Different types of acne–explained.

When you hear the word ‘acne’, you probably think of angry, red, pustular pimples and painful cystic lumps and bumps. However, there are several different types of acne, and, in Traditional Chinese Medicine, these can often be linked to differing underlying issues.


Whether your acne is mild or severe, knowing what you’re dealing with is crucial to prevent further breakouts. This guide to all the different types of blemishes will help get you started.

Non-inflammatory acne

Essentially, acne falls into two main categories: non-inflammatory and inflammatory. Whiteheads and blackheads are examples of non-inflammatory acne, which is typically painless. In whiteheads and blackheads, sebum (oil) and dead skin cells accumulate in the hair follicle to form a hardened ‘plug’.

The result of this is a blocked pore, or comedone, which can be closed or open.


Whiteheads are closed comedones. This means that the pore remains closed at the surface and is not exposed to the air. Generally not associated with redness or pain, whiteheads are a mild form of acne that presents as small white bumps.


Blackheads, on the other hand, are open comedones. In blackheads, the pore is stretched open at the surface and exposed to the air. As the ‘plug’ comes into contact with oxygen, oxidation occurs, resulting in the blackened appearance we all know (and dislike).

How to tackle

In non-inflammatory acne, regular exfoliation is important to prevent dead skin build-up. Oil-control skincare products may also be beneficial, and maintaining good hygiene is essential. Resist picking your blemishes as you risk infection, scarring, and developing more inflamed forms of acne.

Inflammatory acne

More difficult to resolve, inflammatory acne is often accompanied by redness, swelling, heat and discomfort. It varies in severity, from papules and pustules to deep, painful cysts that can destroy the follicle and lead to permanent scarring.


Papules are a closed comedone, with a pink/red appearance and without a visible head. They occur when the hardened plug of oil and debris is large enough to cause the follicle sac to burst. The immune system sends white blood cells in to clean up the mess, resulting in tender red bumps (without any pus).


Pustules are what most of us think of when we hear the word ‘pimple’. When a papule is not resolved, white blood cells can continue to invade the area and pus can form and build up – eventually being forced to the surface of the skin in the form of a pus-filled head. While unpleasant, this pus formation actually helps the healing process.


Nodules are red, painful bumps that arise when an impaction causes a break towards the bottom of a hair follicle. They are similar to papules, but larger and harder. They occur much deeper within the skin and are therefore more difficult to resolve.


Often triggered by hormones, cystic acne is the most severe form of deep, inflammatory acne, characterised by large, soft, painful, pus-filled lumps. In cystic acne, an inflamed pore ruptures, the oil, bacteria and debris inside spills out, and a boil-like cyst is formed to contain the infection.

How to tackle

Always avoid squeezing your skin to prevent spreading acne and causing scarring. Early intervention will help prevent scarring and post-inflammatory hyperpigmentation, so speak to your dermatologist or doctor about appropriate skincare or medication – particularly in the case of cystic acne or nodules.

Or, for a proven gentle approach, try Zilch. 100% natural, Zilch Acne Formula contains a beneficial blend of Chinese Medicine herbs for cases of inflammatory acne. In Traditional Chinese Medicine, pustules are commonly linked to digestive issues and toxicity, while deeper, larger cysts and nodules are linked to blood stagnation. Helping to detoxify, reduce heat and boost blood circulation, Zilch addresses the underlying root causes of all types of acne to provide long-term relief from breakouts.

Increasing blood flow and helping to reduce inflammation, cosmetic acupuncture can also assist in the management of mild acne. It is also a beneficial treatment to help fade post-acne redness and improve the appearance of scarring.



About Dr. Vivian Tam

Dr. Vivian Tam is a Doctor of Chinese Medicine and the founder of Zilch Formulas. She has a passion for healing, without harmful effects and believes most in empowering her patients through education and providing them tools to feel confident on their own health journey.

She is an industry expert in Chinese Medicine Dermatology and is also Melbourne’s leading Cosmetic Acupuncturist. Dr Vivian Tam is a highly respected leader and educator, running seminars across Australia to educate practitioners and students.
Dr. Vivian Tam is a registered practitioner with the Australian Health Practitioner Regulation Agency and an accredited member of the Australian Acupuncture and Chinese Medicine Association.


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