- The nose is one of the most common areas of the face to develop acne
- Nose acne is sometimes confused as acne rosacea, a similar yet different condition
- Nose acne is characterized by blackheads, whiteheads and pustules.
- Nose acne can be reduced with topical medications and/or professional treatments.
The nose is one of the most common areas of the body to develop acne. There are a few different reasons why it forms there, but nose acne can sometimes be a sign of more serious underlying health issues. Not to be confused with acne rosacea, a similar but different condition, there are several treatments, both OTC and RX, that help to control nose acne symptoms.
What Does Acne on the Nose Mean?
Acne vulgaris is caused when a combination of bacteria, excess sebum, dead skin cells and debris become trapped in the pores, resulting in blemishes on the skin’s surface.
Sometimes nose acne can be indicative of other health issues. When it appears on the side of the nose it could be a sign of hormonal oscillations, while blemishes on the tip might be a manifestation of digestive problems, stress, or even poor sleep that leaves you waking up tired.
In traditional Chinese medicine (TCM), it’s believed nose acne indicates cardiovascular problems.
Acne vulgaris vs. acne rosacea
Because of their similarities, acne vulgaris and acne rosacea are commonly confused by patients. However, even though they both occur on the nose, sometimes simultaneously, the two conditions are characteristically distinct in the ways they can affect the skin.
Acne vulgaris is a form of actual acne, consistent with whiteheads, blackheads, cysts and pimples, whereas acne rosacea is acne in name only, and is in fact a specific subset of rosacea.
How they differ is acne rosacea is typified by extreme redness, inflamed skin and swelling, often starting on the nose and spreading to the cheeks, but never the entire face or elsewhere on the body. Acne rosacea can sometimes cause swelling to the point it leaves the nose looking notably enlarged.
Acne vulgaris, on the other hand, is typified by the excess oil, bacteria and clogged pores referred to earlier and manifests as whiteheads, blackheads or tiny pus-filled bumps. Plus, it can appear anywhere on the face, not just the nose and cheeks as is the case with acne rosacea.
What Causes Acne on the Nose?
Nose acne in all its forms can be triggered by a number of factors, including hormonal changes, diet, poor hygiene, and certain medications. Acne is also understood to have a genetic component.
The nose is particularly susceptible to acne as its pores are typically larger than elsewhere on the face, making it easier for dirt and bacteria to penetrate and clog them up. Compounding the problem, the skin on the nose is also oilier, so the combination of larger pores and excess oil (sebum) leaves the nose particularly vulnerable to acne, which feeds on oil, resulting in blackheads, whiteheads, and pustules.
Whiteheads: Whiteheads form when excess sebum, dead skin cells, dirt, and bacteria clog the pores and manifest as acne. Whiteheads are characterized by their closed ends, which appear as small, round, white bumps on the skin’s surface.
While whiteheads on the nose are common due to the large amount of sebum that can get trapped in the pores, several other factors can influence whiteheads to develop, including: stress, anxiety, and hormonal fluctuations resulting from puberty, menstruation, menopause and other situations. Whiteheads flourish in areas where there is a lot of sebum, which makes the nose a prime location for this type of acne.
Blackheads: Blackheads on the nose form for the same reasons as whiteheads; excess sebum, dead skin, debris and bacteria clogging the pores. Except where the hair follicles are closed with the latter type of acne, with blackheads the top of the pore remains open. When the oil and debris in the pore is exposed to the elements, it oxidizes and leaves the top of the blemish a grey or black color, hence the label “blackhead”.
Pustules: Pustules on the nose develop when the pores are deeply clogged, resulting in small pus-filled bumps. Pustules are characterized as inflammatory acne and differ from whiteheads in that they can be painful to the touch and contain pus rather than hardened sebum and dead skin cells. As with blackheads and whiteheads, pustules also tend to occur near oil glands, which explains why they so often appear on the nose.
Treatments for Nose Acne
Acne vulgaris can be inflammatory or non-inflammatory, sometimes requiring different treatments. For mild to moderate forms of acne, many over-the-counter remedies are effective for both varieties. More severe cases of inflammatory acne, as characterized by painful cysts or nodules, may require the services of a dermatologist.
