Pimple on nose: causes and what to do

A pimple on the nose is ordinary acne in most cases, and it needs the same care as acne anywhere on the face. The nose also has a few look-alikes, and one situation, a painful boil on the face, that the NHS treats as urgent. This guide covers what causes nose pimples, why popping them is risky, what else a spot on the nose can be, and when to get help. It is part of Skinli's guide to the types of acne.

Why the nose breaks out

Nose pimples form the same way as other acne. The American Academy of Dermatology (AAD) explains the steps: oil and dead skin cells build up and plug a pore, the bacteria that live on everyone's skin multiply in the trapped oil, and the area swells into a pimple.

The AAD names the forehead, nose and chin together as places where people tend to break out, in its advice on applying acne treatment. The NHS says acne usually affects the face, chest and back.

The triggers are the general acne triggers:

• Hormones. NIAMS, part of the US National Institutes of Health, says rising androgen hormones enlarge oil glands. The NHS lists puberty, periods, menopause and pregnancy.
• Products. The NHS names products that make skin greasy. The AAD says oily makeup and skin care can clog pores.
• Touching and rubbing. MedlinePlus lists touching, resting on or rubbing the skin as a trigger. The AAD says touching your face during the day can make acne flare.
• Medicines. NIAMS names medicines that contain hormones, corticosteroids and lithium.

What causes acne covers each trigger in full.

Blackheads and whiteheads on the nose

Many nose spots are clogged pores without swelling. The AAD says a blackhead forms when the buildup inside a pore widens its opening, and the plug turns dark where it meets the air. A whitehead forms when the plug seals the opening, making a small white or skin-colored bump.

The AAD recommends a retinoid such as adapalene, sold without a prescription, to unclog pores, and says scrubbing blackheads only makes acne worse. Blackheads vs whiteheads explains both, and adapalene for blackheads and whiteheads covers the treatment in detail.

Why popping a nose pimple is risky

The AAD's pimple popping page explains the problem. When you squeeze a pimple, you often push pus, dead skin cells and bacteria deeper into the skin. That increases swelling and can lead to:

• Permanent acne scars
• Acne that looks worse
• More pain
• An infection from the bacteria on your hands

The AAD says squeezing a blackhead can also cause an infection or a permanent scar. It suggests ice for a painful spot and says a dermatologist can drain or inject a large, painful spot safely.

For a boil, the NHS is firm: do not pick, squeeze or pierce it.

When a spot on the nose is urgent

The NHS describes a boil as a hard and painful lump that fills with pus. Most boils go away on their own. The NHS says to ask for an urgent GP appointment, or to call NHS 111, if you have a boil and:

• it is on your face,
• the skin around it feels hot, painful and swollen,
• you feel hot, cold or shivery, or
• you have a weak immune system, for example from steroid treatment or diabetes.

That makes a hard, painful, swelling lump on the nose different from an ordinary pimple. It needs to be seen soon, and it should never be squeezed.

The NHS acne page also says to see a GP if acne shows signs of a skin infection, such as hot, swollen and red skin. It adds that redness can be harder to see on brown and black skin.

Other spots that appear on or around the nose

Three conditions can look like a pimple on the nose.

Rosacea

The AAD says rosacea's acne-like breakouts usually appear where the face is red, and the redness may come and go or stay. The skin tends to be sensitive and may sting or burn. The AAD says treatment can clear the breakouts, and that rosacea often needs ongoing treatment.

Perinasal dermatitis

The AAD describes perioral dermatitis as a breakout that looks like many small pimples around the mouth. It says the same rash sometimes develops only around the nose, where it is called perinasal dermatitis. The skin may burn or itch. The AAD says dermatologists recommend treatment, because without it the rash may last for months or years.

Cold sores

The NHS says cold sore blisters can appear anywhere on the face. They start with tingling, itching or burning, and small blisters filled with fluid appear over the next 48 hours. Cold sores are contagious until they heal. The pimple on the lip page explains how to tell a cold sore from a pimple.

How to treat pimples on the nose

The AAD's advice for pimples applies here:

1. Pick the right product. For red bumps and pus-filled bumps, the AAD suggests a wash with benzoyl peroxide or salicylic acid. For blackheads and whiteheads, it suggests a retinoid.
2. Treat the whole area. The AAD says applying medicine only to spots fails to prevent new ones. If you break out on the forehead, nose and chin, spread a thin layer over all three.
3. Give it 6 to 8 weeks. The AAD says that is how long it takes to see improvement, and complete clearing takes 3 to 4 months.
4. Keep it gentle. Wash twice a day with a mild cleanser, use your fingertips, and skip scrubs, the AAD says.
5. Protect from the sun. The AAD suggests a broad-spectrum sunscreen of SPF 30 or higher labeled non-comedogenic, since some acne medicines make skin more sensitive to the sun.

Skin on the nose can dry out and peel with a retinoid. How to start adapalene without irritation gives a slow start, and the complete acne skincare routine puts every step in order.

Daily habits that help

These habits come from the AAD's pages on skin care and makeup:

• Wash twice a day, when you wake up and before bed, and after sweating. The AAD says washing more often than that can irritate skin and cause more breakouts.
• Use products that will not clog pores. Makeup, sunscreen and moisturizer labeled "non-comedogenic" or "won't clog pores" do not cause breakouts in most people, the AAD says.
• Remove makeup every night. Even non-comedogenic makeup can cause acne if you sleep in it.
• Keep brushes clean and your own. The AAD suggests cleaning makeup brushes every week and not sharing them, because other people's oil, dead skin cells and bacteria can transfer to your skin.
• Skip astringents and rubbing alcohol. The AAD says anything that dries out skin can irritate it, and irritated skin breaks out more.

What a dermatologist can do for nose spots

If home care has not worked, a dermatologist has several tools. The AAD says a procedure called extraction, using sterile tools, can clear stubborn blackheads and whiteheads that have not responded to treatment. For one large, painful spot, a dermatologist can inject a corticosteroid, which the AAD says flattens most nodules and cysts within 48 to 72 hours, or open and drain it with sterile tools. Prescription creams and tablets are another option, and the cystic acne guide lists what doctors use for deep acne.

Dark marks and scars

When a nose pimple heals, it can leave a flat mark. The AAD says these spots can be pink, red, purple, black or brown, and that they clear on their own over time, though some last a year or longer. The darker the spot, the longer it takes. True scars are permanent. Dark marks after pimples explains the difference.

When to see a doctor

See a doctor or dermatologist if:

• A spot on the nose is a hard, painful lump with pus, the skin around it is hot and swollen, or you feel feverish. The NHS says this needs an urgent appointment.
• The spots sit on red skin that flushes, stings or burns, which may be rosacea.
• Many small bumps appear around the nose or mouth and burn or itch, which may be perinasal or perioral dermatitis.
• A product has had 6 to 8 weeks without improvement, as the AAD advises.
• Spots leave scars or dark marks, or affect how you feel, which the NHS lists as a reason to see a GP.

Skinli's photo check looks at one photo, asks two questions and builds a starting plan that flags when a doctor should look.