A pimple literally means a small inflamed elevation on the skin and this might not mean acne. In most cases though, when people talk about pimples, they are referring to acne. In acne terms, a pimple or a “zit” will either be comedones i.e. white or blackheads, pustules (pus filled pimples), papules (inflamed pimples) or nodules and cysts.
Before deciding how to treat pimples, a dermatologist must decide whether a patient has acne pimples or pimples because of other dermatological conditions.
The main lesion to look for in diagnosing acne is the presence of comedones. Other signs include oily skin and lesions affecting mainly the neck and jaw line in adult females. Acne scarring can also be helpful in diagnosing acne.
What other common conditions are often referred to as pimples by patients?
- Acne keloidalis nuchae – firm papules on the back of the scalp of mainly African men, caused by shaving practices.
- Pseudofolliculitis barbae – papules in the beard area or razor bumps, also most common in African men due to a clean shave. On close inspection, coiled hairs are often seen stuck in the pimple.
- Rosacea – tiny painless pustules present with redness of the skin. This occurs mainly on the nose, cheeks and forehead. Patients often report sensitivity of the skin and skin flushing associated with consuming certain foods including spicy foods, red wine and coffee.
- Perioral dermatitis – small clustered tender or itchy red papules around the mouth with spearing of the lip margins. It can also be around the nose and eyes although uncommon. The skin is usually red, dry and scaly.
- Folliculitis – pustules around the hair follicles with redness of the skin. Lesions are usually itchy and painful. It usually favours areas with terminal hairs such as the back, scalp, chest, buttocks and thighs.
How to treat acne
Wash your face at least twice a day with a face wash to help to open up the blocked pores. Look for ingredients like salicylic acid, lactic acid or glycolic acid. Oxy’s Regular and Sensitive Face washes contain salicylic acid. People with sensitive skins however might need to use gentle cleansers without exfoliants.
Use a cream or gel with benzoyl peroxide that will reduce the inflammatory lesions while also helping to kill the P. acnes bacteria that cause acne. Oxy 10 contains benzoyl peroxide.
A topical retinoid will help to clear the blackheads such as illotycin A, differin or dapta cream or gels. Large cysts or nodules are treated with oral retinoids.
Your dermatologist will prescribe hormonal treatment when hormonally influenced acne is suspected.
Always use a sunscreen or moisturisers that contain sunscreens, daily as the sun can worsen acne. The sun can also make acne spots darker while aging the skin.
If your finances allow it, other treatments such as chemical peels and micro needling will help for acne and scarring.
Watch your diet as a diet high in sugar, dairy products and fatty foods might worsen acne in some patients.
Use non-oily cosmetics as excess sebum production is linked to acne.