There’s a hierarchy of pimples. There are blackheads (aka open comedones), annoyances that usually disappear with the right toner. There are whiteheads (closed comedones), frustrating little bumps that respond well to retinoids. There’s inflammatory acne, the angry-looking red bumps that can really ruin your day but thankfully cower in the face of products containing benzoyl peroxide. And then, in their own special hell, are blind pimples — the dreaded type of acne that arises without a warning and makes itself comfortable in your skin for the long haul no matter what you seem to do or what products you throw at it.
“’Blind pimple’ is a layman’s term for cystic acne,” explains Dr. Hadley King, a board-certified dermatologist based in New York. “They’re the kind of deep, tender pimples that aren’t superficial enough to have an obvious connection to the surface.” In other words, unlike the other types of blemishes, blind pimples don’t have a head — they’re unpoppable.
Cystic acne develops when pores become clogged by a pernicious combination of dead skin cells, sebum (aka oil), and bacteria. Though they’re called blind, these bumps are far from invisible — cystic acne typically shows up as a large, red, swollen bump that’s tender to the touch. They run deep in your skin and are the most likely to leave a scar when they go.
Meet the Experts
Hadley King, MD is a board-certified dermatologist who specializes in medical and cosmetic dermatology. She is also a Clinical Instructor of Dermatology at the Weill Medical College of Cornell University.
Technically, no one is immune to blind pimples but cystic acne is often caused by hormones, meaning you might be more likely to see these bumps around your period. They’re common on both the face and the body, popping up everywhere from the chin to the chest, to backs and shoulders, and even behind the ears.
So, how do you get rid of these tenacious blemishes? Here’s your action plan.
How to treat a blind pimple
Given their nastiness, you might be tempted to throw everything you have at a blind pimple to make it go away. But when it comes to cystic acne, Dr. King recommends a less is more approach. “If it hasn’t come to a head, then don’t put pressure on it. You are likely to do more harm than good if it’s not very ready to drain,” she says. Trying to squeeze a blind pimple can make it worse, releasing more pro-inflammatory material like bacteria into the skin, explains Dr. King, “causing more inflammation, which will increase the time to heal, the risk of scarring, and the risk of discoloration.” Trying to pop it can also increase the risk of triggering an infection.
Instead, you can try to encourage the embedded clog to make its way to the surface of the skin, where it can safely drain on its own. “If it is the kind of inflammatory pimple that will come to a head and drain, then a warm compress may expedite this process,” says Dr. King. Soak a washcloth in warm water and apply it to the pimple three times a day for five minutes each time. Topical acne treatments that kill bacteria (like benzoyl peroxide) and encourage exfoliation (like retinol) can also help speed this process.
But not all blind pimples will show themselves on the surface of your skin, no matter what you do. “If it’s deep enough, it may not come to a head and drain. It may slowly resolve over months,” says Dr. King. This is where a dermatologist comes in. “Cystic pimples can be treated with intralesional cortisone injections to decrease the inflammation — nothing works as quickly to decrease the inflammation,” says Dr. King. The process takes less than five minutes and starts working right away. “An intralesional cortisone injection really can often make a pimple dramatically better overnight, particularly if you catch it early,” Dr. King says.
If you get the occasional random blind pimple, a quick trip to the dermatologist for a cortisone shot might be your preferred defense. But if blind pimples are a recurring issue, you may want to go on the offense with acne medication.
There are three primary medications that can take blind pimples down: oral contraceptives, which regulate hormone levels; spironolactone, another hormonal treatment; and Isotretinoin, an oral retinoid you might know as Accutane. (The latter two can cause pregnancy complications, according to the American Academy of Dermatology, so it’s important to discuss your birth control method with your dermatologist.)
As with any acne, it’s good to be proactive with blind pimples. “Deep, cystic acne has a risk of leaving permanent scarring so I would recommend seeing a board-certified dermatologist if you are experiencing this kind of acne,” says Dr. King.
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