- Acne papules are small, red lesions that form around clogged pores.
- There are a number of factors that can increase the likelihood of their formation, including stress and diet.
- Both salicylic acid and benzoyl peroxide are safe and effective over-the-counter treatments.
- Home remedies such as apple cider vinegar, honey and ice are said to help in the management of acne.
Acne papules are essentially inflamed pimples, and occur in those who suffer from moderate to severe acne. They have a variety of causes, and are often the result of a combination of genetic and environmental factors.
This form of acne may be distressing, as it is highly visible and causes skin to be irritated, however there are a variety of methods available to help reduce the number and severity of acne papules.
What Are Papules?
Acne papules are small, red lesions that appear on the surface of the skin.
Like other acne lesions, papules form when excess oil—particularly sebum—and dead skin cells accumulate in pores, and form microcomedones, tiny pimples that form under the skin. This creates an environment for a bacteria called Cutibacterium acnes, to develop.
As the bacteria reproduces, the body responds by sending immune cells to fight the infection. This causes inflammation of the skin around the clogged pores. Papules are red bumps which result from this inflammation.
Papules, like other forms of acne, are more likely to develop in adolescents, and are most commonly found on the face, back, chest and shoulders, since these areas have the most oil-producing sebaceous glands.
Papules vs. pustules
Pustules are a type of acne lesion that contain pus. They look just like papules, but have a white, yellow or even brown spot at their center.
Many papules develop into pustules. This occurs when the immune cells in a papule die while trying to fight off bacteria, and subsequently degrade into pus.
Papules vs. acne nodules
Acne nodules are a more severe type of acne lesion. Compared to papules, they form deeper inside the skin and tend to be bigger and sometimes painful to the touch.
What Causes Acne Papules?
There are several factors which can contribute to the development or increase of papules and acne in general. Many of these factors contribute to an increased production of sebum, which plays a crucial role in the formation and development of microcomedones.
Sex hormones, especially androgens (the male sex hormones), play a significant role in the formation of papules and other acne lesions. Not only do androgens promote the production of sebum, but they also regulate the body’s inflammatory response to acne.
While the exact mechanism responsible for this is unknown, corticotropin-releasing hormone—a key hormone in the stress response—is known to stimulate the production of sebum.
Although more research is needed to officially confirm this theory, diet is often cited as a cause of pimple breakouts. This includes eating a diet high in sugar and dietary fat, certain food groups (such as dairy), and even singular food items. Chocolate is one such food item that is often singled out as a cause of acne.
There is clinical evidence to support that both dairy and chocolate can exacerbate acne, as well as an overall high glycemic diet. Foods with high glycemic indexes include white rice, white bread and potatoes.
Many people believe that poor hygiene—including irregular washing and excessive touching of the face—can trigger the formation of papules and other acne lesions.
The reasoning behind this is that poor hygiene can promote the spread of bacteria and may allow excess oil to build up on the skin. In actuality, there is little clinical evidence that poor hygiene causes acne.
However, cleansing does help to prevent acne by removing sebum, dead skin cells and other debris. For instance, one study found that cleansing twice daily significantly reduced the number of acne lesions.
How Are Acne Papules Treated?
Although acne papules do not produce scarring and resolve on their own over time, many people may find them both visibly and tactilely irritating.
In order to reduce their appearance and speed up recovery time, there are a variety of topical treatments for consideration and other treatment options for more severe cases.
Topical acne treatments are the most common way to treat papules. These include over-the-counter (OTC) acne products such as glycolic acid, salicylic acid (SA) and benzoyl peroxide, which can be found in a range of creams, cleansers and masks.
Glycolic acid, SA and benzoyl peroxide remove excess oil and skin cells from the skin. This can help to clear existing papules, and also prevents the formation of new ones.
When you first start using these medications, your skin might feel overly dry or irritated. This is because hydroxy acid products tend to have a low pH, and their acidity can disrupt the epidermal barrier.
