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Pustule: Causes, Symptoms, Diagnosis, Treatment and Prevention

Pustules indicate a viral, bacterial or fungal skin infection. A pustule is a small patch of bulging skin, filled with pus, which appears as white bumps encircled by red skin. Typically, they are seen on the back, face, shoulders, armpit, and groin. Small pustules get cured on their own, whereas pustules which remain for prolonged periods or which are large, require medical intervention immediately.

PustulesWhat is a Pustule?

Pustules are small, inflamed pus-filled sores on the skin surface. They are larger than normal pimples and look like blisters. It is a very common skin condition, particularly among teenagers and young adults. You can treat pustules with medication, or surgery in extreme cases if they become bothersome.

Our body produces white blood cells as a defensive response to fight infections such as folliculitis (inflammation of the hair follicle), which results in the formation of pus. This pus builds up in the skin pores and forms pustules.

What are the Causes of Pustules?

Acne or pimples are the primary cause of pustules. Clogging of the skin pores by the sebum (oil) and dead skin cells result in the formation of acne. At times, these pores get irritated and break the walls resulting in the formation of swollen, red sores called papules. The inflammatory changes, such as redness and swelling, trigger an immune response in the body of the affected person and produce white blood cells and pus, which accumulate to form pustules.

Other causes of pustules are listed here:

  • Psoriasis: It is an autoimmune skin condition which results in the formation of scaly, red patches on the skin. Any infection, stress and the use of certain medications such as ibuprofen, calcipotriol, and prednisone may trigger an autoimmune response and result in pustular psoriasis.
  • Rosacea: It is a common skin condition which causes redness and pimples on the face. Inflammatory rosacea, a specific form of the skin condition, can also produce pustules.
  • Chickenpox: It is a viral infection that causes itchy rashes and blisters on the skin. As the disease progresses, these skin lesions may become pustules.
  • Smallpox: It is a severe viral infection which may result in the formation of pus-filled blisters on the skin.

Signs and Symptoms:

Pustules appear as small, red or white bumps on the skin. If they appear suddenly on face, shoulders or back, it may be due to bacterial or viral skin infection. Seek immediate medical attention if you have these associated symptoms:

  • Fever
  • Pain in the region having pustules
  • Warmness in the affected area
  • Sweaty skin
  • Nausea or vomiting
  • Diarrhea

Diagnosis of Pustules:

Pustules are usually diagnosed by clinical examination.

Clinical evaluation:

The dermatologist physically examines for the severity of the pustules, extent of redness and pus discharge from the cells. A detailed history from the patients about the severity of the symptoms, pain and associated symptoms such as fever, vomiting or diarrhoea, is noted. The doctor may recommend some laboratory investigations such as:

  • Blood test: A sample of blood is collected to check if there is some increase in the total blood count or the number of white blood cells.
  • Erythrocyte sedimentation rate (ESR): During this test, a blood sample is collected to check for the clogging of the red blood cells. The rate of clogging (sedimentation) of blood cells is usually higher in the patients suffering from infections or inflammatory conditions.
  • Serum chemistry test: A blood sample is collected to determine the levels of certain chemicals. They help to analyse the functioning of some organs in the body and to look for any abnormalities. It also helps to check the levels of specific proteins in the blood such as albumins, plasma globulins and vitamins like calcium and zinc.
  • Skin culture: A sample of pus or fluid from the pustular lesion is extracted to check for germs such as bacteria or fungus that causes infection. This sample is added to a medium that enhances the growth of germs. The skin culture helps to determine the type of organism causing the infection.
  • Skin biopsy: The doctor extracts a small amount of tissue from the affected skin surface by a small incision and examines it under the microscope. Any abnormal growth of tissues can be easily identified.

Treatment of Pustules:

The aim of pustules treatment is getting rid of the existing blisters and preventing the occurrence of new ones. Small pustules usually go away in three or four days without any specific treatment. But, large pustules require medical treatment by topical or oral antibiotics.

Some of the methods of treatment are listed here:

  • Over-the-counter medications such as calamine lotion or benzoyl peroxide gel
  • Ointments containing salicylic acid or sulphur regularly as recommended by the dermatologist
  • Oral antibiotics like amoxicillin and doxycycline

In patients affected with a severe form of pustules, the following method of treatment is helpful:

Photodynamic therapy (PDT):

PDT, also called blue light therapy, involves using a combination of a photosensitive drug (the type of medicine that gets activated by the light exposure) and light (to activate the given drug) to treat acne or pustules and different types of skin cancers.

PDT procedure:

The primary purpose of PDT is to destroy acne by targeting a specific tissue. The treatment with PDT is as follows:

  • A light-sensitizing drug is adminitered intravenously or in the form of a liquid or cream.
  • The patient is asked to wait for a specific period of time (waiting time or incubation period) for the drug to get activated.
  • The affected part of the skin is irradiated with a specific intensity of light which activates the photosensitive medication.

Do’s and Don’ts for Pustules:

The following measures help to prevent the development of pustules:

  • Clean the face at least two times a day with mild soap or face wash.
  • Avoid squeezing or popping the pimples with hands or by using some needles or pins.
  • Use gentle scrubs or masks as peeling agents to remove the dead skin cells regularly.
  • Use pore strips to pull out oil from the pores.

Pustules are one of the common reasons for the people to visit dermatologists. In this modern era, people are more prone to pustules due to unhealthy habits like eating junk food and exposure to environmental pollution. Pustules can be prevented by limiting skin exposure to dust or allergens and following a healthy diet.

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1.
Different kinds of pimples. American academy of Dermatology. https://www.aad.org/public/kids/skin/acne-pimples-zits/different-kinds-of-pimples. Accessed December 1, 2018.
2.
Pustular Psoriasis. E medicine health. https://www.emedicinehealth.com/pustular_psoriasis/article_em.htm#what_are_pustular_psoriasis_treatment_options. Accessed December 1, 2018.

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