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Pustules: Causes, Symptoms, Diagnosis & Treatment

What Are Pustules? Pus-filled, Red bump

A pustule is a type of acne that is characterized by a protruding patch of skin that’s filled with a yellowish fluid called pus. It’s basically takes shape of a bigger and brighter of a pimple.

Where can Pustule occur? Face and Body Parts

Pustules occurs when our body’s white blood cells are fighting off some sort of infection and it can appear anywhere, but they are quite common on areas of the body that are oily, or areas that get sweat easily, such as the as the;-

People may commonly notice pustules around the following body parts such as:-

  • Face and Neck
  • Chest and Back
  • Armpits and Underarms
  • Hairline and Temples
  • Shoulders
  • Pubic area

What causes pustules to form?

Pustules are bigger than typical pimples. The most common cause in circulation of pustules remains to be Acne. Acne usually forms when the skin pores gets choked with oil and dead skin cells. This choking of pores further induces patches of skin to puff up, irritating the pores of the skin to a level that its walls break off, and thus resulting in a pustule.

A Pustule induced by acne can become severely stony with a sharp stingy pain. When these sensations happen, the pustule becomes a cyst. This condition is called as cystic acne.

Still, there are several other conditions that are bothersome and can produce a pustule. As a result of an infection or an allergic reaction of the pore cavity, the skin becomes inflamed and thus the Pustules materialize on parts of face & body. The infection can be a cause of reaction to food, poisonous insect bites, bug bites or environmental allergens.

Several conditions that can lead to Pustule: unthinkable of

  • Psoriasis: This is a skin problem that causes scaly, itchy, pinkish patches on the skin. An allergic reaction, stress, certain chemicals, and some OTC drugs can all trigger an assault of pustular psoriasis.
  • Rosacea: This is a skin condition that usually makes the skin on face red and causes pimples. But a form of the disorder called inflammatory rosacea can trigger an assault of irritant pustules.
  • Chickenpox: This infancy or pre-teens ailments and other diseases caused by a connected virus create skin lesions that become pustules as the disease progresses.
  • Smallpox: Pustules were one of the most evident indications of this lethal disease that assassinated thousands of people over past several years. Thanks to a vaccine, it isn’t a deadly health hazard anymore, but specimen of the virus is secured in laboratories in Russia and USA.
  • IgA pemphigus: this rare autoimmune disorder characterized by hurtful and pruritic vesiculopustular outbreak (blisters) is also a contributing cause of Pustules. These eruptions develop as an outcome of promulgating IgA antibodies against keratinocyte cell surface components responsible for cell to cell compliance that makes the immune system activated itself.
  • Hormonal Imbalances: Pustules may be one of those acne types that are particularly caused by hormonal alterations or hormonal disorders in the body. This is quite a common skin condition notice typically among teenagers and young adults.


How to Spot a Pustule? Do not confuse a whitehead or Inflamed Zit with a Pustule

Maybe you have a whitehead that isn’t red, inflamed or sore but is more like a little, hard white bump; it’s probably not a pustule at all. The skin condition can actually called milia, which develop differently than pustules.

A good section of the white bump in a pustule is composed of pus, while the whiteheads of milia are not pus-filled but trapped in sebum (or oil). Moreover the treatment of a Pustule is different from Milia.

Thus, make sure to choose a skin specialist having virtuoso in treating skin disorders with righteous treatment options. Dr. Rohit Batra of DermaWorld, Delhi, is an acclaimed dermatologist to have favorably treated patients with rare to common skin and hair deformities.

Pustule vs. other types Acne & Pimple

  • Pustules are larger than blackheads and Whiteheads.
  • Though Pustule and Papules are similar, but the former is typically white than the latter and, unlike papules, pustule contain pus.
  • Pustule is much tender to the touch as compare to other acne or pimple.
  • Pustules are smaller than Nodules and cysts and may not need immediate medical attention as with the latter.


