My pimples have never enjoyed being lonely. One rears its nasty, cystic head, and in a matter of days, it’s called upon three whiteheaded friends to keep it company. These clustered breakouts — or as I’ve dubbed them, sympathy pimples — always pop up adjacent to the initial blemish, be it on my cheeks, chin or forehead. Could the initial pimple’s inflammation actually cause a nearby breakout? Or, am I bringing out an acne cluster by spreading bacteria when I try to pop my pimple? To get some answers about why my breakouts come in clusters, I spoke with Dr. Jennifer Chwalek, a board-certified dermatologist based in New York City and Skincare.com consultant. What Is a Pimple? You might brush off all types of pimples as annoying red spots, but knowing the exact type of pimple you have can help you come up with a better plan to treat it. There are many different types of breakouts, but the most common are blackheads, whiteheads, papules, pustules and cystic pimples.    Blackheads, aka open comedones, often look like small, dark spots on the surface of your skin. The dark spots aren’t from dirt, and they can’t be scrubbed off — they get their color when the dirt, oil and bacteria in your pores are exposed to air and oxidize. Whiteheads are closed comedones, and they often look like small, white or flesh-colored bumps on the skin. Papules are small, hard red bumps that have a rough texture, according to the AAD. They can occur when excess dirt, oil and bacteria clog your pores. Pustules are small, pus-filled bumps that look a lot like whiteheads, except they tend to be more inflamed. Lastly, there’s cystic acne, which is composed of large, inflamed breakouts that lay deep under the skin. Cystic pimples are often painful and hard to treat, and they’re likely to cause post-acne scarring as well as hyperpigmentation.    If you’re not sure what kind of acne you have, try taking this quiz on every type of breakout. We also recommend making an appointment with a board-certified dermatologist, who can advise you on your best course of action to treat and prevent pimples from popping up.  What Causes Pimples? All pimples are a result of clogged pores, whether they are clogged due to a buildup of excess oil, dirt, makeup or bacteria. Pimples can also be exacerbated by hormonal fluctuations and allergies. Sometimes breakouts appear in different areas of your face for different reasons — for example, pimples along your chin and jawline are often a result of hormonal acne. “Face mapping” can help you figure out why your breakouts are happening in specific areas.  Why Do Pimples Pop Up in Clusters?  Before getting into why you may get a cluster of pimples, it’s important to understand the areas of the skin involved in the formation of acne. “The cause of acne is complicated and involves the interaction of multiple factors — like sebum production and bacteria — relating to the pilosebaceous unit that’s made up of the hair follicle and oil gland,” says Dr. Chwalek. “When skin cells that are shed into the hair follicle become ‘sticky’ and plug the pore, it prevents the sebum from reaching the surface.” She goes on to explain that this blockage results in the formation of a comedone.    While you may only experience one pimple initially, the backed-up sebum in your pore may have another plan. “At a microscopic level, the sebaceous gland ducts deposit sebum or oil along the hair follicle, but multiple oil glands can be connected to each follicle,” says Dr. Chwalek. “Depending on where the follicle gets plugged, it may potentially block the oil secretion of multiple glands and lead to adjacent lesions or, in more severe cases, cysts.” Why Are My Clusters Only in Certain Areas?  If you notice that you only get clustered pimples in a certain area on your face, such as your cheek or chin, a range of factors could be to blame. “When acne is localized to certain areas, it’s due to certain causes,” says Dr. Chwalek. “For instance, acne that only occurs along the forehead, temples and hairline is often due to hair products that contain ingredients like petrolatum and shea butter, which can cause follicular occlusion or plugged pores.”    She adds that hormonal acne also has a tendency to stay focused on the lower face or jawline, and steroid acne, which can occur after taking high-dose oral or anabolic steroids, is often localized to the chest and upper back.   How to Get Rid of Pimples Wash Your Face Every Day A good cleanser is key for getting rid of excess oil, grime, sweat and makeup. Some skin types can get away with just splashing water or a face spray on in the morning, but no matter your skin type, it’s essential to wash your face with a cleanser every single night (yes, even if you didn’t wear any makeup during the day). You can take your pick between gel, foaming, cream and oil cleansers — this guide breaks down every type of cleanser so you can find the best formula for your skin concerns.  Keep Your Sheets and Phone Screen Clean While keeping your face clean is essential, so is cleaning the surfaces that touch your face the most. Dirty pillowcases and phone screens are a common yet surprising trigger for breakouts, so make sure you’re cleaning both on a regular basis (try for at least once a week).  Use Acne-Fighting Products Look for skincare products with potent acne-fighting ingredients, such as salicylic acid, benzoyl peroxide, sulfur and retinoids. A cleanser with anti-acne ingredients will help keep your skin clear and can be used whether or not you’re experiencing an active breakout. We recommend the CeraVe Acne Control Cleanser, which is formulated with oil-absorbing clay and 2% salicylic acid to clear existing acne, unclog pores and reduce blackheads.      It’s also helpful to have a powerful spot treatment on hand to help shrink pimples when you notice them popping up. One of our favorite picks is the La Roche-Posay Effaclar Duo Acne Spot Treatment, which is formulated with benzoyl peroxide, glycerin, silica and lipo-hydroxy acid. The oil-free, non-comedogenic formula helps to unclog pores and reduce the severity of pimples, including blackheads and whiteheads.    Exfoliate Regularly Regular exfoliation can help unclog pores and leave your skin looking smooth with an added glow. Luckily, most acne-fighting products contain acids that exfoliate your skin — salicylic acid, retinoids and benzoyl peroxide are all great exfoliants. There’s no hard-and-fast rule about how often you should exfoliate — it will vary based on your skin type. “Some people can only handle exfoliating once a week while others need it more regularly,” Dr. Dendy Engelman, a board-certified dermatologist, previously told Skincare.com. In general, try exfoliating once a week, and increase the frequency to two to three times a week if you don’t experience any dryness or irritation. We love the Youth to the People Mandelic Acid + Superfood Unity Exfoliant, which contains three gentle acids to unclog pores and smooth the look of skin texture.    Choose Non-Comedogenic Skincare Products If you deal with frequent breakouts, look for the words “non-comedogenic” on your product labels. Non-comedogenic skincare products are specifically formulated to not clog pores, and there are options in every skincare category, from lightweight moisturizers to sunscreens and even foundations.  Does Popping the Initial Pimple Trigger More Acne?  Here’s the good news: The liquid or pus you squeeze out of your pimple is not known to bring about pimples in nearby areas. “The bacteria that is involved in acne is a bacteria that exists on normal, healthy skin, so you can’t actually infect your surrounding, clear skin with it,” says Dr. Chwalek. That said, being too aggressive when popping your pimple can lead to increased inflammation in the skin, which as a result, can cause clustered acne. “When you pick or try to express a lesion, you risk causing it to rupture underneath the skin,” she says. “This can cause inflammatory debris to be released into the surrounding area and may also stimulate adjacent pimples or cysts.”    The takeaway? Avoid picking your pimples. Not only can it lead to delayed healing, scarring and infection of your current blemish, but playing with your pimple can introduce new bacteria and dirt onto your skin. We love pimple patches for not only treating pimples, but also from keeping our fingers from picking at them. 
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