And what to do when you’ve got this tricky situation on your hands
It’s the one thing we are told relentlessly at the sight of our first pimple: DO NOT POP. No matter how intense the urge, do not poke, do not squeeze, do not pick at your zit. But it’s easier said than done—especially when a case of acne vulgaris (the scientific term for pimples) looks and feels as unpleasant as it sounds.
Though it’s the most common skin conundrum, from which extremely fascinating and informative things like Dr. Pimple Popper on YouTube have risen from, facts about pimples and the Dangerous Triangle of the Face AKA the “danger zone” still aren’t mainstream knowledge.
“Doctors, not just dermatologists specifically, are very careful with this area. Whether it’s an ophthalmologist or an ENT specialist—anything that involves the face, the head, the eyes—physicians all have to be extra careful when it comes to the danger zone,” Irma Tan-Nuñez, M.D., dermatologist at IDerma Skin Clinic in the Medical City, tells Wonder. She’s referring to the imaginary triangle created when you connect these three dots: the area in between the tear ducts of the eyes and the two corners of the lips. “The pimples in the danger zone call our attention because of the particular set of veins underneath the skin here. They have a direct link to the cavernous sinus, which connects to the brain.”
via OMG Facts
Pressing down (the act of applying pressure) and popping (the act of creating a breakage in the skin) not only invite bacteria in but allow it to flow into the brain. Tan-Nuñez shares that rare complications from pimple-pricking in the danger zone include blindness, paralysis and an infection of the brain. “The tricky part about this is there is no way to detect which individual could come down with these complications, so while the they are rare, we want to avoid them nonetheless,” she adds.
A pimple in the danger zone, big or small, painful or manageable, should be left alone but kept a close eye on. And on the off chance that it is pricked, popped or punctured, an even closer eye is required. “Signs of infection include the pimple increasing in size, the skin around it becoming swollen and the pimple becoming more painful over time,” explains Tan-Nuñez. “On average, mild acne heals in three to five days, so if your pimple doesn’t heal within this timeframe and you see that its condition is worsening, you know it’s time to go see a doctor.” There is no reason to fear, however, since there’s nothing a little oral antibiotic can’t treat should the symptoms be detected early. “Treatment will depend on the severity of the infection, of course. In some cases, prescribed oral antibiotics are enough,” she says. “But there are, again, those rare situations wherein intravenous therapy becomes necessary and the patient has to be admitted to the hospital.”
Tan-Nuñez points out that there really is no need to treat aggressive pimples with even more aggression. “Everybody has naturally occurring bacteria on their skin; this is what we call the natural flora. It just sits there, quiet, and doesn’t cause any infection until such time there is a breakage in the skin where it can enter and cause an infection,” she says. “You just do not want, at all costs, to create that entry point for bacteria.”
Whether or not in the danger zone, what is the proper way of treating acne at home anyway? “Topical medication should be enough. Regardless, remember to always consult with a doctor first,” answers Tan-Nuñez. “For this kind of acne (just a pimple here and there and in cases where breakouts don’t occur often), the focus is typically on disinfecting and drying out the pimple and gently exfoliating the area. Other active ingredients that are great as a topical acne treatment are benzoyl peroxide and salicylic acid. I usually give my patients who experience mild acne a Clindamycin solution, too, which they can easily tie into their skincare routines.”
Moderate acne, on the other hand, means a combination of whiteheads, blackheads and the appearance of inflamed acne. In this case, topical medication alone might not do. “What I prescribe my patients with moderate acne are oral antibiotics like tetracycline or doxycycline,” she says. “The issue, however, with oral antibiotics is that they aren’t a permanent fix. They will only clear acne in the period in which the patient is taking them. Stop the antibiotics and the acne recurs. Antibiotics only target the Staphylococcus bacteria, which is only one of the causes of acne. Now, when it comes to severe acne, I prescribe Isotretinoin. This is oral vitamin A, which addresses overproduction of sebum, overall. And since it is, essentially, drying in general, it nips the problem in the bud. I combine the oral Isotretinoin with the topical Clindamycin solution I mentioned earlier to cover all bases.”
Now you know a statement as outrageous as “pimple popping can lead to a brain infection” isn’t just a scare tactic. But no matter what the issue, a reminder: never take treating your skin problems into your own hands, always consult with a physician first and, lastly, keep those hands off that face if you know what’s good for you!
Art Cara Gamo