How To Zap Zits, Pummel Pimples And Keep Your Skin Clear

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Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP. Otherwise, you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work related costs. Or forget and savings like premium bonds. To find out if you need to report a change, search tell DWP. With Woop, you can focus on living better for longer. Understand your sleep, optimize your training, and build habits that support your wellbeing. Woop gives you personalized insights into your sleep, your recovery, your strain, and the patterns that may influence how you feel. With more clarity and consistency, you can create routines that support you throughout the year. Add more life to every moment. Discover Woop at Woop.com. Woop. Hi, I'm Raj Binjabi Johnson, head of identity content at HuffPost. And I'm Noah Michelson, head of HuffPost. Welcome to Am I doing it wrong? The show that explores the all-too-human anxieties we have about trying to get our lives right. Okay Noah, are you doing acne wrong? So I have had acne for, I guess, 30 years now at this point? Maybe more? I feel like I've tried everything. I was on Acutane three times, which I'm sure we'll talk about at some point in this. But I was on, and I got it, except I've done everything over the counter. I feel like my skin is pretty good now. It's gorgeous. Thank you. So I don't know that I'm doing it wrong, but I also don't know a lot. I'm like, can you pop a pimple? Can you not? So I'm curious. What about you? Are you doing it wrong? I mean, I definitely did it wrong in my puberty years. It was bad. Luckily, I only get a couple a year now, but I also wonder why they come around. You know? So I am also super curious. I think most people deal with acne at some point. Yeah. Even adults. And so I'm glad we're doing this show. And I'm glad that we have Dr. Kunal Malik. He's a dermatologist at Spring Street dermatology and the Assistant Clinical Professor of Dermatology at Mount Sinai School of Medicine. Yes, get us right. Okay, Dr. Kunal, thank you so much for being here. We're so excited to have you. Thanks so much for having me. Okay, let's start at the very, very beginning. What exactly is acne and why do we get it? Basically, acne is, you know, I mean, we all know what acne is, right? Like pimples and you can get it like anywhere on the body, anywhere you have skin really, but our understanding of acne has really evolved so much. So like even a couple of years ago, if you asked me what acne was, right? I would tell you, okay, it's like when your skin makes too much oil, the glands get clogged, there's inflammation. But now not to bore you with the science behind that, we're learning so much more, each of those steps is so much more nuanced in detail than what we originally thought. So actually, it's like, there was a study referring to it. Now in 2023, that was published in Nature, which is like one of the highest tier calibrations. Oh, she's the highest. She's the highest. Yeah, I love her. I mean, everything in that journal is great, right? Very evidence-based. And so we now know that there's this concept of bacterial, microbiomes basically the ecosystems, right? Basically, it's not about having good or bad bacteria. It's the balance between them and the interaction between them. And I think that's where more and more of the data is going now. Like why do some people get acne? Of course, we don't really know 100% of everything. Like it's still a work in progress, but we are learning more and more it's this balance between the ecosystems. So it's not as simple as just like oil-clocking lands causing inflammation. It's more than that. Can acne be genetic? Because I wonder about this. I mean, my mom and dad had bad skin. I had really bad skin. Like my little brother didn't have acne at all, really. So if it is genetic, why would it skip hammer? Talk to me about that. Are you talking about specifically at the time most people get acne? Yeah, they can drink puberty. So that's also something that's been having more and more like light shed on it for sure. I mean, you have great skin now. So I will say, you know, there are actually a couple of twins that he's done, which I find so interesting because if you're looking at identical twins, right? Like same genetic makeup. Yeah. And there was like 81% or something. Something crazy, like heredible source, right? So that there are genetic risk factors. We also know now that like parents having acne increases the likelihood of their offspring having it like four times, which is pretty significant if you ask me. So there's definite, and we've identified like at least 15 genetic markers right at the genomics level of like why certain people get acne. So the evidence is pointing to the fact that yes, there are genetic risk factors to answer your question about why certain people get it and mothers don't. I think it's also something that a lot of work needs to be done on now. But basically like we know that it's not just having the gene. It's like having the gene plus other things, right? Environmental factors like did you live a stressful life where you in like a major mega city, right? Like New York, like exposed to the elements. Like so it's the environment, genetics, diet, lifestyle. Like I think it's like we're understanding it's more holistic. Yeah. Yeah. So much of what we talk about in the show, the expert is always like, yeah, this is holistic. Yeah. It's not one thing, which makes sense. And the fact that there's so many studies on this makes me, it just affirms that this really bothers us. Like this is something that matters, right? It's like we're talking mostly about acne in our face. It's like the first way we present ourselves. So yeah. It's really stigmatizing, I think. I mean, I had really bad acne when I was a teen. I went on Acutane three times. And the people don't know what Acutane is. It's just incredibly strong drug. When I was a kid, this is like 30 years ago, they prescribed it much more easily back then. But then they found out that some people were having mental health issues, could even cause suicidality. And we don't know exactly what it does to our bodies. Now, I'm convinced that I'm gonna be like pickled when I'm in another five years, because I've had so much of it. Sounds delicious. But I, you know, my skin was so bad that I didn't wanna leave the house. No, I understand. I had really bad acne too. And it's just like, even though so many kids in middle school have it, it's still like, oh, yeah. The