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The pimple dilemma: To pop or not to pop


This story is sponsored by University of Utah Health. Learn more about University of Utah Health.

In popular culture, theories abound about why acne forms and what are the best methods for making it go away. Is greasy food to blame for that sudden breakout? What about chocolate? Is it ever a good idea to pop a pimple? And what treatments are available for people with mild and severe acne?

Erika Summers, M.D., a dermatologist with University of Utah Health Care, answers questions about acne in an effort to set the record straight.

Is acne caused by eating greasy foods and chocolate?

"It's unlikely that oily foods and sweets play a role in acne," said Summers, noting that genetics along with hormones such as testosterone, which is produced in the adrenal glands and gonads, are the main underlying causes of acne. In addition to hormones, which spring to life during adolescence, acne is caused by bacteria and clogged follicles. The much-maligned chocolate bar is off the hook, at least as far as pimples are concerned.

Should people with acne avoid makeup?

Makeup isn't typically the culprit when it comes to acne problems. But some makeup can make acne worse by clogging pores. If you've got acne, you may want to use noncomedogenic makeup products, which don't clog pores, Summers said.

Should you ever pop a pimple?

"It's very tempting for people, and it's hard not to do," Summers said, "but no, it's not a good idea to pop a pimple. You're at an increased risk of creating a scar." Certain types of pimples, such as cystic lesions or lesions that have become overly inflamed, leave scars on their own as it is. Picking at pimples makes scarring even more likely.

What can you do to treat mild acne at home?

Summers recommends a number of over-the-counter options. Try a benzoyl peroxide wash or glycolic acid wash, or treat with medications that contain benzoyl peroxide or salicylic acid.

What can be done for acne under a doctor's care?

If acne is still on the mild side when Summers sees a patient, she often starts with topical antibiotics, such as clindamycin, and topical retinoids, including adapalene and tretinoin. "If there are inflammatory lesions, then I will usually add oral antibiotics," she said. For severe cystic or scarring acne, Summers prescribes Accutane.

"Accutane works for almost everybody," Summers said. "It's a five- to six-month treatment course. It's a very monitored medication, and patients must come in for a check-up once a month."

About 50 percent of patients who are treated with Accutane will never have acne as bad as they had it before the treatment, and another 50 percent will need to be treated with Accutane again in the future.

What are the different types of acne?

Pimples come in a variety of forms, including whiteheads and blackheads, which are known as closed comedones and open comedones, respectively. Then there are papules (small, pink bumps), pustules (pimples with a red base and pus at the top) and nodulocystic acne (larger, sturdier pimples that are painful and buried deeper in the skin).

Should you hire an aesthetician to extract your acne?

Yes. If you've got a big event coming up and need to be as blemish-free as possible, allow a professional aesthetician to do the dirty work, says Summers. Aestheticians work with tools that reduce the chance of scarring.

What can be done for acne scarring?

"I see a lot of people for acne scarring, and scars are very hard to treat," Summer said. "There are a number of things you can do, including dermabrasion, micro-needling, injection of fillers, nonablative resurfacing, CO2 laser resurfacing, trichloroacetic acid, and surgically excising deep scars."

Click to learn more about fighting and preventing acne.