To Squeeze or Not to Squeeze: The Down Low on Pimples
- A pimple is a pore that has been inflamed.
- It’s not just acne bacteria that cause pimples. The inflammation actually comes from the immune system, not from the bacteria.
- Squeezing pimples can force acne bacteria deeper into the skin.
- Acne bacteria can be covered by healthy pink skin that won’t let them escape, trapping them under the skin.
- Trapping acne bacteria transforms pimples into cysts.
- Squeezing pimples always makes them worse.
- The redness, itchiness, and inflammation of a pimple is caused by the immune system, not by acne bacteria. The bacteria just sensitize the skin to the immune system so it will give them an exit to the surface.
- Squeezing pimples forces bacteria downward instead of upward and refocuses inflammation under the skin.
- If you are concerned about how pimples look, you can conceal them.
- To get rid of pimples, the two most commonly used over-the-counter products complement each other, each one picking up where the other leaves off.
Why Squeezing Pimples Is a Bad Idea
Squeezing pimples is always a bad idea. Part of the problem is that pimples are not inflamed by bacteria. Pimples are inflamed by the immune system.
A pimple differs from a whitehead or blackhead by the presence of inflammation. Pimples, whiteheads, and blackheads all trap acne bacteria inside pores. When the immune system detects acne trapped in the skin, it attempts to destroy them by secreting chemicals called cytokines, especially two cytokines known as IL-6 and IL-8 ( the latter chemical also known as CXCL8).
These cytokines destroy not just bacteria, but also the skin cells around them. That is the reason you feel itching and sometimes pain in a pimple, and they look red. If the immune system does not attack the bacteria, there is no pimple.
Squeezing a pimple does not get all the bacteria out of the skin. Some are left behind. New skin grows over them so they cannot be reached by the kinds of antibacterial products you put on your skin, but the immune system continues to try to get rid of them by secreting inflammatory chemicals. The bacteria fight back by secreting chemicals that make the skin cells surrounding them more sensitive to inflammation than the bacteria themselves, so the area of inflammation can grow and grow and grow.
Squeezing a pimple also destroys the pore’s first line of defense against bacteria, which is the very same sebum that causes clogs. The sebum-making cells in the skin release fat in the form of triglycerides. These are creamy compounds that are also used as a skin-identical ingredient.
The triglycerides released by the skin quickly break down into free fatty acids. The free fatty acids can dissolve acne bacteria. If you squeeze a pimple, however, you kill the cells that make the triglycerides that turn into the free fatty acids that keep a whitehead or a blackhead from turning into a pimple.
A Better Way to Treat Pimples
Just don’t squeeze your pimples. There is a better way to treat pimples.
The first thing you need to do is to encourage your skin’s production of the chemicals that protect it. These chemicals can work even when the pore is red and inflamed. In fact, the skin’s own chemicals usually do most of the real work of healing a pimple from the inside out.
What are these healing chemicals made by the skin? As hard as it is to imagine in this era when fat is always supposed to be bad, the chemicals the skin uses to heal itself are fatty acids—but not just any fatty acids.
Lauric acid can kill 99% of acne bacteria in a pore. Palmitic acid can kill 99.99% of acne bacteria in a pore. Oleic acid can kill 99.999% of acne bacteria in a pore.
These fatty acids are neither the “good” n-3 essential fatty acids nor the “bad” n-6 essential fatty acids. They actually are not “essential” at all. Oleic acid is the fatty acid found in olive oil, but even if you never eat any olive oil, most of the fat under your skin around your belly is oleic acid made by the body as it stores extra calories.
Palmitic acid is not as abundant in the human body as oleic acid, because it is just an intermediate step in making oleic acid. Palmitic acid, as you might imagine, is also found in palm kernel oil.
Lauric acid is found in coconut oil and palm kernel oil and people. Human breast milk is rich in lauric acid, although both males and females make lauric acid in breast tissue.
Lauric acid and palmitic acid fight acne bacteria. Oleic acid, the most abundant fatty acid in the human body, fights both acne and staph bacteria. Your body can fight acne with these fats. You don’t put them on your skin. Your body sends them to your skin from the excess calories you eat every day in the form of triglycerides.
Does This Mean I Need to Eat More to Zap My Zits?
Does this mean that eating more helps heal acne and that a crash diet makes acne worse? With one important exception, this is really the case. Your body uses fat from food to make chemicals that kill infections. Eating enough calories—and not trying to lose weight by calorie restriction—helps your skin make the chemicals that it can use to heal itself.
There is one exception to this rule. That is acne that is caused by polycystic ovarian disease (PCOS), a condition in women caused by overproduction of testosterone in the ovaries. Eating fewer calories improves insulin sensitivity in the rest of the body. (The ovaries don’t have an “off switch” to keep them from absorbing sugar from the bloodstream, but if the rest of the body absorbs sugar more efficiently, the ovaries absorb less.) When the rest of the body uses sugar more efficiently because of lower insulin resistance, the ovaries make less testosterone, and acne clears up, along with other symptoms of the condition.
So don’t squeeze your pimples. Eat dessert, as long as it is not chocolate. Your body has to have a small number of additional calories to fight acne infection. And that’s not all you can do:
1. Don’t pick, prod, poke, or otherwise disturb your pimples, either. Let your skin do the work of healing.
2. Reduce redness with a dab of tea tree oil applied to the pimple with a clean cotton swab twice a day. Many products that smell good because they contain a little tea tree oil don’t contain enough tea tree oil really to do any good. It’s better to use pure tea tree oil on your skin. Don’t take it by mouth, and keep the bottle out of reach of children.
3. Give you skin a second line of defense against infection with benzoyl peroxide. The combination of benzoyl peroxide and tea tree oil works better than either one alone. Start with just 2% benzoyl peroxide to make sure it does not cause peeling.
4. Don’t try to dry out your skin. The problem in acne is never that your skin is too moist. It’s always a problem of oil in pores. Even if you have naturally oily skin, you may need a little moisturizer, especially across the cheeks and on the nose, in dry weather. Moisturizers help the skin maintain a natural color, and keep it soft so oil can flow out of pores.
5. Consider a gentle face peel. If you have dry skin, a fruit acid peel, also known as an alpha-hydroxy acid peel, is best. If you have oily skin, you will probably get better results from a beta-hydroxy acid peel. There is only one beta-hydroxy acid used in acne care. That is salicylic acid.
A word of caution for acne sufferers who have brown or black skin: Brown and black skin repairs itself by making pigment. Anything that irritates the skin can cause long-lasting or even permanent pigmentation. It is always important to be gentle with brown or black skin.
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