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Pimple

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Pimple
Other namesZit, spot
Teenager-with-acne.jpg
A pimple (center) evolved into the pustule stage
SpecialtyDermatology

A pimple is a kind of comedo that results from excess sebum and dead skin cells getting trapped in the pores of the skin. In its aggravated state, it may evolve into a pustule or papules.[1] Pimples can be treated by acne medications, antibiotics, and anti-inflammatories prescribed by a physician, or various over the counter remedies purchased at a pharmacy.

Causes[edit]

Sebaceous glands inside the pore of the skin produce sebum. 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.[2] 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.[3] Pimples can be part of the presentation of rosacea.[4]

Some skin care products, in particular those not labeled as "non-comedogenic", "non-acnegenic", "oil-free" or "won’t clog pores", are more likely to cause skin irritation or acne.[3]

Treatment[edit]

Over-the-counter medications[edit]

Common over-the-counter medications for pimples are benzoyl peroxide, salicylic acid, adapalene, and antibacterial agents such as triclosan. 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.[5] Recently nicotinamide (vitamin B3), applied topically, has been shown to be more effective in treatment of pimples than antibiotics such as clindamycin.[6] Nicotinamide is not an antibiotic and has no side effects typically associated with antibiotics. It has the added advantage of reducing skin hyperpigmentation which results in pimple scars.[7]

An emerging treatment for pimples is toothpaste, which contains anti-microbial agents that are associated with reducing pimples.[8]

Prescription medication[edit]

Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include isotretinoin, which is a retinoid, anti-seborrheic medications, anti-androgen medications, hormonal treatments, alpha hydroxy acid, azelaic acid, and keratolytic soaps.[9] 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.[10] There is unclear evidence on whether oral isotretinoin is a more effective treatment compared to topical or oral antibiotics.[11] For more severe cases of acne dermatologists might recommend Accutane, also known as Sotret, Claravis, or Amnesteem, which is a retinoid that is the most potent of acne treatments. However, accutane can cause various side effects including vomiting, diarrhea, and birth defects if taken during pregnancy.

Evidence is unclear whether oral isotretinoin is superior in reducing severity of pimples and pimple inflammation, compared to oral antibiotics and topical treatment.[12]

Expression[edit]

Expression, the manual bursting of pimples which have evolved into whiteheads with one's fingers, 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.[13][14][15][16][17] Some dermatologists offer incision and drainage services to sterilely drain the pimple.[18]

References[edit]

  1. ^ "pimple" at Dorland's Medical Dictionary
  2. ^ Anderson, Laurence. 2006. Looking Good, the Australian guide to skin care, cosmetic medicine and cosmetic surgery. AMPCo. Sydney. ISBN 0-85557-044-X.
  3. ^ a b "Adult acne! American Academy of Dermatology". www.aad.org. Retrieved 1 August 2019.
  4. ^ Tüzün Y, Wolf R, Kutlubay Z, Karakuş O, Engin B (2014). "Rosacea and rhinophyma". Clinics in Dermatology. 32 (1): 35–46. doi:10.1016/j.clindermatol.2013.05.024. PMID 24314376.
  5. ^ "Understanding Benzoyl Peroxide". Archived from the original on 23 February 2012.
  6. ^ Siegle RJ, Fekety R, Sarbone PD, Finch RN, Deery HG, Voorhees JJ (August 1986). "Effects of topical clindamycin on intestinal microflora in patients with acne". Journal of the American Academy of Dermatology. 15 (2 Pt 1): 180–5. doi:10.1016/S0190-9622(86)70153-9. PMID 2943760.
  7. ^ Handfield-Jones S, Jones S, Peachey R (May 1988). "High dose nicotinamide in the treatment of necrobiosis lipoidica". The British Journal of Dermatology. 118 (5): 693–6. doi:10.1111/j.1365-2133.1988.tb02572.x. PMID 2969260.
  8. ^ Dharmik, Preeti; Gomashe, Ashok (June 2014). Anti-Acne Activity of Toothpaste An Emerging Pimple Treatment. 1. International Journal of Chemical and Pharmaceutical Analysis. pp. 149–53. doi:10.21276/ijcpa.
  9. ^ Ramos-e-Silva M, Carneiro SC (March 2009). "Acne vulgaris: review and guidelines". Dermatology Nursing. 21 (2): 63–8, quiz 69. PMID 19507372.
  10. ^ Morrison A, O'Loughlin S, Powell FC (February 2001). "Suspected skin malignancy: a comparison of diagnoses of family practitioners and dermatologists in 493 patients". International Journal of Dermatology. 40 (2): 104–7. doi:10.1046/j.1365-4362.2001.01159.x. PMID 11328390.
  11. ^ Costa CS, Bagatin E, Martimbianco AL, da Silva EM, Lúcio MM, Magin P, Riera R (November 2018). "Oral isotretinoin for acne". The Cochrane Database of Systematic Reviews. 11: CD009435. doi:10.1002/14651858.cd009435.pub2. PMC 6383843. PMID 30484286.
  12. ^ Costa, Caroline S; Bagatin, Ediléia; Martimbianco, Ana Luiza C; da Silva, Edina MK; Lúcio, Marília M; Magin, Parker; Riera, Rachel (November 2018). "Oral isotretinoin for acne". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd009435.pub2. ISSN 1465-1858. PMC 6383843. PMID 30484286.
  13. ^ "What to Know Before You Pop a Pimple". WebMD. Retrieved 3 April 2017.
  14. ^ "The 10 Most Satisfying Pimple Popping Videos Of 2016". Men's Health. 29 December 2016. Retrieved 3 April 2017.
  15. ^ "Should I Pop My Pimple?". kidshealth.org. Retrieved 3 April 2017.
  16. ^ Merlin, Design: Wolfgang (www.1-2-3-4.info)/Modified. "A14. What should I do after popping a pimple?Skinacea.com". www.skinacea.com. Retrieved 3 April 2017.
  17. ^ "How to Pop a Pimple - Instructions from Acne.org". www.acne.org. Retrieved 3 April 2017.
  18. ^ "Pimple popping: Why only a dermatologist should do it | American Academy of Dermatology". www.aad.org. Retrieved 3 August 2019.

External links[edit]

  • The dictionary definition of pimple at Wiktionary
Classification