cause of so much stress. Will you take us through really quickly, just sort of like the different kinds of acne, the classic pimple versus the black head versus white head. Right. So I'm gonna put it in analogies in terms of a cake. So I hope this will not turn you off to the idea of a cake. I think I've never had that before. Yeah, so basically like the classic sort of pimple, like with the round sort of, we call it a papule, like a raised bump, the round raised red bump, with a central sort of white discoloration in it. Right? And that's basically your classic pimple. And then that's the superficial frosting of it. Right? And then the deeper you get, the more cystic you get. Right? And we'll touch upon like why certain cystic pimples are more painful and what's going on that differentiates them from your classic pimple. But basically these other terms, like white heads and black heads are in this category called comidones. I don't know if you guys have heard of that. Yeah, so we call them comidones. But basically it's just a medical term that describes black heads or white heads. A white head is a closed comidone. So for lack of a better term, it's like the gunk inside of a pimple is underneath the skin, right? And a black head is that, but there's no covering. So the open gunk, so to speak, is oxidized, right? That's why it gets discolored in black. Okay. There's essentially the same. One is closed, one is open, right? And then you have your cystic pimples, which referring back to that cake analogy are in the deeper layers. They're no longer the frosting. They're going down. Those things are monsters. Exactly. And that's where they hurt so much. They're like, they're pressing on nerves. There's a huge inflammatory response. And those nerves that they're pressing on, we associate with pain receptors in our brain. So it's not as simple as just like a zit, right? Like there's a lot of different sort of flavors. And, oh. Sorry, sorry. I'm sorry. I don't know how to use that. Yeah, I don't know. Just let me turn you off to cake. What about adult acne versus teenage acne? So you know, the acne that you get when you're a kid, you're hormonal, that's happening. But I still get to it's now. And I feel like I will forever. What is the difference between those two kinds of acne? Yes. I'm just sorry. I just say I get chew on schedule a year. And I'm like, it's always chew. And I'm always like, they look my, like, you know, yearly pimples is here. Yeah. And I'm like, oh, it's cute. And he's like, it's not. Like, but that's because I'm lucky. I only get a couple of years right now. It's a healthy way to think about it. I think. You're just showing up to show me I'm still youthful. Sorry. Yeah. Does it mean I'm still youthful? If I, of course. I'm still youthful. Yeah, you have radiant skin. So in general, I feel like adult versus teenage acne also goes down to like the differences between adult versus teenage skin, right? That makes sense. Yeah. Like teenage acne in my experience, like clinically, at least from seeing patients, usually focuses on the T zone, right? Like that's not to say, obviously, like, teenage acne can't happen anywhere on the face. Like any acne can happen anywhere on the face. But classically, you see more of those colonelons, which is the term I alluded to earlier. You see a lot more sort of blackheads and whiteheads in the T zone. And a lot of that is influenced also by the puberty hormones, which, you know, hopefully by adulthood, and, you know, a quote unquote, normal adult, like those that hormonal response is kind of tapered off a little bit. But in puberty, the effect of those hormones really shows in terms of like how that acne presents itself. So blackheads, whiteheads on the T zone, teenage skin, just tends to be a lot more resilient than adults can also. And also less scarring, maybe. As long as the acne is treated early on, right? Like any acne, like the longer it kind of lingers, that they're higher the risk for scarring. So all of the data is not pointing at like earlier treatment, be a little bit more aggressive. Go to your dermatologist at the earliest signs of acne before you kind of get to that acutane stage, right? If that's when the scarring can be really challenging to reverse, not impossible to fight, but challenging. But we know, like, you know, in terms of treating adult versus teenage acne, the differences also sort of carry over into how they're treated a little bit differently, too. I think a lot of that has to do with teenage skin just being more resilient. You can be a little bit more aggressive with that. Yeah, that means that the skin, like you have to be a little bit more mindful of the skin barrier, which I know is a very hot term these days. But for a reason, I mean, adult skin just tends to be, you know, doesn't heal us quick. The turnover of the skin cells is slower. Yeah. And women, especially in adult acne, you see a lot more of a hormonal influence as well. Yeah, for sure. That makes sense. I just have to throw in this question. I feel like pimples are a little less stigmatized. I think the kids are nicer and cooler now than they were when I was a kid. Pimple patches. Like, I mean, my friends use them sometimes because we see the Gen Z's doing it. And it's like, you go into the world with this like star stick right here. Just out of your face, right? So crazy. I could never in sixth or seventh grade, but do those work? They absolutely do work. Okay. I am so happy that they're becoming more and more normalized in our culture and our society. Because I agree with you. Like, even a couple of years ago, like people were like embarrassed to walk out with a pimple patch. And I think with like the current generation, they have all these fun colors and shapes. And it's like, people are just more accepting of it and like, open about it, which I think is incredibly destigmatizing. But from like a, like a scientific perspective. They absolutely do work. Most pimple patches, at least the ones that work are hydrocholoid based. Basically, what they're doing is they're draw, they're kind of sucking up the debris in that pimple, right? And they're shielding it from the environment. They're, they're offering a physical barrier for you to against people from picking at it. Or cutting it in. So that helps with it. It's so tempting to touch. It's so tempting. It's so tempting. I know that's like, you know, psychology or risk of alls, I think. It's the squeeze of it, right? Yeah. But terrible, right? Yeah. I live in the real world. I