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Why are some pimples red?

The redness of pimples is directly related to the inflammatory response they trigger. What are the red pimples that can appear?

Summary
Published August 18, 2022, updated on February 21, 2024, by Maylis, Chemical Engineer — 5 min read
Redness

Red pimples are most often associated with inflammatory acne.

Inflammatory acne is due to overproduction of sebum correlated with the proliferation of Cutibacterium acnes. Cutibacterium acnes is a commensal bacterium of the skin microbiota. It contributes to maintaining the skin's good balance. However, under certain conditions, Cutibacterium acnes proliferates abnormally and becomes pathogenic. In defense, the skin cells secrete inflammatory mediators. This triggers an inflammatory response on the skin's surface. Furthermore, Cutibacterium acnes is also responsible for hyperkeratinization of the skin (thickening of the skin) which promotes the appearance of imperfections.

If the inflammation is superficial, papules (red bumps) can be observed, which may transform into pustules (pus-filled pimples). In the case of deep inflammation, very painful nodules appear and can progress into abscesses or cysts.

  • The papules are inflammatory skin features characterized by a solid consistency swelling, that is to say containing neither liquid nor pus, of small size (ranging from 1 to 4 mm) and of a color pink to red.

  • The pustules are small inflammatory lesions of the skin characterized by a well-defined and circumscribed elevation of the epidermis (diameter less than 5 mm) and topped in their center by a purulent liquid of white color or yellow.

Apart from acne, when can we see the appearance of red bumps?

Several scenarios can lead to the occurrence of red spots.

  • Insect bites

    With the heat of summer, insects become numerous.Most of these bite or sting to defend themselves or their territory, which then results in one or more red bumps. Generally, this situation occurs when we get too close to them and/or make sudden movements. They then perceive a threat and defend themselves by stinging.

    Furthermore, certain insects such as mosquitoes and ticks bite in order to feed. For instance, in mosquitoes, only the females bite to sustain themselves on human blood for reproduction purposes.

    Some bites are completely painless (such as those from mosquitoes) while others can be painful. Generally, an allergic reaction to the venom deposited by the insect's labium (the insect's mouth) or its stinger occurs subsequently.

    The vast majority of stings are benign and the discomfort they cause is minor.

  • Ingrown Hairs

    A hair is said to be ingrown when it fails to penetrate the barrier of the dermis and exit the orifice of the hair canal. Thegrowth of the hair thus occurs inside the skin and not on the outside. This leads to the appearance of small red bumps that are inflamed and can itch, and even be painful. In cases where these bumps have become infected, most often due to their manipulation, they can swell and fill with pus. The origin of ingrown hairs can be varied: type of hair removal, type of hair, repeated rubbing of the skin with tight clothing, etc...

  • Some diseases such as chickenpox

    Chickenpox is a very common infectious disease caused by a virus called varicella-zoster (VZV), which belongs to the herpesvirus group. This disease is responsible for the emergence of spots associated with itching and extra-cutaneous symptoms (fever).

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