If you’ve ever woken up to a big bump under your skin, perhaps along your jawline or on your chin, you’ve probably grumbled about its unwelcome appearance. Especially if it’s red and noticeable and it shows up on a big day, like a first day at a new job or a first date. (Because of course.)
These pimples, which lurk beneath the top layer of your skin, are no fun at all. Learn more about where these pimples deep under your skin come from, and what you can do about them.
What’s causing those under-the-skin pimples?
When your pores become clogged with dead skin cells, oil, and bacteria, you get pimples. And you can get two kinds of pimples that tend to form deep under the skin: nodules and cysts, or cystic lesions. When a clog forms around a hair follicle, it creates a hard lump that dermatologists refer to as a nodule. If pus fills the pimple or lump, you get a cyst.
Sometimes it’s hard to tell the difference when they’re deep under the skin, so people tend to lump them together, says Dr. Melissa Piliang, MD, a dermatologist with the Cleveland Clinic. They both can be large and painful.
There are several possible causes that can contribute to the development of these deep-seated pimples, including stress, genetics, certain medications, products that you use on your skin, and yes, your hormone levels.
“Under-the-skin pimples or nodules are common in women along the jawline, and in that case, they are often a hallmark of hormonal acne,” explains Dr. Lisa Chipps, MD, MS, a dermatologist and dermatologic surgeon at Moy Fincher Chipps Facial Plastics & Dermatology.
What products or treatments should you try for under-the-skin pimples?
If you’re like most people (or perhaps all people) in this situation, you just want the pimple to go away as fast as possible. Here’s what the experts want you to know about how to treat this kind of skin problem.
“Number one, don’t pick at it,” says Dr. Piliang. “Just leave them alone. Don’t touch them.”
In other words, back away from the tweezers or other implements, no matter how much you want to use them. Picking at a deep pimple will just leave a scar or scab, which will make it look even worse.
However, if you suspect there’s some pus lurking inside that lump, you could try applying a warm compress to it. Put a washcloth in hot water—“but not so hot that it would burn your skin,” says Dr. Piliang. Then apply it to the nodule for about ten or 15 minutes at a time. You may need to dip it in hot water again periodically. The heat can help to draw any pus up and out.
Related: How to Get Rid of Acne Scars
You could also try one of several possible over-the-counter treatments. For example, check out the vast array of products that contain benzoyl peroxide and salicylic acid in your favorite drugstore. Start out with the lower-strength versions, which are less likely to dry out your skin or be irritating. “Those can help them dry up and go away a little faster,” says Dr. Piliang.
You might also read product labels and look for this ingredient: adapalene. Adapalene, which belongs to a class of drugs known as retinoid-like compounds, works to prevent those pimples from forming under the skin. It tends to be a little milder and less irritating, as it targets inflammation and helps it resolve, according to Dr. Piliang.
If you’ve got one deep pimple that’s really bothering you, you could try applying a small amount of hydrocortisone to it. “But you don’t want to overuse it,” Dr. Piliang says. “It’s not a long-term treatment.”
If this winds up being a hormonal issue, you could ask your doctor if taking an oral contraceptive might be appropriate.
“If the nodulocystic acne is not hormonal, but present consistently throughout the cycle, the dermatologists may prescribe other oral medications,” says Dr. Chipps.
That might include a medicine like doxycycline, an antibiotic that’s often used to treat moderate-to-severe acne, or erythromycin, tetracycline, or minocycline.
Some people may be good candidates for isotretinoin—you may know this prescription medicine by the brand name Accutane, among others—which is intended to treat deep cysts and nodules. While this medication can be very effective, it’s not for everyone. There are some safety concerns associated with isotretinoin, and the American Academy of Dermatology advises doctors to monitor their patients for symptoms of depression, as well as possible signs of inflammatory bowel disease.
As a 2014 study in the British Journal of Dermatology found, an approach that combines a gel containing adapalene and benzoyl peroxide with a dose of doxycycline was effective in treating nodular acne and was a good alternative to isotretinoin for people who can’t or don’t want to take it.
Will home remedies help?
You might be considering the contents of your medicine cabinet and wondering if a home remedy might be an easy, effective treatment for your pimple.
For example, some people swear that applying a dab of toothpaste to the pimple will speed its demise. But Dr. Piliang is skeptical. “It has tons of other ingredients that can be irritating to the skin,” she says.
Another popular remedy, tea tree oil, might help some people, according to a small 2016 study that found that tea tree oil gel seemed to be effective in addressing mild-to-moderate acne. But tea tree oil can be problematic because “People can be allergic to tea tree oil,” cautions Dr. Piliang.
There is one home remedy that can bring you a little relief from the pain, although it will only be temporary: ice.
“If it feels swollen and warm and painful, putting an ice cube on it can help,” Dr. Piliang says. “Take an ice cube and wrap it in a paper towel and let it sit there for five or ten minutes.”
It’s not easy to wait out a glaring, painful pimple. But sometimes, that’s just what you have to do. “It should go away in a few weeks, but if it doesn’t, then you should get it checked out for sure,” says Dr. Piliang.
A dermatologist can take a look at your skin and let you know if anything looks problematic or needs additional treatment.