know people will do it, despite me telling people not to do it all that long. But pimple patches are a great sort of way to protect the pimple. You're not, even if you do touch it, there's a physical barrier there. You're protecting against bacteria, which our fingers are written with, right? Yeah. Just our hands really just go through it. Yeah. Yeah. And so the last thing you want to do is sort of bring all of that onto your face. Yeah. And then they're delivering targeted medicine to us. Yes. Yes. Yes. Yes. They have some of those salicylic acid and teatree oil patches these days, which I'm all for, you know, as long as people are not overdoing it with active, which I'm sure we'll talk about as well, because sometimes, you know, I think, like in our society with like the over consumption of products and like, there's so much to choose from. Yeah. It can actually get overwhelming, even for dermatologists, right? And we're getting so many things to test as PR and all of this, but sometimes, like the less is more and that I always preach to my patients, like you really want to sort of fine tune and be intentional with your skincare and not overdo it because there is this phenomenon of causing too much inflammation with aggressive treatments, right? Of course. And then once that happens, you know, you're kind of being counterproductive. Yes. And not really treating the acne, but causing more damage. I would guess too that if you are screwing with that skin microbiome, that's also not going to be good for your skin, right? So too many things drying it out and then adding lotions and stuff on top of it, your body's just like, what are you doing? Yeah. Exactly. Yeah. Yeah. Too much intervention. Let's take a quick break and we'll be right back. Hey, it's Anna and Mandy from our podcast Sisters in the City and we're currently sponsored by the Department for Work and Pensions. Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP otherwise you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work related costs or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. Tired of thee. I know it's here somewhere. The new ScanSnap IX 2400 scanner means you'll never search for a receipt again. Our simplest scan snap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one-touch scanning, 45 pages per minute speed, and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more missed expense claims or lost warranties. This piece of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit scansnapit.com slash podcast and discover how simple document management can be. Scan snap. The smarter way to work. What if you could feel more confident? Finally, go after that promotion. And feel great about inspiring other women. It all starts by recognising your worth and talking about your wins with confidence. That's why Galaxy Chocolate has created the Unhumble Project, in partnership with the Charity Young Women's Trust. To bring you free confidence training, get the pleasure you deserve from the incredible things you do. Take the training today, search Galaxy Chocolate, the Unhumble Project. Welcome back to Am I doing it wrong? We have so many questions from listeners and from folks who work with us. So let's just get in some of those. Yeah, you have. There's some of the fun ones, I think. You just sort of talked about this, but we had someone ask, what is the deal with popping pimples? Can we ever do it? Should we never do it? Is there one kind, like a tiny whitehead that we can do? I will say this is not scientific, but I feel like when I pop a pimple, it does heal quicker, or it seems like it starts to heal immediately. Right. And it looks better. Yeah, but I've just heard, yeah, no one wants a big, I know. What? I know. Tell us what your professional opinion is. Right. So this is such a popular question also in my practice, like you won't believe how many people are like, do I pop it? Do I not pop it? Yeah. By the book, the answer is no. But again, like we all live in the real world. Like the human sort of tendency to want to just squeeze it is so high and so satisfying, right? And even social media, you'll see all of these pimple-pimple-pimple videos and it's hard to scroll past them. They're just tempting. Yeah. So it's a harm reduction version. Yeah, yeah. So basically you want to do it. I mean, we do extractions in clinic as well. There are certain pimples that can be popped, okay? I'm not advocating for this. Like my fellow dermatologist colleagues will kill me. But basically you want to do it in a very sterile technique as possible, right? You don't want to do it with the wrong amount of pressure with, you know, un-gloved. It's like a pet peeve also because again, you're bringing so much bacteria onto your face. Yeah. Potentially even sort of causing more inflammation on bacteria to go deeper into the skin. Like directly into it. Yeah. And then you're pushing that sort of ball of pus deeper into your skin and that causes more like cystic acne. So if you're going to do it, it's important to realize like what is an okay pimple to pop and what you do not want to pop, right? Just going back quickly about the pimple patches, I always am a fan of pimple patches of repopping if that's something that you're debating between. Right. Because now most of the research that we have also shows that pimple patches will increase the healing time, decrease scarring by as much as 50%. Wow. Right, which is like a high, really high number. Yeah. And sometimes, you know, patients will go after pimples that are kind of inappropriate to pop like the deep cysts. Yes. Yes. You never want to pop. I don't see. Yeah. That looks like don't come near me. Yeah. Yeah. Say more though about why you don't want to pop those. It's causing like inflammation to become super inflammation. You're pushing back to that cake layer. Cooking layer. Yeah. Yeah. Yeah. Like if something wasn't that superficial frosting layer of your cake, now it's like at the depths, right? Got it. And now you've kind of even spread it, right? Like that mother pimple has given its offspring. Oh. Like a big old fruit. Yeah. Something like that. No, don't want to do it. Yeah. And like definitely it can cause once you have that deep inflammation, yeah. Especially in skin of color, which we know scars easier than like non-millinated skin. Yeah. Now you're causing increased risk for scarring, which becomes very sort of challenging to treat, but also emotionally challenging for people to deal with. Yeah. Yeah. I have two more questions related to