What can look like Inflammatory Acne?
Several conditions can cause red bumps or pus filled spots that resemble inflamed acne. Telling them apart matters because they are not managed in the same way.
If you are unsure what you are seeing, clinical assessment can help distinguish between these concerns.
Rosacea
Rosacea may cause persistent facial redness along with acne like bumps and pustules, usually without blackheads or whiteheads.
Fungal Acne
Fungal acne may cause clusters of small, uniform bumps that are often itchy. Despite the name, it is not true acne and is assessed and managed differently.
Folliculitis
Folliculitis is inflammation of the hair follicles that may cause small red bumps or pustules, sometimes in areas where hair is shaved or where skin is covered for long periods.
Perioral Dermatitis
Perioral dermatitis may cause small red bumps around the mouth, nose or eyes, and is sometimes mistaken for acne.
WHAT IT CONTRIBUTES
What can contribute to Inflammatory Acne?
Inflammatory acne usually develops from a combination of factors rather than a single cause.
Blocked Pores
Inflammatory lesions typically begin as blocked pores. Factors that contribute to comedones may therefore also contribute to inflamed spots.
Skin Bacteria and Inflammation
Bacteria that normally live on the skin may contribute to inflammation within a blocked follicle. How strongly the skin responds can differ from person to person.
Hormonal Influences
Hormones may influence oil production, and some people experience recurring inflamed breakouts associated with hormonal changes.
Friction, Pressure and Picking
Repeated friction or pressure from items such as face masks, helmets or straps may aggravate acne in some people. Picking or squeezing inflamed spots may increase irritation and the risk of marks.
Clinical Insight from Dr Ramita
Why do some inflamed spots leave marks while others do not?
Whether an inflamed spot leaves a mark depends on several factors, including the depth and duration of inflammation, individual skin characteristics and whether the spot has been picked or squeezed. When inflammation settles, the skin may produce excess melanin, resulting in brown marks known as post-inflammatory hyperpigmentation.
In other cases, changes in the small blood vessels can leave lingering redness. These colour changes are different from true acne scars, which involve structural changes to the skin. Pigmentation is also more noticeable and may persist longer in certain skin tones, particularly darker skin types. An important distinction is that a spot does not have to be particularly large to leave a mark, and not every mark indicates permanent scarring.
HOW IT IS ASSESSSED
How Inflammatory Acne is Assessed?
01
Current Presentation
Assessment considers the types of inflamed lesions present, the areas affected, the apparent severity and whether marks or early scarring have developed.
02
History and Skin Care
The consultation may consider when the acne began, how it has changed, recurring patterns, current skin care and cosmetics, and previous treatments.
03
Management Discussion
Following assessment, appropriate management options can be discussed according to the patient's clinical needs.
Common Questions about Inflammatory Acne
What is the difference between papules and pustules?
Both are inflamed acne lesions. Papules are small, raised red bumps without a visible centre, while pustules have a white or yellow centre surrounded by redness. Many people with inflammatory acne have both at the same time, often alongside blackheads or whiteheads.
Is inflammatory acne contagious?
No. Although bacteria that normally live on the skin play a role in inflammation, inflammatory acne is not contagious and cannot be passed on through touch or sharing a space with someone.
Should I pop pustules?
Popping pustules is generally best avoided. It may push contents deeper into the skin, increase inflammation and raise the risk of marks or scarring. Leaving inflamed spots alone gives the skin the best chance to settle.
Will inflammatory acne leave scars?
Many inflamed spots settle without scarring, although some may leave temporary red or brown marks. The risk of scarring may be higher with more severe inflammation, deeper lesions or repeated picking. Marks and scarring can be assessed separately.
When should inflammatory acne be assessed?
Assessment may be helpful if inflamed spots are persistent, widespread, painful or recurring, if they are leaving marks, or if you are unsure whether what you are seeing is acne.
Inflammatory Acne Patient Guides
Learn More About Inflamed Acne
Explore information about inflamed spots, acne marks and skin care, with selected clinical content reviewed by Dr Ramita Kaur Shahi where medical review is required.
Then feature up to three existing TAC articles that answer narrower questions than this page. Territories to prioritise:
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Dr. Ramita Kaur Shahi
Dr Ramita Kaur Shahi leads acne consultations at The Acne Clinic. She assesses the skin and relevant history before discussing management options and follow up.
Clinical Assessment Can Help Clarify What You Are Seeing
Inflamed acne, blocked pores and conditions that resemble acne can look similar, and more than one may be present at the same time. Clinical assessment can help clarify the current presentation and support a discussion about appropriate management options.