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Inflammatory Acne: Causes, Symptoms And Treatment

  • Acne can range in severity from mild comedones to painful, inflamed acne that appears impossible to treat.
  • When bacteria become trapped inside clogged pores, it causes inflammation. Your skin may become red, swollen, and uncomfortable as the bacteria multiply. You may notice several large inflamed acne lesions develop close together at times.
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  • Inflammatory Acne can have a serious impact on both your appearance and your self-confidence because it is so visible. 
  • Fortunately, inflammatory acne is almost always treatable. In fact, with the right combination of acne medication, self-care, and good habits, even the most severe inflamed acne breakouts can be treated and clear, blemish-free skin can be achieved.
  • We've talked about how inflamed acne forms, as well as the symptoms you might notice if you're prone to inflamed acne breakouts.
  • We've also shared scientifically proven treatment options for getting rid of acne and preventing it from returning.

 About Inflammatory Acne

  • Inflammatory acne occurs when acne lesions turn red, tender, and swollen.
  • The severity of acne can range from minor papules and pustules to severe cystic or nodular acne.
  • If you have severe or persistent Inflammatory Acne, you may need to use more than one medication to get rid of them.

How Does Inflammatory Acne Form?

  • To understand how inflamed acne develops, you must first understand how acne breakouts occur.
  • All acne, whether inflammatory or non-inflammatory, develops when your hair follicles, or pores, become clogged by a combination of sebum and dead skin cells.
  • Sebum is an oily substance produced by the sebaceous glands. It keeps your skin hydrated and protects it from bacteria, fungi, and other pathogens that can infect and damage your skin.
  • Sebum is required for the proper functioning of your skin. When your sebaceous glands secrete too much sebum, it can accumulate inside your hair follicles and clog them.
  • Your skin renews and repairs itself every day by producing new skin cells to replace old ones. Your old, dead skin cells detach from your skin as they are replaced by new cells, a process known as exfoliation.
  • Dead skin cells do not always exfoliate properly. These old, leftover cells, like sebum, can accumulate inside your hair follicles and contribute to blockages.
  • When a hair follicle is clogged, it becomes an acne lesion. Many acne lesions are comedonal, or non-inflammatory. These are the classic whiteheads and blackheads that you may get near your nose, chin and elsewhere on your face.
  • Inflamed acne develops when bacteria grows inside a clogged hair follicle. As the bacteria starts to multiply, the wall of the hair follicle may break and the acne lesion may become red, inflamed and tender. 

Types of Inflammatory Acne

  • Inflammatory Acne can vary in type and severity.
  • Common types of inflamed acne include:

    1. Papules

  • These are small raised spots that can appear on your skin's surface. The majority of papules are red in color and less than 1cm wide.

    2. Pustules

  • These are tiny, pus-filled acne lesions that resemble blisters. 
  • They are most commonly found on your face, but they can appear anywhere on your body. 
  • When touched, scratched, or squeezed, pustules may burst or leak.

    3. Nodular Acne

  • Nodules are larger, more inflamed than classic acne lesions. These can be painful and tender. 
  • Nodular acne is a type of severe acne that develops deeper beneath your skin than other types of acne.

    4. Cystic Acne 

  • Cystic acne lesions are fluid-filled acne lesions that form deep beneath the skin. This type of inflamed acne, like nodular acne, can be painful, tender, and difficult to treat.
  • Nodulocystic acne occurs when cystic acne coexists with nodular acne. Both of these types of severe acne have the potential to damage your skin and leave acne scarring.

What Factors Contribute to Inflamed Acne?

  • Inflammatory acne is caused by the three factors mentioned above: sebum, dead skin cells, and bacteria.
  • However, acne breakouts can be caused by a number of factors. These are some examples:

    1. Hormones

  • Certain hormones control your skin’s production of sebum. As your levels of these hormones fluctuate, you might be more at risk of developing acne lesions that can become infected and inflamed.
  • A variety of factors can affect your hormone levels, including your menstrual cycle, use of hormonal birth control, pregnancy and menopause. 

    2. Medications

  • Certain medications, including anticonvulsants, lithium, steroids, and others, may increase your chances of developing acne.

    3. Hormones

  • Certain hormones regulate the production of sebum by your skin. As your hormone levels fluctuate, you may be more prone to developing acne lesions that can become infected and inflamed.
  • Hormone levels can be affected by a number of factors, including your menstrual cycle, use of hormonal birth control, pregnancy, and menopause.

    4. Smoking

  • Although smoking does not appear to cause inflamed acne, there is a link between smoking and the likelihood of developing acne

    5. Genetics

  • Your genes may influence your risk of developing acne. For example, you may inherit an increased risk of acne breakouts from your parents. 

