It is almost impossible to resist the urge to pick at our skin.   When we feel there is something there that shouldn’t be, we are compelled to remove it.  Unfortunately,  picking at a pimple can cause the lesion to worsen by creating an infection and/or eventually leave a scar, called post inflammatory hyperpigmentation. (PIH)

When you “pop” a pimple you can actually cause the localized infection to spread under the skin, leading to more inflammation.  Imagine the sac your body forms around the pus as a self defense mechanism.  (like a blister)   When we open the sac and spread the bacteria and introduce new bacteria, we interrupt the skins self defense and healing mechanism.  The sac does not only open to the surface, it can implode under the surface, spreading the infection and increase inflammation   P. acnes is the bacteria which is commonly in our hair follicles and can mix with dead skin cells and sebum to create inflammation which leads to a pimple, or comedone.   Our body will naturally eventually rid of the lesion by pushing the material to the surface or by reabsorbing the “waste” under the skin.  As tempting as it is to push the process along, don’t.  Let it run its course.  When you pick you are introducing bacteria on your hands, on the skins surface and under your nails to the equation, potentially making it worse.



pimple 1

There are different types of blemishes.  The above diagram gives you an idea of what is going on under the surface when you have a pimple or blackhead.  You can visualize how the contained papule or pustule can spread in the tissue when forced.

Instead, try an over the counter benzoyl-peroxide product (ideally 10%) or a retinol or retinoid.  These products will dry the comedone out, helping to shorten its lifespan without scarring the surrounding tissue.

If the lesion is persistent and feels more like a cyst under the skin your dermatologist can inject a small amount of a steroid.  These lesions typically shrink within a day or so.  We do not recommend doing this unless necessary as there are times when the steroid injected can create a divot in the skin.

Additionally, your skin care specialist or esthetician can perform an extraction using sterile tools specifically designed to  thoroughly extract a blemish without scarring.   If you suffer from frequent enough breakouts it may be worth having a routine facial with extractions.

Being aware of what is causing the breakouts.  Ingrown hairs can be a culprit if you suffer from coarse facial hair growth.  Some cases of facial acne are actually related to folliculitis.  This is when the hair creates inflammation as it makes its way to the surface.  I have seen some patients see considerable relief with laser hair removal. (the hair needs to be pigmented)

Always thoroughly cleanse your skin before going to sleep at night.  Using a cleanser with glycolic acid can be helpful.  I am a huge proponent of using a retinol/retinoid for its anti-aging benefits as well as its ability to control breakouts.  Make sure the products you are using do not clog your pores.  Our products can be part of the problem.

If you have picked enough to cause PIH a series of IPL’s or peels can help to remove that pigment.  We are having success with our new IPL (Intense Pulse Light) at TOC Medical Spa, the Lumenis M22.