Types of Pustule— Classification based on Characterization & Causes

  • Acropustulosis: A rare kind of Pustular psoriasis characterized by skin lesions on the ends of the fingers and atypically on the toes. The outbreak usually initiates after an infection or injury to the skin. The lesions can be disabling and inflicting, and cause maalformation of the nails. Bone weakness occasionally occurs in severe cases.
  • Palmoplantar pustulosis (PPP): Characterized by red plaques of skin in a studded patter, PPP usually occurs on the soles of the feet, sides of the heels or palms of the hand, base of the thumb. The red skin later turns brown, stripped and stained.
  • Von Zumbusch: Characterized by widespread areas of blemished, red skin, this form of Pustule appears erratically on the skin which become severely tender and hurtful. This Pustule type can be life-threatening and is typically more prevalent in adults than children, but when it does occurs it is often the first psoriasis flare and may have a better treatment results in adults. It requires immediate medical attention and treatment starts with systemic and OTC treatment, that includes antibiotics. Symptoms associated with Von Zumbusch includes severe dehydration, chills, itching, anemia, and muscle weakness.


When do Pustules need medical care?

Pustules that outbreak without a warning all over your face or in patches on different parts of your body may be a sign of bacterial infection. Contact your doctor if you have an abrupt eruption of pustules.

Other conditions that require immediate doctor’s consultancy are if:

  • A Breakout accompanied with leaking, painful fluid. These may be an indication of a serious skin condition surfaced due to infection
  • Clammy skin or warm skin in the area of breakout
  • Frequently occurring Fever, nausea or diarrhea after getting a breakout
  • large pustules or Severe pain in the area of the skin containing the pustules


Treatment of Pustule

Acne pustule can be effectively treated with oral and OTC medication, or surgery in extreme cases, if they become troublesome.

It is common for health providers/dermatologist to combine or spin therapies for an effective Pustule treatment mainly due to potential side effects of systemic drugs and phototherapy. An apt Standalone or a combination treatment can send inflammatory pustule into rapid remission and ultimately clear off the skin. Treatments for specific types of Pustule include:


Effective Treatment for Small to Large/Moderate to Severe Pustule

It is likely that small pustules may disappear without treatment. If still prevails a small pustule in your skin it’s helpful to:

  • Use (OTC) acne medications, creams and cleansers

OTC Products— Small Pustule

  • OTC products effectively treat pustules by drying out the top layer of the skin and absorbing excess oil from deep within the surfaces.
  • Specially made OTC medications for your skin type consisting certain antioxidants and salicylic acid so your skin condition gets better.
  • Topical products containing sulfur, salicylic acid, and peroxide are best to treat pustule on face and parts of body except the genital area as it can be dangerous to use down there
  • Prescription topical gels and lotions containing tretinoin (a retinoid drug produced from vitamin A)
  • Stronger version of benzoyl peroxide when your acne is moderate to severe.

Oral medications— Moderate to Severe Pustule

Oral medications (medicine taken by mouth and absorbed through gastrointestinal tract) for Pustule also known as systemic therapy as they are absorbed throughout the whole body.

Only made available with a doctor’s prescription, these medications are used to treat moderate to severe acne that doesn’t respond desirably to topical agents. Given below are the common three types of systemic drugs used to treat inflammatory pustule:


A power drug from the retinoid family significantly helps in regulating skin cell turnover and decreasing the size of oil glands so that they make minimal oil. The strong drug is mainly is reserved for those with severe cystic acne. Isotretinoin is mostly prescribed when other acne medications haven’t worked.


Antibiotic called clindamycin to annihilate bacteria when acne is mild to moderate. Your specialist may also prescribe a daily bacterial fighting antibiotic pill, such as tetracycline to help annihilate bacteria and eliminate infection from the inside out.

Antibiotics are usually prescribed with topical medication when topical creams alone fail to improve the skin’s condition.

