Today, we’ll discuss about Pimples, also sometimes called Acne or Muhase(मुंहासे) in hindi.

Why does it occur, what are the problems it can cause and how to get rid of it?

There are oil glands, also called sebaceous glands present in the deeper layer of our skin. These glands have ducts which open up in the surface of our skin. Oil (sebum) is produced within these glands and gets secreted via their ducts.

*Sebum is essential for the skin. It keeps the skin soft, smooth & shiny.

Problem/defect in secretion of these glands can cause pimples :-

Excessive oil secretion can cause pimples
If the secretion is normal, but there is blockage in the ducts or pores through which the oil/sebum is secreted, it causes pimples.
Bacterial infection can cause pimples – A specific bacteria called Propionibacterium Acne or simply P.acne feeds on the sebum produced by our glands and grows on it. Our body’s immune system tries to remove the P.acne bacteria and this reaction causes inflammation and painful Red bumps (acne) in the affected area.

CAUSES OF ACNE / PIMPLES

There can be multiple factors that can cause pimples or acne, some of the most common of which are discussed below :-

Genetic – It is observed that, if in a family the father or mother has a case of pimples, there is a good chance of it appearing in the children too.
Hormonal Imbalances – There are significant hormonal changes during the age of 13 to 25 years. This may cause increased activity of the sebaceous glands in our body, hence increased oil secretion and cause pimples.
Side effects of medicines , such as
Anti convulsants ( for example Carbamazepin, Phenytoin )
Anti Tubercular, used in treatment of Tuberculosis (Isoniazide)
Anti depressants (Lithium, Sertraline)
Side effect of steroids
Excessive use of cosmetics – Cosmetics which are oily / greasy, or which have high concentration of chemicals like Lanolin, Petrolatum etc, block the pores of our sebaceous glands, hence causes pimples.
Diet – There is no definite proof or data to show that our diet directly causes pimples but it is said that eating
High glycemic diet (containing high amount of sugars) &
Fast foods (especially which contains lots of oil) may cause pimples.

Also, there are many aggravating factors which do not cause pimples but, if there is someone already suffering from pimples, these factors can make the condition worse :-

Stress
Insomnia (lack of sleep)

For example, during exams, many students suffer from lack of sleep due to exam stress and anxiety, and this can aggravate the problem of pimples.

Hot & humid climate – hot climate causing excessive sweating can also lead to pimples.

SITES AFFECTED

There is a misconception among most people that pimple can only occur in the face. However, that is not at all true. Pimple can occur anywhere in our body, where there are sebaceous glands. For example, it can occur in :-

Face
Shoulder region
Chest region
The back, and even in the
Scalp region

TYPES OF ACNE

Neonatal Acne – It appears in the infant within 2 weeks after birth. It is caused due to the influence of maternal hormones.

Usually, there is spontaneous recovery by 1-3 months of age. Or it can be cured by giving medicine too.

Infantile Acne – Occurs in children during 6months to 16 months of age.
Pre-pubertal Acne – Occurs in children during 7 to 12 years of age.
Acne Vulgaris – Most common type of acne. Occurs in children during 13 to 25 years of age.

*Over 70-80% of individuals are affected during this age gap.

This does not cause any physical problems in our body, but it may lead to mental / psychological problems, as people often tend to see their faces in mirrors, and this can cause mental irritation. This may lead to lack of mental focus and self confidence.

Adult Acne – May occur in adults after 30 years of age. Usually, it occurs due to hormonal imbalances.

WHAT TO DO

In case of appearance of pimples, the first thing that you should do is consult a dermatologist.

This helps in proper diagnosis of your condition, as there are many skin diseases which mimic the appearance of pimples or acne.

Skin rashes mimicking acne are ;-

Milia
Trichoepithelioma
Gram negative Folliculitis
Acne Rosasea
Syringoma
Veruca Plana
Sycosis Barbae

After diagnosis, the severity or grade of acne / pimple is assessed.

The gradation of pimples is done as follows :-

Grade 1 – Pimple contains only black heads and white heads
Grade 2 – Papules are present along with black heads and white heads
Grade3 – contains pustules and pits
Grade4 – contains nodules and cysts

TREATMENT

Grade 1 & 2 pimple can be treated by :-

Topical creams, such as
Retinoid creams, containing Tretinoin, Adapaline.
Antibiotics, containing Eryhtromycin, Clidamycin, Benzoyl Peroxide, Azithromycin, Dapsone.
Azaleic acid & Glycollic acid are also used
Oral Medicines
Oral Antibiotics – Doxycyclin, Minocyclin, Lymecyclin, Azithromycin
Oral Isotretinoin – effective, and should be taken by dermatologist’s advice only.
Chemical peeling – In this process, certain chemicals such as Salicylic acid, Glycolic acid are used. They induce (a) rapid drying / clearing of pimples & (b) removes the pigmentation as well.

Also, in case of pregnant women, oral medicines are deferred, so it is an appropriate alterantive.

It is a highly effective way of treating pimples. For chemical peeling, you should consult your dermatologist. The number of sessions and the number of days required for this depends on the severity / grade of your condition.

LASER treatment – It is also an effective way of treatment, however it’s quite expensive as well.

*For doing chemical peeling or LASER treatment, always consult a dermatologist. Never do Laser in Saloon / Parlor, as it can cause various side effects, which can be bad for your skin.

DOs & DON’Ts

Early Treatment – People often tend to ignore their pimples, thinking that it will gradually go away. And yes, it might go away. But, if you delay its treatment, and it does not goes away on its own, this may lead to pigmentation (darkening of the skin) and scarring, which might remain for the rest of the life. This can reduce the self confidence of the individual.

Thus, you must always consult a dermatologist for effective and fast recovery.

Use face wash twice daily, after waking up and before going to bed.
Remove your makeup
Use Light moisturizer, which are Non-comedogenic, Aqua/Gel based. This will make your skin soft.
Use broad spectrum Sunscreen SPF 30 – There is a misconception that sunscreen aggravates pimples in oily skin. However, that is not true. There are many Non-comedogenic & Oil free sunscreens, which can be used to keep your skin healthy and pimple free.
Drink plenty of water
Include fresh fruits in your diet
Do NOT pop or squeeze your pimples – This may spread the inflammation and there are high chances of pigmentation occurring in that area.
Avoid using Over-the-counter (OTC) products or self medication – These medicines may reduce your pimples temporarily but may contain steroids which will actually flare up the pimples and cause many side effects.

10. Avoid excessive Scrubbing – Scrubbing won’t cause peeling off of your pimples but might aggravate your problem and cause inflammation in the area.

11. Do not experiment on your face – Do not use toothpaste or other sorts of home remedies on your face for removing your pimples.

Toothpaste contains a certain antibiotic called Triclosan, which may reduce inflammation, but it does not completely cures pimples. It is also not effective for everyone.

Experimenting on your face can cause various side effects such as allergic contact dermatitis, which will just worsen your condition and take more time for treatment.

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Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.