- Acne pustules accompany mild to moderate inflammatory acne.
- When pores become clogged with sebum, dirt and acne-causing bacteria, acne pustules can form.
- Acne pustules appear as inflamed, red and painful skin surrounding white or yellow pus-filled centers.
- Over-the-counter and home remedies are effective in treating mild acne pustules.
- If pustules grow more substantial and more painful, contact your dermatologist.
Small to large bumps on your skin filled with pus, acne pustules are caused by mild to moderate inflammatory acne and, sometimes, hormonal changes. When sebum production increases, your skin’s pores become clogged, creating the ideal environment for acne-causing bacteria to grow. As white blood cells fight the bacteria, white or yellow pus forms within the pore, producing a pustule.
Over-the-counter and home remedies that dry out the skin and reduce bacteria, such as salicylic acid, benzoyl peroxide, essential oils and clay masks are effective in reducing pustular acne. However, if your pustules continue to grow larger and become painful, it’s best to consult your dermatologist to check whether you’re suffering from cystic acne, the most severe form of acne vulgaris.
What Are Acne Pustules?
Acne pustules look similar to pimples but tend to grow larger as they fill with fluid or cloudy pus. You can find them anywhere on your body, but they’re most likely to appear on your back, chest and face, often in clusters of white or red bumps surrounded by red, inflamed skin that’s painful to the touch.
You can distinguish an acne pustule by its asymmetrical center made up of necrotic (dead) inflammatory cells and Propionibacteria acnes (P. acnes), the bacteria that causes acne. At the pustule’s center, it is common to see yellow or white pus that can sometimes form a crust on your skin’s surface.
Pustules vs whiteheads
There are some tell-tale differences between pustules and whiteheads. A whitehead is a plugged hair follicle, while pustules are often larger, full of white or yellow pus that oozes if you pierce the pustule.
Acne pustules will display visible inflammation (redness and swelling), and sometimes a brown dot (comedonal core) within the pustular center.
Pustules vs papules
Pustules and papules have many similarities. Both occur in mild inflammatory acne when your pore walls break down and become clogged.
As pores fill up with acne-causing bacteria, your body’s natural oil (sebum)and dead skin cells, both pustules and papules can harden and become painful.
However, pustules are generally more substantial with a yellow or white pustular head, while papules tend not to come to a head.
What Causes Acne Pustules to Form?
While your skin can form pustules following allergic reactions or insect bites, acne pustules occur when your pores get blocked by sebum, bacteria and dead skin cells. The blockage causes the surrounding skin to bulge, creating a pustule.
As the pore cavity fills and becomes increasingly infected, the acne pustule grows. Your immune system kicks in, sending in white blood cells to combat the infection. The result is an inflammatory response that results in redness, swelling, pain and pus (dead white blood cells that form as a response to the infection).
While they can occur at any age, acne pustules are also a typical result of hormonal changes or imbalances in the skin, often seen in teenagers, young adults and women during menopause. If hormones are the underlying cause of your pustules, you’ll need to see a dermatologist for effective treatment.
Where are they likely to occur?
Although you can experience acne pustules anywhere on your body, they tend to occur near oil glands. This is why you’re more likely to see pustules on your:
Should You Pop a Pustule?
It may be tempting to pop, pick or pinch your acne pustules. However, doing so means it’s more likely you’ll introduce more bacteria from your hands to the pustule, push the infection deeper into your pore. This will prolong the healing process and potentially scar your skin.
If you really must pop a pustule, the safest way to do so is by lancing the head with a sterilized needle. To decrease contamination and reduce the risk of more pustules forming, use tissues or Q-Tips to squeeze the pus and cellular debris from the pore. Clean the area thoroughly but gently with hot water and a medicated cleansing wash containing benzoyl peroxide or aloe vera, which will decrease the incidence of acne-causing bacteria in the pore. Avoid oil-based products that can clog your pores and produce more pustular breakouts.
Acne Pustule Scarring
Acne pustules can scar if you don’t follow the correct treatment guidelines. Squeezing a pustule sometimes pushes the infected material further into your pore, making the area redder, sorer and swollen.
Continually picking at the pustule increases the risk of scarring, which in turn can make you feel concerned, embarrassed or depressed.
