This is just a short reference of the various stages acne takes into form. Even before a spot appears, things will be happening beneath the surface of the skin. For example, you may feel a slight tenderness, soreness or pain in the area just before the spot appears. The type most likely to take time to appear will be the larger, red spots (papules/cysts); these may take a few days to enlarge and a few weeks to fade.
Small pustules (yellow coloured) are the type most likely to appear quickly, sometimes within hours. Understanding the different stages of a spot may help to reinforce the need to use anti-acne medications even when there are no visible spots. They work by attacking the causes of acne before they appear and are the best chance of keeping it under control.
Papule (red spot)
Papules
Stage 1
The very beginnings of a papule may occur up to three or four days before it is seen. The build-up of oil in the hair follicle will begin to mix with dead skin cells that make it sticky and viscous. This blockage leads to the beginning of an inflammatory response.
At this stage, adult acne treatments would be able to fight inflammation and target the P.acnes bacteria, reducing the chances of it developing into stage 2.
Stage 2
The inflammation will now cause an area of redness and swelling, reaching the surface and becoming visible. This may occur two to five days from the first stage.
Stage 3
The papule enlarges as inflammatory responses increase its size and tenderness. After this, the spot will begin to die down and become a macule (a healing red spot). Stage 3 may last up to three weeks, although the average is seven days.
Stage 4
The skin is recovered. Some minor scarring may remain.
Comedone (blackhead, whitehead)
Blackheads
Stage 1
The build-up of dead skin cells in the hair follicle becomes trapped in the oil, as in a papule, but fails to attract the cells responsible for causing inflammation. This build-up may take several weeks.
Stage 2
If the blockage reaches the skin’s surface it will turn black. Blackheads may last several weeks, months or even years if left untouched. The blockages that do not reach the surface and sit in the follicle (a closed comedone) may be very hard to notice with the naked eye; they are the type more likely to trigger an inflammatory response and turn into a papule.
Research suggests that 25 per cent of closed comedones may resolve within three to four days, with 75 per cent developing into inflamed lesions.
Stage 3
If an open comedone is extracted, the pore may close over a period of a few days. However, some comedones may leave behind an enlarged pore due to being ‘stretched’ by the solid plug of the sebum.
Pustule (yellow spot)
Pustules
Stage 1
Inflammatory responses in the hair follicle may be much faster than in a papule. It is difficult to estimate how long it may take the pustule to form, as this will depend on the size and depth of the inflamed area. If the inflammation is close to the surface of the skin, some pustules may appear within 10-12 hours.
Stage 2
If left untouched, pustules can heal into a macule within five days. Deeper pustules may last for up to two to six weeks before healing.
