It seems like there is a million different kinds of spot treatments on the market. You can get quite lost in it. Knowing which product works best for your specific problem is key.
There is no one-size-fits-all spot treatment. You have to identify the type of blemish you have to know which product to opt for. That’s why I like to have a sort of spot skincare wardrobe. This understanding came through years of trial and error to attempt to get rid of my blemishes. I realized that I was assessing my blemishes before choosing the appropriate treatment. This is the process I want to take you through today.
Is it an inflamed blemish?
First and most importantly, I try to determine whether or not it’s an active/inflamed breakout. Indeed, if the answer is negative, trying to dry-out (not that this would be a good approach under any circumstances!) blackheads or closed comedones will lead you nowhere and might actually irritate your skin.
Blackheads are open comedones meaning that the pore is filled with a plug of sebum and dead skin cells that oxidizes and darkens when exposed to the air. Closed comedones, on the other hand, look like little flesh-colored bumps under the skin. You can find an amazingly detailed article about the different types of spots on Renée Rouleau‘s blog (she’s a renowned facialist and brand owner).
To treat those, I focus on exfoliation and extraction when necessary. I like the Cosrx Blackhead power liquid for blackheads and the Bioderma purifying concentrate gentle peel for closed comedones.
Does it have pus on the surface?
Yes, I went there (unavoidable with this topic, really). If the answer is yes, you might be dealing with a whitehead. It’s a closed comedo that is inflamed and filled with a mix of keratin, bacteria and sebum. It gets its name after the whitish shade at the top of the spot.
My approach here is to wait until the head comes to the surface and then pop the blemish and repair the skin (I use the Avène Cicalfate restorative skin cream for that). (I will talk about this process more extensively in my next post on the subject.) However, when the head has not clearly arisen, I try to leave it alone. Indeed, if it’s not “ready” and you pick at it, you can cause further infection and scarring.
Another possibility when you can see pus is that you have a pustule. The difference with a whitehead is that they are usually bigger and more inflamed (with more redness). The treatment is similar but they generally take more time to come to the surface. Be patient! (I know it’s hard…)
If it doesn’t have visible pus
These spots – papules and cysts- are inflamed but don’t present visible white pus. They are the painful ones that you can almost feel pulsating underneath your skin.
Papules are hard reddish bumps that can either come to the surface eventually (they then turn into pustules and you treat them accordingly) or just remain in the same state until the infection is reabsorbed by the body. In this case, I like to use the Nelsons Pure & clear acne treatment gel (it’s sadly discontinued; I’ll have to find an alternative soon). It is soothing and purifying (a rare combination!).
Cysts are large painful bumps that are deeply embedded under the skin. They are the worst type of blemish because they never come to the surface. So you have to play a waiting game (and they can last a long, long time…). You’re better off leaving them alone. Patience and soothing products are key here. I sometimes use ice cubes, wrapped in a cloth, to decrease the inflammation and the pain. Whatever you do, don’t use harsh products. They would only irritate your skin further and dry out its surface but wouldn’t treat the infection beneath. I tend to massage cysts with healing plant oils such as black cumin oil or tamanu oil whilst waiting for them to disappear.
I haven’t talked about milia here. They are small white bumps that look like little rice grains underneath the skin. You shouldn’t try to remove them on your own. They need to be extracted by a dermatologist or an experienced facialist. I sometimes get them around my eyes when I use products that are too rich for me. Mine have never been really prominent and they all went away after some time.
The important thing to note is that I spot treat with these products. They are indeed formulated as targeted treatments and not as something you should use all over the face.
Here’s an infographic that outlines the whole process.