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What exactly is happening under your skin when you pop a pimple

Bethany Ramos is an editor, blogger, and chick lit author. Bethany works as Editor in Chief for Naturally Healthy Publications.

The breakdown of popping a pimple, step-by-step

Like clipping your toenails or other bodily functions of which we shall not speak, popping pimples is something everybody does and no one wants to talk about. For some of us, it’s an unavoidable part of grooming, and for other folks, it’s a guilty pleasure.

It wasn’t until I became licensed as an esthetician nine years ago that I realized how fascinating the process of popping a pimple can be. But before I came to appreciate the pimple pop in all its glory, I had to get past the “ew” factor first.

More: 5 Bad habits you need to break if you want clear skin

You see, pimples are a normal fact of life, and they happen to the best of us. While that first landmark zit is often considered an unpleasant rite of passage that occurs right alongside teenage puberty, some dermatologists estimate that kids can start getting acne as early as 7 or 8 years old with puberty also starting at an earlier age.

Once you become a full-fledged adult, the outlook isn’t much better — the American Academy of Dermatology deems adult acne both frustrating and common. It’s perfectly normal for adults to continue getting pimples well into their 30s, 40s and 50s. This adult acne may also appear even if you never experienced acne as a teen. And because of fluctuating hormone levels, women are more susceptible to adult breakouts than men (thank you, Mother Nature).

More: The best essential oils for acne-prone skin

There are several things you can do to manage and clear up your adult acne, which I’ll get to later. But first, the fascinating science behind the process of pimple popping. I’ve asked skin care experts to share exactly what happens underneath your skin the moment you squeeze that zit.

Before the pop

The blemish that just appeared in the mirror has actually been brewing under the surface for quite some time — about two months, according to Dr. David E. Bank, board-certified dermatologist, author of Beautiful Skin: Every Woman's Guide to Looking Her Best at Any Age and founder and director of The Center For Dermatology, Cosmetic & Laser Surgery in Mt. Kisco, New York. “What many people don't know is that it can take about eight weeks from the time a pore gets blocked to the time it erupts on the skin in the form of a pimple. In effect, by the time you are painstakingly applying topical products to a pimple that has broken out on your skin, you are about eight weeks too late,” he says.

But before you can formulate a plan of attack, you have to know what kind of pimple you’re working with. According to Dr. Neal Schultz, NYC dermatologist, host of and creator of BeautyRx by Dr. Schultz, there are five different types of blemishes that can pop up:

  1. Blackheads appear as flat, dark-colored clogs. It almost looks like a dark-colored plug in the skin. They don’t hurt and are much more visible than they are “feel-able.”
  2. Whiteheads are tiny, white dome-shaped bumps on the skin with no visible opening to the outside. They don’t hurt and are visible and “feel-able.”
  3. Papules are solid, skin-colored or red bumps — solid, meaning there’s no visible pus or liquid in them. They are less than five millimeters in size, which is a fifth of an inch. They can be tender or painless.
  4. Pustules are bumps that contain pus, so they start out red with a yellow top and become completely yellow before they break or dry out and become crusty. The yellow color is pus that you can actually see. Pustules, like papules, are also less than five millimeters. (By the way, these papules and pustules are what we're talking about when we say "pimples" or "zits.” They are usually tender to touch.)
  5. Cysts are larger than papules and pustules, so they’re more than five millimeters. When they're skin-colored, they’re usually painless, but when they're red, or red and yellow, they're usually painful and can look like giant pustules. They can grow very quickly, and you usually notice them because of pain or tenderness before you actually see them.

Dr. Bank advises, “If you do see a pimple and need quick relief, start by picking up some 10 percent benzoyl peroxide (as long as you're not one of the 5 percent of the population who is allergic to it) and apply it two to three times a day. No other product can beat the potent drying, exfoliating and antibacterial effects of it (often found in Clearasil and Oxy-10). Save your money and avoid buying expensive ‘designer’ brands, which have less than 10 percent of this active ingredient.”

The pop

Now, we’re finally getting to the good stuff. Although most estheticians and dermatologists, including Dr. Bank and Dr. Schultz, advise against hands-on popping that is likely to scar the skin, skin care professionals know that it’s going to happen from time to time — we’re only human.

Dr. Margarita Lolis, board-certified and fellowship-trained dermatologist and Mohs surgeon, explains that the act of popping a pimple by applying pressure to force the pus out through the skin essentially tears the skin to cause trauma and inflammation. She says, “You are basically tearing open the top layer of your skin to expel out all the pus and debris that was trapped under the skin.”

More: What to do when your skin still thinks your a teen

And what happens to this dirt after it is released? Dr. Lolis says that popping a pimple introduces dirt and bacteria from the fingers and the face into the pimple, creating a vicious cycle for more skin problems to occur. “I do not recommend popping or picking any pimples. You can make an appointment with a board-certified dermatologist, who can inject it or extract it.” Though Dr. Lolis concedes, “For those who can't help themselves, make sure to wash your face and hands prior to popping.”

The post-pop

If your hands have a mind of their own and the pimple has already been popped, all hope isn’t lost yet. Dr. Lolis recommends placing a Band-Aid over the popped pimple to limit the amount of bacteria exposure and to keep yourself from picking. To help a pimple heal faster, she advises, “Applying an antibiotic cream is helpful. Some pimples respond well to injections.”

While popping and picking may be human nature, Dr. Schultz reminds us once again to take it easy. Scarring the skin by popping a pimple too aggressively is rare, but it can happen. He explains, “To cause an actual scar, you need to damage the dermis, AKA the second layer of skin, and most people don’t pick deep enough (ouch!) to cause a scar. One exception is when you squeeze a cyst, and it bursts under the skin (instead of on the top, in which case the pus just comes out). When the pus (oil, dead cells, bacteria) goes into the dermis or fat layer from bursting under the skin, the inflammation from the cyst contents, i.e., pus, can cause enough destruction of skin, resulting in an ice pick scar or crater-shaped scar.”

To pop or not to pop?

It’s going to be a cold day in hell before you get a dermatologist to sign off on pimple popping at home, but Dr. Bank admits that there is one workaround. While Dr. Bank, like all other reputable skin care professionals, advises against squeezing blemishes at home, he does recommend using the right tools if you are hell-bent on doing it. “If you feel the urge and can't resist squeezing your pimple only do it in the most hygienic way possible. Go to your local pharmacy and pick up a comedone extractor (translation: pimple popper or zit extractor). This usually isn't more than $5-$15 — they are small metal devices with a small cup on one end and a hole in the bottom. To begin, disinfect both the pimple and the extractor by cleaning them with rubbing alcohol. Gently place the extractor over the pimple and discharge the pus without scarring or driving the infection deeper into the skin.”

“Also, an effective and quick zit zapper is to use an ice cube. Simply press an ice cube on a pimple for one full minute to reduce swelling and inflammation. The cold ice cube shouldn’t touch your skin directly, so be sure to wrap it in a soft tissue or cloth. You will notice immediately that the pimple is smaller as the ice helps to diminish the size of the pores by constricting the blood vessels underneath the skin,” Dr. Bank adds.

As the saying goes, the best defense is a good offense, and this couldn’t apply more than to the health of your skin. If you want to prevent the pop — and the potential scarring that comes with it — give your skin some extra TLC in advance.

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