how to treat deep, painful pimples | American Academy of Dermatology
Have a big pimple that just won’t go away? There are steps you can take to help it heal.It’s actually quite normal for those monstrously big blemishes to take a long time to completely disappear. Really deep or large pimples can take up to several months to flatten out and heal. So, if you’ve been battling a big one for a while, you can rest easy knowing that it’s not unusual. Acne nodules (deep, hard, inflamed breakouts) and acne cysts are notoriously long-lived blemishes, but even large papules can take many weeks to disappear.Still, who wants to wait for those big zits to go away on their own? There are things you can do to speed up healing and shrink those “big guys” faster.
1. Resist the Urge to Pop It
First and foremost—don’t ever try to pop a deep pimple. Don’t poke it with a needle. Don’t squeeze it.Squeezing, poking, prodding, or otherwise messing around with the blemish makes the healing time longer. It can actually make that big pimple bigger, and much worse.Trying to pop this type of pimple can seriously damage your skin and cause scarring. These big pimples originate deep in the skin. Squeezing them puts pressure on the already swollen pilosebaceous unit, or what we commonly call the pore.You can be unknowingly pushing the dermal debris deeper into your pore, possibly even breaking the follicle wall and allowing infected material to spread beneath the skin’s surface. As much as you might like to, don’t try to drain this pimple yourself. Popping is rarely a good idea, and especially so with large zits.Why Popping Pimples Is Bad for Your Skin
2. Use an Acne Treatment Medication
If you use topical acne treatments, continue to do so. You can even dab on a bit more on the monster pimple to help it heal more quickly. Don’t confuse a dab with a big blob, though. And limit yourself to a twice-daily application. Using too much medication too often will dry out and irritate the skin instead of healing it.Full disclosure: spot treating works best for pustules (pimples with a white head). It won’t do much for deep nodules or cysts.If you break out regularly but don’t typically use an acne treatment, now is a good time to start. Consistently using an acne treatment medication will stop pimples from forming before they appear on your skin as a huge blemish.What you should never do for these large blemishes is try to spot-treat with items not meant for the skin. For example, things like garlic, honey, cinnamon, lemon, or toothpaste won’t treat large acne cysts, contrary to what some online sources say.
Home remedy spot treatments can’t penetrate the skin deeply enough to do any good. At best, they’ll do nothing for the blemish. At worst, you’ll end up with a irritated spot or a case of contact dermatitis.
3. Break Out the Warm Compresses
You can encourage the pimple to come to a head on its own by using a warm compress. Make one by soaking a washcloth in really warm water. Apply to the pimple for 20 minutes or so, a couple of times a day. You might have to do this for several days.With any luck, the warm compress will help the pimple to drain on its own. Remember, though, don’t squeeze at the pimple even if it comes to a head. Let it drain naturally.
4. Visit Your Dermatologist for Incision and Drainage
When at-home treatments aren’t helping, especially if you’ve had that blemish for more than a few weeks, it’s time to call in the pros. Those deep cystic breakouts sometimes need to be lanced and drained by a medical professional.Called acne surgery, the dermatologist will make a small incision in the skin and carefully drain the debris from the blemish. It’s a bit uncomfortable but not as bad as it sounds. And once done, your skin can begin healing.It’s important that you only let a physician do this. Your esthetician can’t (and legally, shouldn’t) lance a deep blemish. And this is definitely not a DIY job.Common Acne Surgical Procedures
5. Try a Cortisone Injection
Another pro treatment for big pimples is an intralesional cortisone injection. A tiny needle is used to inject a dilute steroid into the blemish. Within just a few days, the pimple shrinks and disappears. Again, this procedure must be done by a dermatologist, but it’s a super fast way to heal those monster zits.Cortisone injections should be seen as a last-resort treatment since it can cause side effects like a depressed or pitted indentation of the skin around the injection site. And not every person, or every blemish, is a good candidate for a cortisone injection. Check with your dermatologist to see if this is a good fit for you.Can Cortisone Shots Help Heal Your Acne?
6. Make Sure It’s Really a Pimple
Are you sure it’s just a blemish? What you think is a simple acne pimple could really be something entirely different. There are many different skin problems that cause acne-like blemishes.
Boils: A boil is an infected hair follicle, and these look exactly like giant pimples. They start off as a red, painful bump under the skin and as they progress develop a white head. Some boils heal on their own with at-home treatment, but others need medical intervention.
Ingrown hairs (AKA pseudofollicultis): Ingrown hairs, especially if the follicle becomes infected, can cause large, painfully red bumps. They’re more common in areas where you shave, and especially for those with curly hair. Regular use of an exfoliating product can help prevent and treat ingrown hairs but severe cases of ingrown hairs should be treated with prescription medications.
Cold sores: Pimples near the lip can sometimes be mistaken for cold sores, and vice versa, but they’re two completely different skin blemishes. Cold sores are caused by the herpes simplex virus. While acne can’t be spread from person to person, the virus that causes cold sores is contagious. Cold sores typically heal without any intervention, but if they’re widespread or incredibly painful talk to your physician about what you can do.
Skin cancer: Although not as common as the skin problems above, skin cancer can also cause a pimple-like bump on your skin. Any pimple, sore, or scaly patch that doesn’t heal within three weeks should be seen by your physician.
When to See a Doctor
Any acne-like bump that appears on your skin and just won’t heal warrants a trip to the doctor. This is especially true if the bump is extremely large, inflamed, or painful, or if the pimple pops up in a place you typically wouldn’t expect to find acne (your underarm, for example, or the back of your knee).
If you aren’t 100 percent certain it’s an acne breakout, make an appointment with your physician.
A Word From Verywell
Although there are things you can do to help soothe and heal a big pimple, the very best option is to keep them from appearing in the first place. That is going to mean a trip to the dermatologist.Severe or cystic acne just doesn’t respond well to over-the-counter acne products. The breakouts are too deep and too swollen for drugstore treatments to treat. There are prescription medications, though, that do a good job at getting large breakouts under control. Depending on your skin, your dermatologist might recommend a topical treatment, oral medication, or both.No matter what treatment you’re prescribed, it will take about three to four months to really get good improvement of the skin. So stick with it! Once your acne is under control, you won’t have to worry about those big pimples appearing.If you’ve got a large pimple that isn’t going away, and you typically don’t have acne, it’s a good idea to see your doctor too. It may not be a pimple at all. But once it’s properly identified, you can start treating it effectively.