A pimple is a kind of
comedo
A comedo is a clogged hair follicle (pore) in the skin. Keratin (skin debris) combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word "comedo" comes from the ...
that results from excess
sebum
A sebaceous gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest nu ...
and dead skin cells getting trapped in the pores of the skin. In its aggravated state, it may evolve into a
pustule or
papules. Pimples can be treated by
acne
Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
medications,
antibiotics, and
anti-inflammatories
Anti-inflammatory is the property of a substance or treatment that reduces inflammation or swelling. Anti-inflammatory drugs, also called anti-inflammatories, make up about half of analgesics. These drugs remedy pain by reducing inflammation as op ...
prescribed by a physician, or various
over the counter remedies purchased at a pharmacy.
Causes
Sebaceous glands inside the pore of the skin produce
sebum
A sebaceous gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest nu ...
. When the outer layers of skin shed (a natural and continuous process, normally), dead skin and oily sebum left behind may bond together and form a blockage of the
sebaceous gland at the base of the skin. This is most common when the skin becomes thicker at
puberty. The sebaceous gland continues to produce sebum, which builds up behind the blockage, allowing
bacteria to grow in the area, including the species ''
Staphylococcus aureus'' and ''
Cutibacterium acnes'', which causes inflammation and infection. Other causes of pimples include family history,
stress, fluctuations in
hormone levels, hair and skincare products, medication
side effects, and un-diagnosed or underlying medical conditions.
Pimples can be part of the presentation of
rosacea.
The American Academy of Dermatology recommends that adults with acne use products labeled as "non-comedogenic", "non-acnegenic", "oil-free" or "won’t clog pores", as they are "least likely" to cause skin irritation or acne.
File:Blackheads.JPG, Sebaceous filaments are commonly mistaken for blackheads
A comedo is a clogged hair follicle (pore) in the skin. Keratin (skin debris) combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word "comedo" comes from the ...
. However, they are completely harmless and are a natural part of the skin for people with oily skin.
File:AcneVulgarisUSMIL.jpg, Some more severe pimples can lead to significant swelling and may appear on the back and chest.
Treatment
Over-the-counter medications
Common
over-the-counter medications for pimples are
benzoyl peroxide
Benzoyl peroxide is a chemical compound (specifically, an organic peroxide) with structural formula , often abbreviated as (BzO)2. In terms of its structure, the molecule can be described as two benzoyl (, Bz) groups connected by a peroxide ( ...
,
salicylic acid,
adapalene
Adapalene is a third-generation topical retinoid primarily used in the treatment of mild-moderate acne, and is also used off-label to treat keratosis pilaris as well as other skin conditions. Studies have found adapalene is as effective as other ...
, and antibacterial agents such as
triclosan
Triclosan (sometimes abbreviated as TCS) is an antibacterial and antifungal agent present in some consumer products, including toothpaste, soaps, detergents, toys, and surgical cleaning treatments. It is similar in its uses and mechanism of act ...
. These topical medications, which can be found in many creams and gels used to treat acne (acne vulgaris), induce skin to slough off more easily, helping to remove bacteria faster. Before application, the face should be washed with warm water or a topical cleanser and then dried.
A regimen of keeping the affected skin area clean, plus the regular application of these topical medications is usually enough to keep acne under control, if not at bay altogether. The most common product is a topical treatment of benzoyl peroxide, which has minimal risk apart from minor skin irritation that may present similar as a mild allergy.
Recently,
nicotinamide (vitamin B
3), applied topically, has been shown to be more effective in treatment of pimples than
antibiotics such as
clindamycin. Nicotinamide is not an antibiotic and has no
side effects typically associated with antibiotics. It has the added advantage of reducing skin
hyperpigmentation
Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.
Causes
Hyperpigmentation can be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris.James, William; Be ...
which results in pimple scars.
Prescription medication
Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include
isotretinoin
Isotretinoin, also known as 13-''cis''-retinoic acid and sold under the brand name Accutane among others, is a medication primarily used to treat severe acne. It is also used to prevent certain skin cancers (squamous-cell carcinoma), and in th ...
, which is a
retinoid, anti-seborrheic medications, anti-androgen medications, hormonal treatments,
alpha hydroxy acid,
azelaic acid
Azelaic acid (AzA) is an organic compound with the formula HOOC(CH2)7 COOH. This saturated dicarboxylic acid exists as a white powder. It is found in wheat, rye, and barley. It is a precursor to diverse industrial products including polymers a ...
, and
keratolytic soaps.
Historically,
antibiotics such as
tetracyclines and
erythromycin were prescribed. While they were more effective than topical applications of benzoyl peroxide, the bacteria eventually grew resistant to the antibiotics and the treatments became less and less effective. Also, antibiotics had more side effects than topical applications, such as stomach cramps and severe discoloration of teeth. Common antibiotics prescribed as of 2001 by dermatologists included
doxycycline and minocycline.
Isotretinoin
Isotretinoin, also known as 13-''cis''-retinoic acid and sold under the brand name Accutane among others, is a medication primarily used to treat severe acne. It is also used to prevent certain skin cancers (squamous-cell carcinoma), and in th ...
is used primarily for severe cystic acne and acne that has not responded to other treatments.
[ Se]
FDA Index page for NDA 018662
for updates Many dermatologists also support its use for treatment of lesser degrees of acne that prove resistant to other treatments, or that produce physical or psychological scarring.
It is
teratogenic
Teratology is the study of abnormalities of physiological development in organisms during their life span. It is a sub-discipline in medical genetics which focuses on the classification of congenital abnormalities in dysmorphology. The related ...
, and requires strict prevention of pregnancy during its use.
Expression
Expression, the manual bursting of pimples which have evolved into
whiteheads with one's fingers (colloquially, "popping"), can allow bacteria to be introduced into the open wound this creates. This can result in infection and permanent scarring. Thus expression is generally recommended against by
dermatologists and
estheticians in favour of allowing pimples to run through their natural lifespans. Some dermatologists offer incision and drainage services to sterilely drain the pimple.
References
External links
*
{{Bacterial cutaneous infections
Dermatologic terminology
Skin care