Pustule: Causes, Treatment, and Prevent

by | Aug 22, 2020

Pustule definition

Medically, it is divided into four levels according to the severity of acne. More severe acne has pustules, nodules, and cysts. Pustular acne belongs to the third level of acne. If not handled properly, pustules have a high probability of developing into severe acne.

Pustular acne initially appears as erythema or small papules, which quickly develop into pea-sized acne.

The shape of the pustule is a raised white bump in the middle, red skin around the white protrusion, and flowing pus inside the white bump.

Because each person’s infection degree is different, the degree of damage caused by pustule blain also varies.

Early Stage: it appears as redness, followed by whitening in the middle of the skin redness, and no pus when squeezing acne.

Early Stage

Mid Stage: The volume is about the size of a papule. At this time, the white mass is larger and the skin is redder. When you touch it, you will feel pain, and there is a small amount of pus inside. At this time, inflammation has invaded deeper skin, and there is a high probability of leaving hyperpigmentation.

Mid Stage

Late Stage: The area covered by the white lump is the red area of the skin. It feels painful to touch it. There is a lot of pus inside, and it will bleed if it is squeezed. At this time, the inflammation has invaded deep into the skin, and may even have damaged the dermis, and it will leave hyperpigmentation, and there is a high probability of leaving depressed scars.

Late Stage

What causes pustules?

The most fundamental cause of pustules is hyperkeratosis at the hair follicle funnel and excessive sebum production.

Hyperkeratosis

Our skin is shedding keratinocytes every day. The normal shedding cycle of these keratinocytes is 28 days. But for some reason, hyperkeratosis of epidermal cells in the hair follicle funnel, making the keratinocytes stick together and unable to shed normally. The accumulation of so many keratinocytes at the opening of the hair follicle will eventually clog pores and form a whitehead.

Whiteheads are non-inflammatory acne, but as the number of P. acnes in the hair follicles increases, P.acne will stimulate the skin to produce inflammation, making the skin red. Whiteheads gradually develop into pustular acne. If treatment is not performed at this time, there is a high probability that pustules will develop into cysts.

The structure of the sebaceous glands. The sebaceous glands connect the hair follicle channels, and the sebum secreted by the sebaceous glands and the dead cells shed from the stratum corneum are excreted through the channels. However, if the cells at the funnel of the hair follicle cannot fall off normally, the pores are covered, and sebum and dead cells are blocked inside the hair follicle.

Excessive sebum production

The sebaceous glands secrete oil all the time. These oils flow out of the pores through the channels before they can flow to the surface of the skin that we can see with the naked eye. If there is too much oil production, the keratinization of the hair follicle funnel is abnormal, and the pores are gradually covered. The oil and dead cells will mix to form a sebum plug to block the pores. The passage of sebum is not smooth enough, but the sebaceous glands do not know that the pores are blocked and continue to secrete oil.

An anaerobic environment is formed inside the hair follicles. Propionibacterium acnes takes advantage of the opportunity to multiply and form inflammatory acne. If the body’s immune system fails to kill P.acne and get rid of inflammation in time, the inflammation will further deteriorate, the pus will gradually increase, and the white bump begins to appear on the lesion. Acne will develop into pustules.

Why do sebaceous glands secrete so much oil?

  • Perhaps your genetic sequence determines that you secrete more sebum than others.
  • Ultraviolet rays stimulate the sebaceous glands to secrete oil.
  • A high-sugar, high-salt diet will stimulate a spike in insulin in the body, which indirectly stimulates androgens, which then leads to strong sebum production.
  • Excessive cleaning will stimulate the skin to secrete more oil.
  • Staying up late will cause a large number of androgens to be secreted and more oil.
  • The growth hormone is active during adolescence, and adolescence is the most active period of sebaceous glands. After 20 years of age, the activity of sebaceous glands will decrease year by year.
  • During menstruation, the ovaries produce a small number of androgens, so it will cause the sebaceous glands to spit out a lot of oil at once.

