How Pimples Form: The Different Types Of Pimples, Prevention, And What To Do Next

Pimples are hard and inflamed spots on the skin. They originate in the follicles when dead skin cells mix with excess oil, causing bacteria to grow and clog the pores. Pimples typically form on your face, neck, back, chest, or shoulders and can appear at any age. Although pimples are common, the effects go beyond the skin’s surface. 

What is acne?

Research has found that pimples are a common occurrence¹ among teens. However, acne can also occur in adults and is commonly called adult acne. It is similar to teenage acne, as the factors causing teenage acne are the same as those present in adult acne. 

Adult acne can be more persistent than the teenage version as it is often a continuation or relapse from adolescence. However, those who have never been affected by acne can also experience this.  

Also known as acne vulgaris, acne is a common skin condition that affects nearly 10%² of the world’s population. It can be caused by various factors and usually involves a combination of four key events: 

• Increased oil production and secretion

• Excessive production of keratin (a protein found in hair, skin, and nails that forms a protective layer) 

• Blockage of hair follicles due to dead skin cells “sticking” to the pores

• Colonization of Cutibacterium acnes, a bacteria causing inflammation in acne

Lifestyle factors including gender, age, and exposure to air pollution can also increase your chances of developing acne, though the relationships between these and pimple formation are still being investigated. 

What causes pimples?

Some key risk factors include: 

Diet 

There is not enough concrete evidence to suggest that what we eat is directly responsible for pimples. However, there may be some links between pimple formation and diets with a high glycemic index (GI)³ (these are highly processed foods that rapidly raise blood sugar). Whey proteins³ in dairy and milk products⁴ can also contribute to acne development. 

A 2021 review⁵ found that certain vitamins and minerals may help reduce inflammation caused by acne. These include vitamins A, C, E, zinc, and selenium. While these results were promising, the conclusions were not definitive and only suggest that nutrition may be one of many contributing factors in pimple formation.

If you suspect that certain dietary changes may be responsible for your pimples, it is best to speak to a doctor or board-certified dermatologist about this before making any changes. They may suggest keeping a food diary to log your meals and any changes that may result from eating certain foods. 

Genetics 

While no one gene causes acne, some research⁶ indicates that genetics can influence how severe your pimples are. Several studies⁷ have found that people with a family history of acne were more likely to experience it in their lifetime. 

In a separate study examining the genetic makeup of 20 identical and non-identical twins, researchers noted that sebum control⁸ also appeared to be influenced by genetic factors. Those with oily skin types showed an increased risk of acne because it is an ideal environment for acne-causing bacteria to grow.  

Types of pimples

There are several types of pimples that have differences in how they look and their severity, such as: 

Whiteheads 

A ‘closed’ skin pore or hair follicle clogged with bacteria, oil, or dead skin cells. These look like small, white, raised bumps on the skin. 

Blackheads 

‘Open’ skin pores or hair follicles clogged with bacteria, oil, or dead skin cells. These appear as black or brown due to air exposure and oxidation of melanin, the skin’s natural pigment. 

Papules

Tender red bumps can develop when excess oil and dead skin cells block the follicles and create inflamed lesions. 

Pustules 

White and yellow squeezable spots are formed from excess oil, dead skin cells, and dead white blood cells. These are often surrounded by red and inflamed skin. 

Nodules

A severe pimple type can form deep under the skin’s surface due to blockage of the follicles. It appears as a hard bump underneath the skin, which can sometimes be painful to touch. 

Cysts 

A larger, pus-filled nodule can also form underneath the skin and potentially cause scarring if agitated. Cystic acne is challenging to treat as it can stick around anywhere from days to months and takes longer to heal. 

Treatments and tips for prevention 

There is a range of treatments that can reduce the spread of pimples to other parts of your body, such as: 

Compression

Applying a warm, damp towel to the pimple could help bring the pus and excess sebum closer to the surface of your skin. However, it is best not to squeeze or push down on the pimple once this has happened, as this could cause more inflammation and possibly move the infected content further into the skin, both leading to a greater chance of scarring. 

Spot treatments 

If your skin is relatively clear with the occasional pimple, spot treatments may be enough. These are targeted solutions in the form of patches, drying lotions, or creams that you can apply to your pimple. What makes these spot treatments so effective are their ingredients, which typically include nonprescription components such as benzoyl peroxide, salicylic acid, and sulfur. 

Over-the-counter (OTC) medications

Nonprescription OTC medications are common quick-fix treatments, including benzoyl peroxide, salicylic acid, and vitamin A derivatives (retinoids). These products come in many forms but ultimately treat pimples by reducing inflammation and killing the bacteria, or slowing its growth. At the same time, these products assist in removing dead skin cells and sebum and may help prevent pimples from returning. 

These OTC products will often help clear pimples in six weeks or less. However, it is important to note that OTC medications do not have an obvious effect until you’ve used them every day for several weeks to a month. 

Prescription medicines

If OTC medications are not helping, it may be time to consider prescription medicines. Prescription-strength medicines include oral and topical antibiotics, oral and topical retinoids, and hormone-based medication. These medications can kill acne-causing bacteria, normalize the shedding of dead skin cells, keep pores clear, and reduce the number of comedones. 

The doctor or dermatologist prescribing these medications will help create the best treatment plan for your lifestyle and medical history. 

Prevention

Pimples are not entirely avoidable, but there are several things you can do to help reduce them forming. Some tips include: 

• Avoid touching your face to prevent the spread of dirt and bacteria 

• Practice good skincare habits with suitable products to prevent further breakouts

• Avoid scratching or popping pimples to lessen the risk of infection and scarring 

• Avoid tight clothing so as not to irritate the pimples on your shoulders or back

• Change your bed sheets regularly

• Avoid using makeup around the affected area 

• Avoid excessive scrubbing of skin to prevent the opening of wounds 

When to see a doctor

Pimples are a common skin condition that you can often treat with OTC medications. However, there is a limit to home remedies. If your pimples do not respond to these products, it may be time to visit your primary doctor or dermatologist. Dermatologists are doctors that specialize in treating skin conditions like acne. 

A doctor can design a treatment plan to help clear existing pimples while keeping new ones from forming. Early treatment is essential for clearing more severe pimples and preventing scarring. 

Regardless of the pimple type, it is important not to pick or pop it to avoid causing irritation and inflammation. 

Pimples can affect more than just your skin, and an increase in self-consciousness is understandable. If you feel that your pimples severely affect your self-esteem, please do not delay seeking help. 

The lowdown

Whether you’re dealing with the occasional pimple or a significant breakout, acne can have upsetting physical and psychological effects, making it an unpleasant experience. Not all pimples are the same and, depending on the type of breakouts you have, you may need to try different treatments before seeing results. Early treatment is paramount for reducing the risk of permanent scarring.

Knowing what type of pimples you’re dealing with can help you effectively treat them, and understanding what could trigger pimple formation may aid in preventing further breakouts.