Is Popping a Pimple a Bad Idea?

Whitehead Pimple

Answer: It can be, especially if done improperly.

Popping a Pimple
Popping a Pimple

Some pimples and other acne lesions benefit from being drained or popped in order to remove pus and accelerate healing, but other pimples should be left alone to heal on their own. The nodules and cysts of those patients who suffer from severe inflammatory acne (Acne Type: 4) are often lanced and drained by a dermatologist. This can prevent further damage and limit post-acne scarring.

The important thing is to identify those zits and pimples which can be effectively popped (and which ones can not), and to do that properly and in a sterile fashion. Although it can be tempting to try and pop all zits pimples, in many cases it is more effective to allow the natural progression of the lesion and healing process to take place.

Benefits of Popping a Pimple

Whitehead Pimple Skin and Cellular View
Whitehead Pimple Skin and Cellular View

In some cases, it can be beneficial to extract the pus from inside of a pimple. Pus (the white stuff, not the clear fluid) is composed largely of specialized white blood cells called Neutrophils. These white blood cells migrate to the site of infection (the zit) and are designed to destroy and phagocytose (eat) the offending bacteria and other foreign material. These white blood cells are most apparent in open comedome lesions (whitehead pimples).

After accumulating in an acne lesion, the white blood cells release powerful enzymes and free radicals that are designed to kill and digest the source of infection. Unfortunately, these weapons also cause collateral damage to the healthy tissue around the infected follicle. In people who suffer from inflammatory acne, it is often an overeager immune response that causes swelling, redness and discomfort. The collateral damage to healthy tissue during this process is what causes the formation of acne scars.

In acne lesions that are significantly inflamed but easy to drain, removing the pus can limit the amount of collateral damage that occurs and can accelerate the healing process. In addition, the infiltration of the follicle with pus can put a lot of pressure on the surrounding nerves, which can be quite uncomfortable and painful. Draining a lesion may be helpful in relieving this pressure and the accompanying discomfort.

Risks of Popping a Pimple

Corticosteroid Injection into Acne Cyst
This Acne Cyst Requires Surgical Extraction

Many acne lesions (especially nodular and cystic acne lesions) can be very difficult to effectively pop and drain. Small, non-inflammatory acne lesions (Acne Types: 1-2) may not contain significant pus that can be drained. In these cases, attempting to drain the lesion can be unhelpful or cause further damage that slows down the healing process and contributes to more acne scarring.

In many acne pimples and cysts it is not just that the follicle is swollen with white blood cells and edema fluid, but rather the entire region of skin tissue is affected. Channels can form in the sub-cutaneous tissue and these channels can be occupied by bacteria laden white blood cells. Non-productive squeezing of pimples in these cases can force these white blood cells (and bacteria) away from the pimple and into the surrounding tissue. This can further spread the underlying infection and inflammation.

Aggressive squeezing of pimples can cause additional damage to the follicle itself, which leads to more inflammation and extends the amount of time it takes for the damage to be repaired. Lancing or popping an acne lesion in a non-sterile fashion can introduce bacteria or foreign material that can lead to more inflammation or even a secondary infection.

In conclusion, there are a lot of things that can go wrong when popping a pimple. Most of these are related to improperly draining a lesion or attempting to drain an unsuitable lesion, or non-sterile technique.

Considerations for Popping a Pimple

Sterility

Neosporin Ointment
Neosporin Ointment

It is very important to sterilize the area to be treated both before and after attempting to extract a blackhead or drain a pimple. This includes thoroughly washing your hands, cleaning the treated area and swabbing the lesion with alcohol or medicated wipe before and after extraction/draining. Topical application of Neosporin can also be used to limit the chances of secondary infection and accelerate healing.

Selecting Appropriate Pimples

It is going to do more harm than good if you try to pop a pimple that is not ready or is not suitable for draining. For example, many whiteheads are good candidates for drainage because the infiltrate (pus) is pooled near the surface. However, many inflammatory acne lesions, like nodules and cysts are poor candidates for drainage because there is no easy way for the infiiltrate to reach the surface.

In acne lesions where you have inflamed red bumps, like nodules and cysts, the infiltrate is fairly deep under the surface of the skin, with no clear exit pathway. In these cases of inflammatory acne, the entire length of follicle above the epicenter of the lesion is likely to be inflamed, and basically swollen shut. Attempting to squeeze or drain these type of lesions often forces the infiltrate (which contains many inflammatory factors) down and out, into the surrounding tissue. This will most likely aggravate the situation, causing more inflammation, scarring and a lengthier healing process.

In general, to effectively drain an inflammatory acne cyst or nodule, they often must be surgically lanced, which is a procedure best done in a dermatology clinic.

Proper Technique

Whitehead Removal with Comedome Extractor
Whitehead Removal with Comedome Extractor

To extract a blackhead, or drain a whitehead, it is important to use good technique. This means applying gentle pressure in a manner that forces the plug or infiltrate up and out. To do this you need to try and get under the main pocket of the lesion and gently work it out. It is important to use gentle rolling pressure.

Vigorous squeezing and applying lots of pressure are much more likely to cause additional damage and aggravate the acne lesion. There are several manual “extractors” used to extract blackheads. These generally have a small ring that fits around the blackhead and are designed to apply even pressure around the follicle. However, research studies into these blackhead extractions show that they produce, at best, a mild improvement compared to doing nothing.

Some dermatologists use a machine that extracts hyperkeratinic plugs and other follicle plugs using a suction based extraction machine. For the casual, at-home user, pore strips offer a means to extract some easily accessible blackheads, but pore strips are not suitable for inflamed lesions (eg. whitehead pimples).

Example Technique