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How to Treat Pimples Under the Skin

Finally! How to Get Rid of Lurkers, or Hidden Pimples

Every morning before I apply my makeup, I inspect my skin for signs of fine lines, wrinkles, and breakouts — and the first thing I said today was "uh-oh." I generally have a clear complexion, but today I found myself suffering from a few painful pimples. You know the ones . . . hard bumps that lurk under the skin and seemingly never come to a head. And for good reason: according to NYC dermatologist Dr. Neal Schultz, host of DermTV.com and creator of BeautyRx by Dr. Schultz, they're called blind pimples or cysts.

Like most pimples, lurkers are caused by a combination of bacteria, clogging from dead cells, and excessive oil production. But what distinguishes them is that they are deep below the skin's surface, extending into the subcutaneous (fatty) layer. This makes them painfully lurk for weeks — even months. "The oil contains a lipid called triglycerides, and the bacteria make an enzyme that actually splits the triglycerides into free fatty acids," explained Dr. Schultz. "These are very irritating chemicals, which cause a lot of inflammation, resulting in rapid pus accumulation in the cyst." This fast pus growth stretches the cyst wall and surrounding nerves, causing pain.

Frequent sufferers of blind pimples, you do have some options! "You can avoid them by taking internal medication that affects either the oil or the bacteria," said Dr. Schultz. He said on a short-term, prevention basis, people usually take antibiotics or birth control pills. Antibiotics can kill the bacteria that causes free fatty acids (which makes these pimples so painful), while birth control pills decrease oil production.

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And, if you try to flatten them at home like I do via layers and layers of topical ointments, you're doing it wrong. "It's much better to try and get the blind pimple to come to a head and rupture," said Dr. Schultz, who suggested applying warm compresses several times a day to make it surface. "Then the pus can drain out, shrinking the cyst, stopping the pain, and healing."

If you don't have time to coddle your blind pimple until it comes out of lurking mode, there is a quick fix! To stop the swelling in one day, have your dermatologist open the cyst with a sterile needle and then inject the inflamed cyst wall with cortisone. That way, the cyst will rapidly shrink and heal.

Image Source: POPSUGAR Photography / Glen Giffen
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