Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/25/2021
We’ve all been there. We feel a little tenderness — maybe on the chin. We look in the mirror and there’s barely anything to see, but we know it’s coming: a giant, deep, painful pimple.
One of those sneaky suckers that hides beneath the skin and seems to take forever to go away.
If you've ever had a monster zit that hurts when you touch it, congratulations — chances are you've had deep acne, too.
Luckily, you can do something about it. Here’s everything you need to know.
To understand deep acne, let’s quickly go over acne in general.
First of all, acne is a common skin condition that can be divided into four types: blackheads, whiteheads, pimples and the last type, which consists of both cysts (pus-filled bumps) and nodules (which are not pus-filled).
The term “deep acne” refers to the cysts and nodules.
Sometimes, these painful pimples burrow so deep, you can barely see a protruding bump. No wonder they can be called “blind pimples.”
Like all types of acne, deep acne occurs when pores become clogged, either by excess oil, dead skin cells and/or bacteria.
But what sets cystic breakouts apart from other types of breakouts is that the trapped bacteria and dead skin cells become red, swollen and infected, and that infection goes deep into your skin.
And while acne — including deep acne — is definitely more common in teens (hello, hormonal acne), lots of women still get deep, cystic pimples, even past those awkward years.
Menstrual cycle hormones, genetics, cosmetics, diet, stress and tobacco are all culprits for those adult acne flare-ups.
Let’s be honest. Acne — especially deep, red, swollen and pus-filled acne — is not the look you’re going for.
And to add insult to injury, these stubborn bumps can also be painful, and sometimes even itchy.
These super deep pimples are the most inflamed, pus-filled bumps, which cause the discomfort you feel.
But beware: as much as you may want to pop or play with the unsightly, uncomfortable bumps, don’t do it! Deep acne can leave scars if not treated correctly, which makes your momentary inconvenient problem a life-long “ugh” moment.
Hands over your head! Back away from that zit! This is a job for a professional.
First of all, when a cyst bursts, the infection may spread, leading to even more breakouts and that would be a big time bummer.
And unfortunately, while over-the-counter meds may work on more common lesions like blackheads and whiteheads, they often don’t do the trick with deep acne.
So the best thing to do is enlist the help of a dermatology practitioner.
They’ll be able to help identify the cause of your acne woes, and help you figure out the type of acne treatment that’ll work best.
And speaking of treatment, let’s talk about that. Acne nodules and cysts penetrate so deep into the skin, they can cause acne scars when they heal. So it’s important to treat deep acne correctly, and quickly.
A dermatology practitioner will consider treatment options that focus on clogged pores, bacteria, inflammation and excess oil. Here are some of the treatments they may suggest:
Studies have shown that hormonal therapy, such as oral contraceptives, are a particularly effective treatment for women with deep cystic pimples on the face and neck.
A dermatology practitioner may choose to prescribe an oral antibiotic. These medications treat the bacteria that causes acne lesions, called. P. acnes. By treating the bacteria in the acne lesion, the inflammation, infection, and swelling all decrease.
Some oral antibiotics need to be closely monitored for side effects, like isotretinoin (which you cannot take while pregnant) and spironolactone (which has potential side-effects like breast growth).
Another possible treatment may be cortisone shots, which almost immediately help reduce the size and pain of deep acne. It is important that this procedure is done in a healthcare provider’s office under medical supervision.
If medication seems to be an ineffective treatment, a professional may choose to drain the deep pimple.
Beware: this can cause infection if done incorrectly, so never try it at home.
Lastly, your dermatologist may apply a glycolic acid peel. This topical acne treatment is rich in vitamin C, vitamin A and vitamin E, to help reduce scarring — and acne scars are an unfortunate effect of deep acne.
Whatever you do — even if you cannot see a dermatology practitioner right away — do not play with, squeeze, pop, fondle, fiddle or fuss with your deep acne! Instead, follow these steps:
First, cleanse your skin well (Like with our Deep Sea Cleanser).
Next, wrap some ice in a clean towel and apply it to the stubborn bump. This should help reduce the swelling and numb the pain.
After 10 or 15 minutes of icing, apply an over-the-counter topical acne treatment with benzoyl peroxide as its active ingredient — it will help kill the bacteria that causes acne.
Sometimes , after a few days of icing, a whitehead will form. Once it does, try applying a clean, warm compress several times daily. Eventually, this should help release the pus.
While this quick fix may provide some relief, it’s not a winning long-term solution. To really win the fight against deep acne, get help from a dermatologist. They will be able to determine the best treatment options for you so you can prevent future breakouts for good.
All acne can be an absolute pain to deal with, but deep acne is a whole different animal.
These deep, swollen and oftentimes painful acne lesions can take time to heal and even lead to scarring if not treated promptly and properly.
Luckily, deep acne is also very treatable, with things like oral antibiotics, steroid injections and minor surgical procedures.
If you’re experiencing the headache that is deep acne, as always, we recommend reaching out to your healthcare provider or scheduling a visit with a certified dermatology practitioner.