If you have a painful blemish trapped under your skin's surface, it might be a blind pimple
Picture this: you’re sitting at your desk when all of a sudden you feel a very tender, large pimple forming on your chin. No one is ever excited to get a zit, but this one brings on a wave of dread because you know (and feel!) it’s deep and brewing under the surface of your skin. Sound familiar? It’s likely a blind pimple.
Meet the experts: Zenovia Gabriel, MD, is a dermatologist, hormonal skin expert, and founder of Dr. Zenovia Skincare. Peter Young, MD, is a dermatologist and medical director of Nurx Dermatology. Carmen Castilla, MD, is a dermatologist with New York Dermatology Group and clinical professor at Mount Sinai. Dendy Engelman, MD, ACMS, FAAD, is a board-certified cosmetic dermatologist and Mohs surgeon at the Shafer Clinic Fifth Avenue in New York City.
'Blind acne, or underground acne, gets its name because these pimples are not at the surface and largely occur under the surface of the skin,' says Zenovia Gabriel, MD, a dermatologist, hormonal skin expert, and the founder of Dr. Zenovia Skincare. 'Common places for deep acne, aka blind pimples, to appear are the chin, jawline, side of the face, and neck, and this is because there is a high density of oil glands clustered in these areas and the oil glands are deeper in the tissue here,' she explains.
These oil glands are then triggered by a hormonal stimulation at the follicle level so the pocket of oil is deep and not at the skin’s surface like with a whitehead or blackhead, she adds. As a result, blind pimples are often painful and difficult to treat.
Ready to clear up your skin (and any confusion you might have on blind pimples)? Great. Keep reading to find out why you get blind pimples in the first place and how to treat them once and for all, according to dermatologists.
What is a blind pimple?
A blind pimple is a small lump or bump that forms under the surface of your skin, and usually develops on the face, chest, or upper back, says Peter Young, MD, a dermatologist and the medical director of Nurx Dermatology.
'They may stay beneath your skin’s surface and cause inflammation and pain, or they may eventually erupt through the surface of the skin and form a whitehead, blackhead, or red bump,' he explains. Blind pimples are also often larger than a normal pimple, and because they live deep in the skin, they are slow to heal, impossible to pop, and usually tender to the touch.
What does a blind pimple look like?
As the name suggests, you usually can’t see a blind pimple. That said, you might be able to feel a small, firm bump if you run your (clean!) fingers over the surface of your skin. You may also notice some swelling, says Dr. Young.
Blind pimples can also be red, tender, and larger than a normal pimple, but they do not come to a 'head' or surface above the skin, adds Carmen Castilla, MD, a dermatologist with New York Dermatology Group and a clinical professor at Mount Sinai.
What causes blind pimples?
Blind pimples develop when your pores become blocked with dead skin cells, sebum (oil produced by your skin), and bacteria, says Dr. Young. 'If your skin produces too much sebum, then the oil and dead skin cells tend to pool up under your skin and become a feeding ground for bacteria, which leads to pus formation,' he explains.
'Unlike blackheads and whiteheads, blind pimples are a bit deeper under the skin, and there is no escape route for this collection of sebum, dead skin, and bacteria, so they tend to become more inflamed and painful than blackheads and whiteheads.'
And while acne and blind pimples can happen at any age, they are more common in teenagers and young adults, adds Dr. Young.
Why do blind pimples hurt?
According to Dendy Engelman, MD, ACMS, FAAD, board-certified cosmetic dermatologist and Mohs surgeon at the Shafer Clinic Fifth Avenue, blind pimples tend to be extra painful because of the buildup of pus and bacteria. Dr. Engelman says that this can trigger your skin’s sensory nerves and cause tenderness and pain. She adds that the area under these pimples are more inflamed, which is more likely to hurt.
To relieve some of the pain, she recommends using a warm compress for a few minutes. As an added bonus, she says that this will help draw the pimple to the surface and come to a head.
How long do blind pimples last?
Unfortunately, blind pimples aren’t the easiest to treat. It will take some patience when dealing with them. '[They] do not go away overnight,' says Dr. Engelman. 'It can take days if not a few weeks. However they can still linger under the skin for longer.'
Can I pop a blind pimple?
As with any pesky breakout, experts recommend resisting the urge to pop a blind pimple, since it'll cause more harm than good. 'These pimples are often too deep in the skin to pop. By even attempting to pop it, it can further irritate the skin, exacerbate the size, deepen the cyst, and leave post-blemish scarring,' says Dr. Engelman.