this. One, I've heard like instead of popping, put a hot compress and let the heat sort of empty the pus out, is that good or is that bad? I am kind of not in favor of that. I like to use cold compresses. Interesting. Interesting. Yeah. So usually I tell patients like a cold, metal spoon or something, put on a pimple that's like throbbing in painful or just very inflamed. Yeah. Right? We know that the cold will actually decrease that inflammation. The idea behind a warm compress like scientifically is to increase blood flow to the area, but you can also increase potential with blood flow, increase more inflammation as well. So that's where the current, to my understanding. Yeah. So that's where the current sort of evidence lies around that, right? Like, I usually just help people just go to the dermatologist. Like we have so many options in our toolbox, but if you're in a jiffy and you have like a pimple, like we can definitely like right before a big event, we can do a cornies own shot. Right. I have done that. Yeah. Are they magical? In unbelievably amazing. They're great. I have to say, like we've heard every kind of like how to fix your pimple, you know, without asking for help, just go to the fucking dermatologist. Right. Like if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if if like a lot of essential oils will do it. So that's a whole another conversation about like natural being good or not, right? But just be careful with what you're showing on your face. Yeah, I mean, I think the reality is though too, like we said, go see a dermatologist. But number one, if you just have a couple, you're probably not gonna go in. And two, if you don't have insurance, probably not gonna go in. And three, it takes a long time to get into see a dermatologist. Like I just made my annual appointment for my skin check. His first opening was February 28th. Let's talk about some of the things that actually do work if you're at home, you have a Z. What are you sort of gonna be in your toolkit that you're gonna tell us to put in our toolkit? Right. So I think we kind of addressed some of them. So people patches definitely huge fan, especially the ones that have hydrochloride, which is very well studied in terms of like wound healing and all of that. So it definitely, that definitely helps. Cold will help, right? Like the cold metals, wounds will help decrease inflammation. I always caution against putting like, ice directly on the skin, can cause more issues like burns, right? Like cold burns. So you don't wanna do that. There's some great over the counter products these days, right? Yeah, but what do you have? Yeah, so I usually like benzal peroxide for those really sort of inflamed juices. That's right. I think there's a lot of data showing now that there's anti-inflammatory antibacterial function. And in fact, like now we even know that the lower concentrations work equally as good as like the stronger one. I've heard that. These are great. They'll dry you right up. They will dry you. I love benzal peroxide. I don't think I've not had a tube in my medicine cabinet over the last 30 years. It works so well. And I have heard that you could use like 5%, 2 1 1 2 1 2 instead of 10. Yes. And it would probably be just as effective. And you just put it on once. Truly, like overnight it makes it difficult. It dries it out. And now there's actually like so many brands out there that are catching on that, you know, this can be potentially an irritating ingredient. And now with the movement being towards like skin barrier friendly products, I think companies are also formulating products that are very skin barrier friendly. So you have the benzal peroxide, but you have the ceramides. You have the hydrating ingredients also. Not this is not a sponsored recommendation. Like Syrivy is like a great brand also. So many dermatologists say that. Yeah. They have like a really good acne foaming cleanser that has like they have a 5% and a 10% a little from my shower. Yeah. And it's not irritating at all. And I promise I'm not getting paid to say that. But like it's great. Send us up those there. No, I think that's great. What about like salicylic acid? Yeah. So salicylic acid is also good as well. I think it works better for other specific types of acne. So it works really well for, remember those comedones we were talking about like those blackheads and those whiteheads. So salicylic acid is a beta hydroxy acid. And what that means is it's oil soluble, oil loving. So it actually gets deep into the pores, right? Because we may have learned in like middle school chemistry class like like oil loves oil right. Like it's hydro full back. It's basically going to go deep into the oils, producing glands and sort of dissolve all of the gunk and prevent it from building up, prevent that clog up from happening. OK. And so it's really good for blackheads and whiteheads. OK. So got to be careful with combining too many things together because that's definitely a recipe for irritation. Yeah. Your face is not a chemistry lab. Exactly. Like I don't, I'm not a huge fan of combining like benzoproxide with salicylic acid together. Yep. Have been there, have done it personally. Can cause a lot of irritation. Yeah. So different types of acne I think can benefit from different sort of angles of treatment. We have so much irritable oxygen. Let's take a quick break and we'll be right back. Tired of the, I know it's here somewhere, moment. The new scan snap IX 2400 scanner means you'll never search for a receipt again. Our simplest scan snap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one-touch scanning, 45 pages per minute speed, and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more mystic spence claims or lost warranties. Just peace of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit scansnapit.com slash podcast and discover how simple document management can be. Scan snap. The smarter way to work. Hey, it's Anna and Mandy from our podcast, Sisters in the City, and we're currently sponsored by the Department for Work and Pensions. Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP, otherwise you could face a penalty. That could be a partner moving in, even if they keep their own place, or if your car doubles up as a taxi and a family car, you must only report work related costs, or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. We get it. Making tax digital can sometimes feel daunting, but with zero's HMRC recognized software, you quickly get to feeling confident. If you're a sold trader or landlord whose income tax is going digital, not only is zero MTD ready, it also gives you better control of your finances, like having the clear financial visibility you need every quarter to avoid end-of-year tax surprises. Change the way you see MTD. Search MTD ready with zero.! Welcome back to Am I doing it wrong? I feel like everyone's parents were like, don't eat chocolate and junk food, that's gonna give you acne, which sounds like horseshit. I eat a lot of chocolate. Yeah, when it comes to diet, let's just start with that. Like what the chocolate cause acne. So it's such an interesting question because I feel like there's so much research going on these days over the last couple of years into diet and acne and I have a lot of patience and asking similar questions about that. But that's because of the microbiome, not because of junk food, right? Exactly. So we are learning that there is a connection between the gut skin access, right? Okay, it makes sense. Yes, and a lot of that has to do with the microbiome to your point. And so we're learning also that cortisol and insulin spikes can cause. Access oil production and can affect that lot. At least on the molecular and biological level increased acne predisposition. So it's definitely not completely false. I hate when my mom is right and she's right a lot. But when it comes to specific food groups, I think like it's the evidence is not quite out. Yeah, to say like X food group is gonna cause acne. Yeah, to demonize, like want to, it's more like balance, eat, eat, eat, eat, eat. Exactly. We know for example, like dairy, right? Like that's a big one. Yeah. And I think that more and more research is showing that specific types of dairy, like skin milk in particular, you know, will sort of cause some sort of interplay between hormones and affect the skin as well. Is it for everyone? Because I have two girlfriends in particular who dairy like makes their skin just, it just fucks it up. But it's not me. So I'm like, is it certain demographics? Is it, you know, or hormonal makeup? Yeah, so I think it kind of goes to like that first point we were talking about, like it's not just one risk factor. It's like the right genetics and the right patient, like doing like some, like the right diet or the wrong diet. What kind of environment they're growing up and what kind of products, like it's so multifaceted and multifactorial that I think a lot of the research while we're finding out all of these cool studies about like diet and environment and genes and genetics. Like there's a lot of teasing out to still be done about like the interplay and the relationship between all of these different things. So it's like, I think we love to like over simplify things but it's really just not that simple. Yes, right. Sounds like it. One simple thing that we've heard though is like wash your face but talk to us about that because I feel like you can probably wash it too much. I've definitely done that. Yeah, if you have acne especially you're like, I just need to keep this clean but then I think you can be doing damage too, right? You're absolutely right. At bare minimum, I do think people should be washing their face morning and evening, right? And then anything more than that, I mean also like kind of to my earlier points depends on the environment you're in. Like if you're in some like smog, written city, right? Like in the like maybe like, I don't know, like what kind of environment you're in, like what kind of work you're doing, what kind of things your face is coming into contact with. But at bare minimum, I think twice a day is a good option for most people especially. And you know more and more people are realizing, you know, you can also just wash your face with plain water in the morning for example. Your skin hasn't really been through the elements throughout the night, right? Like, and we can talk about sleep hygiene as well. But at the end of the day, definitely I recommend using a cleanser just to take the day off, right? Like you're throughout most people's regular nine to five's. Like you've been through it, like you know, you're going outside, you're going on the subway, you're coming into contact with things you're cooking meals. Like things are getting on your face. Like you want to also before bed, make sure you're doing a really good job about taking makeup and sunscreen off, right? Like those are definitely acne triggers. Like when people go to sleep with those kind of things on like that's poor clogging. That's like inflammation inducing. Yeah. To the sleep hygiene point, my two pimples usually happen after I haven't changed my pillow case for too long. Like if I, you know, it goes like two weeks and whatever. And I'm like, oh shit, I try to change it quickly, but that's when my pimples come. When the pillow case is like, yeah. Been there for a while. I have such an interesting fact here that is kind of going to blow your mind because when I read it, I was like, no way. But can you guess how much bacteria increases on our pillow cases? Like over like a night? I'm so scared. I'm scared too. Oh my God, it's like 17,000%. Wow. When I saw that, I was, I was, I didn't know that. I can see having no pimples a year. After one week, 17,000% increase in bacteria. That makes me want to like hang upside down, just feeling it never ends up like that. Yeah, like that is terrifying. Wait, that's incredible. Like it's such an easy thing to do to change your pillow case. You don't even have to change the rest of your face. Right. That's so gross. And I really just be making love to my pillow cases. Like I'm rubbing my face on it. I sleep, I sleep good. Yeah. Oh my God. Are there particular kinds of pillow cases that are better? Like I always hear about like satin versus cotton versus polyester. Yeah, so I like silk pillow cases. Okay. I know it sounds so fancy, but honestly, like silk has some level of antimicrobial properties. I'm not saying that this is also BS. Like, but I read that this is true. It's true for your hair, right? Yeah, even for your hair. And that might have to do with like friction. And right, like it's just like a little bit smoother sliding, right, in terms of like the substance. But when it comes to like pillow cases and bacterial and build up and skin dead skin saw build up, having silk pillow cases is not like a replacement. Like I'm not saying if you have a silk pillow case, you don't have to wash your pillows for like, imagine a pillow case is for like a month. Like you still should wash them. Right. But if you