Hey, Quick Question: Why Do I Keep Breaking Out in the Same Exact Spot? - Fashionista

Hey, Quick Question: Why Do I Keep Breaking Out in the Same Exact Spot?

Your pimple's unwelcome return isn't just bad karma, and it's not that uncommon, either.
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Photo: Imaxtree

Photo: Imaxtree

Welcome to our column, "Hey, Quick Question," where we investigate seemingly random happenings in the fashion and beauty industries. Enjoy!

We've all experienced an unfortunate series of breakouts that can only be referred to as a constellation — usually right before an important meeting or an unexpected run-in with an ex, because of course. But what happens when you keep breaking out in the exact same spot repeatedly? We don't just mean vaguely "along your jawline" or "in the vicinity of your nose," but rather, down to the very pore you just excavated mere weeks ago. While you were shaking your fist at the sky and wondering "why me?" — oh, sorry, was that just us? — we asked Los Angeles-based dermatologist Dr. Annie Chiu and Dr. Jeannette Graf, a dermatologist in Great Neck, New York, what the hell is up.

Turns out, your pimple's unwelcome return isn't just bad karma, and it's not that uncommon, either: "Typically, [recurring breakouts] happen because there's still a clogged pore or residual deep inflammation that seems resolved but instead, it just re-flares," says Dr. Chiu, who also notes that it's usually deep, cystic pimples that return along the chin and jawline.

Chances are, you messed with it (you definitely tried to pop it), didn't get to the root of the infection, and now it's gone even deeper, says Dr. Graf. If you're lucky, it might hibernate for a few weeks, giving the surrounding skin that may have been flaky or red a chance to heal. But then, days or weeks later, the breakout is back with a vengeance: It's almost like Whack-a-Mole, but said mole surprises you by hiding in plain sight — atop the fresh scar of acne from the not-so-distant past. One key indicator that your pimple's going to make a return? It looks like it's healed, but there's still a tiny bump, even after any scab is gone.

"I've found that cysts that are manipulated and squeezed tend to recur more frequently, and because these types of cysts are so deep under the skin, it's best to leave them alone," Dr. Graf adds. Plus, if you already messed with the first pimple, you're left contemplating two equally bad options: First, you can try to obliterate Pimple 2.0 with topical acne medication and risk non-stop flaking; or you can attempt to pop it and start the cycle all over again.

Instead, both Dr. Chiu and Dr. Graf recommend that when you're faced with an adamant cyst that perseveres through a steady stream of topical benzoyl peroxide and hydrocortisone, it's best to consult a dermatologist. "After two-to-three recurrences, [your dermatologist] may either lance and extract the remaining inflammation or calm it with a cortisone shot," says Dr. Chiu. The latter happens in-office, and while it's relatively painless and can reduce the size of a cyst within hours, it comes with the small risk of possibly leaving a permanent indentation on the skin.

Another solution, Dr. Graf suggests, is to talk to your doctor about spironolactone, which helps block androgen hormone receptors and comes with relatively few side effects (multiple Fashionista editors swear by it).

But in the meantime? "Just stop picking," offers Dr. Chiu. Easier said than done. 

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