Health & Wellness

Pimples and blackheads 101: How to clear up those dreaded skin blemishes

It’s a cruel summer when your skin breaks out just as you’re showing it off the most.

Pimples and blackheads can appear at any time, but you may notice more of the unsightly spots during the warmest months.

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Don't pop or squeeze pimples, dermatologists say.

“Summer tends to be a particularly aggravating time of year for them,” Dr. Julie Karen, a board certified dermatologist in New York and an assistant clinical professor at NYU Langone Medical Center, told TODAY.

People are more diligent about applying sunscreen and they sweat more, all of which can contribute to clogging of the pores, she noted.

We asked Karen and Dr. Carolyn Jacob, founder and medical director of Chicago Cosmetic Surgery and Dermatology, how best to deal with pimples and blackheads.

Why do they form?

It's less about dirt, and more about oil. Your skin has glands that produce oil, which is a good thing.

“You need to produce oil, otherwise your skin would be really dry,” Jacob noted.

But too much oil can mix with dead skin cells and other grime on the surface of your skin and form a plug — a whitehead — that clogs a pore. When whiteheads are exposed to air, they oxidize, turn black and become blackheads.

Blackheads and whiteheads are one spectrum of acne. The dreaded pimple is more about bacteria and inflammation. The stuff clogging your pores is a very good environment for bacteria to live and grow, Karen said. As your body responds, you’ll see the classic bump and pus.

Related: How to get rid of acne: Easy home remedies, clear-skin tips

Why would my skin produce too much oil?

Hormones can boost skin oil production, especially around women’s periods, Jacob said. Stress increases the hormone that drives oil production, as do sugary foods, she noted. More on the possible diet connection later.

Related: The biggest skin-care dilemmas women face in their 20s — and how to fix them

What’s the best prevention and treatment?

Wash your face regularly and gently. People often think scrubbing will prevent blackheads, but it increases the shedding of skin cells and causes further clogging of the pores, Karen noted.

Remove any makeup before you exercise and wash your face afterwards, or use face wipes to get rid of the dirt and sweat so your pores can breathe a little bit more, she added.

Once blackheads and pimples appear, there are many options.

“We need to unplug the pore, calm down the bacteria and the inflammation, and control the oil production,” Jacob said.

  • Salicylic acid helps rid the skin of the dead skin cells that are clogging the pores.
  • Benzoyl peroxide is anti-inflammatory, so it limits the inflammation that leads to pimples or pustules. (It bleaches towels, clothing and bedding, so use white towels or wash it off completely, Karen cautioned.)
  • Vitamin A creams, or topical retinoids, help to unplug the pores, fade away pink spots and decrease inflammation. Not everybody can tolerate them because they tend to be very irritating, Karen noted. You have to try them slowly in small amounts. Be aware they can make you more sun sensitive.
  • Antibiotics, given topically or orally, can be of some help to decrease inflammation.
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Should you ever pop or squeeze?

Don’t do it! Our experts warned that while picking can be tempting, it can lead to small scarring.

You might also increase the amount of inflammation that’s already there.

You’d be better off putting benzoyl peroxide on a pimple than to try to pop it, Jacob said.

There is one time it's OK to squeeze, according to Karen. If a blackhead is “super ripe” and you absolutely can’t resist getting rid of it:

  • Clean your face and use clean fingers
  • very gently apply pressure to the periphery of the black bump

Related: The biggest skin-care dilemmas women face in their 30s — and how to fix them

Does diet matter?

The literature has gone back and forth as to whether what you eat plays a role, Karen said.

“Yes, it is relevant in some people,” she noted. But having acne is not always “a sign that they have a bad diet, that they’re eating too much chocolate or greasy foods.”

Some people can eat a chocolate bar a day and nothing happens; while others can look at a chocolate bar and break out, Jacob noted. Genetics may be a factor in how your body reacts.

Her advice is to adjust your diet as part of your strategy to clear up your skin.

“You are what you eat,” Jacob said.

Related: Can 'all-natural' products irritate your skin? Yes, and here's how to avoid it

Keep wearing sunscreen

Don't avoid sunscreen because you're worried it's going to make you break out. There are many good options targeted for acne-prone skin, both dermatologists said. Look for a gel-based, lightweight formulation that works for you.

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