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Pimples: can I pop them?!

It’s official, 2017 was the year of the pimple.  Blackheads, dilated pores, and cysts have “exploded” to become one of the internet’s biggest stars.  One popular YouTuber that specializes in all things extractable in the skin has over 8 million followers!   Let’s take a deeper dive into this juicy obsession and once and for all answer the question “Can I pop it?”

Comedo (blackheads) – These are small plugged pores typically occurring on the face or trunk.  They are caused by skin cells failing to mature properly and leading them to stick together and plug the exit of a pore.  They are not caused by dirt on the skin and are not related to hygiene.  There is often a strong hormonal influence and results in their appearance with acne starting around puberty and continuing through the teenage years.  Chronic sun damage can also cause them.   They cannot be “scrubbed” away because the plugging is beneath the level of the skin in the pore.  Medications such and retinoids (Retin A, Differin, Epiduo, etc) and alpha hydroxy acids (Glycolic, Salicylic, Lactic) can help prevent and clear comedones by their action of exfoliating within the pores.  Firm pressure on the sides of a comedo can help release the plug and allow to heal faster.  This can be assisted by 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 can 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.  Keratin is 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.  Most commonly they are found on the trunk and extremities.  They are slow growing, occasionally painful, and can be found in large numbers in people with a genetic predisposition.  While they can often look and feel a lot like a cyst, lipomas 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 cause by puss 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 puss 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 are concerned you have an abscess. Verdict: Do not pop!



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