She adds that popping can lead to bacterial infection and can prolong the healing process. When you push the cyst, you actually push it deeper into the skin and can cause a larger cyst to appear. So, hands off until it completely heals.
How to get rid of blind pimples
First things first. Do not pick, prod, poke, pop, or squeeze your blind pimples! As tempting as it may seem, this can make matters worse and actually turn surface level pimples into blind pimples by pushing the sebum, dead skin cells, and bacteria deeper into your skin, says Dr. Young. If you do try to squeeze, you’ll create more inflammation making the blemish deeper, bigger, and more painful (ugh!).
Luckily, though, blind pimples typically go away in one to two weeks when treated (if left untreated, they can persist under your skin for a few months), and simple home remedies can be key, says Dr. Young.
Warm compresses:'Warm compresses encourage the pus from a blind pimple to come to the skin surface and form a head, which ultimately turns a deeper blind pimple into a regular surface level pimple which is easier to get rid of,' he explains. Try placing a clean, warm washcloth over the blind pimple three to four times a day, for around ten minutes at a time.
Niacinamide: Niacinamide gel also works as a spot treatment for blind pimples, since it’s an anti-inflammatory which helps resolve the pimple without causing further irritation, says Dr. Castilla. Her go-to is The Inkey List 20% Niacinamide Serum, which is best used overnight since it leaves a small white residue on the blemish.
Acne patches: These come in handy if you feel the urge to touch or pick the pimple, says Dr. Castilla. If you have sensitive skin, she suggests opting for the plain hydrocolloid acne patches. However, acne patches with benzoyl peroxide and salicylic acid also work well, adds Dr. Young. 'I find that acne stickers embedded with either of these medications tend to work best, because if you place the small sticker on your skin, it releases the medication over a period of several hours and can penetrate into the deeper layers of your skin where the blind pimple has formed,' Dr Young explains.
Benzoyl peroxide: Topical treatments with benzoyl peroxide also work well for banishing blind pimples, since benzoyl peroxide can kill the bacteria and reduce inflammation. Tea tree oil is another great anti-inflammatory that will help penetrate the skin and kill the bacteria, adds Dr. Young.
Steroid injections: If your blind pimples are extremely painful, stubborn, and/or persistent, Dr. Castilla recommends visiting your dermatologist for a steroid injection. 'The best way to resolve blind pimples quickly is to see your board-certified dermatologist for an anti-inflammatory steroid injection directly into the pimple, which puts the medication exactly where it needs to go in order to calm down the inflammation.'
How to prevent blind pimples
While getting rid of a blind pimple is no walk in the park, there are a few ways you can keep them from popping up altogether:
1. Put together a skincare routine
Prevention is key for blind pimples, so first and foremost, always keep your skin clean by washing your face every morning, night, and anytime you sweat, says Dr. Young. Also make sure to only use non-comedogenic makeup, moisturisers, sunscreens, and cleansers that are specifically noted to not clog pores, he adds.
2. Use a benzoyl peroxide cleanser
Next, a first line of prevention defence is an over-the-counter benzoyl peroxide wash. 'It is best to use a benzoyl peroxide wash that is less than 5 percent for your face, since concentrations of benzoyl peroxide higher than 5 percent are more irritating without being more effective,' says Dr. Castilla.
3. Consider using adapalene gel
Adapalene gel is another great prevention topical, though it may be irritating and/or drying when first starting, says Dr. Castilla. She recommends starting with a pea sized amount every three days, followed by a moisturiser. For those with sensitive skin, Dr. Castilla also recommends cleansers with salicylic acid for blind pimples since this wash contains to help exfoliate and decrease sebum.
4. Talk to your doctor about prescription medications
If topical treatments aren’t hitting the spot (literally), prescription oral medications may be recommended.
5. Pay attention to your diet
Your diet is another important consideration for acne prevention. 'High glycemic index foods, or foods that raise your blood sugar quickly, can potentially cause acne flares, and this is not just sugar in the obvious cookies and cakes, but also white processed carbohydrates such as white rice, pasta, or bread,' explains Dr. Castilla. Dairy and whey protein supplements may also be a potential trigger, she adds.
6. Consider in-office treatments
Lastly, for those who do not want to take oral acne medications or are not responding to topical acne prevention regimens, Dr. Castilla says laser treatments may be an option. 'Aviclear is a laser FDA-approved to target the sebaceous gland and treat acne, and it requires a series of three treatments spaced about one month apart.'
Just remember that blind pimples can be extremely stubborn and persistent, so if you experience chronic acne, talk with your dermatologist to find the perfect treatment plan. And whatever you do…keep your hands off and do not try to pop!
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