- Pimples can be broadly classified as inflammatory and non-inflammatory.
- Each type of pimple requires a targeted approach for treatment.
- The treatment modalities are also based on the severity of the type of pimple.
- Most pimples of mild to moderate category can be treated with a simple face wash and natural remedies.
Pimples, scientifically known as acne vulgaris, are the result of blockages caused in the skin's pores. They usually commence with the hormonal changes occurring during adolescence and can sometimes persist for a long time.
Different Types Of Pimples
There are two types of pimples – inflammatory and non-inflammatory. Each type requires a different approach to treatment. So, before you start treating your pimples, it pays well to know what kind of pimple you are dealing with.
Non-inflammatory pimples are also called comedones. They are gentler when compared to the inflammatory types. The common types of non-inflammatory pimples are blackheads and whiteheads.
They occur as a result of sebum production that blocks the pores of the skin. These pimples commonly breakout in the T-zone of the face, consisting of the forehead, nose, and chin.
Inflammatory pimples occur when blackheads and whiteheads become infected with bacteria, thereby getting inflamed. Such inflammation, in turn, causes four varieties of pimples, namely papule, pustules, cysts, and nodules.
Let us look into each type of pimple in detail and how they should be dealt with:
Whiteheads are non-inflammatory acne and are commonly called as closed comedones. Whiteheads are formed due to the accumulation of dirt, bacteria, and dead skin cells blocking the pores of the hair follicles.
The dead skin cells covering the whiteheads give them a white color and, hence, the name whitehead. However, whiteheads do not contain a head that can be popped! These are small painless bumps that do not contain any pus.
However, when popped forcibly, these whiteheads can get infected by bacteria and turn into poppable pimples.
Whiteheads can also be caused due to various cosmetic products that seal the skin’s surface or cause irritation to the skin. They may also occur due to hormonal changes occurring in one’s body.
According to Clarissa Yang, M.D., Chairperson of Dermatology at the Tufts Medical Center, if whiteheads occur below the hairline or forehead, it is more likely because of an irritating oil-based hair product.
If these whiteheads are more concentrated on the chin and the jawline, the whiteheads could possibly be hormonally-driven. The hormonal changes can result in excess or little sebum production, leaving the oil glands in the chin and the jaw area overworked and leading to the breakout of whiteheads.
How to deal with whiteheads:
Whiteheads can be controlled at the onset, and one should act promptly on seeing the first signs of a whitehead. The most important point to be kept in mind is that one must always keep the face clean and prevent bacteria and dirt buildup.
While whiteheads may sometimes resolve on their own, any bacteria or dirt buildup or even stress can aggravate them, causing them to become red, painful, and challenging to treat. Hence, cleanliness is the best possible and simple first-line treatment.
Whiteheads may be stubborn at times due the pores being closed. Products that contain salicylic acid may help in dealing with whiteheads in such cases. Topical retinoids also work in favor. One can start with over-the-counter retinoids initially, and if that doesn't work, opt for stronger retinoids on the advice of a dermatologist.
Technically called open comedones, blackheads are formed when the closed pores of whiteheads get exposed to air. Once exposed, these pores oxidize by coming in contact with the outside air and turn black, hence the name blackheads.
How to deal with blackheads:
The strict rule is to avoid touching blackheads. The dirt and oil from one’s hands can get transferred to the blackheads and can make things worse. Also, make sure you keep your bed linen clean and hygienic.
Papules belong to the category of inflammatory pimples. They occur when the walls of the pores break down due to high inflammation. As a result, one may get small hard bumps that are tender to touch. The skin surrounding them is usually pink in color. When papules are infected with bacteria, they transform into pimples.
How to deal with papules:
Stick to a mild cleansing routine. Do not scrub the skin when cleansing and do not over-cleanse. Use lukewarm to warm water, not hot water, for cleansing. Use gentle soaps and avoid strong perfumes and lotions.
Use skincare products that suit your skin type. One can wash the face with an anti-acne face wash that contains salicylic acid or benzoyl peroxide. Topical creams can also be used, and in some cases, the dermatologist may advise an oral antibiotic in addition to the topical creams. Also, one must follow a healthy diet and drink at least two liters of water per day.
When a papule gets infected and is filled with pus, the result is a pustule. The difference between a papule and a pustule is that pustules are like papules except that they are filled with a sort of yellow-liquid pus with a white or yellow center.
How to deal with pustules:
One must resist the urge to pluck or pop a pustule. Topical treatments with salicylic acid or benzoyl peroxide are useful. If that doesn't work, one should consult a dermatologist.
Nodules are big, inflamed, and painful lumps that lie beneath the skin's surface. When the skin's open pores get infected with bacteria, there can be inflammation on the inside of the skin, thereby giving way to nodules on the outside. Unlike pustules, nodular acne does not have a head and is relatively bigger.
How to deal with nodular acne:
Nodules affect the deeper layer of the skin, and hence, over-the-counter topical medications may not work. Nodules require a more intensive approach. Isotretinoin, a vitamin A derivative, is said to deal with nodular acne effectively, but should be used under the prescription of a dermatologist. 
Your doctor may also prescribe oral antibiotics, corticosteroids, and prescription retinoids in severe cases.
One has to be more careful when shaving and avoid using products that conceal acne.
Cysts occur when the pores get clogged with bacteria, dead skin cells, and sebum. Cysts occur deep within the skin and are more in-depth than nodules. While nodules are prominent and hard lumps, cystic lesions are fluid-like pus-filled sacs. They can be painful, swollen, and quite nasty and can also end up in skin scars.
How to deal with cysts
According to the board-certified dermatologist Joshua Zeichner, those with cystic acne can opt for cleansers with high concentrations of salicylic acid and beta-hydroxy acid (BHA), for these help eliminate excess oil, slough off the dead skin cells, and dry out pimples. Cystic acne may require a dermatologist's help.
The Severity of Various Types of Acne:
- Blackheads and Whiteheads belong to the non-inflammatory category and are the mildest forms of acne. These can be treated with OTC medications and spot treatments.
- Pustules and Papules are moderate forms of acne; they may not be treated with OTC medications at times, and, hence, may require prescription medications.
- Nodules and Cysts are the most severe forms and require dermatologist intervention.
Most pimples of mild to moderate categories can be treated with a simple face wash and natural remedies.