Birth control pills

Using birth control pills can help regulating hormone levels that further leads to improvement in acne amongst women. However, one must refrain from using birth control pills during pregnancy to banish breakouts.

Non-surgical Medical Procedures – Severe Cystic Acne

Not recommended as frequently as oral and topical medication, a few non-surgical medical procedures are quite efficient and convenient to get rid of severe Pustule and for the patches that are left behind on the skin after the treatment.

These procedures can all essentially be conducted in the specialist’s office. Before you schedule any of the given medical procedure, know that Health insurance plans don’t cover them.

  • Laser therapy: Light-energy assisted Laser therapy typically helps in improving acne induced Pustule. Laser light helps decreasing the amount of bacteria on your skin that causes acne caused painful Pustule.
  • Microdermabrasion and Chemical Peels: Microdermabrasion and Chemical peels are quite effectual in casting off the top layer of your skin that’s clogged with pore cavity. In the process, zits, blackheads and whiteheads are also withdrawn.
  • Drainage and extraction: During the procedure of drainage and extraction, your specialist draws off huge cysts formed under your skin. The doctor manually ejects out pus, secretions, dirt, debris and dead skin inside the cyst to decrease infection, inflammation and infliction. In order to prompt healing and reduce the risk of scarring, your specialist may inject steroid or antibiotics into the cyst.

Effective Treatment for Localized pustular psoriasis

One of the obstinate types of Pustule to treat can be controlled with Topical treatments at first. If OTC fails to respond, your specialist may prescribe PUVA (light-sensitizing medication psoralen plus ultraviolet light A), (UVB), cyclosporine or methotrexate.

Effective Treatment for Generalized pustular psoriasis

Most prescribed treatment for generalized pustular psoriasis type Pustule includes oral PUVA and antibiotics such as Acitretin, methotrexate, and TNF-alpha inhibitors, such as infliximab.

The motive of the therapy is to intercept infection and fluid loss, while balancing the skin’s chemical composition and stabilizing body’s temperature.

Effective Treatment for Acropustulosis pustular psoriasis

Conventionally, this form of pustular psoriasis has been one of the difficult to treat. Some people might have favorable outcome using systemic drugs to clear lesions.

Effective Treatment for Von Zumbusch pustular psoriasis

Most prescribed treatment for this form of Pustule consists of PUVA and antibiotics including acitretin, or methotrexate.

Specialist may prescribe oral steroids for people who have become severely diseased or do not respond favorably to other treatments, though their use is disputed since sudden discontinuation of steroids can incite von Zumbusch pustular psoriasis.


Prevention Of Pustule— Put a Stop on Pimple becoming Pustule

People can essentially prevent pustules by gently washing the areas of skin that are disposed to developing pimples by keeping them oil free. Cleaning routine must take place at least twice a day using a mild soap. Other preventive measures include;-

  • Avoid sunscreens, skin care and cosmetic products that contain oils. The oil-based can block skin pores and push pustules to form.
  • Strictly avoid greasy products such a petroleum jelly or creams, in the areas affected by pustules. These products can further stir up more pustules to produce.
  • Wash off the affected skin with a mild facial cleanser and lukewarm water twice per day to eliminate any excess oil, which is a chief contributor of acne.
  • Using fingertips instead of a washcloth to cleanse the face that will prevent irritating the skin.
  • Avoid using any products that contain ingredient you are allergic to, that even includes sulfur
  • Do not ever pop, pinch or prick a Pustule. Doing so cause worsen your skin



Pustules are plaguing, annoying but otherwise harmless, and they generally clear off on their own. The preventive measures mentioned above can greatly help People to avert them or minimize their severity by keeping pustule-prone parts washed and oil free.

However, if your pustules are chronic or are getting worse, do not deal with them on your own. Speak to a skilled skin specialist about the most effective treatment options.

You can also visit senior skin specialist at Derma World, West Delhi for diagnosis and additional treatment options.