have the option between like a cotton pillow case versus a silk pillow case, and you're looking to just optimize everything, I think a silk pillow case is a better investment. Okay. I just can not imagine myself being a person with silk pillow cases. It sounds pretty hard for me to imagine that. I want that for you. Okay. Maybe 2025 will be the year of. I'm gonna save up and get it for your next birthday, but just one. That's the only thing that's gonna happen. If someone gives us me as a gift, maybe I'll try it, but I can't imagine hitting by on, you know, on those. It's just our own values. But I mean, if the science is there, like that makes sense. I get it. I understand why that would be. But let's talk a little bit about old wives remedies. Yes. And let's just go through them. Does toothpaste do anything to them? Oh, I used to do that. Oh my God. toothpaste is one of the worst things you can throw. Oh my God. It dries out. It dries out. It dries it out, but it does not make it go away. It does not make it go away. It may have a temporary drying effect, but there's so many potential harmful things that come with putting toothpaste on your face. So pH, right? Like toothpaste is very alkaline. It can cause chemical burns and I've seen that. Yeah. And also, it's 2025. We have so many better things to put on your face. Right. I did it in 1998. Okay. Yeah. Maybe the science wasn't there. It ain't the grade. Yeah. No, you're not the only one I hear so many people like that currently even put toothpaste on their face. And it's just like so many better things are out there now. Remember when back in the day when the burn was supposed to be a good thing, like stuff you put on your face was supposed to kind of tingle a little? That's not good. That's usually a sign that your skin barrier is being damaged. Right. You're getting a burn. Yeah. So I'm going to guess if you said that toothpaste is alkaline, then we shouldn't put baking soda on our face. Baking soda is a gnogo similar to toothpaste. It can cause a lot of chemical burns. It can disrupt your microbiome, right? Which can over the long run, if you're doing that like on a weekly basis, let's say you're going to end up with more acne over the long run because now you're like you're kind of have caused this imbalance of your microbiome and cause burns and destruction of your skin barrier. What about I've heard people say too, they will crush up an aspirin, make a paste out of that and use that same idea. I don't recommend it. I mean, all of these things in the short run might feel like they're doing something, but trust me, over the long run, you don't want to deal with like a baking soda or toothpaste-induced chemical burn which can now take months to sort of heal. You don't want to be left with chronic skin barrier disruption which can also take weeks to months to sort of fix, right? Like so just stay away from it. Okay, I have a scenario for you. It's a new experimentation, yeah. It's a Friday night and I'm on vacation and I all of a sudden have a big juicy pimple and I'm looking in the mirror and I look on the sink and I have a tuba toothpaste, I have some baking soda, I have some aspirin and I just have cleanser. What are you telling me to do for that big juicy pimple? Just wash it and leave it alone, use anything. Do you have a fridge? I have a fridge. So if you have a fridge and I would go and I would definitely use your cleanser. Pat your face dry, right? This is like the emergency protocol. Put like a cold spoon on it or put some sort of cold on it, right? To decrease that inflammation. I don't know if you have access to a pimple patch but also like if you're on vacation you can probably go to the drug store at some point. Go to CVS. Go to CVS, go to Walgreens, get a pimple patch and put a pimple patch on it, right? Don't pop things on vacation, especially if you can't. You see a dermatologist or don't have access to like good medical care. Like what if you cause now like a deep sort of cystic inflammatory pimple, right? Yeah. Like you just need a course on shot, you need an antibiotic. Like we have things that we can do in office. And to your point, I know not everyone can get access to a dermatologist or physician ASAP. But you know there are certain like emergency situations and I know it sounds funny to say that, you know, a pimple would be an emergency situation but they can be, especially if it's like a deep sort of cystic pimple and you're concerned for like a deeper infection going on. Right. Is it, is it like an urban legend or can you possibly contract like staff from like popping a pimple? Absolutely can. Okay. Yeah. Yeah. That's not scary. Yeah. Yeah. They've raged in me at the emergency room every time we have a sit. No, no, because our twice a year, we're going to use the pimple patch. There you go. Exactly. Are there old wives remedies that we talked a little bit about tea tree oil? Are there things that you're like, actually this does work or this is beneficial? Right. I was going through some of them honey, which I feel like a lot of people have talked about like Manuka honey. Okay. There is actually evidence that there's antibacterial antimicrobial properties honey has. I mean, it has to be like unadulterated honey or I like, it has to be like pure honey but and also like there are things before honey that I would recommend, right? Like we talked about some of them. Yeah. But honey is one of them that I do think works. Interesting. So that's an interesting one. Green tea is another one, right? Like whether like there is some data out there that it has anti-inflammatory compounds in it and that's like whether you're sipping it or putting it on, right? Like there is evidence that it can actually. Yeah, like a tea bag. It can decrease inflammation as well. Again, similar to that medical grade honey, like there are other things that I would recommend before green tea, tea tree oil or honey. But I'm just saying like there are things that we're learning more and more about that. Teedagging, how new. Teedagging, you'll bring it back. For your skin. I don't love that. Say the pimple is not there yet, but yeah. You can feel it. There's like a fetus of a pimple and it's like you can see it happening. There's this hilarious episode of Sex and City where Carrie's about to see big and she's like, I can feel it. What should you do? Yeah, I would do the same thing with cold, with cold that compresses that I was talking about to decrease any inflammation before it comes up and put a pimple patch on there, right? Yeah, oh, good