When a pimple rears its ugly, pus-filled head, we all find ourselves Googling one thing: how to get rid of it. But in our furious state of popping and spot-treating, rarely do we stop to think about what a pimple actually is.
Scientists always aim to understand the nature of something—where it comes from, how it behaves—before focusing on a cure. So in the spirit of scientific curiosity, we got in touch with celebrity esthetician Renée Rouleau and dermatologist Michele J. Farber to track the life cycle of a blemish from birth to blessed death.
Keep reading to learn exactly what to look out for when it comes to how long pimples last.
Meet the Expert
- Renée Rouleau is a celebrity esthetician based in Austin, TX. She is also the founder and creator of her eponymous skincare line.
- Michele J. Farber, MD, is a board-certified dermatologist who has been published in peer-reviewed dermatology journals and textbooks. She practices with the Schweiger Dermatology Group in Philadelphia, PA.
What Are Pimples?
Is there one specific kind of spot that can be defined as a "pimple"? The answer is no. Broadly speaking, a pimple can be defined as an acne lesion. "This can include non-inflammatory lesions such as open and closed comedones (blackheads and whiteheads, respectively), and inflammatory lesions such as papules, pustules, and deeper cysts," says Farber.
How Do Pimples Form?
"The formation of a blemish can start weeks, or potentially months before it ever appears visibly," says Rouleau. "Most infected blemishes form due to pre-existing whiteheads and blackheads, which consist of blocked and hardened sebum [aka oil] deep within the pores. These become inflamed due to dead cells that line the hair follicle and create bacteria." It's important to note that all follicles (or pores) contain bacteria naturally, she adds. When oxygen can easily flow into the follicle, the bacteria can’t thrive or cause problems. It's only when you get the perfect storm of a little too much sebum, plus some dead skin cells, that you're put on the path to a pimple.
How Long Do They Last?
There are three main stages of an inflammatory pimple's life cycle. As Rouleau mentioned, hardened sebum causes a blockage in the pores, et voilà—a blemish is born. Bacteria brews and bubbles inside the growth, causing bumps (called papules) on the surface of the skin, along with redness and, sometimes, tenderness and pain. White blood cells rush to the area to do their job of breaking down the bacteria, and the resulting carnage transforms the papule into a pustule, filled with the leftovers of the bacterial battleground. As the infection wanes, the bump will scab and potentially scar, sometimes leaving dark spots called post-inflammatory hyperpigmentation (the chances of which are increased by picking at papules, warns Farber). Over time, the skin cells' natural renewal cycle will push out darkened cells, and the scar will fade gradually.
So exactly how long will this sebaceous intruder take up residence on our face? We've got places to go and people to see. Farber says to buckle up for the long haul: "Non-inflammatory comedones can last for a long time without treatment; they often require a retinoid to help remove excess keratin," she warns. "Pustular or cystic lesions can last weeks (four to six) once it starts to form to the time that inflammation resolves."
Don't try to pop a cystic pimple prematurely and make matters worse; see your dermatologist for a cortisone injection, which can rapidly reduce inflammation and swelling in time for a big event, says Farber.
How To Properly Treat A Pimple
"At any stage, if you leave the pimple alone, it will eventually heal on its own, assuming your immune system and healing processes are in good working order," says Rouleau. But let's say you can't help but pop it. According to Rouleau, that's not necessarily a bad thing. "If you choose to squeeze a whitehead, it’s similar to draining an abscess or infected wound," she says. It's a way of removing the bacteria. But be cautious: The risk in popping your pimples is that "you can displace the infection so instead of coming out the surface, it can go deeper within the pore and cause more inflammation, making a blemish last even longer," says Rouleau.
To treat a pustule properly, here's what you should do: Wait for a day or two after you feel the zit coming on for the infection to appear on the surface. "Waiting will allow you to control the blemish effectively without damaging the skin," says Rouleau. Once the whitehead is visible, you can apply a spot treatment like the Mario Badescu Drying Lotion, cold compress, or over-the-counter cortisone cream to try to treat it.
If your blemish buddies are more long-term or chronic, like recurring blackheads and whiteheads, retinoids that help with topical exfoliation and skin cell turnover are going to be your best bet, says Farber. Differin gel, which contains a retinoid called adapalene, "is a great option for over-the-counter," she says. She also recommends benzoyl peroxide face washes to help control the bacteria associated with acne.
After the infection goes away, you're then left with a scab, "especially if you picked at it," says Rouleau. After the dead cells of the scab dissolve, a red or purple scar may be left behind. The bad news is that time is the best ingredient to fade this pigment. Still, there are products out there to quicken the skin's recovery from hyperpigmentation, like Murad's InvisiScar Resurfacing Treatment ($52). You can be proactive about prevention with SPF. "Never forget sun protection, as this is vital to preventing dark marks from acne," says Farber.
If your breakout is still a papule (a red spot with no obvious head), don't use drying spot treatments meant for pustules. You run the risk of drying out the skin, potentially keeping the infection trapped underneath even longer.
When To Consult A Doctor
There's a limit to the power of at-home treatment; if your breakouts persist despite your best efforts, when exactly should you consider a visit to your dermatologist's office? "If your acne is not responding to over-the-counter products, your dermatologist can prescribe prescription retinoids, antibacterial creams, and other oral medications as appropriate for you," says Farber. "Another important reason to seek treatment is deeper cystic acne or scarring, as early intervention is vital for clearing acne and preventing long term marks." In other words, don't delay if problem spots continue to appear.
Not every pimple takes the same course of life. Some red papules never turn into whiteheads. Cystic breakouts could take literal weeks to come to the surface of the skin. Identifying the type of pimple plaguing you, and knowing roughly where it is in its life cycle, will give you the confidence to either treat it correctly or consult your dermatologist for intervention.