Understanding how pimples form

Understanding how pimples form

Pimples, the term we use to refer to a wide variety of acne and other ‘bumps’ on our skin. But have you ever wondered how they form? I mean, why would you? But then again, why would you not because by learning how they come about, we can ensure that they either don’t happen in the first place or if they do, we’ll know what to do to get rid of them. Are you ready to find out about how pimples form? Well worry not, I have done all the hard work for you, so brace yourselves since today I am going to teach you your ABCs about everything pimple related!

1) Microcomedone (or early acne, as we know it) occurs when dead skin cells get trapped into the pore, as a result of which more skin cells are shed near the top of the pore than the bottom, and the skin starts overproducing sebum. Sebum is food for Propionibacterium acnes (aka P. acnes), a bacteria that lives inside the pores and feeds on sebum. So as you can imagine, overproduction of sebum means more food for P. acnes and it multiplies. However, there’s no infection at this early stage for acne development so symptoms are quite superficial.

Treat it with: Over the counter benzoyl peroxide which kills P. acnes or azelaic acid 10% which acts as a leave on exfoliant helps to clean up the pores too.

2) Closed comedone/ whitehead occurs when sebum and dead skin cells build and become thick in consistency. If the opening of the pore is narrow or if it’s closed, it becomes a closed comedone which is often referred to as whiteheads since the pore appears as a small white bump on the skin. If P. acnes infects the surrounding cells, it becomes infected.

Treat it with: Whiteheads generally respond well to chemical exfoliation as that deep cleans the skin and its pores. Over the counter salicylic acid 2% lotion which helps to make the build-up of cells and sebum less sticky, or benzoyl peroxide to help kill the bacteria work just a well!

3) Open comedone/ blackhead occurs when dead skin cells and sebum builds up, but unlike whiteheads, the opening of the pore remains open and looks black in colour. Again, blackheads may also be infected with P. acne.

Treat it with: The key to keeping blackheads at bay is thorough cleansing so things like physical or chemical exfoliation work really well to clean out the pores of all the build up. Alternatively, benzoyl peroxide which kills the bacteria, salicylic acid 2% lotion to help get rid of the stickiness of the sebum and skin cells which propagates their removal, or prescription topical antibiotics which help to get rid of infection (should they be infected) are standard treatments for blackheads.

4) Inflammatory papule/ pimple (yes, this is what a ‘pimple’ actually is) forms when the build-up of sebum and dead skin cells infected with P. acne spreads to neighbouring cells and a red bump forms on the surface of the skin.

Treat it with: Papules are harder to treat than the above. Some people swear by drying lotions, whilst others need, you guessed it, benzoyl peroxide or salicylic acid 2% lotion.

5) Pustules form when white blood cells build up in the pore as the immune system tries to fight off the P. acne infection in the pimple, and this creates pus in the pore. It’s still unclear why pustules form in some pores and not in others, but they are treated in very much the same way as pimples

Treat it with: This is perhaps the only type of pimple you could pop without leaving a scar. Make sure you thoroughly clean your skin beforehand though! If like me, you’re not a fan of popping pimples, then… yes, yes I know you have it memorised by now, benzoyl peroxide or salycilic acid 2% lotion are your two other bets!

6) Cysts or nodules form when the sebum and bacteria leak into surrounding cells and causes scarring. These are usually very painful and over the counter medication usually don’t work, so people generally have to see their doctors for a solution.

Treat it with: You could try chemical exfoliation, but nothing will work as well as prescription oral antibiotics to kill the bacteria or isotretinoin which helps to remove cystic acne.

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