Pimples 101: Everything You Want To Know, But Are Too Grossed Out To Ask

May 26, 2015 by Lisa Fogarty
shefinds | beauty

We’re forever cursing them and trying to banish them from existence, but how much do most of us really know about pimples? Maybe you’re thinking: yuck, how much does anyone need to know except that they ruined my prom, wedding, and every driver’s license photo I’ve ever taken? But remember, knowing your enemy is the first step to defeating it. And to that end, we spoke with skin experts to find out everything there is to know about pimples from where they come from to how we can effectively destroy and crush their souls forever (too extreme?).

What, exactly, is acne?

Once and for all, here’s the definition you need to determine whether you’re one of 40 to 50 million Americans who suffer from acne. “Acne is a common, inflammatory skin condition that is characterized by plugged pores, blackheads, pimples, and deep bumps,” says Dr. Jill Waibel, a dermatologist with Miami Dermatology & Laser Institute. “Acne can be irritating, annoying and even a little embarrassing, and for those with acne prone skin, it can be especially frustrating to manage. Luckily, there are several kinds of treatment available that can assist in treating all different kinds of acne.”

Are there different types of pimples?

You betcha. Dr. Chynna Steele of Steele Dermatology says, when it comes to acne she typically sees three different kinds of bumps: whiteheads and blackheads, small red bumps and “pustules,” and deep cysts. Let’s get to know these fellas a little more intimately, shall we?

– Whiteheads and blackheads. Steele describes this type of acne as congested pores. These aren’t necessarily the result of improper face-washing, but could just come about because some of us have skin cells that can be a little “too sticky” and create a plug in the pores. “Besides just being prone to them, using heavy oils or pore-clogging moisturizers may make these come about,” Steele says. Skin and beauty expert Katrina Fadda of Bona Fide Skin Care describes blackheads as an entirely different beast. “These little plugs can form even if the rest of your skin is completely clear,” she explains. “Because they are a ‘plug’ that doesn’t close over, the body doesn’t have to get rid of them (no inflammation) so they can stay indefinitely. They are extremely common anywhere that pores may be larger due to more oil production, such as the ‘T Zone.'”

– Red bumps and pustules. Pustules are what people generally think of when they hear the word “zit,” Steele says. “It’s the cartoon version of a zit on commercials and in ads; you know, that red bump with a little white blister on top with pus.” Both papules and pistules (don’t they sound like the names of evil twins from a horror movie?) are raised, red spots that are often a result of infected hair follicles, Waibel says. “Papules and pustules are tender to the touch, but the main difference is that pustules contain a yellowish, liquid pus center while papules can be hard,” Waibel explains.

– Cysts. These painful and tender red bumps, which feel like they are beneath the skin, are the ones most associated with genetics and hormones. “Cysts are caused by hormones called androgens, and during teenage years, these androgens are at a high,” Waibel says. “Hormonal changes in women can result from menstrual cycles, pregnancy and menopause, causing cysts. Truthfully, eating a lot of chocolate or never washing your face won’t result in bad acne; it is 100 percent caused by hormones.”

Why do some pimples form pus?

Next time you notice a pimple filled with pus, thank your body instead of cussing it because this sticky yellowish-white goo is a sign that our systems are working well enough to send white blood cells (which are called dead leukocytes) to an infection to help get rid of it. “The ‘pus filled’ pimples are inflamed, the pus is the body’s reaction to an infection,” Fadda says. “The smaller pimples that don’t seem to form a head are usually just a blocked pore that isn’t a threat.”

Is it bad to pop pimples?

In a nutshell: it depends on the pimple and its stage of life. “I encourage patients not to ‘pop’ anything that is red (i.e. cysts and pustules) because that redness is a sign of inflammation, so most of the time you’re not going to get anything out and you’re only going to make the bump more inflamed by messing with it,” Steele says. “While it won’t hurt to just remove the pus filled top of a pustule (the ‘head’), you won’t get rid of the underlying red bump by doing so and you run the risk of making it more inflamed and/or infected. My biggest advice is to be gentle! Pushing harder and using tools to dig deeper just a bad idea. Whiteheads and blackheads can be extracted, but again, be gentle. If they aren’t easily coming out then don’t push the issue.”

How can we prevent acne?

Once you get acne, there’s no quick fix, Waibel says. The best thing you can do is get yourself on a skin care regimen that prevents pimples and keeps skin clear. “All over skin treatments to keep your skin clear include topical creams and solutions and oral medications,” Steele says. “Also, there are some cleansers that I sell in office that are great for acne. I tend to stay away from strictly salicylic acid or benzoyl peroxide cleansers that you often find in the drug store, which can be drying and irritating; Instead I like multi acid cleansers with glycolic acid.”

Examples of topicals that might be prescribed to you include AcZone, Tazorac, Acanya, and benzoyl peroxide, Waibel says. “These can help rid the skin of oil and dead skin cells. Oral antibiotics can also be offered to help control bacteria and lower inflammation. I always recommend doxycycline,” she says. Hormonal therapy is another choice for acne treatment, as oral contraceptive pills or Spirnalactone help control hormones and counter those that promote acne development, Waibel adds.

What in-office treatments do you recommend to help acne?

If you’ve tried everything you can at home and nothing seems to work for you, it may be time to give over your skin to professionals and consider an in-office treatment. “I’m a big fan of chemical peels–salicylic acid in particular is great for acne,” Fadda says. “A course of peels from a professional can greatly reduce acne, control oil, reduce scars and help balance skin overall. If acne is very severe, antibiotics, prescription Vitamin A or Accutane may be recommended by a dermatologist.”

What about lasers?

Laser therapies, like PDL laser and Blu-U, also help moderate acne, Waibel says, but as of now, the only real cure for acne is Isotretinoin, also known as Accutane. Unfortunately, the side effects of taking Accutane can be dramatic and can include depression, Crohn’s disease, and even birth defects if taken while pregnant. But doctors are making strides every day in finding other progressive solutions to treat and eliminate acne, so don’t be discouraged. “We are currently conducting a clinical trial that aims to treat acne using tunable gold nanoparticles that absorb laser light,” Waibel says. “When the gold nanoparticles are applied to the skin, they transverse down the hair follicle and sebaceous gland and are activated by the laser to help treat acne. We are one of 20 sites in the nation that was chosen to conduct this important study and hope to see a new treatment on the market that will ease the frustrations and pains of managing stubborn acne.”

For more beauty tips, check out everything you want to know about ingrown hairs and 8 places you don’t think to put sunscreen, but should.


Lisa Fogarty is a lifestyle writer and reporter based in New York who covers health, wellness, relationships, sex, beauty, and parenting.

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