Name Those Zits: Everything about Papules, Pustules, White-heads, Blackheads and Cysts. Of course, not all zits are created equal. In fact, they differ widely in terms of size, appearance, and severity.

Some appear as large, nearly bruise-sized welts; others show up as the tiniest of red bumps. Some are extremely tender and painful to the touch; others cause little or no physical discomfort.


Some can be treated with special cleansers and common topical ointments available in any drugstore; others may require stronger prescribed medications or surgical removal by a dermatologist. But all zits, as we have seen, stem from blockage of the skin’s oil ducts.

Two principal factors determine what type of zit results from a specific blockage; where the blockage occurs within the duct, and whether the opening of the affected pore is open or closed. A blockage that occurs at or very near the surface of the skin typically produces one of four types:


Papules, which are small, inflamed (red) zits lacking the familiar "head" that characterizes whiteheads and pustules.


Pustules, also lovingly referred to as pus-heads, which are larger red bumps capped by a festive crown of whitish pus protruding from the opening of the pore.


Whiteheads, which resemble pustules in some respects, except that the pus-head is completely enclosed under the opening of the pore and the surrounding skin is not inflamed.


Blackheads, which display a dark, some would say (dirty looking) head and no inflammation of the surrounding skin.

Types Of Zits

Much of the difference between pustules, whiteheads, and blackheads can be attributed to the size of the opening of the affected oil pore: If the opening has contracted to the extent that fluid cannot easily escape, the result is a pustule or whitehead. In pustules, the pore, though constricted, remains open; in whiteheads, it is closed.

If the pore's opening is somewhat larger, a blackhead typically results. With blackheads, you won’t see the surrounding redness of a papule or pustule, nor much of a bump, if any at all, because the problem area is almost entirely confined to the pore itself. Also, it's worth noting that blackheads don't derive their dark coloring from dirt or grime on the surface of your skin, but from pigment that has latched on to the oily fluid during its journey from the sebaceous gland to the oil pore.

When they Zits form as a result of deep, subsurface blockages often create cysts. In this type of zit, sebum accumulates far enough below the skin's surface that the fluid has no opportunity to drain, which eventually causes the swollen oil gland to rupture. In time, a sac forms around the site of the rupture and becomes filled with a gummy, off-white substance composed of dead skin cells and the contents of the damaged gland.

The deeply embedded bumps that ensue are usually larger, more tender, and more difficult to treat than any of the other kinds of zits we've discussed thus far. The sac containing the cyst, in particular, can prove especially resistant to treatment. It tends to cling tightly to neighboring tissue, and will often reappear even after a cyst has been lanced or surgically removed. If even a minuscule portion of the sac remains after treatment, the potential exists for the formation of a new cyst at the site of the old one.

Last, some cysts will ooze a clear, almost watery fluid to the skin's surface and present a red, inflamed appearance; others will be dry to the touch and possess the surface coloring of normal skin. Cysts can appear alone or as part of acne. It is not at all uncommon for an individual to get the odd cyst every now and again.

In some instances, an individual cyst will heal on its own; in others, a dermatologist's care will be required to treat or remove it. But when cysts appear in bunches, this indicates a very severe form of acne (called cystic acne) that necessitates professional attention.

While there are many things you can do at home to cope with minor outbreaks of small papules, pustules, whiteheads, or blackheads, trying to handle cystic acne without qualified help can easily lead to permanent scarring and rapid worsening of the condition. Don't make that mistake! See your dermatologist right away if your acne bumps seem deeply embedded, overly large, or especially painful.

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Author: Tanna Mayer
Updated: February 27, 2015

Photo Credits: Copyright
Beauty And The Bath