From the time we get our first pimple as preteens, zits cause a strange amount of fascination for us: how to prevent them, treat them, hide them when they appear. Some people even spend hours online watching graphic pimple-popping videos (which we won’t show you here, because yikes) to satisfy their curiosity.
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).
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 Mount 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.
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.”
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.”
It’s going to be a cold day in hell before you get a dermatologist to sign off on pimple-popping at home, but Bank admits there is one workaround. While 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 to $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,” Bank adds.
The post-pop & potential for scarring
If your hands have a mind of their own and the pimple has already been popped, all hope isn’t lost yet. 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, 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.”
A version of this article was originally published in January 2016.