Symptoms of Inflammatory Acne

  • Acne that is inflamed can cause a variety of symptoms. Small papules or pustules may appear in certain areas of your face, or you may experience severe, persistent cystic acne breakouts that are difficult to treat.
  • Inflamed acne is characterized by the following symptoms:
      • Acne lesions are red and swollen.
      • Tenderness, discomfort, and pain
      • Fluid and/or pus-filled lesions. 
      • When acne becomes inflamed, it can cause psychological symptoms such as depression and/or low self-esteem.
      • Inflamed acne can also cause scarring and dark spots, which can affect the appearance of your skin after your acne breakouts have healed.

How to Get Rid of Inflamed Acne

  • Acne that is inflamed is treatable. 
  • Even if your breakouts are severe and persistent, inflamed acne is almost always treatable with the right combination of science-based acne treatments and changes to your skin care routine.

    1. Cleanser for the face

  • A gentle, non-abrasive cleanser will aid in the removal of dead skin cells and excess sebum, which can clog your pores and cause breakouts.

    2. Peroxide of benzoyl

  • Benzoyl peroxide is a popular acne treatment that works by inhibiting the growth of acne-causing bacteria. Many over-the-counter acne creams, gels, and cleansers contain benzoyl peroxide.

    3. Retinoids 

  • Retinoids, which are vitamin A-derived medications, are widely used to treat acne. Mild retinoids, such as retinol and adapalene, can be found in over-the-counter acne creams, gels, and other products.

Inflammatory Acne Medications 

Prescription medications commonly used to treat inflamed acne include:

    1. Tretinoin

  • Tretinoin is a retinoid that is applied topically to treat acne. It works by increasing the turnover of new cells in your skin and preventing hair follicles in your skin from becoming clogged.
  • Tretinoin comes as a prescription cream or gel. It's also one of the ingredients in our Customized Rx Acne Cream, which is designed to treat your specific acne problems.

    2. Clindamycin

  • Clindamycin is an antibiotic that is applied topically. It works by preventing the growth of bacteria that cause inflamed acne on your skin. 
  • It also helps to reduce swelling, which is common during inflamed acne breakouts.
  • Clindamycin, like tretinoin, is available as a topical cream, gel, or an active ingredient in our Customized Rx Acne Cream.

    3. Hormonal contraception

  • There are several types of combination birth control pills available to treat acne. These work by altering your hormone levels to reduce sebum production and keep your hair follicles from clogging.
  • The FDA has currently approved three birth control pills as acne treatments. More information on using these medications for inflamed acne can be found in our guide to birth control and acne.

    4. Isotretinoin

  • Isotretinoin is an acne medication that is taken orally. It is very effective at treating inflamed acne, but it can cause side effects like cracked lips and dry, peeling skin, especially in the first few weeks or months of treatment.
  • If you've been prescribed isotretinoin, you'll need to see your doctor on a regular basis. Because isotretinoin is not safe to use during pregnancy, you will need to use multiple forms of birth control while taking it

How to Prevent Inflammatory Acne

The first step in treating inflamed acne is to eliminate existing breakouts. After that, it's equally important to make changes to your skin care routine and lifestyle to keep your inflamed acne from reappearing. 

    1. Wash your face twice a day 

  • This aids in the removal of sweat and bacteria that can cause or worsen acne breakouts. Wash your face twice a day, as well as after exercising or doing anything else that makes you sweat.
  • When washing your face, use a gentle, non-comedogenic cleanser and massage it into your skin. Washing your skin too frequently or scrubbing it too hard can both aggravate acne breakouts.

    2. Avoid touching Acne

  • This could cause acne flare-ups and spread bacteria from your hands to your face. If you must touch your face, make sure to thoroughly wash your hands with soap and water first.

    3. Treat acne as soon as you notice it

  • The sooner you take action and treat your acne, the less likely you are to experience severe or persistent breakouts, scars, and dark spots known as post-inflammatory hyperpigmentation (PIH).

    4. Non-comedogenic Makeup 

  • Look for "non-comedogenic" or "oil-free" makeup and skin care products. These are less likely to clog your pores and cause acne.
  • Avoid skin care products containing alcohol, artificial fragrances, or other ingredients that can cause irritation and inflammation.
  • Make sure to carefully remove your makeup before going to bed, regardless of the type of makeup you use.


  • Inflammatory Acne can be stressful to deal with, especially if you're prone to random breakouts that appear at inconvenient times.
  • Even the most severe inflamed acne, however, is typically treatable with the right combination of skin care products, acne medication, and self-care.
  • To begin treating acne, browse our selection of prescription acne treatments and speak with a licensed healthcare provider online. If necessary, you will be given a prescription for acne medication to help control your acne and prevent future breakouts.


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