My struggle with acne is personal, and if you’re already reading this - so is probably yours.
While acne is generally viewed as a superficial health problem affecting the body, the real danger lies in acne’s ability to harm a person’s mental health.
Every teen knows how difficult it is to deal with acne. From anxiety to questioning our self-worth and even bouts of depression, severe acne brings a lot of added challenges that go further than skin deep. For most people, however, this side-effect of adolescence is temporary, but some of us aren’t so lucky. And truth be told, we’re long past sweet sixteen, and we need to take better care of ourselves - which makes learning more about acne more important than ever.
What we call acne is actually a complex sum of varying skin conditions - there are over a dozen various types of acne. Ranging from the simple blackheads, all the way to pustules, nodules and cystic acne, our ‘enemy’ is diverse and difficult to defeat. On top of that, it’s annoying as hell!
But as the saying goes, knowledge is power, and today we’ll talk about one of the less dangerous types of acne, the papules acne. Albeit less unseemly than other types, these acnes are still a pretty uncomfortable type to ‘wear.’
Papules acne occurs when those small, clogged hair openings (called comedones) become inflamed. While a normal comedone transforms into a blackhead or a whitehead, papules acne are a real ‘pain in the, eh, behind’ because the inflammation can spread through an entire area, leaving the skin red, bumpy, and painful to the touch. That’s why my dermatology professor called those comedones little time bombs.
Imagine a blemish becoming a hundred times worse. These acne form tiny, numerous pimples which can’t be burst or cleaned elegantly. In fact, trying to do so often results in intense pain, because a large surface of the skin has already been damaged. What’s worse, rubbing the area usually spreads the infection to healthy skin, because the ‘wildfire’ is actually caused by Propionibacterium acnes, a common microscopic skin resident.
This bacterium is one of the most abundant creatures living on our skin, but it’s usually dormant. However, when hair follicles become clogged and filled with oil, they basically resemble huge pizza joints for the Propionibacterium acnes. Suddenly, the little critters have the feast of their lives, and thanks to the abundance of skin oil (i.e. ‘bacterium pizza’) they multiply like crazy and never want to stop. (Yeah, it’s pretty much like Black Friday for bacteria.) This makes the hair follicles become bruised, red, and finally burst.
These explosions of bacteria and oil spread over the surrounding skin, making it inflamed, bumpy and sore. Dermatologists call these tiny bumps papules, hence the name papules acne. They're awful as is, but what makes matters even worse is that they can leave scars too.
Sigh. The ‘usual’ papules acne can grow big and bulging, effectively transforming itself into super-acne, a so-called acne nodule. Both papules and nodules form due to blockage of the hair follicle, but nodules become clogged much deeper in the skin and resemble small ‘hills’ over the usually normal, smooth skin terrain. That’s because the follicle wall actually bursts under the pressure of the infected material, which then spills into the surrounding dermis - thereby forming a nodule. (Think of an underground water explosion, only a lot nastier and super gross.)
As you can imagine, nodules take longer to heal than papules too. While the papules can be dealt with within days or weeks, nodules can drag on for months and even leave scars. Make no mistake - this is serious, and the best way to treat this type of acne is to consult a dermatologist.
But back to papules acne, which is thankfully easier to manage. Depending on the severity of the inflammation, you have several weapons at your disposal.
Solutions, solutions! Of course, that’s why we’re here for. If it’s just a few spots on otherwise clean, healthy skin, your best bet is to use acne spot treatments. The most effective acne spot treatments are those that contain benzoyl peroxide, salicylic acid, and sulfur, and these can be easily found in most drug stores. But it’s crucial to keep an eye on the ingredients so you can use the right thing to help your skin heal. You wanna know why? Besides being wise with your money, there are other good reasons too. Sit tight, it’s time for a brief science lesson.
An otherwise pretty generic compound used in a number of different products and industries, benzoyl peroxide is particularly well-suited in the treatment of acne. Why you might ask?
Well, it’s sort of ingenious really.
See, our ‘friends’, the Propionibacterium acnes are anaerobic fellows, which is science-speak for “they hate oxygen.” This is where the ‘peroxide’ part of the benzoyl peroxide comes into play. It is basically an oxygen shower for the filthy oxygen-hating partygoers. These acne-inducing bacteria hate oxygen, so they run away or choke on the benzoyl peroxide and the inflammation tones down. Additionally, the extra oxygen helps the unclogging of pores and hair follicles, so it’s a win-win!
When a scientist says something is keratolytic, what they’re actually trying to say is that it helps dissolve the cellular bonds that keep dead skin cells together. This means that keratolytics keep the pores clean, dismantle all the dead pimples and hasten skin regeneration. Salicylic acid is a well-known keratolytic, and although it can be found in nature (like inside tree bark), the ingredient used in skin care solutions is usually synthetic. Which is just as well, because it gets the job done.
However, we must remember that salicylic acid doesn’t have antimicrobial properties, so it won’t fight bacterial infection on its own. But when combined with benzoyl peroxide and sulfur - it works wonders.
It stinks like rotten eggs, it’s used in matchsticks, it can be found in volcanoes - but it eats acne for breakfast. Originally referred to as brimstone, sulfur was one of the earliest treatments against acne in the history of humanity. But why? Well, sulfur being sulfur - a mildly caustic chemical element - it dries the skin and makes it peel. On top of that, sulfur also has the useful property of absorbing extra skin oil (sebum), so it also aids prevention. Of course, this isn’t recommended for healthy skin (and you should never do it), but when dealing with acne breakouts, it helps.
As the name suggests, these spot treatment solutions should be applied sparingly - and only to the inflamed pimples. Just dab some solution on each spot (gently), and you should see results in a few days. In most cases - as long as the papules don’t mutate into the acne equivalent of supervillains, aka nodules - healing occurs quickly. Keep in mind that you’ll need to be willing to be disciplined and follow a routine. One dab on Monday morning won’t help much - consistency is key.
However, be mindful that acne spot treatment products are the final solution for papules acne. They are a post-inflammatory treatment, but not a preventive measure.
Ideally, your best bet is to never let your skin become the massive pizza joint for the billions of Propionibacterium acnes partygoers in the first place. To make sure that doesn’t happen you need skin cleaning solutions.
Thankfully, for mild inflammation, most over-the-counter skin cleaning products work pretty well. Just look for the magic combo of salicylic acid, sulfur, and benzoyl peroxide and you’re good to go.
For severe papules acne, however, you will have to see a dermatologist.
Remember, everyone is different. Each person’s metabolism works at different speeds and in different ways. Some people are allergic to strawberries or peanuts, while others gorge themselves full without blinking an eye. Just like with food, drinks, and diets, human skin types are similarly diverse. Do you have unusually dry skin? Or maybe an especially oily one? Even if you’re smack dab in the middle of the skin type spectrum, the treatment that your dermatologist will devise for your papules acne will be adequate for your skin type. Furthermore, a professional dermatologist will also take your personal health needs into account. So why wait?
Professional dermatologists will prescribe you a specific acne medication and come up with a skin treatment plan tailored to your specific needs. These plans are usually not short-lived and need to be followed for weeks, and sometimes even months (or in severe cases, years). There is no easy way to say this, but you’ll need to be persistent, responsible and disciplined. Following a routine is crucial because it’s not enough to merely treat the inflammation or its consequences, but slowly change your approach in such a way that acne never happens again. Or if it does, it takes a milder, more manageable form.