How to get rid of a pustule?

If you have mid-stage pustules on your face, don’t hesitate to see a dermatologist immediately. Over-the-counter can’t cure acne on your face. You must have some medicines prescribed by a dermatologist to treat pustules.

Doctors usually prescribe the following prescription.

Benzoyl peroxide. External application of benzoyl peroxide in the treatment of pustules in the early and middle stages has a good effect.

Benzoyl peroxide is a strong oxidant, there are a lot of Propionibacterium acnes in the pustules. P.acne is a bacterium suitable for survival and reproduction in an anaerobic environment.

Benzoyl peroxide can release new ecological oxygen and benzoyl in the skin, destroying the habitable environment of anaerobic bacteria, and kill P.acne in pimples, thus eliminating pustules.

However, the external application of benzoyl peroxide can only act on the surface of the skin, and cannot eliminate bacterial infections deep in the skin.

Neutrogena's benzoyl peroxide gel

Topical antibiotics. Topical antibiotics have a good effect on eliminating pustular inflammation in the early and middle stages. Antibiotics can act on the surface of the skin, kill bacteria, and eliminate inflammation caused by bacteria. Dermatologists usually prescribe clindamycin phosphate gel, fusidic acid cream, mupirocin ointment, etc. Long-term use of antibiotics bacteria will produce resistance to antibiotics. Do not use the same ointment for more than 2 months.

Oral antibiotics. Late pustules have severe inflammation deep in the skin, and local antibiotics cannot work deep in the skin. Dermatologists prescribe oral antibiotics to treat severe inflammation. Common oral antibiotics are minocycline, doxycycline, doxycycline, clarithromycin.

Minocycline hydrochloride
Doxycycline Hyclate

Photodynamic therapy. Photodynamic therapy is to irradiate your skin with red light and blue light, which can inhibit sebum production, kill P. acnes, anti-inflammatory, improve keratinization of sebaceous ducts, repair skin tissue, and reduce acne scars.

Laser. Various near-infrared wavelength lasers such as 1320 nm laser, 1450 nm laser, and 1550 nm laser can help to inhibit sebaceous gland secretion and anti-inflammatory effects. Strong pulsed light and pulsed dye laser can help the inflammatory acne get rid of red marks.

How to prevent repeated pustules?

If you want to prevent repeated acne, you need to have good eating habits, lifestyle habits, and correct skin care habits

  • Pustules destroy deeper skin tissue. When choosing skin care products, should choose to contain repair skin barrier skin care products. With a healthy skin barrier, the body’s immune system can eliminate inflammation on its own, killing bacteria and avoiding infection.
  • Wash your face twice a day with a mild amino acid facial cleanser. Do not use a soap-based facial cleanser. Soap-based facial cleanser has strong decontamination ability. It takes away the oil from the face and also removes the moisture from the face, which destroys the skin barrier and can cause acne more easily.
  • If you have pustules on your face, do not use functional skin care products. Such as a high concentration of vitamin C, retinol, kojic acid, fruit acid, salicylic acid, and so on. These functional skin care products are suitable for healthy skin. If the skin barrier function is damaged, use skin care products containing these ingredients, which will irritate the skin and make the skin more prone to acne.
  • Do not grab your face with your hands, and keep your hair and pillows clean.
  • Sun protection, avoid direct UV radiation on the skin. When ultraviolet rays are irradiated into the skin, free radicals are generated in the skin, which can cause acne on the skin. At the same time, ultraviolet rays can also cause skin aging.
  • Reduce stress, do not stay up late, eat more fruits, vegetables, and fermented foods.
  • Avoid spicy foods, eat less chocolate, sweets, high GI foods, milk, and fried foods.
  • Reducing caffeine intake helps maintain hormonal balance and remove acne on the face. Please see this article for the acne muscle diet.
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