Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 11/18/2021
For many of us, pimples and zits are a curse of adolescence.
And while acne — a skin condition that occurs when hair follicles under the skin become clogged — affects upward of 95 percent of U.S. teens each year, the American Academy of Dermatology says between 40 and 50 million U.S. adults also suffer from it.
While frustrating, with proper medication, breakouts typically begin to go away after two to three months.
Other types of acne can be more stubborn. For many, acne papules fall into this category. The good news is that there are various treatment options for those struggling with acne.
Unlike whiteheads and blackheads, which are forms of noninflammatory acne, papules are examples of inflamed acne, appearing as small red bumps on the skin.
Papules form when oil and skin cells clog a pore, causing a blockage called a comedone — or comedones if there are multiple. The oil lodged in the skin feeds bacteria.
This process results in what’s called a microcomedone, which can be seen and felt on the skin. If the site of the comedone becomes inflamed from fighting the bacterial infection, it becomes a lesion. This lesion may rupture, sending bacteria down into the skin tissue.
According to the Merck Manual definition of acne vulgaris, the resulting acne lesion is a papule, also called a pimple or zit.
While acne papules and nodular acne are similar in the fact that they both block a hair follicle, nodules occur deep beneath the skin. According to the American Academy of Dermatology, acne nodules are also typically hard, extremely painful and are more likely to scar than a papule. Nodular acne typically requires a prescription acne treatment.
Acne pustules are a bit of a different story. According to the same American Academy of Dermatology article, pustules are nearly the same thing as papules, except they are filled with yellowish pus. This form of acne is typically soft but can be treated by over-the-counter acne medication.
While oil and dead skin cells are the main culprits behind papules, there are other factors involved. They include:
Diet. The jury is out on whether what you eat and drink impacts your chances of developing acne. A study published in the Journal of Drugs in Dermatology found a link between consuming refined carbohydrates and acne.
Stress. Published in a journal called Advances in Dermatology and Venerology, a study of adolescents with mild-to-moderate acne that measured sebum production did not find a link between high or low stress levels and acne, but determined that all experienced stress levels that contributed to their acne.
Hormones. The American Academy of Dermatology says that acne can flare up in reaction to hormonal changes in the body, especially when the level of androgens, which affect reproductive activity and male traits, rise in the body. According to the Institute for Quality and Efficiency in Health Care, this occurs during puberty; it also can occur during menopause (according to the International Journal of Women’s Health).
Genes. While there is no so-called acne gene, one study published in the Journal of Investigative Dermatology of 458 pairs of monozygotic and 1099 pairs of dizygotic twins found that a family history of acne was associated with increased risk.
Suffering from acne papules can be annoying and in some cases distressing. However, there are ways to treat this condition that should help clear blemishes in a matter of months.
Use a mild, non-drying soap or cleanser, or one with salicylic acid or benzoyl peroxide once or twice a day. If you have oilier skin, make sure to wash your skin after exercising to remove excess oil.
If you have oily hair, wash it daily and pull strands away from your face.
Avoid oil-based makeup and cleansers and toners that are too drying, which may increase your skin’s oil production and cause clogged pores.
According to the Journal of the American Academy of Dermatology, persistent acne can also be treated with topical treatments available over-the-counter that may contain benzoyl peroxide, adapalene, or salicylic acid.
These ingredients kill bacteria on the surface of the skin.
Unfortunately, they may also make your skin peel or become red. If this happens, drop to every other day or a few days a week until your skin becomes used to them.
You may also try using a smaller amount and wait 10 to 15 minutes after washing your face to apply them.
Stubborn acne may need different medications, often prescribed by a dermatologist or other healthcare professional.
These might include antibiotics, topical treatments such as antibacterial gels or creams, isotretinoin pills, hormone therapy or oral contraceptives for women and chemical skin peels.
It may also include photodynamic therapy, a procedure that involves light pulses and a gentle vacuum to remove dead skin cells and excess oil from clogged pores to treat blackheads, whiteheads and some types of pimples, as well as potentially reduce pore size.
Women may also try our acne treatment, a regimen that includes a customized prescription cream, moisturizer and cleanser to help treat acne and specific skin issues.
No one likes an acne flare-up. But with the proper personal hygiene habits and targeted medications especially for your skin type, you can help clear zits and pimples.
Those with stubborn or severe acne might benefit from talking to a healthcare professional about other acne treatment options such as customized prescription acne cream from Hers.