Over the counter cleansers
Salicylic acid: Salicylic acid is considered the gold standard of OTC acne medications and is commonly found in many creams and gels designed to help with the condition. While it doesn’t kill bacteria or curb sebum production, as a beta hydroxy acid (BHA) exfoliant salicylic acid works by removing dead cells and debris from the pores and inhibiting acne lesions from forming. Because it’s not an antibacterial agent, it’s often combined with benzoyl peroxide for a more comprehensive treatment.
Benzoyl peroxide: Benzoyl peroxide is another commonly found ingredient in OTC acne treatments. Like salicylic acid, this compound is an exfoliant, however, benzoyl peroxide is also bactericidal, meaning it not only helps clear the pores but kills bacteria. It does not, however, moderate sebum production and, because it reduces swelling, is considered most appropriate for cases of inflammatory acne and acne rosacea..
Topical retinoids: Retinoids are especially good at opening and unclogging the pores. By effectively removing sebum and dead skin cells from clogged hair follicles, they enable other acne medications to function better. Derived from vitamin A, retinoids are a core topical therapy for both inflammatory and non-inflammatory acne and usually used in combination with other acne treatments.
Isotretinoin is a powerful oral retinoid typically reserved for cases of severe inflammatory acne. It’s an RX treatment that works by shrinking the sebaceous glands, reducing the amount of oil produced by the skin. While a potent, highly effective acne medication, it comes with a long list of potential side effects, which is why it’s considered by many health professionals to be a last resort solution.
Laser therapy: There are several different kinds of laser surgery’s, with a patient’s skin type and color governing which one is best for any one individual’s acne condition. Laser therapy for acne involves a high-intensity pulse of light that is directed on to the skin, reducing inflammation and acne-causing bacteria while stimulating the skin to rejuvenate itself.
Chemical Peel: Chemical peels are available over-the-counter but for cases of severe acne professional treatment is required. Peels exfoliate the skin with an agent such as glycolic or salicylic acid, causing the surface layer of the epidermis to gradually peel off and allow renewed skin to rise to the surface, essentially stimulating the skin to heal itself.
Treating acne rosacea
As there is some overlap between the conditions, acne vulgaris and acne rosacea share several possible treatments, including light/laser therapy, oral and topical antibiotics, isotretinoin, and others. The following treatment approaches, however, are more specific to rosacea.
Oral antibiotics such as tetracycline, doxycycline and minocycline are commonly prescribed to treat moderate rosacea. These medications work to curb the acne-like breakouts and redness of acne rosacea by reducing inflammation.
Azelaic acid comes in gel, foam and cream form and is used to clear the redness and swelling caused by acne rosacea by reducing inflammation, killing bacteria in the pores, and decreasing the body’s production of keratin, a natural substance which can lead to acne and acne-like skin blemishes.
Metronidazole is another topical antibiotic available in gel or cream from. It has been a staple treatment for acne rosacea for decades. It contains anti-inflammatory properties that have been shown to reduce the swelling redness and acne-like blemishes that are symptomatic of the condition. Metronidazole works as an anti-inflammatory drug by altering neutrophil chemotaxis and inactivating reactive oxygen species.
Sodium sulfacetamide and sulfur: Available without a prescription or as a prescription cream, sulfur has been shown to reduce both acne vulgaris and acne rosacea symptoms. It’s typically used as an alternative to metronidazole and other antibiotic drugs. Sulfur is a keratolytic, which causes the skin to dry and peel, functioning as an exfoliant. Sulfur is also believed to prevent bacteria on the skin from multiplying, which inhibits the development of new blemishes.
Tea Tree Oil: An essential oil proven to be a powerful natural acne-fighter, with studies showing it can be as effective as benzoyl peroxide in treating the condition. It contains antiseptic, anti-inflammatory and antibacterial properties and is preferred by some patients because, in comparison to many conventional acne medications, it’s a relatively gentle yet effective treatment.
Nose acne is a common condition whose ubiquity can be attributed to the larger pores and greater sebum production on this part of the face. Characterized by blackheads, whiteheads and pustules, most nose acne is non-inflammatory and not to be confused with acne rosacea, a similar acne-like condition that is instead a subset of rosacea. While different conditions, treatments for both acne vulgaris and acne rosacea often overlap, with oral antibiotics and some professional procedures, such as chemical peels, proven to be effective procedures to improve their symptoms.
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