Why Does My Pimple Keep Coming Back?
I have an on-and-off five-year relationship with the cyst on the left side of my lower chin. Its inflammation and pus comes and goes, but without fail the pimple always returns — with all its painful glory — to the exact same location. I’m not sure if the blemish ever goes away entirely or if the area just likes to refill with oil, debris and dead cells every couple of weeks or so. Regardless, I want to end things with my recurring pimple once and for all. To help, I turned to board-certified esthetician Nicole Hatfield and board-certified dermatologist and Skincare.come expert Dr. Hadley King.
Why Do Pimples Come Back to the Same Spot?
Having to constantly battle against acne in the same area can be frustrating, but there are actually a few logical reasons why nasty cysts or whiteheads pop up in the same spot on repeat. One cause is that certain locations are more susceptible to irritation or friction. Hatfield explains that external factors, such as glasses resting on the bridge of the nose or wearing a protective face mask, can increase the likelihood of pores becoming clogged.
If you can’t seem to identify an external trigger, though, it’s possible that you simply have some pores that are more susceptible to acne. “The accelerated skin cellular turnover rate that is associated with having retention hyperkeratosis, which is the precursor to all acne, is the main cause for these pimples,” she says. “Some pores, especially pores that are put under repeated stress like heat, friction or excessive touching, can become enlarged and collect debris quicker than others.” Hatfield explains that some of these “problematic pores” will have accompanying pimples that appear to subside when, in fact, the area is never fully cleared out. “The pore can have damaged walls where the sebum has spread underneath the skin,” she says. As a result, inflammation will spike again and the exact same spot will present again with the cyst.
Dr. King also emphasizes the role hormones play in the formation of recurring pimples. “Genetics and age determine which areas are the most hormone sensitive,” she says. “For example during puberty, the oil glands in the T-zone of the face tend to be the most hormone-sensitive, whereas in adult female acne, it’s the oil glands in the beard distribution that tend to be the most hormone sensitive.” These sensitivities, paired with factors like large pores and more active oil glands, can cause pimples to pop up in either the same general region or exact same location on the face.
How to Treat Returning Pimples
Before talking about how to treat these types of pimples, it’s important to acknowledge that there’s not necessarily a quick fix. Some pimples, such as cysts, can take months to go away entirely and will wax and wane with inflammation in the interim. If you are looking for an efficient way to completely clean out an area that is susceptible to recurring cystic acne though, Dr. King suggests consulting with your dermatologist. “For cystic pimples, an intralesional cortisone injection can be very helpful to reduce the inflammation and allow the lesion to heal,” she says. “Hormonal medications like oral contraceptives and Spironolactone can also be helpful for hormonal acne by decreasing the hormones that are causing the breakouts.”
If your recurring acne is more along the lines of whiteheads and blackheads, Hatfield recommends incorporating a benzoyl peroxide face wash, like the CeraVe Acne Foaming Cream Cleanser, into your routine. “Benzoyl peroxide forces anything that is underneath the skin to come to the surface rather than staying stuck underneath,” she says.
Design: Hannah Packer