Your cousin’s wedding is in a week and you have a monster zit right at the center of your chin. You’ve been scrubbing it, cleansing with toner, and diligently applying the acne-fighting super lotion you bought off an infomercial when you were high at 3 AM last month. Oh, and you’ve been picking at it. A lot.
You know you’re not supposed to pick pimples, but honestly it just soothes the shit out of you—until you look in the mirror and see the same zit coming back bigger and bolder the next morning. And then you’ve got to pick again, because you’re already stressed out about fitting into that magenta strapless bridesmaids’ dress and getting seated at the weirdo table with irrationally angry Aunt Debbie at the reception.
To make matters worse, your chin volcano has now sprouted neighboring offspring—little zit clusters sprinkled across your skin like remnants of a bacterial glitter bomb. They should reach their peak just as the wedding photographer calls for fun, casual shots by the gazebo.
Your plan is to just keep scraping at those zits—big and small—for the next week to keep them pruned until the big day, slap on a half-gallon of concealer for the photos, and then deal with the facial fallout once your cuz and her partner are off to Hawaii for the honeymoon.
How bad is it to pop your pimples?
Bottom line? It’s not great, but you probably already knew that. It can lead to “worse inflammation, prolonged duration of your pimple, and can cause scarring,” says Tsippora Shainhouse, a board-certified dermatologist and clinical instructor of pediatric dermatology at the University of Southern California. The scarring can be more frequent and noticeable in people with darker skin tones.
What happens when you pop a pimple?
“Pimples are essentially small sacs under the skin that are filled with natural oils, dead skin cells and sometimes bacteria and white blood cells,” Shainhouse explains. “Sometimes, they have a small opening to the skin surface—a pore. When you squeeze the skin and 'burst' the pimple, you’re creating a tear in the skin, which then needs to heal and can leave a scar.” She adds that if the popped pimple had acne-causing bacteria in it (more formally known as Propionobacterium acnes), then it could spread into adjacent pores when the pus squirts onto your skin.
So that’s how your one mega pimple turned into a zitstorm.
Why does picking or popping acne feel so good, though?
Acne picking actually gives people a sense of accomplishment and makes our brain produce that delightful neurochemical dopamine, says Sanam Hafeez, a clinical psychologist and faculty member at Columbia University Teacher’s College, and that's especially true if you’re someone who’s a problem-solver with a desire for control.
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When you self-treat a pimple, you get immediate gratification. “Dopamine is released in the brain when you feel a sense of accomplishment. It's the brain's reward center. Seeing the pus, blood, or liquid come from a popped pimple makes the person feel accomplished, like ‘I got it,’” she says. “So there's a combination of brain activity here. First the ‘oh no there's a pimple’ anxiety followed by the physical relief when it's self-treated and the sense of calm and pleasure when it it's gone.”
The problem is that picking acne can make it worse, which can make it come back, which starts the anxiety cycle all over again. In severe cases, people who do pop pimples a lot may develop an OCD-related condition called Skin-Picking Disorder or Excoriation Disorder. The International OCD Foundation estimates that the disorder affects one in 20 people and can cause severe physical, emotional, and psychological distress.
And then there was that time a lady nearly died from encephalomalacia—brain damage associated with the softening of brain tissue—because she couldn’t stop picking at her forehead with a knitting needle. For the record, you’ll probably be fine but it’s only fair to give you all the info while sufficiently freaking you out.
But what if you’re just an occasional picker and very careful?
It depends. Are you a dermatologist yourself? No? Then don’t do it.
But what if you’re going to do it anyway because, oh my god, you’ve gotta pick this thing?
We’re clear that no one is recommending this, right? Okay. In the interest of harm reduction, Shainhouse has offered a detailed “How To” guide on how to pop that fucker in the safest way possible.
1. Wash the area with soap and water to remove any makeup or concealer.
2. Wipe the pimple with rubbing alcohol to disinfect the skin.
3. Wash your own hands well to minimize adding bacteria from your fingers and nails into the site.
4. Take a needle or pin and dip it in rubbing alcohol to disinfect it (burning it over a flame will not necessarily kill bacteria).
5. Pop the skin overlying the most 'ready area'—usually stretched-out skin over a yellow pus-filled bump.
6. Use two clean Q-tips and roll inwards from the outer edges of the lesion to remove the pus or sebum/dead skin cell debris. Try to do it in one shot in order to minimize irritation and even tearing the surrounding and overlying skin.
7. Consider applying a dab of antibacterial ointment or acne cream on the site to prevent infection and help it heal up.
Can you do anything about that heinous magenta bridesmaids’ dress?
Nope. It’s not your day. Say hi to Aunt Debbie.
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This article originally appeared on VICE US.