Pimple popping: Should you do it?

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In general, noninflamed acne blemishes are the only type that a person should ever consider popping at home.

Noninflamed acne includes different types of comedones, which form when plugs of excess oil and dead skin cells become trapped in hair follicles. Examples include blackheads, which are open pores with a black or dark-colored plug on the surface, and whiteheads, which are small bumps with a yellow or white center. Whiteheads form when blocked pores close.

These blemishes are close to the surface of the skin, so it does not usually require much intervention to get the contents out.

The only whiteheads that are suitable to pop are those that look as though they are almost ready to burst on their own.

Although people can pop some noninflamed whiteheads and blackheads if they take the necessary precautions, they should never try to pop or extract inflamed acne. This type of acne is deeper in the skin and may be more likely to cause scarring and infection if a person tries to squeeze it.

Forms of inflamed acne include:

• Papules: Red, purple, or brown bumps that do not have a whitehead
• Pustules: Bumps that have a white or yellow center of pus with red, purple, or brown skin around the edges
• Nodules: Swollen, painful, hard lumps deep in the skin with no whitehead
• Cysts: Swollen, painful lumps that tend to be red, brown, or purple and soft to the touch

A person with these types of blemishes should contact their dermatologist. Some dermatologists can perform an extraction in their office with specialized instruments and sterile procedures. They may also offer cortisone injections, which can help shrink nodules or cysts and relieve some of the pain and pressure.

Cleanliness and being gentle are the two most important rules when a person tries to pop a blackhead or whitehead.

Popping a whitehead

If the pimple looks ready to pop, there are some steps to take for safety:

• Wash the hands thoroughly with soap and water for 30 seconds and then dry them with a clean towel.
• Wash the face with a normal facial cleanser.
• Use an exfoliating product with alpha hydroxy or beta hydroxy acid.
• Use a cotton ball to apply rubbing alcohol to the area of the pimple.

Once the area is clean, a person may take the following steps to pop a whitehead:

• Apply a clean, warm washcloth to the pimple for up to 5 minutes. Doing this can help soften the skin and allow the contents to come out more easily.
• Sterilize a small needle with rubbing alcohol.
• Poke the center of the whitehead gently with the needle. In some cases, this is enough to allow the whitehead to drain.
• If the contents do not come out, wrap tissues or cotton pads around the tips of fingers.
• With padded fingers, gently push down and inward to apply pressure to the whitehead and encourage the contents to come out.
• If gentle pressure does not achieve results, stop squeezing. The pimple may not be ready to pop.

It is important to avoid using the fingernails, as they may puncture the skin, creating a skin injury and spreading bacteria.

Extracting a blackhead

Blackheads are different than whiteheads as the pore is already open at the top. Therefore, emptying a blackhead requires a different strategy.

• Wash the face and hands in the same way as above and use an exfoliating product with alpha hydroxy or beta hydroxy acid.
• Apply a warm, clean washcloth to the area for 5 minutes.
• Use the fingers to press gently inward and down toward the blackhead.
• Avoid squeezing too close to the blackhead, as this can make it harder to extract. Instead, start farther away from it and move the fingers around in a clock-like motion to extract it from different angles.
• Do not use the fingernails. Trim the nails short or place cotton pads or tissues on the fingertips to protect the skin from injury.

Another option is to use a blackhead extractor, although some experts state that these are only safe when dermatologists use them. These tools are usually metal and have a small open loop at the end.

People can follow these steps to use a loop-style blackhead extractor:

• Center the loop over the blackhead.
• Press down on the blackhead.
• If the plug does not pop out, use a sliding motion while pressing the loop to encourage the blackhead to come out.
• If this motion does not remove the contents, stop. The blackhead may not be ready to come out. Alternatively, it could be a sebaceous filament, which is not a blackhead but has a similar appearance.

Acne can cause both physical scarring and emotional or mental distress. If a person has persistent acne that does not clear up with over-the-counter treatments, such as benzoyl peroxide and salicylic acid, they should see a dermatologist.

A person should see a dermatologist if they have inflamed acne, which can include large pimples or painful cysts. They should never try to pop or extract this type of acne, as doing so can cause pain, infection, and permanent skin damage.

People who frequently pick at acne or have an uncontrollable urge to pick their skin should also see a dermatologist. They may have a condition known as acne excoriée.

A dermatologist can prescribe specialized prescription medications that can help clear acne and prevent further scarring or skin damage. They may also offer in-office procedures, such as professional extractions and skin peels.

Treatment from a dermatologist may also help a person gain self-confidence.

Dermatologists generally do not recommend that people try to pop or extract their acne. In many cases, a dermatologist can prescribe oral or topical treatments to help prevent acne. They may also perform pimple extractions in office or administer a cortisone shot to shrink a large pimple.

However, using clean and gentle techniques, people can pop certain noninflamed whiteheads and blackheads at home.

If acne is persistent or is leading to scarring, a person should see a dermatologist.