The word “pimple” is a broad term for whiteheads, blackheads, and pimples, plus a variety of acne types.
Pimple: A pimple is simply a clogged pore. When a pore is clogged, swelling and redness occur because your body sends out white blood cells to eat the bacteria and debris. The force of having extra blood in the area makes it swell and sometimes feel painful.
Pimples on top of the skin are referred to as comedones and these may or may not include pus. Pilo sebaceous glands (hair follicles) live right above the oil glands which function to lubricate the hair follicles. If excess lubrication is produced, it builds up within the gland. If the pore is clogged by a thin layer of dead skin then, you may see a small amount of pus starting to build up.
General Pimple Solution: In the treatment room, I use an enzyme mask with steam for 3-7 minutes to soften the top layer of skin. Using gloves and cotton-covered fingers, I gently press around the pimple and ease out the congestion. Afterward, I cleanse with an antibacterial cleanser and reduce leftover inflammation by using an ice pack. Home care products include toners, serums or masks containing salicylic acid to continually dissolve oil and bacteria.
Blackhead: A blackhead is also known as an open comedone.This happens when the pore fills with a collection of dead skin, oil, and melanin. The debris oxidizes and turns black when exposed to light. Melanin is responsible for producing our skin color.
Blackhead Solution: Gently pressing around the blackhead may bring the debris towards the surface where you can wipe it away.
Whitehead: The medical term for this is pustule. These bumps are less than .5 cm and are an indication of infection, including blood, pus, and clear fluid. They are raised and have a ‘white head’. Whiteheads are white in color because there is a collection of white blood cells eating the debris within the clogged pore which we call ‘pus’. When squeezed, we will first notice the pus, then blood and finally clear fluid which is lymphatic fluid.
Whitehead Solution: You may treat a whitehead in the same manner as a blackhead. However, if you are unsuccessful in squeezing it out, a professional can step in and use a lancet. Lancets are sterile needles that can prick the side of the bump to release the pressure and debris.
Cystic Acne: Commonly referred to as cystic acne lesions, these are deep, fluid-filled nodules that result when a pilosebaceous gland fills with debris, ruptures beneath the skin, and causes a long-term infection. These are greater than .5 cm clear fluid. There are many reasons why we get these but essentially dead skin cells collect and cover the sebaceous gland deep beneath the skin’s surface.
Acne Solution: This is the most severe type of acne. Never attempt to rupture cystic acne. This will damage the skin cells around it and make an infection worse. Talk to your skin care professional for advice. Your doctor may prescribe oral antibiotics along with topical medications for treatment.
As an Esthetician, I always respect what doctors say. However, if my client wants to go the alternative route I will put them on a peel plan. Generally, I recommend a melanocyte inhibitor product for 2-3 weeks prior to a peel to prevent skin darkening. This product is to be used only at night and an SPF must be used during the day. On the day of the peel, we discuss the level of intensity and desired results. Salicylic, lactic, glycolic or a blend of acids will be applied to target the issues. Depending on the type of peel, your skin may experience flakiness for the first few days. Within a week the skin begins to repair itself, demonstrating less oil, reduced scarring, and overall clarity. We repeat the treatments every several weeks until we reach the goal.
Retinoids (aka Retin-A, Retinol, Vitamin A) are generally prescribed for severe acne, to decrease oil production. The retinoids communicate with the oil (sebaceous) glands and ask them politely to produce less oil. Additional benefits include increased cellular turnover (exfoliation) and decreased scar formation.
Medical professionals often go for Benzoyl peroxide (BPO) which is sold in potencies of 5% and 10%. The upside is that BPO kills the bacteria that lives in the pores and decreases inflammation. The downside is that it dries the out the skin and is very strong, so it is not recommended for daily use. The second thumbs down is that BPO makes the skin extremely sensitive to the sun, so use with caution and tons of SPF.