The epidermal barrier, also called the skin’s natural barrier, protects the skin against bacteria and photodamage, and keeps it moisturized. Therefore, when compromised, skin is more likely to dry out and feel irritated.
For more severe cases of inflammatory acne, your doctor might prescribe retinoids, such as tretinoin (Retin-A), or antibiotics, such as dapsone (Aczone). Retinoids fight against the root cause of papules—clogged pores—but also help to reduce inflammation. Topical antibiotics work by killing off acne-related skin bacteria.
Alternative treatments for papules consist primarily of oral medications. These include oral antibiotics, such as erythromycin, and various hormonal agents. For women, both oral contraceptives and antiandrogens can help reduce acne under some circumstances.
Natural Remedies for Acne Papules
There are very few home remedies which specifically target papules. Instead, a number of general acne remedies are reported to help treat and prevent lesions and pimples by cleaning away excess oil and skin cells, killing bacteria and reducing inflammation.
Apple cider vinegar
Method: Mix equal parts water and apple cider vinegar and dab the mixture onto pimples with a cotton swab or ball.
Logic: Apple cider vinegar contains organic acids which kill off bacteria, therefore it reduces the presence of acne-causing bacteria.
Method: Cut a wedge of lemon and gently press it against your pimples.
Logic: Lemon juice contains citric acid. Just like with apple cider vinegar, these acidic properties may be able to kill the bacteria associated with acne. However, some warn that lemon juice is too acidic for the skin, and may do more harm than good.
Method: Steep 1 tea bag in hot water for several minutes, then cool; apply the tea bag directly to your pimples.
Logic: Green tea is said to fight off bacteria. It has also been shown to reduce inflammation, so it may help with soothing existing lesions.
Method: Dab a small amount of honey onto your pimples.
Logic: Honey is a natural antibacterial. This means it may be able to reduce the bacteria that contribute to acne.
Method: Wrap an ice cube in a clean cloth and hold it gently against your pimples for a few seconds at a time.
Logic: Ice helps to soothe inflammation. Although it won’t prevent lesions from forming, it may be able to reduce redness and swelling.
Acne Papules Prevention Do’s and Don’ts
Preventative measures can go a long way to discourage the formation of papules. Use your skin care products consistently, maintain hygiene and following a proper diet. Here are some guidelines for prevention:
- Use glycolic acid, SA or benzoyl peroxide. Although they may be irritating in high concentrations, face washes and other products containing these ingredients in a low concentration are safe treatments for pimples of all kinds.
- Use the remedies that work for you. Individuals will see different results depending on the remedy they choose; it is important to assess your options and target your specific needs.
- Consult a dermatologist. For treating more severe acne with a large number of papules, it is best to consult a dermatologist in search of stronger medications, such as dapsone.
- Pop your pimples. Not only does picking at your skin help spread bacteria; it makes it harder for pimples to heal and may even cause scarring.
- Eat foods that cause acne. If you have noticed that certain food groups, especially high glycemic foods, or food items seem to worsen your acne, limit consumption or avoid them altogether.
Acne papules are inflammatory pimples that are not to be confused with pustules which contain pus. Papules occur when pimples remain untreated, and the pressure built up inside the closed comedone inflames and irritates surrounding skin. This can be caused by genetics, as well as external factors such as stress or diet.
Treatments for papules coincide with general acne treatments, with a focus on antibacterial and anti-inflammatory ingredients. In most cases of acne, OTC topical products—especially cleansers containing hydroxy acids—are the most widely studied and used.
Some at-home remedies may also be viable options for those who have mild to moderate acne. If your acne is severe, or if hormones are the identifiable cause, talk to your doctor about oral contraceptives as a possible treatment.
Although it may be tempting to pick at pimples and papules, it should be avoided. Doing this, as well as using overly abrasive products, will only irritate skin further, leading to increased inflammation and possibly scarring.
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