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Decoded: The Different Types of Spots, and How Best To Treat Each One

Vogue Arabia, January 2019. Photo: Duncan Killick

Not all spots are created equal. In fact, there are many different types of spots, ranging from the modest blackhead to the mighty cyst, and each type should be treated in a slightly different way (and no, not every spot should be squeezed). Administering the wrong treatment could make things far worse, so it’s worth brushing up on how to identify what you’re dealing with.

Whether you get the occasional breakout, or suffer from acne, our spots affect our lives more than we think. According to a study carried out by Neutrogena, 40% of British people admit spots and acne prevent them from going about their daily routines. But no, that doesn’t necessarily mean you have to book straight in with an expensive dermatologist every time you get a spot.

“There are varying degrees of acne – from whiteheads and blackheads to nodules and cysts,” explains Lesley Reynolds Co-Founder of Harley Street Skin Clinic. So what can really be done to tackle a breakout? Here’s everything you need to know about the different types of spots as well as the best way to treat each one…

Open Comedones (Blackheads)

Easily recognized by their black color, blackheads can be tricky to get rid of. Lesley explains: “Blackheads are caused when a pore is blocked and the sebum at the surface oxidizes so that it looks black. They are at the mild end of the scale but they can often take a long time to clear.” The sebum forms a sticky ‘plug’ in the pore which makes them near-on impossible to squeeze successfully. If they’re getting you down, some professionals recommend using AHAs to help loosen and breakdown blackheads.


If you’re a squeezer, pustules are the types of zit you love – they’re a dictionary definition, run of the mill zit. Unlike whiteheads, pustules are usually filled with pus (nice) and appear inflamed. Lesley explains: “Pustules are inflamed red spots with a white or yellow centre. These zits can be popped, but only when they are ready to burst. Pop them with a sterile needle, then wrap a clean tissue around each of your index fingers and squeeze gently. Best to do this after a warm shower as they’ll be softer. If clear liquid or blood starts to appear, it’s time to stop squeezing.”

Closed Comedones (Whiteheads)

Unlike blackheads, whiteheads sit on the surface of the skin and are relatively easy to manage. When pores are blocked, the oil produced by the skin is trapped inside along with dead skin cells. As the pore becomes over-filled, you see a small white raised lump on the surface of the skin. Luckily, they are tackled quite easily through gentle cleansing and exfoliation and don’t require too much attention.


OK, this is where things get serious. Nodules are hard, painful bumps that sit under the skin. They don’t have a head and don’t always appear red. “You must NEVER squeeze a nodule as this can cause permanent scarring. The best thing to do is have them injected in-clinic with cortisone which works by killing bacteria and reducing inflammation,” says Lesley.


Unlike blackheads and whiteheads, papules are inflamed acne lesions that appear red and bump-like with no head. You may experience some pain with papules, but it is likely to be minor. As tempting as it may be, it’s recommended to never squeeze a papule – their stubborn nature can leave you with a nasty scar. Instead, try a topical drying spot treatment.


Cysts are similar to nodules, expect they are full of pus. They are still extremely painful and can often leave serious scarring. Usually caused by some sort of blockage and often infection, they should also never be squeezed. Lesley warns: “Squeezing cysts can cause a deep irritation and very painful inflammation which will last much longer than if you had simply left it alone. Again, cortisone injections can help and the cyst usually disappears after 48 hours.”

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