idea. Yeah. Try to pop things that especially don't have a head. Yeah. Because those deeper sort of pimples or pimples that haven't come to a head, usually they come to a head in three to four days is my experience, but sometimes can take a little bit longer. But if it's not, if it's that fetus of a pimple that you were saying, and you've kind of pop it, now you've sort of pushed that inflammation into that sort of cake analogy deeper into the layers of the cake and cause more trouble and scarring and inflammation. And so it's not going to end up well. All right. I think one of the things that's going to haunt me the most from this conversation is the idea of that popping a pimple pushes inflammation in the border. It's not what you would think. I never really heard about that before. In your mind, you think it's pushing it out. You're getting rid of it. Right. Not always. Remember, we all also do extractions in the office, but it's like, you have to know what is poppable. Yes. What you're doing. And how you're popping it. Yeah, the strategy. Yeah. Right. And watching Dr. Pimple Popper on YouTube is not the same as having a medical degree. No. It's fun as it may be. I met her once. She is a doll. I know. She is so sweet. She's so sweet. I loved her. Like, I was like, you can't be as nice as you are on TV. And I mean, I only met her for 10 minutes, but she was. I love when people are. That's the nicest. Yeah. Completely. She did not ruin it for me. I heard that stress can cause or is, you know, somehow related to acne is this true? Absolutely. OK. So we know going back to that sort of cortisol, right? Like when we wake up in the morning or cortisol levels are the highest. That's our body trying to wake us up. To an extent, cortisol is normal. Like we need it for normal life. But when those levels get higher than what they should, they can definitely at the level of those oil glands, right? In the skin can cause more sebum production, can cause more oil production, which leads to the cascade, the complicated cascade of acne developing. And so that also ties into like, wiser and food groups, which we were talking about earlier, lead to acne. And it has to do with that insulin spike and that cortisol as well. OK. Interesting. Yeah. It's pretty interesting. What is this telltale sign that we should go see a doctor for acne? When do we know that we should give you a call? Right. So as a journalist, I will say there's no right or wrong answer to this. Like usually when people are even debating it, that's a sign just come in. OK. If it starts affecting your emotional sort of health, right? Like our face, we talk about is like kind of how you present yourself to the world. Now if you're getting emotionally just dressed by having acne, I think that's a sign to come to the dermatologist. People don't realize that we have so many new and emerging tools in our toolbox. Like there's so many over the last decade, there have been so many new medications that have been FDA cleared for acne. And not everything is like not everyone is good candidate for everything. But we have so many things we can do for acne that we didn't have back even a couple of years ago. Yeah. And so earlier treatment has better. And all of the research is now showing this, like scars, for example, even when you treat acne scars earlier, when you treat acne earlier, people are finding more and more success with earlier interventions, with combined interventions. So rather than just doing your pimple patches, like do pimple patches, plus benzoproxide, plus retinoids, plus like oral. Right, like not everything is like a cookie cutter sort of solution for everyone. Yeah. But I often will combine a lot of different things for different people. And the earlier you start to do that, the better of the results are. Yeah. Yeah, so it is like a very personalized cocktail kind of thing. Yeah. Okay. It's interesting to you because I was talking to a friend about this episode. And we were just saying, if you've never had bad acne, and you see someone with acne, like a lot of people just think like they don't wash their face, or they're not taking care of themselves. But like that's not enough for a lot of people. Right. And you need a doctor who can say, this is what we're going to try. Yeah. And it's really awful to be going through that and then to have people judging you for it. That's true. It is associated with bad hygiene. And you're like, that's not at all what's happening here. Yeah. That's such misinformation. Yeah. Like acne is a medical condition. And it's not a reflection of like self worth or hygiene. Right. Yeah. You know, and I think people are hopefully more people start to realize. I think it's changing for a short. I had a moisturizer question because when you're like shiny and like, completely, the last thing you want to do is like put an emollient on your face. But you should still be moisturizing when you're like treating acne, right? Absolutely. And I think it's kind of kind of like intuitive. Like you were like, okay, if I'm oily, why would I put more moisturizers on? I get it. Like as of a couple of years ago, I think a lot of dermatologists used to think the same. But I think now we know better, right? Like even an acne prone oily skin still needs a moist. Like you still need a healthy skin barrier, right? Yeah. Like that oil and sebum that your skin is making might be a paradoxical response to having dry skin. Yeah, totally. And so now there's actually, you know, like brands also are realizing that acne's prone and oilier skin needs a moisturizer. And there's so many really good moisturizers. Like oil-free moisturizers. Exactly. And they have like, there's so many moisturizers with things like silica in it, which will absorb oil throughout the day. So you don't have to look really dry. Okay, so what, and again, not sponsor, but like what are some of your name a couple of moisturizers that you like for people that struggle with that? So I personally have oilier skin as well. And I really like the La Roche, which I would say it's in the blue bottle. Okay. It's the double repair matte moisturizer. Okay. It's perfect. Again, this is totally non-smiles right there. I personally use it every single day. I love that. So that's a great option. It has what I was talking about earlier, the silica, which will over throughout the course of the day will sort of normalize oil control and make sure that you're not making too much. It has nice cinnamon in it, which is also a buzzy ingredient. But there's