Pimples: How Do They Form And How Long Do They Last? - Byrdie

When a pimple starts to crop up, you likely want to get rid of it as soon as possible. But perhaps you've never stopped to consider what a pimple is, or how long it might last on its own. Scientists always aim to understand the nature of something—where it comes from, how it behaves—before focusing on a cure. So in the spirit of scientific curiosity, we got in touch with celebrity esthetician Renée Rouleau, and dermatologists Rachel Nazarian and Michele J. Farber to track the life cycle of a blemish from birth to blessed death.

Keep reading to learn exactly what to look out for when it comes to how long pimples last.

Meet the Experts

• Michele J. Farber, MD, is a board-certified dermatologist who has been published in peer-reviewed dermatology journals and textbooks. She practices with the Schweiger Dermatology Group in Philadelphia, PA.
• Rachel Nazarian, MD, is a board-certified dermatologist who practices at the Schweiger Dermatology Group in New York City, NY. She is also a Member of Byrdie's Beauty & Wellness Board.
• Renée Rouleau is a celebrity esthetician based in Austin, TX. She is also the founder and creator of her eponymous skincare line.

What Are Pimples?

Is there one specific kind of spot that can be defined as a "pimple"? The answer is no. Broadly speaking, a pimple can be defined as an acne lesion. "This can include non-inflammatory lesions such as open and closed comedones (blackheads and whiteheads, respectively), and inflammatory lesions such as papules, pustules, and deeper cysts," says Farber.

How Do Pimples Form?

"The formation of a blemish can start weeks, or potentially months before it ever appears visibly," says Rouleau. "Most infected blemishes form due to pre-existing whiteheads and blackheads, which consist of blocked and hardened sebum [aka oil] deep within the pores. These become inflamed due to dead cells that line the hair follicle and create bacteria." It's important to note that all follicles (or pores) contain bacteria naturally, she adds. When oxygen can easily flow into the follicle, the bacteria can’t thrive or cause problems. It's only when you get the perfect storm of a little too much sebum, plus some dead skin cells, that you're put on the path to a pimple.

How Long Do They Last?

Typically a pimple will last anywhere from 3-6 weeks, depending on the types of treatments you use and how inflamed it is.

• Treated Pimples: According to Nazarian, dermatologists can inject stubborn, painful pimples which can reduce their size in as little as 24 hours.
• Untreated Pimples: Farber says, "Pustular or cystic lesions can last weeks (four to six) once it starts to form to the time that inflammation resolves."
• Popped Pimples: Popping a pimple will technically deflate the breakout within 4-5 weeks, it can also backfire and cause inflammation that will last far longer than an untouched pimple would have, warns Rouleau.

The Life Cycle of a Pimple

1. As Rouleau mentioned, hardened sebum causes a blockage in the pores, et voilà—a blemish is born. Bacteria brews and bubbles inside the growth, causing bumps (called papules) on the surface of the skin, along with redness and, sometimes, tenderness and pain.
2. White blood cells rush to the area to do their job of breaking down the bacteria, and the resulting carnage transforms the papule into a pustule, filled with the leftovers of the bacterial battleground.
3. As the infection wanes, the bump will scab and potentially scar, sometimes leaving dark spots called post-inflammatory hyperpigmentation (the chances of which are increased by picking at papules, warns Farber). Over time, the skin cells' natural renewal cycle will push out darkened cells, and the scar will fade gradually.

So exactly how long will this sebaceous intruder take up residence on our face? We've got places to go and people to see. Farber says to buckle up for the long haul: "Non-inflammatory comedones can last for a long time without treatment; they often require a retinoid to help remove excess keratin," she warns. "Pustular or cystic lesions can last weeks (four to six) once it starts to form to the time that inflammation resolves."

Byrdie Tip

Don't try to pop a cystic pimple prematurely and make matters worse; see your dermatologist for a cortisone injection, which can rapidly reduce inflammation and swelling in time for a big event, says Farber.

How To Properly Treat A Pimple

"At any stage, if you leave the pimple alone, it will eventually heal on its own, assuming your immune system and healing processes are in good working order," says Rouleau. But let's say you can't help but pop it. According to Rouleau, that's not necessarily a bad thing. "If you choose to squeeze a whitehead, it’s similar to draining an abscess or infected wound," she says. It's a way of removing the bacteria.

But be cautious: The risk in popping your pimples is that "you can displace the infection so instead of coming out the surface, it can go deeper within the pore and cause more inflammation, making a blemish last even longer," says Rouleau.

Whiteheads and Pustules

Wait for a day or two after you feel the zit coming on for the infection to appear on the surface. "Waiting will allow you to control the blemish effectively without damaging the skin," says Rouleau. Once the whitehead is visible, you can apply a spot treatment like the Mario Badescu Drying Lotion, cold compress, or over-the-counter cortisone cream to try to treat it.

Blackheads

If your blemish buddies are more long-term or chronic, like recurring blackheads and whiteheads, retinoids that help with topical exfoliation and skin cell turnover are going to be your best bet, says Farber. Differin gel, which contains a retinoid called adapalene, "is a great option for over-the-counter," she says. She also recommends benzoyl peroxide face washes to help control the bacteria associated with acne.

Cystic Breakouts

Cystic breakouts are often harder to treat and take longer to go away than pustules, blackheads and whiteheads since they're deep under the skin. These should be treated by a dermatologist who can treat cystic acne with antibiotic creams, gels, anti-inflammatories, acids, or retinoids.

Byrdie Tip

If your breakout is still a papule (a red spot with no obvious head), don't use drying spot treatments meant for pustules. You run the risk of drying out the skin, potentially keeping the infection trapped underneath even longer.

Why Are My Pimples Not Going Away?

There's a limit to the power of at-home treatment; if your breakouts persist despite your best efforts, when should you consider a visit to your dermatologist's office? "If your acne is not responding to over-the-counter products, your dermatologist can prescribe prescription retinoids, antibacterial creams, and other oral medications as appropriate for you," says Farber. "Another important reason to seek treatment is deeper cystic acne or scarring, as early intervention is vital for clearing acne and preventing long term marks." In other words, don't delay if problem spots continue to appear.

The Takeaway

Not every pimple takes the same course of life. Some red papules never turn into whiteheads. Cystic breakouts could take literal weeks to come to the surface of the skin. Identifying the type of pimple plaguing you, and knowing roughly where it is in its life cycle, will give you the confidence to either treat it correctly or consult your dermatologist for intervention.

FAQ

• Do pimples go away on their own?

  Most pimples do go away on their own. "Although pimples do go away on their own, as your body works to eventually release the plug and replace the dead skin cells, some pimples like blackheads can sit for long periods of time and require a little assistance to help them disappear faster," Nazarian says. 

• Why are my pimples not going away?

  "Occasionally, a clogged pore can trigger the creation of a lining, becoming a true cyst," Nazarian explains. "These little sacks sit under the skin and fill with dead skin cells and oil. Although true cyst formation is not nearly as common as other other typical acne pimples, these cyst do not disappear and sit under the skin long-term."

• How long do treated pimples last?

  When treated topically, most pimples improve in one or two weeks. You can also consult with your dermatologist, who can inject painful, stubborn spots. According to Nazarian, this can reduce their size as quickly as 24 hours.