Most of us know how to deal with the odd spot, but those deep, often painful cystic pimples that emerge under the surface of the skin need to be approached with caution. Acne can appear in several shapes, sizes and forms—factors such as poor hygiene, hormone imbalances, diet and genetics can exacerbate them. “Sporadic surface spots such as blackheads and whiteheads can be easily removed with exfoliation, deep cleansing and extractions,” explains Dr Howard Murad, a board-certified dermatologist based in Los Angeles.
“If the skin does not heal normally, the follicle wall may rupture, and the skin surface becomes red and swollen. Pustules are the next stage of the process when a severe inflammatory reaction can result in large, tender pus-filled lesions in the deeper layers of the skin, which are called cysts,” he adds. Dermatologists class these spots as the most severe and difficult to treat, but there is plenty you can do to tackle and tame the occasional cystic spot at home.
1. First, cleanse
However tempting it may be to squeeze or pick a cystic spot—don’t do it. “The absolute worst thing you can do is attempt to pop a cystic spot,” warns Mumbai-based celebrity dermatologist Dr Rashmi Shetty. “Since this type of spot lies beneath the skin, it isn’t easy to squeeze and doing so can spread the infection, leading to painful inflammation, scarring and hyperpigmentation,” she says.
Cystic spots are formed when a combination of sebum, bacteria and dry skin cells get trapped in the pores. If you are afflicted with severe and persistent cystic acne, consult a dermatologist, who can asses your skin and put together a tailored regime. You can usually feel a cystic spot forming, so cleansing with the right zit-zapping ingredients may help shrink it before it develops.
“Salicylic acid is a brilliant anti-inflammatory and antibacterial ingredient found in many blemish-fighting cleansers, but when we are dealing with a single cystic spot, you don’t want to upset the delicate balance of the rest of the skin, so look for a cleanser that can clean the skin without leaving it feeling dry,” advises Dr Murad.
He recommends a gel to oil based cleanser that emulsifies with water. “The oil breaks down sebum and helps flush out blocked pores, while keeping a healthy balance of hydration,” he explains. “Then apply an astringent toner containing witch hazel, precisely to the oil prone and affected areas of skin. This will dry out excess sebum and calm redness,” he adds.
2. Then, stop the swelling
If the bump is swollen, using a cold compress can constrict the blood vessels helping to reduce the size of the spot. “Use an ice cube wrapped in a clean cloth to to help reduce inflammation,” advises Dr Shetty. “Hold this onto the skin for a few minutes, every few hours. But, if the spot has already developed and is ready to burst, apply a warm compress to consolidate the pus,” she adds.
3. Treat it fast
Using the wrong active ingredients can leave the spot looking dry, irritated and difficult to conceal. Dr Murad recommends spot treating emerging pimples with salicylic acid. “It is a great anti-inflammatory ingredient, which is able to penetrate the pores, calm redness, reduce swelling, it also kills bacteria and exfoliates the skin’s surface to speed up healing,” shares Dr Murad.
If all other options fail or you have a big event the following day, Dr Shetty suggests using antibacterial benzoyl peroxide, as it acts quickly to eradicate acne-causing bacteria within the pores.“Dab a thin layer of benzoyl peroxide directly onto the spot, just before bedtime to prevent it from getting worse, but use this ingredient sparingly and with caution as it can cause dryness and peeling,” she says. If the blemish becomes red or painful you may need a stronger option. “Try a one per cent hydrocortisone cream, which contains a low dose of steroids that can help to shrink the spot and ease redness,” adds Dr Shetty.
If your skin is not sensitive or prone to dryness, invest in a deep cleansing mask and apply it to blemish prone areas to keep spots at bay. “Look for masks with ingredients like kaolin clay and sulphur, as they keep the pores clean by gently drawing out excess oil and exfoliating the skin,” explains Dr Murad.
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