good research that it sort of balances oil production. I mentioned a brand earlier, Serivii. That's also a great brand, right? That has a really nice oil absorbing moisturizers as well. And it's affordable. And it's affordable. Yeah, that's great for people who don't want to use it. People think that drug store brands are not great. I'm a huge fan of drug store brands. Like, as long as the science is there, and these companies, like some of the bigger ones, have invested a lot of research into making sure that the products they're putting out are scientifically sound and they partner with a lot of dermatologists to make their products. Love that. Do we always want a product to be non-clogging? I forget the exact term and I can't pronounce it. It's non-commodogenic. There you go. Is that what we want to be looking for? Absolutely. And so non-commodogenic basically just means what you said and gets non-porclogging. And so, I always tell people in my clinic, just if you're ever concerned about a product, just flip over the back, right? And look at the ingredient list. It should say non-commodogenic non-porclogging. You want to look for makeup. That's non-commodogenic. This is why I know this word because it's makeup. I used to use a certain brand that I won't mention that was like Dr. Parik told me he's like, don't that clogged it for his. But now I look in, it's like a different world. Yeah. Yeah. That moisturizer is right, like things that you're putting in your face. Now, I think people are becoming more and more well-versed about what that means. Yeah. And hopefully, it's always good to just read what you're putting in your face. Sure. With shows like this, hopefully even more, we've been starting to do this thing at the very end where we ask our expert, you know, like, what is one thing you wouldn't do if you had a pimple? What would that be for you? Don't wait, I think a lot of people wait until they have, they're like, okay, like maybe I can do this, maybe I can do this. And yeah, I'm not completely dismissing, like, you know, self-treatment and self-empowerment to do things from like the drugs or even there's great things out there. But if you're doing things and honestly, if you feel that your acne is not getting better, you know, just summarizing all of the sort of studies we were talking about in the research, like more and more data is now showing the earlier intervention is better. And I know, you know, not everyone has access to a dermatologist, but you know, make that appointment. Just come in sooner, like there's so many things, honestly, that we can do to help your skin. And I also would add in, like, don't feel that acne is a reflection of yourself worth or you're sort of hygiene, right? Like it's really not, it's a medical condition that you may have no control over. Yeah. And so there are things to do to help it. Yeah. Yeah. I love that. My very last question I have, we didn't get to this, but I think there's this idea that if you're drinking gallons of water a day, your skin's gonna be better. What is the relationship between hydration and acne? Oh my God, that's such a pet peeve of mine. Yeah. Because on social media, if you're like, I feel all of these people are like, just drink water, right? And I'm like, that's not the answer. It's a medical condition. Yeah. Yeah, of course, you should be drinking water, like just for your overall health, but drinking water, there's no research that says drinking water will cure you of your acne, right? Like that's just not, yeah. There's more to it than just being dehydrated or not drinking enough water. That's good that we said that. So I think you're right. So many people, influencers like have their big Stanley cops or whatever and they're like, you're not getting enough water. And I'm like, we did a whole episode on hydration and we busted a lot of those myths there. Yeah. But I think especially with acne. Drink your water, but treat your acne appropriately. Love that. I feel so much better. Yeah. I learned a lot. I do them both next year, this year. Maybe just one. It just one. Yeah. Damn, the pillowcase thing. Isn't that crazy? Change your pillowcases or at least like flip them through at the night. Flip them. Yeah. If you like the cold side better. Yeah. I do. Yes. Thank you so much. You've always thought we were having me. Yeah. It's so good. It's time for better and five. These are your top five takeaways from this episode. Number one, acne is caused by a combination of factors which can include genetics, environment, and diet. Number two, popping pimples might feel good, but it shouldn't be your first line of offense. It can actually make things much worse. Number three, Gen Z is correct. Pimple patches really work and can protect your skin as it heals. And they're cute. Number four, you're going to want to change your pillowcases frequently. They can in harbor insane amounts of bacteria. And if you're fancy, maybe try a silk pillowcase. You are fancy. And number five, the tendencies to over cleanse your face when you have acne. Don't do it. Twice a day is perfect and use an oil remoicurizer. Okay, rise. Have you been doing acne wrong? I mean, I was right when we started. I was doing it wrong. They're like, everything I tried under the table as like a swarthy oily 13-year-old. Swarthy, you're not pirate. I was a little pimply pirate. Luckily I grew out of that face. But it's humbling to know that even dermatologists didn't have all the answers when I was growing up. So it's like I wasn't alone in my chaos. And it was nice to learn about how the research is evolving. I mean, yeah, my dermatologist put me on acne three times, which is insane. So yeah, I agree. I learned a lot. I don't think I'm going to pop another pimple. That's terrifying. That's still my, but only a very tiny one. Not the deep ones. No, definitely not. But yeah, I also like that it's evolving. We're learning more about it. None of us are alone with this. Yeah. Most of us are dealing with it at some point or another. And I feel better when I have more information. Yeah. And it's not coming directly from TikTok. Totally. Except I do want those patches. Yeah. Except for the patches. But don't put the toothpaste on your face. No. Oh, anyway. Until next time, as long as there are things to get wrong, we're going to be right here to help you do them better. I love you guys. Do you have something you think you're doing wrong? Email us at am I doing it wrong at huffpost.com and let us know. 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