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27 Major Acne Questions Everyone Has—Answered By Dr. Pimple Popper
Odds are, if you have acne, you have major questions. What's the right way to pop a pimple? Why do I keep getting breakouts as an adult? Do those blackhead pore strips really work? (And most importantly: How do I cover that sh*t up?)
We know you have these question because, let's face it, we have them too. Which is why we turned to our new adult-acne expert, Dr. Sandra Lee, M.D. (better known as "Dr. Pimple Popper.) She's taken 27 reader questions sent to us via Instagram and answered them fast (one in just eight words!), so you can get your skin in the free and clear ASAP.
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Can I control hormonal acne?—Polina T.
Yes—by controlling your hormones. Hormonal acne can appear anywhere on the body, and it typically flares the week before or as you get your period, which is when our hormones peak. High levels of types of hormones called androgens (which include testosterone) can lead to acne. Since this type of acne is unpredictable and can be hard to avoid using only topical treatments, talk to your dermatologist about the oral medication spironolactone; it's technically a blood pressure treatment, but its anti-androgen properties make it a popular choice for docs treating hormonal acne.
Is there any way to close my pores?—Nicky J.
Pores don't open and close, but keeping them unclogged and clean can make them appear smaller. My SLMD Acne Cleanser (, ) exfoliates with salicylic acid, which helps to degunk pores and also diminish acne-causing bacteria. You can use it every time you wash your face, unless you experience irritation or dryness—then reduce use to once a day or every other day.
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Will splashing my face with cold water shrink my pores?—Nicky J.
Yes, but it's temporary—only about five minutes.
How often should I wash my face to maintain clear skin?—Amy C.
The most important time is at night. If your skin is clean, you don't need to scrub away in the morning. People with acne tend to wash too often and rub too hard because they feel their skin looks dirty, but that can aggravate skin and cause it to become more red and flaky.
Is there a way to avoid blackheads?—Kiley D.
No, but you can minimize them with acne treatments like salicylic acid and retinoids. Wash with salicylic acid once or twice a day, and use a retinoid, such as Differin Adapalene Gel Acne Treatment (, ), every night. If you have sensitive skin or notice redness or flaking, use it only every other night to start.
I eat clean, drink water, and sleep well. Why do I still break out?—Keira W.
Although your lifestyle can impact your complexion, it's hormones and genetics that mainly dictate your skin condition.
Will eating sugar cause acne?—Alex M.
There's a belief that a high sugar intake may promote acne. A high-glycemic diet—one with many refined carbohydrates, including sugar, that rapidly raise your blood glucose and insulin levels—may be associated with more frequent breakouts, and recent small studies back that up.
Why do I keep getting the same pimple on my cheek?—Felicia B.
Sometimes a pimple just never fully heals, and when hormones increase oil production in the skin, that can activate it again. I recommend using a salicylic acid spot treatment, like Philosophy Clear Days Ahead Acne Spot Treatment (, ), whenever a zit arises.
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How can I prevent post-inflammatory hyperpigmentation?—Hannah H.
Stay out of the sun—UV exposure can further darken spots from acne—and wear an SPF 30 or higher daily. And don't pick at your acne, which can cause skin trauma and lead to more hyperpigmentation.
Can I get rid of post-inflammatory hyperpigmentation?—Hannah H.
For the most part, it will resolve on its own over time, unless you repeatedly cause hyperpigmentation from sun exposure or from picking in the same spot. The speed at which hyperpigmentation resolves depends on the trauma and how deep it is. You can also get prescription-level skin-lightening creams with hydroquinone from your derm. Over-the-counter formulas can work, but creams with a higher percentage of hydroquinone are available by prescription only and are more effective.
What will treat my existing acne and post-inflammatory hyperpigmentation at the same time?—Melissa M.
Azelaic acid, an anti-acne ingredient, blocks an enzyme that leads to the darkening of skin after a pimple. Try it in The Ordinary Azelaic Acid Suspension 10% (, ). Retinol can help with both too.
Can I treat acne if I have sensitive skin?—Caitie S.
Most people can tolerate salicylic acid. The most common cause of irritation is benzoyl peroxide, and then retinol. Both are drying.
Can birth control cause body acne?—Nicole L.
Some oral contraceptives don't affect acne. Others do cause it, but this acne can occur anywhere; it doesn't have a predilection for the body. And actually, in many people, their acne improves with birth control. Once you start certain types of birth control, breakouts can sometimes get worse before they get better as your body adjusts to the change in hormones. This adjustment can take two to three months, so use topical acne medications while your body normalizes.
Learn everything you could ever want to know about adult acne:
How do I treat acne when I'm pregnant?—Sabrina L.
