Pimple

Common over-the-counter medications for pimples are benzoyl peroxide, salicylic acid, adapalene, and antibacterial agents such as triclosan. These topical medications, which can be found in many creams and gels used to treat acne (acne vulgaris), induce skin to slough off more easily, helping to remove bacteria faster. Before application, the face should be washed with warm water or a topical cleanser and then dried.

A regimen of keeping the affected skin area clean plus the regular application of these topical medications is usually enough to keep acne under control, if not at bay altogether. The most common product is a topical treatment of benzoyl peroxide, which has minimal risk apart from minor skin irritation that may present similar as a mild allergy.[6] Recently nicotinamide (vitamin B₃), applied topically, has been shown to be more effective in treatment of pimples than antibiotics such as clindamycin.[7] Nicotinamide is not an antibiotic and has no side effects typically associated with antibiotics. It has the added advantage of reducing skin hyperpigmentation which results in pimple scars.[8]

An emerging treatment for pimples is toothpaste, which contains anti-microbial agents that are associated with reducing pimples.[9]

Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include isotretinoin, which is a retinoid, anti-seborrheic medications, anti-androgen medications, hormonal treatments, alpha hydroxy acid, azelaic acid, and keratolytic soaps.[10] Historically, antibiotics such as tetracyclines and erythromycin were prescribed. While they were more effective than topical applications of benzoyl peroxide, the bacteria eventually grew resistant to the antibiotics and the treatments became less and less effective. Also, antibiotics had more side effects than topical applications, such as stomach cramps and severe discoloration of teeth. Common antibiotics prescribed as of 2001 by dermatologists included doxycycline and minocycline.[11] There is unclear evidence on whether oral isotretinoin is a more effective treatment compared to topical or oral antibiotics.[12] For more severe cases of acne dermatologists might recommend Accutane, also known as Sotret, Claravis, or Amnesteem, which is a retinoid that is the most potent of acne treatments. However, accutane can cause various side effects including vomiting, diarrhea, and birth defects if taken during pregnancy.

Evidence is unclear whether oral isotretinoin is superior in reducing severity of pimples and pimple inflammation, compared to oral antibiotics and topical treatment.[13]

Expression, the manual bursting of pimples which have evolved into whiteheads with one's fingers, can allow bacteria to be introduced into the open wound this creates. This can result in infection and permanent scarring. Thus expression is generally recommended against by dermatologists and estheticians in favour of allowing pimples to run through their natural lifespans.[14][15][16][17][18] Some dermatologists offer incision and drainage services to sterilely drain the pimple.[19]