Types of pimples
Whiteheads and blackheads are clogged pores; pus, inflammation and scars come with the deeper, red bumps, while milia, rosacea and fungal acne only look like pimples.
- Whiteheads (Closed Comedones)
- Blackheads (Open Comedones)
- Papules
- Pustules
Identify yours
Tap a bump or answer three questions.
| Type | Looks like | Feels like | How deep | Usually lasts | Scar risk |
|---|---|---|---|---|---|
| non-inflammatory | |||||
| Whiteheads (Closed Comedones) | White or skin-colored dot | Smooth, no pain | In the pore, closed | Until it clears | Low |
| Blackheads (Open Comedones) | Dark dot in an open pore | Flat, no pain | In the pore, open | Until it clears | Low |
| inflammatory | |||||
| Papules | Small red or pink bump, no head | Hard and tender | Upper skin | Under two weeks | Some |
| Pustules | Red bump, white or yellow center | Tender | Upper skin | Under two weeks | Some |
| Nodules | Large lump, no head | Hard, solid, painful | Deep in the skin | Weeks to months | High |
| Cysts | Large lump filled with pus | Softer, painful | Deep in the skin | Weeks to months | Highest |
Non-Inflammatory Acne (Mild)
Non-inflammatory acne is clogged pores with no redness or swelling. It means oil (sebum) and dead skin plug a pore while the skin around it stays calm. The color of a blackhead is the plug reacting with air, not dirt.
Whiteheads (Closed Comedones)
A whitehead is a plugged pore sealed at the surface: a small white or skin-colored dot that doesn't hurt.
Blackheads (Open Comedones)
A blackhead is a plugged pore that stays open. The plug darkens in air like a cut apple, so scrubbing won't remove it.
Inflammatory Acne (Moderate to Severe)
Inflammatory acne is a plugged pore that has turned red, swollen and tender. It means the pore wall is irritated or broken. The depth of an inflammatory spot sets how long it lasts and how likely it is to scar.
Papules
A papule is a small, hard, red or pink bump with no head. Many together can feel like sandpaper. On brown and black skin, papules can look brown or purple rather than red.
Pustules
A pustule is a papule with a white or yellow center of pus.
One papule or pustule is exactly what acne spot treatment is made for; nodules and cysts need more than a dab.
Nodules
A nodule is a large, solid, painful lump deep in the skin, with no pus and no head.
Cysts
A cyst is a deep, painful lump that contains pus. It feels softer than a nodule and has the highest scar risk. Nodules and cysts can join together.
Single spots usually clear in under two weeks; nodules can last for months.
What can be mistaken for a pimple
A lookalike is a bump that resembles acne but has another cause. It means acne products won't fix it.
| Lookalike | Tell-tale sign | Where |
|---|---|---|
| Milia | Tiny, pearly-white keratin cysts | Eyelids, cheeks |
| Fungal acne | Malassezia folliculitis; no blackheads. Same-size, itchy bumps that ignore acne creams are often fungal acne, which needs an antifungal. | Upper back, chest, hairline |
| Rosacea | Redness that comes and goes, burning or stinging; common in middle age | Nose, cheeks |
| Keratosis pilaris | Rough, dry, skin-colored bumps; harmless, in 50 to 70% of teens | Upper arms, thighs |
| Perioral dermatitis | Clusters of small red bumps | Around the mouth, nose and eyes |
| Boil | One tender, red, swollen lump from an infected hair follicle; see a doctor if it's on the face | Anywhere with hair |
How severe is it
Acne severity is a grade based on how many spots of each kind you have. It means more spots call for stronger treatment.
| Grade | Comedones | Inflammatory spots | Or total spots |
|---|---|---|---|
| Mild | Fewer than 20 | Fewer than 15 | Fewer than 30 |
| Moderate | 20 to 100 | 15 to 50 | 30 to 125 |
| Severe | More than 100 | More than 50, or more than 5 cyst-like lumps | More than 125 |
Some dermatologists grade against reference photos instead. Counting in a mirror is hard; a photo analysis shows which grade is yours.
General Treatments
Acne treatment is matched to the spot type. It means each kind needs a different first step.
- Over-the-Counter (OTC) Products
- Whiteheads and blackheads: adapalene gel plus a benzoyl peroxide wash. Papules and pustules: a benzoyl peroxide or salicylic acid wash. Give it 6 to 8 weeks.
- Prescription Care
- Nodules and cysts need a dermatologist. Ask your doctor about prescription creams or pills, or a cortisone shot for one large lump.
If these types first showed up after your teens, the options in adult acne treatment fit grown-up skin better.
When to see a dermatologist
- You have nodules or cysts.
- Scars are forming.
- No change after 6 to 8 weeks.
- You can't tell if it's acne.
Questions people ask
What is the difference between an acne papule and a pustule?
Pus. A papule is a red, hard bump with no head; once a white or yellow center shows, it's a pustule.
How do I identify my pimple type?
Ask three things: is it red, does it have a white or yellow center, and does it hurt deep down? The key above does that. If you have a mix, a photo analysis sorts every spot at once.
What can be mistaken for a pimple?
Milia, fungal acne, rosacea, keratosis pilaris, perioral dermatitis and boils. If acne products don't help, suspect a lookalike.
What are the unpoppable pimples?
Nodules and cysts. They sit deep with no head, and squeezing pushes the swelling further in.
Why is my pimple so big but won't pop?
It's probably a nodule or cyst, too deep to reach the surface. Leave it; a dermatologist can flatten a large one with a cortisone shot.
What do stress pimples look like?
Like normal acne. Stress doesn't make a special spot; it can worsen the acne you have.
Sources
- NIAMS, Acne. niams.nih.gov/health-topics/acne
- AAD, Acne symptoms. aad.org/public/diseases/acne/really-acne/symptoms
- AAD, Treating types of acne. aad.org/public/diseases/acne/diy/types-breakouts
- DermNet, Acne vulgaris. dermnetnz.org/topics/acne-vulgaris
- NHS, Acne. nhs.uk/conditions/acne
- DermNet, Milium. dermnetnz.org/topics/milium
- DermNet, Malassezia folliculitis. dermnetnz.org/topics/malassezia-folliculitis
- NHS, Rosacea. nhs.uk/conditions/rosacea
- NIAMS, Rosacea. niams.nih.gov/health-topics/rosacea
- DermNet, Keratosis pilaris. dermnetnz.org/topics/keratosis-pilaris
- NHS, Keratosis pilaris. nhs.uk/conditions/keratosis-pilaris
- DermNet, Periorificial dermatitis. dermnetnz.org/topics/periorificial-dermatitis
- MedlinePlus, Boils. medlineplus.gov/ency/article/001474.htm
- JAAD acne guidelines, 2024. pubmed.ncbi.nlm.nih.gov/38300170
Last reviewed . This page is general information, not a diagnosis. See a dermatologist if any sign under "When to see a dermatologist" fits.