Acne Scars: Treatment for Incomplete Popping

Skin disease acne

Hello doctor, I had a pimple that was swollen.
After I squeezed it, it bled a lot, but it wasn't fully drained, and the surface of the pimple has turned black.
Is this a scar? If so, how should I treat it? What should I do about the part that wasn't fully drained?

Niming, 10~19 year old female. Ask Date: 2020/11/17

Dr. Wu Yuxin reply Dermatology

The darkening of the surface is likely due to scabbing or pigmentation.

Reply Date: 2020/11/17

More Info

Acne scars can be a frustrating and distressing issue for many individuals, especially after experiencing severe acne lesions. When you mention that you had a pimple that bled significantly after attempting to pop it, and that the surface has turned black, it is likely that you are dealing with post-inflammatory hyperpigmentation (PIH) rather than a true scar. PIH occurs when the skin darkens in response to inflammation, which is common after acne lesions heal.
To address your concerns, it is important to understand the difference between acne scars and hyperpigmentation. Acne scars are typically classified into two main types: atrophic scars, which are depressed and can appear as icepick, boxcar, or rolling scars, and hypertrophic scars, which are raised and can be more prominent. On the other hand, PIH is a temporary discoloration that can fade over time, but it may take several weeks to months to resolve.

If you have not completely extracted the contents of the pimple, it is crucial to avoid further manipulation. Popping pimples can lead to additional inflammation, infection, and potentially worsen scarring. Instead, it is advisable to allow the area to heal naturally. Here are some treatment options you can consider for managing the area:
1. Topical Treatments: Over-the-counter products containing ingredients like salicylic acid, benzoyl peroxide, or retinoids can help in treating acne and preventing new breakouts. For hyperpigmentation, products with ingredients like hydroquinone, vitamin C, niacinamide, or alpha hydroxy acids (AHAs) can help lighten dark spots over time.

2. Sun Protection: It is essential to protect the affected area from sun exposure. UV rays can exacerbate hyperpigmentation, making dark spots more pronounced. Use a broad-spectrum sunscreen with an SPF of 30 or higher daily, even on cloudy days.

3. Professional Treatments: If the discoloration persists or if you develop scars, consider consulting a dermatologist for professional treatments. Options include chemical peels, microdermabrasion, laser therapy, or microneedling. These treatments can help improve skin texture and reduce the appearance of scars and hyperpigmentation.

4. Avoid Picking: It is crucial to resist the urge to pick at or pop pimples, as this can lead to further irritation and potential scarring. Instead, focus on a gentle skincare routine that promotes healing.

5. Patience: Healing takes time, and while it can be frustrating, many cases of PIH will fade with proper care. Consistency in your skincare routine and patience are key.

In summary, the blackened area you are observing is likely post-inflammatory hyperpigmentation rather than a permanent scar. Focus on gentle care, sun protection, and consider consulting a dermatologist for tailored advice and potential treatments. With time and appropriate management, you can achieve clearer and healthier skin.

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