Ew! Beauty: Unsurfaced Pimples

Stop it, don't pop it

Illustration by Liz Riccardi

Let’s face it: Along with summer’s heat, humidity, and other sweat-inducing qualities comes a ton of gross beauty problems. From dry, cracked feet to ingrown hairs and chafing, there’s a lot that can hold you back from living the confident poolside life you’re destined to lead. But don’t worry—we’re talking to experts about how to fix them. Welcome to Ew! Beauty.

Zits. Pimples. Cysts. Whatever you call your acne doesn't matter, because they all cause the same thinga pain in your face. While all acne initially manifests beneath the surface, sometimes it ruptures. This causes an inflammatory reaction which can lead to nodules, cysts, whiteheads, blackheads, and rosacea forming on your face.

Dr. Annie Chiu, owner of The Derm Institute, says that cystic acne is a genetic condition caused by overactive oil glands, pores clogged with dead skin cells, and bacteria. Oftentimes, you feel acne before you can see it because it exists deep below the skin’s surface. Dr. David Bank, founder and director of The Center For Dermatology, Cosmetic & Laser Surgery and author of Beautiful Skin: Every Woman's Guide to Looking Her Best at Any Age, further explains that unsurfaced pimples form when the cells in our pores become sticky and construct a plug below the skin's surface. From there, sebaceous oils build up underneath the skin to create the dreaded cyst. 

The worst thing you can do if your face is covered in unsurfaced pimples is aggravate them. Picking the bumps can lead to an infection while squeezing them results in more inflammation. The biggest risk is causing hyperpigmentation and scarring.

Most dermatologists agree that the best way to treat unsurfaced pimples requires getting a cortisone injection to drain the lesion; it's also the quickest solution. "The longer a pimple sits there chewing up collagen, the greater the chance of it causing a scar," says Dr. Todd Minars, a dermatologist based in Florida.

Dr. Dina Strachan, the director of Aglow Dermatology, recommends getting on an acne routine if this becomes a common problem because "prevention is key." She also points out that birth control pills are helpful to many women with this issue because, often, unsurfaced pimples are related to hormones. (Signs of this include cystic acne along the jawline or chin area.) 

For home treatment, Dr. Chiu recommends using a warm compress several times a day to try to draw out the pimple. "Once a whitehead forms, the pus will drain and the pimple will dry up," she said. "While you wait, wash your face with a salicylic acid cleaner and exfoliate with a chemical exfoliant. This will help clear away dead skin and bring the pimple to the surface more quickly."

There is no exact amount of time for when you can expect these pimples to heal, but you should notice results within a few days if treated properly. Dr. Banks also suggest products with benzoyl peroxide, but there's no guarantee that this will work because it "might not penetrate deeply enough to be effective."

"The best ingredient I would say to look for in product would be salicylic acid, although I don’t know how well this would work for something this deep," said Dr. Debra Jaliman, a New York-based dermatologist and author of Skin Rules: Trade Secrets From A Top New York Dermatologist.

If you're having a similar problem, definitely seek help from a board certified dermatologist near you to figure out the best method of treatment.