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What are Papules?

J.S. Metzker Erdemir
J.S. Metzker Erdemir

Papules are a type of skin lesion. They are bumps on the surface of the skin that are usually 3/8 inch (1 cm) or smaller, and they can be red, brown, purple, or pink, depending on their causes. If papules are scratched or picked, they can burst open and become crusty, itchy, or infected. Papules are a symptom of common skin disorders like acne or rosacea, and they can also be a symptom of a disease like chickenpox.

In people with acne, lesions on the face, neck, chest, back, and upper arms are the result of clogged sebaceous follicles. These follicles, or pores, also produce oil and hair. In cases of acne, the pores become clogged with dead skin cells and bacteria. Acne bumps are usually quite small and concentrated in one area, often giving the skin a rough, sandpaper-like feel.

A boy with chickenpox papules.
A boy with chickenpox papules.

Papules associated with acne are not to be confused with acne pustules or cysts. Pustules contain pus and are often painful, while these bumps are generally painless unless scratched or picked open, and do not contain pus. Papules usually go away on their own without treatment whereas pustules can progress into more serious, deeper lesions called cysts, which often lead to scarring.

Papules are a symptom of skin disorders like acne.
Papules are a symptom of skin disorders like acne.

Rosacea sufferers also get bumps on the cheeks, nose, chin, neck, and scalp. Rosacea is often confused with adult acne, but they are quite different conditions. Rosacea sufferers rarely have severely infected lesions like acne sufferers, and rosacea is often characterized by serious reddening of the face when exposed to light, heat, or triggers like spicy foods or alcohol. Although adults may suffer from acne, it is more common in adolescents of all races while rosacea tends to affect adults of northwestern European descent.

Some birth control pills can be taken to treat acne.
Some birth control pills can be taken to treat acne.

Mild acne papules can be treated with over-the counter medications like alcohol, benzoyl peroxide, or salicylic acid. These treatments reduce excess oil in the skin and kill the bacteria that cause more serious lesions. Treatment for severe acne includes cortisone to reduce inflammation or anti-inflammatory antibiotics like tetracycline. Female acne sufferers might also use oral contraceptives to reduce acne outbreaks associated with hormonal changes brought on by menstruation.

People at risk of developing papules should use a facial wash formulated for sensitive skin.
People at risk of developing papules should use a facial wash formulated for sensitive skin.

While some rosacea is treated with cosmetics to reduce its appearance, prescription medications like tetracycline or topical azelaic acid can be used as well. Rosacea patients can also be asked to keep a diary of triggers that led to reddening or papules such as foods or sun exposure so they can reduce their symptoms by avoiding the triggers.

Discussion Comments

anon992697

I believe that what I have are papules on my face. I have three, one on the side of my nose, one on the forehead and one on the cheekbone area. I have had them for years. I have picked at them before. When I broke it, blood and oil kept oozing. I don't mean to sound gross or disgusting. But it did not heal, it just went back to the way it was after the 'abrasion' healed. I think that I should see a dermatologist about this to find out if these are papules and if they can be removed.

I did read somewhere that you should not pick at them (long after I did to the one on my forehead), because they could get worse. I can't remember the online site where I read this.

anon306962

If a rosacea papule doesn't have pus in it, what does it have? Just blood?

anon306960

Is there a view of a papule in side view, as if it had been cut in half?

wavy58

I had keratosis pilaris for years. This condition is also called “chicken skin” because it involves clusters of tiny white and red papules that resemble the look of raw chicken.

The backs of my upper arms were covered with these tiny papules. I used products containing glycolic acid to try and get rid of them, but it only helped a tiny bit. Rough exfoliants and scrubbing seemed to worsen the problem. Applying lotion temporarily reduced the rough appearance, but the papules remained.

When I started taking birth control pills, the papules began to diminish along with my facial pustules. It probably helps that I’m in my thirties, too, because I have read that these papules lessen with age.

Oceana

My uncle has suffered from rosacea for many years. It started out slow, with flare-ups only lasting a few days. As he aged, the redness, swelling, and burning began to linger for months at a time.

Due to his condition, he has papules across different areas of his face. These red bumps are as small as pinheads. His dermatologist told him that the papules formed as a result of vascular flushing.

Since his face remained flushed for long periods of time, inflammatory cells leaked from his blood vessels into his skin. These cells migrated toward his skin’s surface and showed themselves in the form of papules.

orangey03

As a teenager, I had both papules and acne. I often mistook the papules for pimples in the making, and sometimes I would get so frustrated with them that I would try to squeeze or pick them, even though they weren’t showing signs of having pus.

Squeezing the papules really hurt. I would take a Q-tip, cut it in half, and apply pressure to both sides of a papule. Within seconds, I would figure out that it wasn’t a pimple. It would swell and nothing would come out. The pain could be compared to punching yourself in a bruised area.

Eventually I figured out how to be patient and wait for pus to appear before squeezing a facial flaw. I figured out that for papules, hydrocortisone cream works wonders by reducing the redness and swelling.

StarJo

I suffered from frequent papules on my jawline and chin around the age of 26 and 27. They were so prevalent that I saved up money to visit a dermatologist for treatment.

I had several visits spanning over 6 months. At each visit, he applied a chemical exfoliant. After my initial consultation, he put me on an antibiotic called doxycycline. He gave me Differin gel to apply topically, but I think that the doxycycline worked the best out of all the methods he used on me.

The reason I think this is because he made me stop taking it after a few months, and the papules flared up some more. He just told me to keep applying the gel for two more years and I should be fine. Eventually, the papules went away entirely, and I discontinued the gel.

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    • A boy with chickenpox papules.
      By: Dan Race
      A boy with chickenpox papules.
    • Papules are a symptom of skin disorders like acne.
      By: soupstock
      Papules are a symptom of skin disorders like acne.
    • Some birth control pills can be taken to treat acne.
      By: Kimberly Reinick
      Some birth control pills can be taken to treat acne.
    • People at risk of developing papules should use a facial wash formulated for sensitive skin.
      By: ipag
      People at risk of developing papules should use a facial wash formulated for sensitive skin.
    • Papules may become itchy and infected if scratched.
      By: Piotr Marcinski
      Papules may become itchy and infected if scratched.