An Overview of Acne Pustules

Forehead of a teenage boy with pimples

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An acne pustule is an inflamed skin pore clogged with pus, sebum (oil), and cell debris. Common names for an acne pustule are pimple, whitehead, blemish, and zit. Though pustules can arise anywhere on the body, they're usually found on the face, neck, shoulders, and back. They can occur at any age but are especially common among teenagers and young adults who are undergoing hormonal changes that sometimes trigger acne breakouts. The treatments for acne pustules include over-the-counter (OTC) topical products containing salicylic acid or benzoyl peroxide and prescription medications such as topical and oral retinoids. Some home remedies have also been found to be effective. Lifestyle approaches that focus on keeping skin clean and clear of excess sweat and debris can help prevent pustules.

Symptoms

The characteristic symptom of a pustule is its appearance, which is different from other types of acne blemishes. A pustule is a red, inflamed pimple that has a white head filled with white, yellow, or cream-colored pus that oozes out if the pustule is pierced or broken. Sometimes a brownish dot can be seen in the middle of a whitehead. This is known as the comedonal core and is debris clogging the pore.

Pustules tend to occur near oil glands, especially around the face, back, chest, and shoulders. They can vary in size from very small to quite large.

Unlike non-inflamed acne lesions, such as blackheads, milia, and comedones, pustules are sometimes tender to the touch.

Causes

Acne pustules develop when the walls of an affected pore begin to break down and a red, swollen skin blemish called a papule develops on the skin. White blood cells converge on the papule, forming the pus that fights off infection from the dirt or bacteria that has entered the pore. At this point, the papule becomes a pustule that is filled with sebum, bacteria, and cell debris. The bacteria associated with acne is Propionibacteria acnes.

Typical acne triggers include hormonal changes that occur during puberty, pregnancy, and menopause; diet; oil and dirt allowed to build up on the skin; and certain medications. Acne also has a genetic component.

Diagnosis

Acne pustules are easily diagnosed based on appearance, other symptoms of acne such as blackheads, and a medical history. A child who starts breaking out with pimples is likely to be in the midst of puberty. Another type of acne is hormonal acne, which occurs in young women; acne sometimes develops during pregnancy as well.

However, there are skin conditions other than acne that can cause pustules. These include psoriasis, chicken pox, and even insect bites. A pustule that's exceptionally large may be a boil. A dermatologist can differentiate between acne pustules and those caused by another condition.

Treatment

Acne pustules typically heal on their own if left alone. However, because they're unsightly, especially when they appear on the face, most people don't want to wait for them to clear up naturally. To speed healing, there are a variety of over-the-counter products formulated for acne.

Topical treatments: These include spot treatments that are applied to individual blemishes as well as cleansers, body washes, and other products that are available either over the counter or by prescription.

The active ingredients in most acne products are:

Salicylic acid, which works as an exfoliant.

Benzoyl peroxide, which kills the bacteria that cause acne

Retinoids, such as Tretinoin, which are derived from vitamin A

Adapalene, a retinoid-like ingredient sold under the brand name Differin in both OTC and prescription strengths.

Topical antibiotics including clindamycin and erythromycin

Oral treatments. Antibiotics such as tetracycline, erythromycin, minocycline, and doxycycline are commonly used for acne. For very severe acne, a powerful oral retinoid called isotretinoin (formerly available under the brand name Accutane) is sometimes prescribed. It must be used with caution as it causes severe birth defects.

For severe acne pustules, a procedure called photodynamic therapy (PDT) may be used, which combines light and a special light-activated solution to shrink the skin's oil glands. This can drastically reduce the amount of oil within the pores, thereby reducing comedones.

Some natural products may also help treat acne pustules although there is scant research to prove they're effective. These include tea tree oil, bovine cartilage, zinc, jojoba oil, and aloe vera.

Hands Off

Although tempting, popping pimples can lead to scarring and infection. It also can prolong the amount of time it takes for a blemish to clear up.

Prevention

For people who are prone to frequent acne breakouts, there are measures that can help prevent blemishes such as pustules.

  • Keeping skin clean and free of oil.
  • Shampooing regularly to prevent acne breakouts at the hairline.
  • Using sunscreens, moisturizers, make-up, and other products that are labeled "non-comedogenic," which means they're formulate to not provoke acne.
  • Bathing or showering after strenuous physical activity: Oil and sweat left on skin can lead to breakouts.

A Word From Verywell

Acne pustules are common and harmless, but they also are unsightly—which can be upsetting. There are a number of effective measures that can help treat and/or prevent pustules and other blemishes, from simple home remedies to prescription medications. If you frequently develop acne pustules, given the wide range of options, you should be able to find an effective approach to dealing with them.

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