Bumps and Lumps

I’ve Got a Bump… Can I Pop It?

Sure, it might be gross, but that doesn’t change the fact that it’s human nature to want to pop bumps that crop up on our skin. And gross or not, we’re fascinated by this idea — as proven by the popularity of Dr. Pimple Popper who started as a YouTuber specializing in all things extractable and had over 8 million followers!

Let’s dive in and answer the question. “Can I pop it?”

First of all – what is it?

Comedo (blackheads) – These are small clogged pores that crop up on the face or trunk. They are caused by skin cells that don’t mature properly and stick together, plugging the exit of a pore. They are not caused by dirt on the skin and they’re not related to hygiene, no matter what your mother told you.

There is often a strong hormonal influence that results in the appearance of blackheads, with acne starting around puberty and continuing through the teenage years. Chronic sun damage can also cause them.

Blackheads cannot be “scrubbed” away because the plugging is beneath the level of the skin in the pore. Medications like retinoids (Retin A, Differin, Epiduo, etc) and alpha hydroxy acids (Glycolic, Salicylic, Lactic) can help prevent and clear comedones by exfoliating within the pores.

Now to the popping question: Firm pressure on the sides of a comedo can help release the plug and allow it to heal faster. The best way to do this is to use a special extractor that allows even pressure on all sides of the lesion for an easier extraction. Comedones should never be picked or scratched to remove, as this can damage the surrounding skin and lead to scarring. Pustules, or whiteheads, should not be popped as this can push infection deeper into the skin and worsen the lesion. When in doubt, consult your dermatologist. Popping pimples is one of our specialties!

Verdict: OK to pop!

Cyst – There are many different types of cysts that can affect the skin, but the vast majority are epidermal inclusion cysts, often referred to incorrectly as sebaceous cysts. These are slow-growing nodules that can occur anywhere on the skin and can be as small as a pea or as large as a golf ball. They often have a central pore, which will release a cheese-like material with pressure.

While it is extremely tempting to “pop” a cyst, it is not recommended. Cysts are actually like balloons under the skin. They contain a fragile wall that surrounds a ball of keratin (that’s the cheese-like material within and is the remnants of dead skin cells that accumulate inside the cyst.) Pressure can cause the cyst wall to rupture, resulting in infection and inflammation of the surrounding skin, which can be quite painful. The only safe way to remove a cyst is with a small surgical procedure done by a dermatologist in the office.

Verdict: Do not pop!

Lipoma – A lipoma is a benign tumor of fat cells located beneath the skin. These are usually found on the trunk and extremities. They’re slow growing, occasionally painful, and can be found in large numbers in people with a genetic predisposition.

Lipomas often look and feel a lot like a cyst, but they live in the deeper layers of the skin and do not connect with the surface. If you try to pop them, the only thing you will get for your effort is a bruise. Lipomas can be removed by a small in-office procedure by your dermatologist.

Verdict: Do not pop!

Abscess – An abscess is caused by pus pooling under the skin due to an acute bacterial infection. They are often fast growing, red, warm, and very painful. While it is important that the pus be released, this is not something that should be done at home, as improper “popping” can spread the infection. You should see your physician immediately if you think you might have an abscess.

Verdict: Do not pop!

For more information about lumps and bumps that occur on the skin, be sure to watch Dr. McKelvey featured on Journey with the Experts!