Zitfilter: What to do after a cystic pimple pops?

May 6, 2013 7:38 PM

On its own, so no berating me!

It's my inaugural "gross" ask!

So. About two weeks ago, I had what I thought was a run-of-the-mill blackhead on my lipline, which I tried to extract. That did not work, and to punish me for my insolence, a monstrous dragon-cystic pimple began to form in its place. (ON MY LIP.) Because my grandfather taught me never to step in the same pile of, um, poo twice, I dutifully left it alone. No squeezing, no poking. However, I did start to apply hot compresses soaked in epsom salt water to the blemish as often as I could stand, and today I joyfully awoke to a giant, fully-realized head on my deep, deep cystic pimple. Hooray!

During one hot compress application today, I removed the compress to find that the pimple had burst on its own. (There might still be some sebum in there, but I sure as heck won't be squeezing to find out.) My question: what should I do/apply now? It looks like a little dark crater collapsing in on itself. Neosporin? Benzyl peroxide cream? Fairy dust? I have an appointment with a dermatologist on Thursday, which I would just LOVE to cancel if I can, as I'm uninsured and money is tight at the moment. I've read this previous ask, but that's geared toward pre-eruption.

By the way, if you ever want to thank your lucky stars that AskMeFi exists, just try Googling for information about pimples. It's like panning for gold, but with poor grammar and spelling.

posted by sevensnowflakes to Health & Fitness (15 answers total)

Response by poster: And no gold.
posted by sevensnowflakes at 7:41 PM on May 6, 2013 [26 favorites]

Acne is unpleasant but not really life threatening, if money is tight you can most definitely skip your dermatologist appointment.

I would apply a bit of antibiotic ointment like Neosporin and otherwise leave it alone as much as possible. And I mean actually leave it alone, not like "I left it alone by applying hot compresses all the time" (sorry, that part of your post made me laugh!). It will heal up on its own without incident as long as you keep it clean, which is best achieved by not touching it.

Sorry that happened to you, lip zits are fresh hell.
posted by telegraph at 7:48 PM on May 6, 2013 [5 favorites]

Oh man, I feel your pain. At this point, I would put medication on it nightly, keep it clean during the day (don't glob on makeup, etc.), but otherwise let time do its thing. As far as medication/ointment, I recently ran out of my prescription benzoyl peroxide and bought this sulfur ointment to use until my next derm appointment. I really like it so far. (I also bought this clay powder to use with apple cider vinegar for masks, and it's been great for clearing out my pores. It won't help your current situation, but if you deal with this regularly it might be worth a try.) Good job not picking at it - now just try to be patient and give it some time.
posted by hefeweizen at 8:08 PM on May 6, 2013

You actually SHOULD squeeze slightly - it will heal better once you empty it of sebum and puss. If it's just clear liquid or any blood, stop.
posted by amaire at 8:11 PM on May 6, 2013 [12 favorites]

I don't think I've ever had cystic acne, but whenever I get a pimple I put raw honey on it, even if it's popped. I have found it to be very effective in speeding up the healing time and reducing irritation and redness.
posted by luciernaga at 8:15 PM on May 6, 2013 [4 favorites]

Honey is a natural antibiotic and a well-known home remedy for cystic acne.

Just keep dabbing it with honey, resisting the temptation to lick it off (though it won't hurt you if you do, unlike other antibiotics suggested above, which are not intended to be ingested).

I would skip the dermatologist appointment. I bet it'll be much better by Thursday.
posted by ottereroticist at 8:15 PM on May 6, 2013 [2 favorites]

I'm confused -- you had a dermatologist appointment for a pimple? One solitary... Wow. Yeah, cancel that puppy. Not much to be done by a derm -- they can inject cysts but this's too late, I should say, and a derm for a single spot is too strong a remedy...

I would use a hydrocolloid dressing on it at night to soak up 'exudate' and speed healing. (There are ones specifically made for acne but they are hard to find in N America -- I buy them on eBay -- but you can just buy a small regular bandage one, or cut to fit and first-aid tape it on) I (too) would give the most gentle of squeezes, after washing with hot water, before bed. Then peroxide or another disinfectant then hydrocolloid. If you do not have easy access to a drugstore for hydrocolloids but do have a basic clay mask on hand, put a dollop of that on the spot.

