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Chako: Should I squeeze a pimple?

Paula: If you are going to, then do it right. But the basic thing is that if you overdo it you will make a scab. If you overdo it you will make it worse. That's the problem. Most people overdo it.

Dr. Levy: A pimple should not be squeezed. It should be gently extracted.

[laughter]

Chako: I like that.

Paula: In a gentle squeezing! Actually, that's true. It should be a gentle squeeze.

Dr. Levy: There is an art and there is a way to do it in a way that won't leave a blemish or a scar, and that's the main issue with squeezing a pimple. You are causing more inflammation than is already there.

Paula: If you don't know what you're doing.

Dr. Levy: You can leave a blemish that becomes an even greater problem.

Chako: Okay. So I have a question that a lot of people on Real Self are asking, and that is, I have a cystic. Can I get rid of it in one day? I've got an event, I've got a party, I've got a date. What is the answer to that?

Paula: No, you can't. Well, I mean, you can get an injection, but...

[laughter]

Yeah. Particularly a cystic. But you can get an injection from a dermatologist. But there are risks to getting those kinds of shots into a pimple.

Dr. Levy: It's a very common injection that we do in the office. It has been well described in Hollywood as the Hollywood shot, because people who go on TV and are acting have a breakout and this is the only magic miracle that will make it go away within a day.

That's a treatment that's covered by insurance, typically. I think it's about $77 or something to administer that injection.

Chako: I have got acne. Give me two things that I can take away and make sure that I'm doing the right thing moving forward with my acne.

Dr. Levy: So acne is a plumbing issue in the skin. The pores are congested. That's typically caused by hormonal inflammation at the root of the core. So to decongest you need something that's gonna be in the alpha-hydroxy or beta hydroxy acid family. So salicylic acid, as an example, or glycolic acid, lactic acid... Those are different types of beta and alpha-hydroxy acid.

They will get some of the clutter out, some of the dead skin, which we call carotene, that's trapped in the pores. Then a retinol, which is slowing down the sebum production in the oil gland. I would say look for those two ingredients.

Paula: The other thing I would add to it is that because acne is an inflammatory process in the skin, that anything you do that irritates the skin is gonna be counter productive. So when you look for exactly those ingredients, salicylic acid and retinol product, it should be at a 1% to 2% level that will usually be declared on the label.

Chako: Okay.

Paula: And it should contain no other irritants. No alcohol, no essential oils, no peppermint, no menthol. That will all hyper-inflame the skin and cause more oil production and be detrimental. It makes it look worse. Irritating ingredients are a problem for all skin, but particularly blemish marks.

Chako: Body acne, bacne, bimples? I don't know what to call it.

Paula: Bimples? I like that! [laughs]

Chako: I just thought it sounded cute. Bimples.

So can you talk a little bit? Tell me about that treatment. Why do I get that? Not me. Why do other people get that?

Dr. Levy: Well, all forms of acne usually have a hormonal trigger. Sometimes there are some lifestyle modifications. We know that hormones are in dairy products and some people just eat a lot of cheese and drink a lot of milk, and some people on the back have the problem of ingrown hairs. On the buttock, I think that's a common issue.

A lot of times a laser hair removal treatment or two clears it and solves the problem.

Paula: Tush acne. Backside acne. Rear end acne. Whatever you want to call it.

Dr. Levy: Bimples.

Paula: Bimples! I so love that. Bimples.

Sometimes that's a friction irritation problem. If you are wearing a thong pair of underpants and your tight jeans are right next to your backside and rubbing, that can cause an inflammation type of acne response. Also, the type of clothing you wear. A lot of people are allergic to the detergents that they are cleaning their clothes with.

You might want to consider... I think they are called the Fab Free, or All Free, and get your clothes cleaned with a more gentle type of laundry detergent. That can be the step to clear it up.

Chako: Do I need products that dry out my pimples?

Paula: Drying out skin causes damage, causes the barrier to be damaged. That makes acne worse. It's inflaming. Drying up skin, no. Don't do that. The ingredients that do that actually make acne worse.

Dr. Levy: To some extent it's not so much drying where we're making your skin texture feel dry. I think this acne prone skin, we have to slow down the oil slick, and the oil slick is part of the inflammation and there are some products that help do that.

Help! I Have Acne: Paula Begoun and Dr. Daniel Levy on Fast Fixes

Is it OK to squeeze a pimple? “Cosmetics Cop” Paula Begoun and dermatologist Dr. Daniel Levy share their advice for battling acne.

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