Some acne products, prescription and over-the-counter, are not recommended during pregnancy; avoid salicylic acid, benzoyl peroxide, and retinol. Azelaic acid and glycolic acid are okay—find the latter in L'Oreal Paris Revitalift Bright Reveal Brightening Peel Pads (, ).
How can I treat cystic acne?—Vanessa C.
Cysts are a severe form of acne that's deeper under the skin than other types of pimples. Go to a derm, who will likely put you on one or a combination of prescription medications, because with cystic acne there's a chance for permanent scarring, and you don't want to play around with that.
Is there a home remedy for acne?—Anika P.
Crush one aspirin tablet, add tap water until it creates a paste, and apply it to any active red pimples. It has salicylates, a derivative of salicylic acid, which helps decrease inflammation. Don't do this if you're allergic to aspirin though!
I change my underwear daily and also post-workout, wash with salicylic acid, gently exfoliate, and have switched laundry detergents. Why can't I clear up my buttne?—Katarina L.
This isn't true acne—it's folliculitis, an infection of the hair follicles. It can certainly occur on the butt, particularly if you wear tight jeans or pants and are sitting for long periods of time. We typically prescribe antibiotics or topical antibiotic creams—if you see a derm—but you may have success with standard over-the-counter topical acne treatments as well. People with folliculitis on their butt tend to have small bumps called inflammatory papules, which respond best to the prescription treatments that target the bacterial component.
Will extractions help my acne?—Sara M.*
They can. If you have many blackheads, getting extractions on a monthly basis can help clean the pores out. But extractions won't help if you just have red pimples and no noticeable blackheads or whiteheads, and they won't help with cystic acne.
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Are the little bumps I get after threading pimples?—Richa S.
No, they are ingrown hairs, which cause acne-like bumps. After you pull your hair out at its root, the new hair can curl under as it grows and get caught underneath the skin. You can treat it with a common acne ingredient though: salicylic acid.
How do I fix acne scarring?—Erin J.
Consult with a cosmetic dermatologist about which method is best, because different acne scars respond to different treatments. Generally, there are three types of acne scars: a rolling scar (a slight indent), an ice-pick depression scar (a deep dent), and a boxcar scar (a flat depression in the skin). Sometimes people have multiple kinds of scars, so they need a combination of treatments. Options include laser treatments, subcisions (a needle is inserted under skin, parallel to the skin surface, to break up scar tissue), microneedling (creating tiny punctures in skin to stimulate collagen to fill out dents), fillers, and chemical peels.
Once acne's cleared, can you wean yourself off harsh acne treatments?—Carrie R.*
Yes. You can decrease the frequency or stop them altogether. If it comes back, though, you may need to stay on them. It depends on what's causing your acne. A woman who has adult acne can have breakouts that seem to follow her menstrual cycle, and they may not get better until she goes through menopause and no longer has those normal hormonal changes related to ovulation and menstruation.
What can I do about stress-related breakouts?—Meg K.
Stress can exacerbate acne, particularly if you're genetically predisposed to it, but it's not the primary cause. Stress depresses your immune system, and that may make your acne worse by lowering your body's ability to fight inflammation. Also, when we're stressed, many of us start picking at our skin. A good spot treatment will not only treat the area but keep you from putting your hands all over it. You can also use a small bandage to cover the area when you're not in public, because you may not even notice you're picking.
Are there alternatives to Accutane—without its side effects?—Madi R.
Nothing comes close to what Accutane, an oral isotretinoin treatment, can do. It's mainly used to treat severe acne that has a high risk of scarring.
Do face masks help with acne?—Priyanka D.
Any that contain anti-acne ingredients, like charcoal, acids, or clay, can. A clay mask, such as Dermalogica Sebum Clearing Masque (, ), can create a mild vacuum when applied to the skin, so it can help pull out blackheads. It also has a drying effect, which can help clear up breakouts.
RELATED: How To Get Rid Of Dark Spots, According To Dermatologists
My face breaks out when I moisturize. What's the problem?—Noelle C.
If your moisturizer is heavy or rich, it can clog your pores and cause acne. Switch to a light or oil-free moisturizer, like Aveeno Positively Radiant Sheer Daily Moisturizer SPF 30 (, ).
Should I use a toner or an astringent for breakouts?—Parker M.
If you have very oily skin—which is sometimes the case for people with acne—a toner or an astringent with salicylic acid twice a day can help you. It draws out the excess oil that can clog pores and is gentle for all skin types.
How do you suggest I treat painful, under-the-skin pimples?—Celine C.
These are similar to cystic acne, but not as deep. Put a warm compress on them to help increase the speed at which they come to the surface, where they can then be popped. Don't squeeze or pinch, which can make them bigger. Or visit a derm for a corticosteroid injection, which can make a bump go away in 24 hours.
*Name has been changed.
This article originally appeared in the January/February 2019 issue of Women's Health. For more great advice, pick up a copy of the issue on newsstands now!
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