Later if you really want to you can try a cream for 'post inflammatory hyperpigmentation' that will likely stick around for a little bit. More on that

If you are trying to cover it with make-up during the day and it won't stop oozing, a styptic pencil can fix that.
posted by kmennie at 8:15 PM on May 6, 2013 [4 favorites]

If you want to leave it alone, I'd recommend a hydrocolloid bandage (the kind for blisters and burns) applied over the zit over the Neosporin, especially if your skin is sensitive to petrolatum. Wash the area with plain water, dry with a clean paper towel and leave the bandage on overnight. The bandage will keep the area moist and drain the pus - with any luck, you'll wake up for a flat pimple.

If you want to go ahead and drain that sucker (since it's gone kablooey already), wrap your fingertips in clean paper towels and gently (cradle a baby gently) apply pressure on both sides of the zit. If gooey evil comes out, you're fine. If nothing comes out, stop and revert to leaving it alone. I'm guilty of doing this, but if the pus comes out on a gentle push, my skin tends to heal over cleaner than if I leave it to heal over any buried-deep oil plugs. YMMV - good luck!
posted by zennish at 8:16 PM on May 6, 2013 [4 favorites]

Response by poster: Sorry, should have mentioned - I am graduating from graduate school in two weeks, hence the derm appointment. No balloon-face pictures for this major milestone. Keep the suggestions coming!
posted by sevensnowflakes at 8:21 PM on May 6, 2013

FYI, this is an excellent time to take advantage of the very highly educated pharmacist at your local drugstore!! They should be able to recommend whatever topical cream/medication/nothing that you should use.

(I personally would do some combo of neosporin and benzoyl peroxide, but i'm no expert. Just a person with zits.)
posted by Kololo at 9:59 PM on May 6, 2013

Salicylic acid works well for me. I use Rapid Clear Neutrogena gel. It'll probably sting like hell the first couple times you apply it, but in my experience the swelling would be down in a day or so. You may still have a purple/red mark, but it will be much less noticeable, in my experience.
posted by RogueTech at 10:02 PM on May 6, 2013

My sister is a dermatologist. Whenever a zit rears its ugly white head, she recommends a sterile pin prick to open it, a clean Q-tip to gently remove the puss, and anything with salicylic acid to dry it out. Also, you won't believe how awesome aspirin is at helping this situation. My sister swears by it. Take one or two aspirin and crush into powder form; add a few drops of water to make a paste. Cake paste onto zit. Leave. Reapply as needed. This reduces the redness and swelling and helps dry the zit up. It really does work.
posted by Falwless at 6:15 AM on May 7, 2013 [16 favorites]

I get cystic acne around my chin and mouth and my doc prescribed Clindoxyl gel and it has worked wonders for me. It's great for reducing swelling in a freshly-popped pimple and kills emerging zits. Can't say enough good about it and I only need to use it sporadically when my skin flares up.
posted by futureisunwritten at 10:09 AM on May 7, 2013

I prefer the more natural route. I wash my face with coconut oil by rubbing the liquified coconut oil (it becomes liquified when warm, usually I just leave it in my car for a few hours after I buy it in solid form). Then I wash it off with a warm towel and once dry I moisturize with Moroccan argan oil. Mogador is a great company and you can get it from Amazon for about $20 for 2 ounces. It lasts you for months and a little goes a long way, usually needing about 3-4 drops, and is basically liquid gold.

I had really severe acne for about 3 years before I tried to clean up my diet and begin exercising and drinking more water. This very simple face care regimen has changed the skin on my face from coarse, rough texture and angry painful pimples to a soft calmer complexion and my acne scars are fading. I have even noticed that after two or three days of getting a new pimple (which lately has been a less and less frequent occurrence) that it is no longer as red and is healing much quicker and going away much faster.
posted by lunastellasol at 10:48 AM on May 7, 2013 [1 favorite]

Adding to what was said above, while you are treating the surface, focus on eating unprocessed foods, drinking lots of water, and avoiding excess carbs and sugar. Acne is caused or made worse from inflammation in the body and eating badly definitely makes it worse for me. I have dealt with hormonal acne for quite a while now but I hadn't made any progress with different topical treatments until changing my diet.
Also, I use Clean & clear drying paste to get it healing as fast as possible. This is really the only topical treatment that helps for me. It doesn't seem to cause as much flakiness as other stuff.
posted by photoexplorer at 11:29 AM on May 7, 2013