Pimples: Causes, Symptoms & OTC Products for Treatments

Picture of Pimples


What is Pimple?

A pimple is a small pustule or papule. Pimples are small skin lesions or inflammations of the skin – they are sebaceous glands (oil glands) which are infected with bacteria, swell up, and then fill up with pus.

Pimples are also known as spots or zits

Pimples occur when the sebaceous glands, which are located at the base of hair follicles, become overactive. The most vulnerable parts of the body are the face, back, chest and shoulders. Pimples are palpable signs of acne, especially when a breakout occurs.

Concern is growing among experts regarding the long-term use of antibiotics for acne treatment, and its contribution to bacterial resistance. Experts from the Centre of Evidence-Based Dermatology at the University of Nottingham, England, wrote in The Lancet (August 2011 issue) that although pharmacies are well stocked with a wide range of acne medications, few studies have been carried out regarding their efficacy.

What Does Pimple Look Like?

Pimple can appear as one of the following:

Whiteheads: White dots that are pores impacted with oil and skin covered by skin layers.

Blackheads: Black bumps that are impacted pores in which material pushes out through the follicles. The black color is not from dirt. It may be from bacteria, dead skin cells, and matter that react with oxygen.

Papules, pustules or nodules: More serious lesions appearing red and swollen due to inflammation or infection of the tissue around the clogged follicles, which are often painful and feel hard.

Cysts: Deep, pus-filled pimples.

Causes of Pimple

No one factor causes Pimple. Pimple occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a “blackhead.” The plugged hair follicle gradually enlarges, producing a bump.

Symptoms of Pimple

There are several different types of pimples and they have different signs and symptoms:

  • Whiteheads – also known as a closed comedo. These are very small and remain under the skin, appearing as a small, flesh-colored papules.
  • Blackheads – also known as an open comedo. These are clearly visible; they are black and appear on the surface of the skin. Some people mistakenly believe they are caused by dirt, because of their color, and scrub their faces vigorously – this does not help and may irritate the skin and cause other problems.
  • Papules – these are small, solid, rounded bumps that rise from the skin. The bumps are often pink.
  • Pustules – these are pimples full of pus. They are clearly visible on the surface of the skin. The base is red and the pus is on the top.
  • Nodules – these are morphologically similar (similar structure) to papules, but larger. They can be painful and are embedded deep in the skin.
  • Cysts – these are clearly visible on the surface of the skin. They are filled with pus and are usually painful. Cysts commonly cause scars.

Treatments for Pimple

The majority of OTC products for pimples or acne contain the following active ingredients:

  • Resorcinol – Resorcinol helps break down blackheads and whiteheads. It is a crystalline phenol (carbolic acid, C6H5OH) and comes from various resins. This active ingredient is also used for the treatment of dandruff, eczema and psoriasis.
  • Benzoyl Peroxide – (C6H5CO) 2O2 – this active ingredient attacks and kills bacteria and slows down the glands’ production of oil. Benzoyl works as a peeling agent, accelerating skin turnover and clearing pores, which in turn reduces the bacterial count in the affected area.
  • Salicylic Acid – C6H4 (OH)COOH – helps break down blackheads and whiteheads, also slows down the shedding of cells which line the follicles of the oil glands, effective in treating inflammation and swelling. Salicylic acid is a white crystalline substance which is also used as a fungicide, or in making aspirin or dyes or perfumes. It causes the epidermis to shed skin more easily, prevents pores from becoming blocked while at the same time allowing space for new cells to grow. Many dandruff shampoos contain salicylic acid.
  • Sulfur – A chemical element which is denoted with the symbol S. It helps breakdown blackheads and whiteheads. Sulfur, in its native form, is a yellow crystalline solid. Sulfur has been used for centuries for treating acne, psoriasis and eczema. Scientists are not sure how sulfur works to help skin diseases. We do know that elemental sulfur does oxidize slowly to sulfurous acid which is a mild reducing and antibacterial agent.
  • Retin-A – Retin-A helps unplug blocked pores. Retin-A contains Tretinoin, an acid form of vitamin A, also known as all-trans retinoic acid (ATRA). Tretinoin is also used for the treatment of acute promyelocytic leukemia. Retin-A has been used widely to combat aging of the skin, it also acts as a chemical peel. It was the first retinoid developed for acne use by applying it on the skin (retinoids are a class of chemical compounds that are related chemically to vitamin A).
  • Azelaic Acid – HOOC(CH2)7CCOH – strengthens cells that line the follicles, stops oil eruptions, reduces bacteria growth. It is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. Azelaic acid also mops up free radicals, which reduces inflammation. It is useful for patients with darker skin who have dark patches on their face (melasma), or whose acne spots leave persistent brown marks.

Most of these active ingredients may be found in medications in the form of gels, pads, creams, lotions and soaps. OTC medications will have different concentrations of these active ingredients; it is advisable to start with the lowest strengths. At first you may experience skin irritation, redness, or burning – eventually, after continued use, these side effects go away.

People with sensitive skin are commonly advised to look at creams or lotions.

Gels tend to be better for people with oily skins. Gels are usually alcohol based and dry the skin.