Acne is more often associated with youth, but women in their 30s and 40s, who never had acne problems, can experience flare-ups.
Acne breeds a special kind of hysteria. From mild to psychotic, our reactions to pimples too often lead to desperate, reckless attempts to vanquish the offending skin disturbance.
Sure, the experts tell us to leave it alone. We know they are right, but when we feel that prickly, itchy sensation, it taunts our fingertips into action.
The professionals are not entirely unsympathetic.
“Acne is not life-threatening,” explained dermatologist Sandra Lee, who practices in Upland, Calif. But she said that she’s worked with plenty of patients who perceive blemishes in terms of life and death.
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She said that women are more likely to be “pickers” than men.
“We just want to do something … have to do something and have to do it now,” Lee said.
Acne is more often associated with youth, but women in their 30s and 40s, who never had acne problems before, can experience mild but persistent flare-ups for years, if not decades.
The worst part of acne is not the three to seven days of waiting for it to run its course; it’s the potential for long-term scarring or hyper-pigmentation. Those with darker skin tones are at greater risk.
“Most of us think, ‘How can I be a grown woman and be a slave to my hair or my weight or a zit,’ but that kind of thing really can leave you heartbroken for the whole day, no matter who you are,” said St. Louis dermatologist Madhavi Kandula.
Should it? Obviously not. A bad hair day, an extra pound on the scale or acne should not drive us crazy. We know that consistency and good habits matter more than an arbitrary day of misfortune.
But the reality is that it matters, because it does!
“Sometimes people just need something to relieve the stress; it’s hard not to do something,” said Caroline Mann, a dermatologist with the Washington University School of Medicine.
We want to do the right thing, but when the right thing (do nothing) is unsatisfying, we’ll settle for doing the wrong thing (pick, pick, pop).
Kandula, Lee and Mann chalked it up to human nature.
I will admit to many a day of irrational bargaining with the gods of complexion to just take this or that skin affliction away. If someone told me that altars needed to be erected and chickens sacrificed, I’d have considered it.
The Latin name is “acne vulgaris,” and I can’t think of anything more apt.
So the day the Tanda Zap ($49) arrived, I secretly dreamed that perhaps it would be an acne miracle cure. The device’s LED lights simulate the blue in the UV spectrum that penetrates the skin and targets the bacteria that cause acne. It was discovered and refined because sunlight does wonders for acne, but the accompanying sun damage is not so admirable.
After consulting a handful of experts about whether this thing actually works, here’s what I learned: At its best the device will destroy the most common acne-causing bacteria under the skin before the bacteria can achieve critical mass (i.e., no zits). At its worst, the device will have no effect on your pimple.
But everyone recommended it anyway, sight unseen and untested.
Madhavi said that even at its worst, the product has one crucial benefit: It gives you something to do.
But she warns it may simply offer a placebo effect. I was a little embarrassed to confess that I’d been carrying this device around in my purse for three days and subconsciously using it much like a pacifier. The pamphlet recommends two to three treatments a day to an area (each treatment is a steady stream of blue light, vibration and mild heat meted out in timed, two-minute intervals), and I used it diligently morning, noon and night.
The quarter-sized treatment area required moving the device five to eight times (that takes 10 to 20 minutes) along my acne-prone jawline. It felt therapeutic, but people in control groups have said the same. I continued to use it, and by day four, I had to replace the three AAA batteries that work the gizmo. And 10 days later, I’d been through three sets of batteries.
It’s almost always best to do less, not more, when acne flares up, Mann said, but she understands why many patients find this level of inaction to be nearly impossible to achieve. So having a device on hand to administer emergency, proactive spot treatment is not such a bad idea.
“And the best thing, is that it might work,” Madhavi said.
— — —
You have a pimple, now what?
We consulted three dermatologists and a skin care specialist for acne treatment tips that would do the least amount of harm to your epidermis.
1. Breathe, relax, ignore.
2. OK, now that you’ve failed at that you can use a spot treatment.
3. If your skin tolerates potions (some of which can be drying) try that. However, some potions can leave a chalky mark on your face, which is not a good idea at the office or if you have to leave the house to run errands. Alternately, you can use one of the handheld, high-tech, acne-clearing devices such as Tanda Zap ($49), Claro Portable Personal Acne Clearing Device ($195), Zeno Heat Treat ($40) or Tria Skin Clarifying System ($295).
4. Remember, if you feel the pressure of a pimple building under your skin (that tender feeling of impending inflammation), you should not squeeze … ever. It won’t help, it’s too deep.
5. Schedule a facial. Aestheticians can administer a number of remedies and aids, including full face blue light treatments that take less time than the handheld devices and include helpful topical treatments that can drastically impact present and future blemishes.
6. If you want to speed a pimple along, you can apply warm (not hot) compresses to the skin a few times a day to encourage it to the surface and relieve the pressure. Bonus: It keeps your hands busy.
7. Get thee to a professional. If you’ve got an important event coming up, weddings come to mind, you should run to the dermatologist for an assessment. There are injections that obliterate acne-causing bacteria overnight, and as a bonus, they can introduce you to a regimen that can better prevent acne.
8. A dermatologist or trained aesthetician will also be able to pop (they don’t like that word though) a pimple the right way, if it’s ripe. Yes, there is a right way.
9. Now, you want to know how to do it yourself, don’t you. You’ve zapped it, slathered it in potions, applied a compress, stared it down in the mirror, given it a good tongue lashing and you can’t take it any more. OK, OK …
Start with a warm compress or warm shower and clean hands. The moist heat is to open the pore and loosen the debris inside. Now, you might opt to wrap your fingers in tissue to perform the procedure. It’s helpful because it can absorb the debris that’s going to come out. That debris is full of bacteria that can reinfect your skin if you don’t remove it.
Next is the most important step. DON’T SQUEEZE. It’s also the trickiest step.
You have to use a technique that opens and spreads the pore (more pressing than squeezing) that allows the buildup to release. There are some tools designed to make this easier (always sterilize them with alcohol first). And if you’re practiced you can even employ a sterile needle to prick the zit just a tiny bit to aid removal. Finish with a low dose of benzoyl peroxide to fight bacteria. In the morning you can use a low dose of salicylic acid to keep the pore clean.
But you should not be overzealous.
If you have the time, you should ask a professional to demonstrate first, most will gladly show you exactly how to pop … er … I mean, liberate a pimple. They might give you a lecture first, but don’t be shy about asking.
Any skin care expert with a heart would rather you ask them how and when to do it the right way, rather than treat you for scarring and hyper-pigmentation later.
They know that you are going to be tempted beyond reason at some point.
10. Consider changing your prevention routine. One of the biggest acne-offenders is overtreatment, meaning you wash aggressively, scrub vigorously, apply potions and astringents generously, all the while provoking your skin to rebel. Exfoliating is often enemy No. 1.
We know, scrubs feel so good, because you’re taking action. But can we blame our pores for taking offense?
Maybe it’s time to start a new less is more cleansing routine — mild cleanser (something like the highly recommended Cetaphil), toner (witch hazel) and a low dose (i.e. not maximum strength) of an over-the-counter acne treatment.
Try it for a month, and in the meantime, keep practicing step one.
Our experts team: Madhavi Kandula, cosmetic dermatologist; Caroline Mann, dermatologist at Washington University School of Medicine; Sandra Lee, a dermatologist with Skin Physicians and Surgeons in Upland, Calif.; Dora Peters of Esthetics Face and Body.