Reasons of pimples on face: secrets revealed

Posted On December 5, 2020March 13, 2022

Introduction

What’s up guys! Welcome back to pharmacistopinions.com/. Today I will talk about a common skin problem that is pimples. Along with, I am going to reveal the secrets that are reasons of pimples on face.

But before that, I would like to share a short story about myself.

I was in adolescence at age 16. A lot of changes were happening in my body – my voice, my height, the appearance of underarm hair and my personality. Along with this, pimples started appearing on my face.

The pimples also caused pain, redness, inflamed and swelling. I used to feel anxious and frustrated. This made the face look ugly and bad physical appearance. Because of this, I used to feel embarrassed. I used to lose my self-confidence.

After some time, my face was full of pimples. It was really the biggest problem for me. I wanted to get rid of this problem. 

Friends! It was my story. I myself, have suffered from pimples in teenage. You would be suffer from same problem. So, I thought why not I write something on this topic. If you are also struggling from this pimples problem. This article is going to be informative and helpful.

So, let’s know about this skin disease and why it happens?

What are pimples? 

Pimples are small bumps or comedo. It is packed with bacteria, dead skin, sebum and white blood cells. Pimples are the symptom of a skin disease which is known as Acne (also known as Acne Vulgaris).

It is the 8^th most common skin disease as per the Global Burden of Disease Study 2010. It especially appears on face, neck, chest and shoulder.

Acne can develop in any stage of your life but it usually begins with adolescence (affect 90%) when you hit puberty. It has the highest prevalence in adolescents which affecting 9.4% globally.

According to AAD (American academy of dermatology) association, acne is a more common skin condition in the United States which affects 50 million Americans annually.

Although, pimple doesn’t give life-threatening risk to your health.  But it strongly impacts on your quality of life.

Mostly it automatically reduces as you grow up to the age of 30. But sometimes you need medical attention to get rid of this condition.

Why and how acne develop?

Friends! You must have seen some small hair shaft on your face or other body parts. It arises from your skin pores (opening of hair follicles).

The hair shaft is the part of the pilosebaceous unit. These units are distributed in your entire body except soles, palm, lower lip and top of the feet. It is the most abundant on the scalp and face.

Ok. Let me separate this term to understand clearly.

Pilosebaceous unit = Pilo (means hair) + sebaceous (means sebaceous gland)

It is a part of your skin structure which consist of hair, hair follicle, arrector pili muscle and the sebaceous gland.

Under normal circumstances, your skin produces some small amount of sebum from the sebaceous gland. It helps to keep your skin lubricate and moist. It makes your skin smooth, attractive and glossy appearance.

Pathophysiology –

But there are some factors which involve in the development of acne. These are four major factors which aggravate acne, it includes –

• Increase sebum production by hormonal influence
• Follicular hyperkeratosis (abnormal shedding of hair cell/dead skin cells)
• Bacterial infection by P. Acne (Propionibacterium acnes)
• Inflammation

Let’s understand in details –

1. Increase sebum production by hormonal influence

The initial factor to stimulate acne is to increase the activity of oil gland. The androgens (sex hormones) are the main hormones to control sebum production. These are testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA)

In the male, when you hit the puberty, your testosterone hormone converts into more potent DHT (Dihydrotestosterone) by 5- alpha-reductase enzyme. This DHT binds to specific receptors in the sebaceous gland which results produce an excess amount of sebum.

Similarly, in females – dehydroepiandrosterone (DHEA) are responsible for produces excess sebum by the sebaceous gland.

2. Follicular hyperkeratosis

The excess amount of sebum may lead to increase hyperproliferation (an abnormal rapid division of cells) of the topmost layer of skin.

The excess sebum and dead skin cells together blocked the opening of the hair follicle (skin pore). It develops into comedone. It may be open comedones (blackhead) and closed comedones (whitehead).

3. Bacterial infection

P. Acne (Propionibacterium acnes or Cutibacterium acnes) are the most common bacteria involve to cause of pimples on the face. It is a facultative anaerobic Gram-positive bacterium.

Normally, it is present on human skin. P. Acne also found in the entire gastrointestinal tract, conjunctiva and external ear canal.

But sometimes it may get out of control then trouble starts. It starts to multiply when sebum collects in clog skin pore.

This excess sebum is food for bacteria which destabilise the skin follicle and make the condition worsen.

4. Inflammation

When infection occurs in your acne. It triggers an alarm in your body to stimulate the defence system. Then your body releases white blood cells and antibodies to fight against infection.

As a result, this area becomes inflamed, redness, swelling and pus formed.

What are different stages of acne?

