We know it’s bad. Maybe parents or partners have scolded us for it. Perhaps we’ve borne the consequences, in the form of angry red sores on our chins and brows. And yet, when a pimple starts to form … don’t you just want to pop it?
“Lots of people pop their pimples,” says Dr Howa Yeung, assistant professor of dermatology at the Emory University School of Medicine. “But that process, if done incorrectly, often leads to more inflammation.”
How bad is it, really? What happens when we have a go at our chin at the end of a stressful day? And why can it feel so damn satisfying?
What is acne?
“When people have acne, there are several things going on,” says Yeung. First, dead skin builds up around a hair follicle. This combines with sebum, an oily substance that moisturizes and protects the skin, and results in a pimple.
The difference between acne and pimples, according to the Cleveland Clinic, is that acne is a disease, and pimples may be a symptom of acne.
There are two main types of acne, explains Dr Olga Bunimovich, dermatologist at the University of Pittsburgh Medical Center: comedonal and inflammatory.
Comedonal acne means blackheads and whiteheads. With blackheads, the excess of oil and dead skin is open at the surface of the skin, while whiteheads are closed at the surface of the skin.
In some cases, this acne attracts bacteria, which turn results in inflammation. This can lead to pustules, cysts or nodules, which are typically more painful.
Why do we pop pimples?
“We have an unconscious pull towards damaging behaviors,” says Fabiana Casanova, a psychotherapist and owner of Nova Psychotherapy in Boston. Some obvious examples include addiction and overeating, she says, but popping pimples is part of the same tendency – what Sigmund Freud called the “death drive”.
“It is not necessarily a soothing behavior per se,” she explains. “But it’s one that brings a slight enjoyment despite the pain.”
Casanova says it is common to see an increase in such behavior in times of stress. The behavior becomes problematic when it starts “affecting our ability to perform our regular tasks and daily activities”, she says – say, if your pimple popping delays you leaving the house, or it makes you feel self-conscious about your appearance.
To manage the behavior, Casanova says that being aware of one’s emotional triggers and being able to process those emotions can reduce how drawn we are to the activity.
What happens to your skin when you pop a pimple?
When people pop pimples, they tend to put pressure on the skin around the bump, pressing on it to expel what lurks beneath the surface. But while some of the pus may come out, Bunimovich notes that this pressure may lead some of it to seep deeper into the skin, causing greater inflammation.
“This also increases the risk of pigmentary changes and/or scarring,” says Dr Lindy Fox, professor of dermatology at the University of California, San Francisco.
When you pop a pimple to relieve pain or to express pus, you also run the risk of nothing coming out. Bunimovich says she works with a lot of patients with acne scars. “I can always tell which are the picked acne scars,” she says – the scars that form when patients try to pop a pimple and nothing comes out, so they keep picking at it. These scars often have jagged edges, she says.
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Is there a way to safely pop pimples?
Picking at pimples is bad for your skin. But is there any way to do it with minimal damage?
“Painful pimples are best treated in a doctor’s office where they can be drained and/or injected with a small amount of corticosteroid to help decrease the inflammation,” says Fox.
For those who don’t have the time or resources to visit dermatologists regularly, there are some things you can do yourself.
Bunimovich says that if you see the pus on a pimple and it is right at skin level, you can use clean hands or a clean, sterilized needle to open the top and then wipe away some of the pus. But use “hardly any pressure”, she warns.
If you have a deep, painful pimple, the American Academy of Dermatology (AAD) suggests applying a clean, warm, damp washcloth to the pimple for 10 to 15 minutes a day, three times a day. “This will help the deep pimple move closer to your skin’s surface so it can heal,” they explain in a blog post. Use a fresh washcloth every time, and “resist popping the pimple”.
Topical treatments can also be helpful. Yeung recommends benzoyl peroxide gel, an over-the-counter acne treatment that he says can be “excellent for treating individual pimple spots”. According to the AAD, products that contain acne-fighting ingredients such as adapalene and salicylic acid can also be helpful, as can hydrocolloid acne patches, which “protect your skin and improve healing”.
How can you prevent acne?
One way to stop picking at pimples is to prevent acne from forming in the first place.
Bunimovich says she recommends dietary modifications, especially reducing intake of sugar and dairy. For patients who wear a lot of makeup, she also suggests wearing slightly less, as heavy makeup can block pores and contribute to acne formation.
Yeung also warns about over-exfoliating. “Even though exfoliation is popular on social media, I generally don’t love using it for people who have acne-prone skin,” he says. Excessive exfoliation can remove sebum, and thus make the skin produce even more of it, leading to more acne.
If one is struggling with acne, experts recommend working with a board-certified dermatologist. “We have so many good treatments for acne,” Yeung says.