Papules: How to treat them?

The papules are full and dry spots that form as a result of the obstruction and inflammation of hair follicles. Three factors are mainly involved: an overproduction of sebum by the sebaceous glands, an abnormal proliferation of keratinocytes, leading to an accumulation of dead cells on the skin's surface, and the multiplication of bacteria Cutibacterium acnes, which feed on sebum and release free fatty acids responsible for inflammation. To combat papules, it is recommended to opt for products containing several active ingredients capable of acting on these different elements. Here are a few that have been well documented in the scientific literature:

• Succinic Acid.

  Antibacterial, sebum-regulating, and anti-inflammatory, succinic acid is a good ally for skin prone to papule-type imperfections. This molecule can indeed disrupt the membrane of bacteria and cause cellular lysis, thereby reducing bacterial populations. Concurrently, succinic acid keeps sebum production under control by decreasing the activity of the sebaceous glands. Finally, this acid inhibits the release of certain pro-inflammatory cytokines and chemokines, thus helping to reduce the redness associated with papules.

  The efficacy of succinic acid on papules has been highlighted in several studies, one of which was very recently conducted by DE LUCAS and his team. Over eight weeks, 43 individuals with inflammatory and non-inflammatory spots used a lotion containing succinic acid, niacinamide, and a phyto-complex. After 56 days, a significant decrease in the abundance of C. acnes was observed, along with a 49.66% reduction in papules in individuals. The combination of this active ingredient and niacinamide therefore appears to be promising for eliminating papules.

• Salicylic Acid.

  Renowned for its comedolytic effects, salicylic acid is a well-known active ingredient for those prone to blemishes. Being liposoluble, it is indeed capable of penetrating deep into the pores and unclogging them, thus promoting the disappearance of spots. Moreover, salicylic acid possesses interesting antibacterial properties for purifying the skin. Its effectiveness against papules and other types of spots has been demonstrated in numerous studies.

  A study has specifically examined the effects of a 30% salicylic acid peel on 35 individuals with inflammatory and non-inflammatory lesions. This solution was applied twice a week for twelve weeks. At the end of the study, a mean reduction of 56% in papules was measured in the volunteers, attesting to the effectiveness of salicylic acid on this skin issue.

• Bakuchiol.

  Often considered a gentle alternative to retinol, bakuchiol is also an effective active ingredient for blemishes. It works via several mechanisms, allowing it to target the various factors responsible for spots. Bakuchiol notably limits the synthesis of sebum by acting on the enzyme 5α-reductase, which catalyses the conversion of testosterone into dihydroxytestosterone (DHT), a hormone that activates the sebaceous glands. Furthermore, bakuchiol reduces bacterial proliferation and the activity of cyclooxygenase-2, an enzyme involved in the release of inflammation mediators.

  The effect of bakuchiol on pustules was notably demonstrated in a 2011 study involving 13 individuals suffering from acne. After a daily application for six weeks of a 1% bakuchiol solution, a mean reduction of 57% in acne lesions was recorded, including a significant decrease in papules. The scientists concluded that bakuchiol was a good ally in the case of skin imperfections.

• The essential oil of tea tree.

  Finally, the use of tea tree essential oil can be beneficial in reducing papules. This ingredient has indeed demonstrated excellent bactericidal and bacteriostatic properties, which means that its mechanism of action is twofold: it can both kill bacteria and inhibit bacterial growth. Tea tree essential oil also has anti-inflammatory effects that are useful in the case of papules. However, it is important to note that, like most essential oils, it should not be applied directly to the skin in its pure form and must first be diluted in a carrier oil. Preferably choose a light oil, such as hazelnut oil or jojoba oil.

  A clinical trial involving 58 individuals has highlighted the benefits of using a 5% tea tree essential oil solution to reduce spots. After daily application for three months, the patients were able to observe a 49% reduction in inflammatory lesions, including a significant decrease in the number and severity of papules. Therefore, tea tree essential oil is a good alternative for treating papules.

Unlike open and closed comedones, papules indicate an inflammatory context. If, after six to eight weeks of applying anti-blemish treatments, they persist, transform into pustules or multiply, it is strongly recommended to consult a dermatologist.

Indeed, papules are likely to leave pink or brown spots where blemishes were previously located. The colour of these marks primarily depends on the phototype: individuals with darker skin are more prone to post-inflammatory hyperpigmentation, and thus to brown marks, while those with lighter skin are more affected by post-inflammatory erythema, or pink spots. Although these marks are not considered scars and fade gradually, they can take several months to disappear, hence the importance of preventing them by addressing the papules as early as possible.

There are several options for dermatological treatments in the case of papules, such as oral antibiotics, benzoyl peroxide, retinoids, laser... Your dermatologist will guide you towards the treatment most suited to your situation.

• BARNETSON R. & al. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. The Medical journal of Australia (1990).

• KIM I. H. & al. Salicylic acid peels for the treatment of acne vulgaris in Asian patients. Dermatologic surgery (2003).

• MARCHIO F. & al. Bakuchiol in the management of acne-affected Skin. Cosmetics & Toiletries (2011).

• TANGHETTI E. & al. The Role of Inflammation in the Pathology of Acne. Journal of Clinical and Aesthetic Dermatology (2013).

• MANGI R. & al. A Brief Review on Acne Vulgaris: Pathogenesis, Diagnosis and Treatment. Research and Reviews: Journal of Pharmacology (2014).

• DE LUCAS R. & al. A new topical biotechnological phytocomplex for truncal mild-moderate acne restores skin microbiota balance. Skin Research and Technology (2024).