Seemingly, there are no limits to the depths of her knowledge around all things zit-related, and since acne is the most common skin condition in America, I thought it might make sense to pare down her wide-ranging expertise to the five most common questions she gets asked on the reg. Below, she advises on some of the most common concerns surrounding those red, black, and white (this feels like an old-timey joke about newspapers suddenly) spots.
1. What type of pimple should you never pop?
I’m going to be like every dermatologist and tell you there are no types of pimple you should pop; however, there is a particular type of pimple you should avoid trying to pop the most. If you have a red pimple that hurts to touch, and is deep under the skin, you should really avoid squeezing it. Those deep pimples are too deep under the skin, so squeezing and manipulating this area will just cause increased redness, swelling, pain, and probably even a bigger pimple. Also, the deeper an inflamed pimple is under your skin, the higher the risk of permanent scarring. Apply a spot treatment to target the problem spot instead—this will help treat the area and also remind you to keep your hands off. Also, if you're suffering from adult acne, know you're not alone:
2. What should I do when a pimple pops up right before a big event?
I always have one of my spot treatments on hand for this reason—you never know when a pimple is going to pop up out of nowhere. They’re the best way to target a breakout if you don’t have access to a dermatologist. If you have a blackhead or a whitehead, use my SLMD Salicylic Acid Spot Treatment ($25). Salicylic acid is a great beta-hydroxy acid that's able to crystalize to a small enough size to get deep into your pores, cleaning out the dead skin cells, debris and oil that caused the breakout. If you have a big, angry, red inflamed pimple, try benzoyl peroxide. It's an antibacterial ingredient that will destroy the bacteria that leads to the pimple, and make it less red and inflamed. If you are desperate and have access to a dermatologist, you can make an appointment and have them give you a low potency corticosteroid injection that can make a pimple disappear in 24 hours.
3. Why do I get blackheads around my nose?
The nose has a higher density of oil glands than most of the skin on your face. Actually, the T-zone, tends to have the highest concentration of oil glands, which is why this area is where people commonly see acne breakouts. Oil glands, aka sebaceous glands, produce sebum (oil) and when it mixes with dirt and dead skin cells, bacteria get interested, which can cause a breakout.
Whiteheads are white because they have a thin layer of skin overlying them, and blackheads are open at the surface of the skin, the contents within the pore get oxidized because of exposure to oxygen, which is why they appear dark or black in color. The best way to treat both of them is by using an exfoliating face wash that will help unclog pores and break down sebum. Also retinol is a keratolytic, meaning it also helps to keep pores clear of blackheads and whiteheads and also speeds the turnover of new skin cells. (Here's more about retinol ICYWW.)
4. Most acne treatments dry my skin out—what can I do?
In general, the majority of patients who have consistent acne tend to be on the oilier side, because higher oil production is a common element in acne formation. Unfortunately, this doesn’t mean that people without oily skin don’t also experience breakouts. Since excess oil on your skin can be a causative factor for acne development, it makes sense that many acne medications work by decreasing the oiliness of your skin. People with oily skin will feel less oily, but people with normal or dry skin will feel more dry. Sometimes this dryness can lead to redness, irritation, scaling, and peeling. In general, my first word of advice is to always be sure you apply moisturizer after applying your acne treatment.
Though a bit of dryness from acne treatments can be normal, there are some people who may find that they experience extreme dryness or irritation from acne-fighting ingredients like benzoyl peroxide. Though this doesn’t necessarily mean you are allergic to an ingredient, it may be uncomfortable and if this becomes the case, you may want to avoid this particular acne-fighting ingredient. In this case, you may want to switch to a less irritating product such as a sulfur acne treatment. Sulfur helps control excess oil and stops the growth of acne-causing bacteria, but is often gentler on the skin and less likely to cause irritation.
5. How do you treat annoying dark marks left behind after popping a pimple?
Those dark spots are called post-inflammatory hyperpigmentation (PIH for short). The good news is that these kinds of dark marks will most likely fade and disappear over time. The bad news is that sometimes it can take months for some of them to fully disappear. You will notice that these marks will appear more pink, red, or darker brown depending on your skin tone.
To speed up the healing process, I recommend using ingredients like salicylic acid and retinol, which will exfoliate the skin’s surface and help speed up cell regeneration to give you new, fresh skin. Also, be sure you are using and reapplying a broad-spectrum SPF, as sun exposure is going to darken those marks even more.
Ed Note: Responses were edited for brevity and clarity.
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