How to Get Rid of Hidden Acne, According to Experts

Everything (and every treatment) you need to know ASAP.

imageAh, yes. Sneaky, hidden blind pimples.

You know the ones—so painful and deeply rooted under your skin that they feel like they're coming straight from your soul. The most difficult kind of acne, cystic pimples hide below the surface and never come to a head, and yet you insist on either picking at them and slathering them with drying products that never work. Sound familiar?

You see, blind pimples are not your typical zits, and they shouldn't be treated like they are. In other words, give your regular acne creams a rest, and give the below advice from board-certified dermatologist Neal Schultz, MD, and celebrity esthetician Renée Rouleau, a try instead.

What causes blind pimples?

Before we get into the solutions, let's first understand why you get blind pimples in the first place (despite what you might think, it's not because the universe hates you). "They're typically triggered by a surge of hormones, which is why they commonly occur around a woman’s menstrual cycle," Rouleau says. "During this time, the skin’s oil glands become hypersensitive to the hormone surge and then react by overproducing sebum, which can become engorged, swollen, or hardened."

All that to say, they're not your fault, k? Blind pimples, though annoying, are totally normal and happen simply because you exist as a human. Thankfully, though, you've got options to treat them (keep on reading).

Are blind pimples cystic acne?

Yes, the more ~clinical~ term for blind pimples is cystic acne, meaning an infection below the skin that causes inflammation and rarely comes to a head. That doesn't necessarily mean all cystic zits are blind pimples, though. As Schultz explains it, cystic acne can appear in one of two ways: completely under the skin and flat on the surface (the blind kind) or both above and below the skin. Think of the latter one like an iceberg: it's mostly under the surface, but it also has a little bit of a bump or slight redness above the skin. Either way, they're both painful and annoyingly hard to get rid of, and are cystic in nature.

Do blind pimples go away on their own?

Yes, but get comfortable because it might be a while (and when I say "might," I mean it definitely will). "50 to 80 per cent of the time, blind pimples go away on their own after a few weeks to a few months," Schultz says. "But the problem is the longer it’s there, the more likely it is to cause an atrophic scar, which is like a crater or an ice pick scar." Not to mention that the longer it's there, the longer you have to resist the temptation to go at it yourself with very non-sterile things.

How do you get rid of a blind pimple overnight?

If this is your question, prepare to be super disappointed by the answer: you can't get rid of blind pimples overnight. Cystic zits are not your average pimples; they rarely have a connection to the surface of the skin—the infection is deep within the pore—which means topical spot treatments hardly make a dent, especially with such intense inflammation happening beneath the skin.

So how do I get rid of a cystic pimple?

Again, this is probably not the answer you're looking for because it doesn't involve a cheap, easy hack with a magical kitchen ingredient, but the fastest way to get rid of a blind pimple or cystic pimple is with a cortisone injection from a dermatologist. At anywhere from $50 to $200 a shot (unless your insurance covers it, which it often does), cortisone shots can be pricey, but they work. In 24 to 48 hours after the injection, your previously painful and large pimple can be all but a memory.

If you get blind or cystic pimples once or twice a year, Schultz recommends managing it with cortisone injections as you need them, but if you have regularly occurring blind cysts or regular cysts, internal treatment would be the better option, though it's more of a long-term solution than a quick fix. "There are four categories of internal treatments: antibiotics, birth control pills, Accutane, and spironolactone," Schultz says. "The root cause [of cystic acne] is excess oil, and all of these things in some way reduce the production of oil or the effect bacteria has on the oil."

Does benzoyl peroxide work on blind pimples?

Unfortunately, your typical acne treatments, which are made for surface breakouts, will not work on blind pimples. Not only are they ineffective, but Schultz says if it's a truly blind pimple, these regular drying treatments could even cause irritation instead. And because I know you're probably wondering, toothpaste doesn't work either (trust me, I tried every brand and type during a truly desperate time in my life).

But! If deep down, you know you're never going to make it in to a derm's office for a cortisone injection and want an at-home solution, I am living, breathing proof that Renee Rouleau's Anti-Bump Solution can work in a pinch on regular cysts. "It's an alternative to cortisone shots," Rouleau says. "Specifically formulated to treat bumps deep within the skin, it speeds up recovery time with a blend of exfoliating and anti-inflammatory ingredients."

Does icing a blind pimple help?

If you're dealing with a cyst, Schultz says you actually want to start with a warm compress (a washcloth soaked in warm water) instead. "Heat will bring more blood to the area to help the body reduce the inflammation," Schultz says. So when is ice the right choice? "If you pop a pimple and get swelling from popping it, then icing the area can reduce that induced swelling."

Can you pop a blind pimple?

Okay, first of all, you should never pop any pimple—got it? You have a 50 percent chance of making the inflammation way, way worse. But, in short, if your zit doesn't have a visible white head, consider it un-popable (unless you pay a visit to the dermatologist). "These pimples are so deep below the surface of the skin that you won't be able to do much to fix it on your own," says Rouleau, adding that "most likely, you'll cause scarring to your skin by trying to extract it."

If it’s not a completely blind cyst and it’s more of an iceberg, then Schultz says warm compresses can also work to maybe, possibly, hopefully (doubtfully) bring it to a head or to help the head mature so that it can either drain itself or be carefully popped.

If (seriously, only if!) it's developed a whitehead, and you decide to try it yourself, Schultz has one warning: “You can’t squeeze it at the top. If you do that, then you’re blocking the way you want it to pop, and then it could pop internally and lead to a scar." Again why it's so not worth it to even try on your own. But, if you do, "you gotta squeeze from the bottom, almost underneath it, so you’re sort of propelling the junk outwards rather than having it perhaps rupture internally." Uhh, don't know about you, but that's enough to scare me away from trying it myself, thank you.

Final thoughts

Though the options are few and at times expensive, treating and preventing blind pimples and cystic acne is possible with the right approach and a good amount of patience. And while you wait it out, you can always slap on some pimple patches to stop you from picking in the meantime.