As a dermatologist with a decade of experience in skin care and treatment of various skin conditions, I've come across a wide range of acne-related issues. Pimples are a common concern, but some can be particularly painful. Let's delve into the reasons why some pimples can cause significant discomfort.
Step 1: Understanding Pimples
Pimples, also known as acne vulgaris, are a type of skin lesion that occurs when hair follicles become clogged with oil and dead skin cells. They are a common skin problem that affects most people at some point in their lives. Pimples can range from mild to severe and can vary in size and appearance.
Step 2: The Role of Inflammation
Inflammation is a key factor in the pain associated with pimples. When the body detects a foreign substance or an injury, it responds by increasing blood flow to the area, which brings more immune cells to fight off the perceived threat. This process, while beneficial for healing, can cause redness, heat, swelling, and pain. In the case of pimples, the inflammation occurs as the body tries to deal with the clogged hair follicle.
Step 3: The Presence of Bacteria
The pain from pimples can also be exacerbated by the presence of bacteria. The bacteria, primarily *Propionibacterium acnes*, can multiply inside the clogged hair follicle, leading to a more severe inflammatory response. This can result in the formation of pus, which is a sign of infection and can cause the pimple to be more painful.
Step 4: Location of the Pimple
The location of a pimple on the body can also determine how painful it is. Pimples that are closer to the surface of the skin are generally less painful, while those that are deeper, such as cystic acne, can be quite painful. This is because they are inflamed cysts, which are large pimples or boils. As Dr. Ostad mentioned, these are more inflamed and can be on top of or near a minor nerve ending, which can cause significant pain.
Step 5: The Body's Immune Response
The immune system plays a critical role in the development and pain of pimples. When the hair follicle becomes clogged and bacteria are present, the immune system sends white blood cells to the area to fight the infection. The release of certain chemicals by these white blood cells can cause further inflammation and pain.
Step 6: The Size and Depth of the Pimple
The size and depth of the pimple can also influence the level of pain. Larger and deeper pimples, such as nodules and cysts, are more likely to cause pain because they involve more tissue damage and a greater inflammatory response. These types of pimples can also take longer to heal, which can prolong the discomfort.
Step 7: External Pressure or Friction
Sometimes, even minor pressure or friction on a pimple can increase the pain. This can happen when you accidentally touch or bump the pimple, or when it's subjected to pressure from clothing or a pillow. The pressure can cause additional inflammation and stimulate nerve endings, leading to increased pain.
Step 8: Infection
An infected pimple can be very painful. When a pimple becomes infected, the body's immune response is heightened, leading to more inflammation and potentially more pain. In some cases, an infected pimple may require medical attention, especially if it's causing significant pain or if there are signs of a spreading infection.
Step 9: Individual Pain Thresholds
It's important to note that individual pain thresholds can vary greatly. What may be mildly uncomfortable for one person could be quite painful for another. Factors such as genetics, overall health, and even emotional state can influence how much pain a person feels from a pimple.
In conclusion, the pain from pimples is a complex issue that involves a combination of factors, including inflammation, bacterial infection, the body's immune response, the location and size of the pimple, and individual pain thresholds. Understanding these factors can help in managing and treating painful pimples effectively.

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"Pimples that really hurt are more than 'pimples'," says Dr. Ostad. "They are inflamed cysts -- large pimples or boils. They hurt because they are more inflamed and the inflammation can be on top of or near a minor nerve ending which causes pain. And unfortunately, the more inflammation the more pain there is."Dec 5, 2012read more >>