Over the Counter Treatments for Acne Pustules
Most over-the-counter treatments for acne pustules work to open up your pores, dry the top layers of your skin and absorb excess oil on the surface. They can cause peeling, so if your skin is sensitive, it’s crucial to find the right one for your skin type.
Salicylic acid regulates your skin’s ability to shed dead cells to make room for new cells. It unclogs pores and prevent lesions but does not affect sebum production or bacterial growth.
You’ll find it in a wide range of over-the-counter acne treatments, including creams, lotions and pad wipes. However, you’ll need to use it continually because if you stop your pores may start to clog and the pustules return.
One of the most effective over-the-counter acne treatments available, benzoyl peroxide works effectively for pustules because it removes excess oil, dead skin cells and the bacteria that causes the acne.
However, if you have sensitive skin, benzoyl peroxide is not the right treatment for you. It’s more drying than salicylic acid and could cause you to peel, which will just aggravate your skin and create more dead skin cells to block pores. You may be able to use it as a spot treatment, depending on the severity of your breakout.
Azelaic acid is a natural dicarboxylic acid that has anti-inflammatory, anti-oxidizing (preventing cell damage) and anti-keratinizing (skin softening) properties as well as inhibiting the growth of P. acnes. Combining it with benzoyl peroxide or hydroxy acids make it even more effective for pustular acne. You’ll find azelaic acid in creams, lotions and washes.
These over-the-counter treatments work like salicylic acid and benzoyl peroxide but are gentler on your skin. Some products may also combine sulfur with other acne-fighting ingredients like resorcinol. Sulfur topicals tend to smell so are less popular.
Sulfur topicals will absorb sebum, dry out the dead skin cells that clog your pores and decrease P. acnes, but they’re often better for very mild forms of pustular acne. Overall, they seem to be less effective than benzoyl peroxide, but may be worth using if you have very sensitive skin.
A recent study has shown topical application of hydrogen peroxide yields comparable results to benzoyl peroxide. An oxidizing agent that can kill bacteria cells and reduce excessive sebum on the skin’s surface, hydrogen peroxide is not without its dangers. It can also kill skin cells as well as the connective tissue (fibroblasts) that helps heal wounds.
This means there may be an increased chance of scarring unless you use hydrogen peroxide carefully and speak to your doctor first to check it’s the right treatment for you.
Natural Remedies for Acne Pustules
Some natural remedies have proven effective for mild pustular acne. These include products that draw out excess sebum and dirt from pores, soothe inflamed skin and target bacteria:
- Essential oils. Tea tree and rosemary oil contain the anti-inflammatory and antimicrobial properties proven to reduce the redness, swelling, bacterial infection and pain of acne pustules. Make sure you dilute them before applying to your skin.
- Aloe vera gel. When combined with retinoids like tretinoin, aloe vera’s naturally antibacterial, and anti-inflammatory is beneficial for treating acne pustules.
- Natural masks. Applying natural clay masks, such as those containing jojoba oil or bentonite, often helps reduce pustules because they draw oil and dirt from your pores. Use an excellent oil-free moisturizer after treating the skin, as products containing oil can plug your pores more and cause further breakouts.
When to Seek Medical Attention
If your pustules are resistant to over-the-counter or natural remedies, or the breakout has grown severe, you should see your dermatologist. Leaving your acne pustules untreated can lead to developing cystic acne; a much more severe acne diagnosis that’s harder to remedy.
Cystic acne occurs when the bacterial infection of pustular acne deepens beneath the skin, producing red, tender bumps full of pus that can itch and hurt. The chances of scarring also become more significant with cystic acne.
While a GP can manage mild and moderate acne pustules, cystic acne requires the help of a specialist and more aggressive treatment options, including oral and topical antibiotics, or, in very severe cases, PDT (photodynamic therapy) that eliminates pustules, diminishes scars and smooths your skin’s texture.
Acne pustules are a symptom of mild inflammatory acne and, sometimes, hormonal changes in the skin. Appearing as small bumps on your skin, they’re commonly caused when your skin’s natural oil (sebum) and acne-causing bacteria clogs your pores, sparking an immune response that floods white blood cells into the area and generates pus.
Over-the-counter and home remedies are effective in reducing pustular acne because they dry out the skin and reduce bacteria. However, they can also cause sensitive skins to peel. Acne pustules that become larger and more painful may require treatment by a dermatologist to rule out a diagnosis of cystic acne, the most severe form of acne vulgaris.
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