It seems truly unfair that after dealing with an especially aggressive zit, diligently spot-treating it and handling it with the care of a surgeon for days and days on end, that another zit should pop back up in the same exact spot, just months, or even weeks, later. Like, why? What cruel force of nature allows pimples to keep resurfacing like a bad Tinder date that can’t take a hint? And how the hell do you prevent it from coming back?
These aren’t rhetorical questions, mind you. I genuinely wanted—no, needed—to know, seeing as the hormonal zit on my jaw had gone from a four-day visitor to a permanent squatter over the last few months. So I asked Yale dermatologist and VPP (Very Patient Person) Mona Gohara, who I have on speed-dial for skin “emergencies” like these. Her answer? It’s only partially your fault, and there’s definitely ways to fix it. YAY!
“If we’re talking about your classic, raised pimple with a visible whitehead, then chances are, it was spread by you picking at your skin or popping a nearby pimple at some point,” says Gohara. (Don’t even try to tell me that you never pop your pimples or touch your face, OK?) “Each time you pop your zits or try to squeeze them at all, you transmit bacteria into your other pores, while also causing inflammation in the surrounding tissue,” she says. Doesn’t sound like a huge deal, but when you consider the fact that inflammation is already a big cause of acne, you’re essentially throwing fuel onto the fire.
And, says Gohara, the inflammation and bacteria spreading is made a billion times worse if you’ve already been using acne-killing products on the area. “When someone has a pimple, they tend to douse it with a ton of irritating, drying spot treatments, which weakens their skin’s barrier and compromises their good, healthy cells,” she notes. “And when you irritate an already-compromised skin barrier and throw a bunch of bacteria into it from picking and squeezing, you’re pretty much asking for re-occurring breakouts.”
But let’s pretend that you’ve never once touched your face, and you never put any zit creams on your pimples, and you also exist in an ethereal cloud of perfection, and your zits still come back in the same spot—then what? “There’s a theory that some sebaceous glands on certain parts of your face are simply more susceptible to hormonal changes and fluctuations in oil productions,” says Gohara, adding that people with recurrent cystic pimples on their jaw and chin may fall into this category. “If your cystic acne seems especially tied to your hormones, then the only way to fix the issue is to eliminate the hormonal cause, which means working with your doctor to try Accutane or oral hormone stabilizers.”
OK—cool. But you already knew that you should be talking about your acne with your derm, right? You just want to know what you can do right now, at home, to fix this shit from happening again. We’re going to be really honest, though, and say that nothing you apply topically will be as effective as what your derm will prescribe you. As long as you’re cool with those odds, you can still try to mitigate re-occurring zits by treating the area nightly with a lightweight salicylic acid (which gently exfoliates and unclogs pores), like Clinique’s Acne Solutions Clinical Clearing Gel, then dabbing a sheer, sheer layer of benzoyl peroxide (which kills acne-causing bacteria), like Neutrogena On-the-Spot Acne Treatment, every other day on the exact spot you last had a zit.
If your skin gets irritated, though, stop using them for at least four days, or you’ll cause a compromised skin barrier, extra inflammation, and, of course, more acne. Fun, right? But at least you can stop feeling like a crazy person the next time you see a zit appear in literally the exact same spot as before, and that’s almost as satisfying as having clear skin. OK, it’s not at all, but it’s still something.