pimple

Sebaceous glands inside the pore of the skin produce sebum. When the outer layers of skin shed (a natural and continuous process, normally), dead skin and oily sebum left behind may bond together and form a blockage of the sebaceous gland at the base of the skin. This is most common when the skin becomes thicker at puberty.Anderson, Laurence. 2006. Looking Good, the Australian guide to skin care, cosmetic medicine and cosmetic surgery. AMPCo. Sydney. {{ISBN|0-85557-044-X}}. The sebaceous gland continues to produce sebum, which builds up behind the blockage, allowing bacteria to grow in the area, including the species Staphylococcus aureus and Cutibacterium acnes, which causes inflammation and infection. Other causes of pimples include family history, stress, fluctuations in hormone levels, hair and skincare products, medication side effects, and un-diagnosed or underlying medical conditions.{{Cite web|url=https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne|title=Adult acne! American Academy of Dermatology|website=www.aad.org|access-date=1 August 2019}} Pimples can be part of the presentation of rosacea.{{cite journal|vauthors=Tüzün Y, Wolf R, Kutlubay Z, Karakuş O, Engin B|date=2014|title=Rosacea and rhinophyma|journal=Clinics in Dermatology|volume=32|issue=1|pages=35–46|doi=10.1016/j.clindermatol.2013.05.024|pmid=24314376}}

The American Academy of Dermatology recommends that adults with acne use products labeled as "non-comedogenic", "non-acnegenic", "oil-free" or "won’t clog pores", as they are "least likely" to cause skin irritation or acne.

File:Blackheads.JPG|Sebaceous filaments are commonly mistaken for blackheads. However, they are completely harmless and are a natural part of the skin for people with oily skin.{{cite book |last1=Plewig |first1=Gerd |last2=Melnik |first2=Bodo |last3=WenChieh |first3=Chen |title=Plewig and Kligman's Acne and Rosacea |publisher=Springer |isbn=978-3-319-49274-2 |page=64|date=8 June 2019 }}

File:AcneVulgarisUSMIL.jpg|Some more severe pimples can lead to significant swelling and may appear on the back and chest.

{{see also|Acne vulgaris#Management}}

Common over-the-counter medications for pimples are benzoyl peroxide, salicylic acid, adapalene, and antibacterial agents such as triclosan. These topical medications, which can be found in many creams and gels used to treat acne (acne vulgaris), induce skin to slough off more easily, helping to remove bacteria faster. Before application, the face should be washed with warm water or a topical cleanser and then dried.

A regimen of keeping the affected skin area clean, plus the regular application of these topical medications is usually enough to keep acne under control, if not at bay altogether. The most common product is a topical treatment of benzoyl peroxide, which has minimal risk apart from minor skin irritation that may present similar as a mild allergy.{{cite web|url=http://www.zitfreetoday.com/understanding-benzoyl-peroxide/|title=Understanding Benzoyl Peroxide|archive-url=https://web.archive.org/web/20120223193522/http://www.zitfreetoday.com/understanding-benzoyl-peroxide/|archive-date=23 February 2012|url-status=dead}} Recently, nicotinamide (vitamin B₃), applied topically, has been shown to be more effective in treatment of pimples than antibiotics such as clindamycin.{{cite journal|vauthors=Siegle RJ, Fekety R, Sarbone PD, Finch RN, Deery HG, Voorhees JJ|date=August 1986|title=Effects of topical clindamycin on intestinal microflora in patients with acne|journal=Journal of the American Academy of Dermatology|volume=15|issue=2 Pt 1|pages=180–5|doi=10.1016/S0190-9622(86)70153-9|pmid=2943760}} Nicotinamide is not an antibiotic and has no side effects typically associated with antibiotics. It has the added advantage of reducing skin hyperpigmentation which results in pimple scars.{{cite journal | vauthors = Handfield-Jones S, Jones S, Peachey R | title = High dose nicotinamide in the treatment of necrobiosis lipoidica | journal = The British Journal of Dermatology | volume = 118 | issue = 5 | pages = 693–6 | date = May 1988 | pmid = 2969260 | doi = 10.1111/j.1365-2133.1988.tb02572.x | s2cid = 37912645 }}

Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include isotretinoin, which is a retinoid, anti-seborrheic medications, anti-androgen medications, hormonal treatments, alpha hydroxy acid, azelaic acid, and keratolytic soaps.{{cite journal | vauthors = Ramos-e-Silva M, Carneiro SC | title = Acne vulgaris: review and guidelines | journal = Dermatology Nursing | volume = 21 | issue = 2 | pages = 63–8; quiz 69 | date = March 2009 | pmid = 19507372 }}

