What Are Those Bumps on My Face?

Although Instagram and Photoshop can have us think otherwise, skin texture, pores, and other “blemishes” are natural and totally normal. Our skin is not plastic, and we often experience bumps, redness, blackheads, ect. These blemishes don’t necessarily mean anything is seriously wrong with your face, and we are here to decode what these small bumps mean about your microbiome & skin health. 

Bumps on our face tend to occur in the ever-problematic “T Zone”. The T-Zone consists of your forehead, nose, and chin area. This area is home to thousands of sebaceous glands, which produce sebum and oil that hydrates & protects your skin. 

However, this area is prone to overproduction, too much oil or sebum can cause a myriad of skin blemishes including acne, blackheads, zits & conditions you might not have heard about - but have experienced. 

Blackheads & Whiteheads 

At some point in your life, you’ve probably experienced a variation of a blackhead or a whitehead. Although these are different in appearance, they are both caused by sebum, or oil, clogging your pores. 

Blackheads

• Blackheads are considered to be “open comedones'', which are clogged follicles with openings exposing its contents to the air.
• Blackheads are considered a non-inflammatory skin lesion

Whiteheads

• Whiteheads are considered “closed comedones” which are clogged follicles without an opening.  

Whiteheads and Blackheads are similar in formation, but different in how they appear on the face. Forming of blackheads and whiteheads are caused when the size of the sebaceous gland and sebum secretion activity increases. Basically, when your skin produces too much oil and it gets caught within the follicle. When skin cells are covering the follicles, a whitehead will form. When exposed to the outside environment, it is a blackhead. Blackheads and whiteheads are caused but lipophilic, or lipid-loving bacterial species, such as Cutibacterium acnes and Malassezia. These two species are commensals in healthy skin, but it is still currently unknown what mechanisms trigger them to transition to the disease state and become bad bacteria that causes these skin complications.

Milia 

Milia are tiny white bumps that can appear on your face, they often look like whiteheads but are usually much smaller and more dense, so removing them on your own is not recommended. Milia occur when keratin becomes trapped beneath the surface of the skin. Keratin is a strong protein that’s typically found in skin tissues, hair, and nail cells. Primary milia are formed directly from entrapped keratin. These cysts are usually found on the faces of infants or adults. Secondary milia look similar, but they develop after something clogs the ducts leading to the skin’s surface, like after an injury, burn, or blistering. 

Papules and Pustules

Papules, pustules, nodules, and cysts are all considered inflammatory skin lesions. They are the two most common types of inflammatory acne, or pimples. These red and inflamed bumps are filled with a clear or yellowish liquid pus. Papules and Pustules are common for teenagers because they are associated with fluctuating hormone levels, which can alter sebum production in the skin. This change can lead to pimples & acne, which we all encountered during those lovely teenage years. 

Papules:

• Papules are raised skin lesions that are smaller than 1 cm in diameter, while pustules are similar to papules but are inflamed and filled with pus

• Papules originate in the epidermis - the outermost layer of the skin.

• When acne-causing bacteria spreads from inside the follicle to the surrounding skin, irritation and swelling occurs. 

• Occasional papules are considered to be mild acne, whereas frequent clusters of papules may be classified as moderate or severe acne.

Pustules:

Pustules are essentially papules that have formed a white or yellowish point at the center. Basically, a papule that has come to a head. So, why does this happen? Our bodies and our skin are expert at immune response - like a 911 call on your skin. When your skin senses an influx of bacteria, like P. acnes, white blood cells rush to fight off the “infection”. When the white immune cells die they turn into a pus and protrude from the pore. 

 Fungal Acne

What is Pityrosporum Folliculitis?

Pityrosporum folliculitis is caused by fungi, while acne is caused by bacteria, this is the main difference between acne and fungal acne. Pityrosporum folliculitis, or fungal acne, is a skin infection in the hair follicles and is caused by the overgrowth of Malassezia yeast present as a member of the normal skin microflora during dysbiosis, which is a state of disruption in the skin microbiome.  Disruption of the skin microbiome may be the result of a weakened immune system and antibiotic use. So be sure to keep special attention to your skin during moments of high stress, when our immune system tends to be weakened.  Malassezia species thrives on oily lipids produced by sebum, which is more common in adolescents likely due to increased sebaceous gland activity. Fungal acne is common in individuals to live in hot and humid climates. In the summer months you may notice small bumps occur on your forehead and T zone area, this could be caused by fungal acne. 

We are always preaching the effectiveness and validity of a less is more skincare routine, centered around the health of your microbiome. If you have been experiencing any of the above conditions, we highly recommend learning more about the state of your microbiome.  Our Skin Microbiome Kit provides you with scientifically accurate results on the state of your microbiome. You will receive a breakdown of the top 10 bacteria on your face, and even learn if the bacteria found on your skin is harmful or not. In addition, you will receive personalized recommendations based on your skin profile on the most optimal diet & skincare for your profile. 

Research has shown that salicylic acid, BHA & azelaic acids are the best first line of defense when it comes to treating acne. Our recommendation is to make sure the active ingredients you are using are paired with hydrating and minimal skincare products, like our serums and cleansers. Limit the amount of actives you use at once on your skin to ensure your skin isn’t reactive to the ingredients. Additionally, this will allow you to see what actives are working best with your skin and providing you with optimal results. 

Above all, understand that our aim is never for “perfect skin”, because we all have occasional bumps and zits here and there. Understanding  your skin and why it acts the way it does should be the first step in every skincare journey, we hope this helped you on yours.