13. Picking – The Ultimate Acne Worsener

I'm Doctor Jacob, and this episode is entitled "Picking - The Ultimate Acne Worsener."

If anything can worsen your acne, it's direct manual trauma from the fingernails, or even worse, from instruments like tweezers or needles that are wielded by the patient. There's only one exception, and that's if you are seeing a qualified acne therapist, such as a dermatologist or an aesthetician who is skilled in opening ripe pimples and extracting blackheads or whiteheads, but that's rare. Most of the people who are getting their acne worsened by picking at their acne are standing in front of a mirror in their bathroom, or magnifying mirror and picking at pimples in hopes that it will make them go away. We'll talk later about spot treatments that can be used on pimples to make them go away, but that does not include picking.

How does picking worsen acne? In case you're wondering, I'm going to tell you. So the mechanical force does two things: it squeezes the plug of the pore, whatever's clogging up the pore, the sludged up oil and bacteria and cellular debris. It squeezes it deeper into the depths of the skin. Some of it may come out, but some of it gets squirted down deep, and that creates inflammation. If that follicle that the oil gland is associated with, if that pore follicle ruptures and it comes out of the pore structure and into the skin around it called the dermis, the second layer of skin, then that recruits a lot of inflammatory cells that start to gobble up the debris, but also start to secrete things to destroy that debris, but also destroy the collagen, which is a structure of the skin which leads to acne scarring. So picking not only will not make the acne go away and worsen the acne by driving it deeper, but will also promote the inflammation that leads to acne scarring. You don't have to pick in order to get acne scarring, but picking is one of the best ways to give yourself acne scars.

That's all for today. I'm Doctor Jacob, we'll see you next time.