Historically, antibiotics such as tetracyclines and erythromycin were prescribed. While they were more effective than topical applications of benzoyl peroxide, the bacteria eventually grew resistant to the antibiotics and the treatments became less and less effective. Also, antibiotics had more side effects than topical applications, such as stomach cramps and severe discoloration of teeth. Common antibiotics prescribed as of 2001 by dermatologists included doxycycline and minocycline.{{cite journal | vauthors = Morrison A, O'Loughlin S, Powell FC | title = Suspected skin malignancy: a comparison of diagnoses of family practitioners and dermatologists in 493 patients | journal = International Journal of Dermatology | volume = 40 | issue = 2 | pages = 104–7 | date = February 2001 | pmid = 11328390 | doi = 10.1046/j.1365-4362.2001.01159.x | s2cid = 29620121 }}

Isotretinoin is used primarily for severe cystic acne and acne that has not responded to other treatments.{{cite journal | vauthors = Merritt B, Burkhart CN, Morrell DS | title = Use of isotretinoin for acne vulgaris | journal = Pediatric Annals | volume = 38 | issue = 6 | pages = 311–20 | date = June 2009 | pmid = 19588674 | doi = 10.3928/00904481-20090512-01 }}{{cite journal | vauthors = Layton A | title = The use of isotretinoin in acne | journal = Dermato-Endocrinology | volume = 1 | issue = 3 | pages = 162–9 | date = May 2009 | pmid = 20436884 | pmc = 2835909 | doi = 10.4161/derm.1.3.9364 }}{{cite web|title=Roaccutane 20mg Soft Capsules - Summary of Product Characteristics|url=https://www.medicines.org.uk/emc/medicine/21511|publisher=UK Electronic Medicines Compendium|language=en|date=1 July 2015}}{{Cite report |orig-year= January 2010 |title= US Label |url= http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018662s060lbl.pdf |archive-url= https://web.archive.org/web/20121018202453/http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018662s060lbl.pdf |url-status= dead |archive-date= 18 October 2012 |publisher= FDA |date= 22 October 2010 |access-date= 1 June 2017 }} See [https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=018662 FDA Index page for NDA 018662] for updates Many dermatologists also support its use for treatment of lesser degrees of acne that prove resistant to other treatments, or that produce physical or psychological scarring.{{cite journal | vauthors = Strauss JS, Krowchuk DP, Leyden JJ, Lucky AW, Shalita AR, Siegfried EC, Thiboutot DM, Van Voorhees AS, Beutner KA, Sieck CK, Bhushan R | title = Guidelines of care for acne vulgaris management | journal = Journal of the American Academy of Dermatology | volume = 56 | issue = 4 | pages = 651–63 | date = April 2007 | pmid = 17276540 | doi = 10.1016/j.jaad.2006.08.048 }} It is teratogenic, and requires strict prevention of pregnancy during its use.

Expression, the manual bursting of pimples which have evolved into whiteheads with one's fingers (colloquially, "popping"), can allow bacteria to be introduced into the open wound this creates. This can result in infection and permanent scarring. Thus expression is generally recommended against by dermatologists and estheticians in favour of allowing pimples to run through their natural lifespans.{{cite web|title=What to Know Before You Pop a Pimple|url=http://www.webmd.com/skin-problems-and-treatments/features/pop-a-zit#1|website=WebMD|access-date=3 April 2017}}{{cite web|url=http://www.menshealth.com/style/most-satisfying-pimple-popping-videos|title=The 10 Most Satisfying Pimple Popping Videos Of 2016|date=29 December 2016|website=Men's Health|access-date=3 April 2017}}{{cite web|title=Should I Pop My Pimple?|url=http://kidshealth.org/en/teens/popzit.html|website=kidshealth.org|access-date=3 April 2017}}{{cite web|url=http://www.skinacea.com/faq/acne/a14-healing-popped-pimple.html|title=A14. What should I do after popping a pimple?Skinacea.com|last1=Merlin|first1=Design: Wolfgang (www.1-2-3-4.info)/Modified|website=www.skinacea.com|access-date=3 April 2017}}{{cite web|title=How to Pop a Pimple - Instructions from Acne.org|url=http://www.acne.org/pop-a-pimple.html|website=www.acne.org|access-date=3 April 2017}} Some dermatologists offer incision and drainage services to sterilely drain the pimple.{{Cite web|url=https://www.aad.org/public/diseases/acne-and-rosacea/pimple-popping-why-only-a-dermatologist-should-do-it|title=Pimple popping: Why only a dermatologist should do it {{!}} American Academy of Dermatology|website=www.aad.org|access-date=3 August 2019}}

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{{Spoken Wikipedia|Pimple.ogg|date=2010-04-26}}

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{{Skin and subcutaneous tissue symptoms and signs}}

{{Bacterial cutaneous infections}}

Category:Dermatologic terminology

Category:Skin care