The different stages (grading) depends upon the severity of acne. 

Grade 1 acne

Initially, it is in comedones form then it converts into papules (a red bump).

This stage is non-inflammatory with comedones and a few papules.

Comedones are a combination of dead skin and sebum. It may be open comedones (blackhead) or closed comedones (whitehead).

In blackheads, it appears the black surface of the skin due to clogged hair follicle. Conversely, whiteheads are some small collection of pus in the opening of the hair follicle.

Papules are tiny red bump with no visible pus and its diameter less than 5mm.

Grade 2 acne

Comedones, papules and few Pustules

The accumulation of pus in papules then it becomes a pustule (yellow bump).

Grade 3 acne

Nodules along with whitehead

Nodules are a severe form, inflammatory and painful stage which appears look like a pus-filled bump. It is slightly larger (>1 cm diameter) than pustules and affects the deeper layer of skin.

Grade 4 acne

Cysts

It is the most serious stage of acne. It contains deeper lumps, redness and inflammation.

What food causes pimples?

Most of you believe that we should avoid pizza, burgers, and other oily foods because they may cause pimples.

Relax! There is not strong evidence which suggests that these foods cause new acne. But regular intake of these foods may worsen the condition of your existing acne.

According to AAD (American academy of dermatology) association, there are some high glycemic index foods which cause acne – Examples are potato chips, white bread, white rice, sugary soft drinks, dairy products, chocolate, sweets etc. These foods spike your blood sugar level quickly.

The high sugar level increases the activity of androgen hormones and makes more sebum which can lead to acne.

What medications cause acne?

You must have seen pimples in some athletes and bodybuilders as they use anabolic steroids (danazol, stanozolol and nandrolone) to improve performances. These hormones stimulate sebaceous gland to produce more sebum which causes acne.

Similarly, oral corticosteroids (like hydrocortisone) and oral contraceptives pills also cause acne by the same mechanism.

These steroids may also increase the growth of bacterial infection (P. Acne).

According to the study, too much Vitamin B12 can lead to acne. The vitamin B12 supplements affect the normal bacteria of your skin which lead to either generate new pimple or inflammation in your existing pimple.

You may be on risk if you are taking certain drugs – lithium and anticonvulsant agent.

Does cosmetics cause acne?

The oil-based cosmetics and facial massage are comedogenic products which can clog your skin pores and aggravate the condition of acne.

If you develop acne due to cosmetics, it is called acne cosmetica.

If you are having acne you make sure that you are using non-comedogenic products which is less likely to have acne.

Does acne run in the family?

This is another important risk factor which may cause acne. You may be on higher risk if both your parents had this acne problem.

Acne is more susceptible by the influence of multiple genes – TNF alpha (tumar necrosis factor), IL-1 alpha (Interleukin) and CYP1A1.

What is hormonal acne? How to identify it?

Hormonal acne is also the biggest reasons of pimples on face.

Acne is usually appearing in 12 to 25 years but sometimes it develops in your adult stage around 30 years or beyond 30 years of age. It is called “adult-onset acne” or “late-onset acne”. They are also known as Hormonal acne.

Sometimes your hormones abnormally work or fluctuate which may lead to developing acne in late stage. You may identify the reason of pimples on face if you are struggling from acne beyond 30 years –

• Poor response to conventional treatment (normal treatment)
• Quick reappear of acne after stopping the treatment
• Continue pimples for many years
• Mostly appear pimples near jawline lower face
• An underlying hormonal problem like PCOD (polycystic ovary disease)
• Most common in menopause condition
• During menstruation period
• Pregnancy

Conclusion 

Now we have understood the reasons of pimples on face. Pimples significantly worsen the teenager’s quality of life and affect them psychologically as well.

So, I have provided complete information on reasons of pimples on face. In my next blog, I will be explaining how to remove pimples from face. It is coming very soon.

I hope you would have found this post (reasons of pimples on face) to be informative. Share it in social media to spread awareness.

References –

1. Manal Saeed Alanazi et al. Prevalence and psychological impact of Acne vulgaris among female secondary school students in Arar city, Saudi Arabia, in 2018. Electron Physician. 2018 Aug; 10(8): 7224–7229. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122864/

2. AAD (American academy of dermatology) association

https://www.aad.org/public/diseases/acne/really-acne/overview

3. Amita H sutaria et al. Acne Vulgaris. Stat pearls, Aug 2020.

https://www.ncbi.nlm.nih.gov/books/NBK459173/

4. Jonette E. Keri. Acne Vulgaris. MSD manual professional version.

https://www.msdmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/acne-vulgaris

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