From the Guidelines
Papules are a common skin lesion that can be managed with topical treatments, such as benzoyl peroxide or retinoids, and require careful assessment to determine the underlying cause and appropriate treatment approach.
Definition and Causes
A papule is a small, raised, solid bump on the skin that is less than 1 centimeter in diameter, and can be various colors including red, pink, brown, or flesh-colored, typically not containing fluid 1. They can appear as part of many different skin conditions, including acne, eczema, psoriasis, dermatitis, warts, and certain infections.
Treatment and Management
Treatment depends on the underlying cause but may include topical medications like benzoyl peroxide or retinoids for acne-related papules, corticosteroids for inflammatory conditions, or antifungal medications for fungal infections 1. If you develop papules, it's essential to avoid scratching them as this can lead to infection or scarring. Keeping the affected area clean and moisturized can help manage symptoms.
Diagnosis and Pathology
Papules form when there is inflammation or abnormal growth in the skin's upper layers, often due to immune responses, clogged pores, or cellular changes 1. The exanthema presents follicular papules and pustules and usually initially develops in areas with a high density of sebaceous glands, mainly the face, potentially then progressing to chest and upper back.
Key Considerations
If papules persist, spread rapidly, or are accompanied by other symptoms like fever or pain, you should consult a healthcare provider for proper diagnosis and treatment. Managing the inflammatory response is the mainstay of therapy, and oral antibiotics for 6 weeks at the start of therapy with or without topical low/moderate strength steroid to face and chest b.i.d. may be recommended 1.
From the Research
Definition and Classification of Acne
- Acne vulgaris is an inflammatory disease of the pilosebaceous unit of the skin that primarily involves the face and trunk and affects approximately 9% of the population worldwide 2
- Acne vulgaris can be classified based on patient age, lesion morphology (comedonal, inflammatory, mixed, nodulocystic), distribution (location on face, trunk, or both), and severity (extent, presence or absence of scarring, postinflammatory erythema, or hyperpigmentation) 2
Types of Lesions
- A papule is a type of inflammatory lesion that can occur in acne vulgaris, although the provided studies do not specifically define or discuss papules in detail
- Other types of lesions that can occur in acne vulgaris include comedones, nodules, and cysts 2
Treatment Options
- Topical therapies such as retinoids (eg, tretinoin, adapalene), benzoyl peroxide, azelaic acid, and/or combinations of topical agents are first-line treatments for acne vulgaris 2
- Combination therapy with topical retinoids and benzoyl peroxide can be effective in improving acne lesions 3, 4
- Oral antibiotics such as doxycycline and minocycline, hormonal therapies such as combination oral contraception or spironolactone, or isotretinoin may be recommended for more severe disease 2, 3
Safety and Efficacy of Topical Treatments
- Topical retinoids are safe and efficacious for the treatment of acne vulgaris, with adapalene having a superior tolerability profile amongst topical retinoids 4
- Benzoyl peroxide may be more effective than placebo or no treatment for improving acne, but may have a higher risk of adverse events such as erythema, pruritus, and skin burning 5