【外刊精读】How bad is it to pop a pimple, really?

We know it’s bad. Maybe parents or partners have scolded us for it. Perhaps we’ve borne the consequences, in the form of angry red sores on our chins and brows. And yet, when a pimple starts to form … don’t you just want to pop it?

“Lots of people pop their pimples,” says Dr Howa Yeung, assistant professor of dermatology at the Emory University School of Medicine. “But that process, if done incorrectly, often leads to more inflammation.”

How bad is it, really? What happens when we have a go at our chin at the end of a stressful day? And why can it feel so damn satisfying?

我们知道这不好。也许父母或伴侣已经因为这个问题训斥过我们。也许我们已经因为这个问题付出了代价，例如脸上和眉毛上出现了愤怒的红色疱疹。然而，当一个粉刺开始形成时……你不想挤它吗？

“很多人都会挤自己的粉刺，”埃默里大学医学院皮肤科助理教授霍娅·杨博士说。“但是，如果这个过程做得不正确，往往会导致更多的炎症。”

这到底有多糟糕？当我们在压力大的日子里挤自己的脸时会发生什么？为什么这会让人感觉如此满足？

What is a pimple?

什么是痘痘？

“When people have acne, there are several things going on,” says Yeung. First, dead skin builds up around a hair follicle. This combines with sebum, an oily substance that moisturizes and protects the skin, and results in a pimple.

The difference between acne and pimples, according to the Cleveland Clinic, is that acne is a disease, and pimples may be a symptom of acne.

There are two main types of acne, explains Dr Olga Bunimovich, dermatologist at the University of Pittsburgh Medical Center: comedonal and inflammatory.

Comedonal acne means blackheads and whiteheads. With blackheads, the excess of oil and dead skin is open at the surface of the skin, while whiteheads are closed at the surface of the skin.

In some cases, this acne attracts bacteria, which turn results in inflammation. This can lead to pustules, cysts or nodules, which are typically more painful.

“当人们患有痤疮时，会发生几件事情，”霍娅·杨博士说。首先，死皮细胞会在毛囊周围积聚。这些死皮细胞与皮脂结合，皮脂是一种油性物质，可以滋润和保护皮肤，从而导致痘痘的形成。

根据克利夫兰诊所的说法，痤疮和痘痘之间的区别在于，痤疮是一种疾病，而痘痘可能是痤疮的症状。

匹兹堡大学医学中心的皮肤科医生奥尔加·布尼莫维奇博士解释说，痤疮有两种主要类型：粉刺型和炎症型。

粉刺型痤疮指的是黑头和白头。黑头是指皮肤表面有多余的油脂和死皮细胞，而白头则是皮肤表面被封闭的死皮细胞。

在某些情况下，这种痤疮会吸引细菌，导致炎症。这可能会导致脓疱、囊肿或结节的形成，这些通常更痛苦。

Why do we pop pimples?

为什么我们会挤痘痘？

“We have an unconscious pull towards damaging behaviors,” says Fabiana Casanova, a psychotherapist and owner of Nova Psychotherapy in Boston. Some obvious examples include addiction and overeating, she says, but popping pimples is part of the same tendency – what Sigmund Freud called the “death drive”.

“It is not necessarily a soothing behavior per se,” she explains. “But it’s one that brings a slight enjoyment despite the pain.”

Casanova says it is common to see an increase in such behavior in times of stress. The behavior becomes problematic when it starts “affecting our ability to perform our regular tasks and daily activities”, she says – say, if your pimple popping delays you leaving the house, or it makes you feel self-conscious about your appearance.

To manage the behavior, Casanova says that being aware of one’s emotional triggers and being able to process those emotions can reduce how drawn we are to the activity.

“我们对有害行为有一种无意识的吸引，”波士顿Nova心理治疗中心的心理治疗师法比安娜·卡萨诺瓦说。她提到，一些显而易见的例子包括成瘾和暴饮暴食，但挤痘痘也是这种倾向的一部分——西格蒙德·弗洛伊德称之为“死亡驱动”。

“这并不一定是一种安抚行为，”她解释道。“但尽管有痛苦，它仍然能带来一点享受。”

卡萨诺瓦表示，在压力时期，这种行为的增加是很常见的。她说，当这种行为开始“影响我们完成日常任务和活动的能力”时，就会变得有问题——例如，如果挤痘痘耽误了你出门，或者让你对自己的外貌感到自卑。

为了管理这种行为，卡萨诺瓦表示，意识到自己的情绪触发点并能够处理这些情绪，可以减少我们对这一活动的吸引力。

What happens to your skin when you pop a pimple?

挤痘痘时你的皮肤会发生什么？
When people pop pimples, they tend to put pressure on the skin around the bump, pressing on it to expel what lurks beneath the surface. But while some of the pus may come out, Bunimovich notes that this pressure may lead some of it to seep deeper into the skin, causing greater inflammation.

“This also increases the risk of pigmentary changes and/or scarring,” says Dr Lindy Fox, professor of dermatology at the University of California, San Francisco.

When you pop a pimple to relieve pain or to express pus, you also run the risk of nothing coming out. Bunimovich says she works with a lot of patients with acne scars. “I can always tell which are the picked acne scars,” she says – the scars that form when patients try to pop a pimple and nothing comes out, so they keep picking at it. These scars often have jagged edges, she says.

当人们长痘痘时，他们倾向于对痘痘周围的皮肤施加压力，按压它以排出潜伏在表面下的东西。但是，尽管一些脓液可能会流出，Bunimovich指出，这种压力可能会导致一些脓液渗入皮肤更深，引起更大的炎症。

旧金山加利福尼亚大学皮肤病学教授林迪·福克斯博士说：“这也增加了色素改变和/或疤痕的风险。”

当你用痘痘来缓解疼痛或分泌脓液时，你也有可能什么都不出来。Bunimovich说，她与许多有痤疮疤痕的患者一起工作。她说：“我总是能分辨出哪些是挑出来的痤疮疤痕。”当患者试图戳出痘痘但什么也没出来时，就会形成疤痕，所以他们一直在挑。她说，这些疤痕通常有锯齿状的边缘。

Is there a way to safely pop pimples?

有没有一种方法可以安全地祛痘？

Picking at pimples is bad for your skin. But is there any way to do it with minimal damage?

“Painful pimples are best treated in a doctor’s office where they can be drained and/or injected with a small amount of corticosteroid to help decrease the inflammation,” says Fox.

For those who don’t have the time or resources to visit dermatologists regularly, there are some things you can do yourself.

Bunimovich says that if you see the pus on a pimple and it is right at skin level, you can use clean hands or a clean, sterilized needle to open the top and then wipe away some of the pus. But use “hardly any pressure”, she warns.

If you have a deep, painful pimple, the American Academy of Dermatology (AAD) suggests applying a clean, warm, damp washcloth to the pimple for 10 to 15 minutes a day, three times a day. “This will help the deep pimple move closer to your skin’s surface so it can heal,” they explain in a blog post. Use a fresh washcloth every time, and “resist popping the pimple”.

Topical treatments can also be helpful. Yeung recommends benzoyl peroxide gel, an over-the-counter acne treatment that he says can be “excellent for treating individual pimple spots”. According to the AAD, products that contain acne-fighting ingredients such as adapalene and salicylic acid can also be helpful, as can hydrocolloid acne patches, which “protect your skin and improve healing”.

抓痘痘对你的皮肤不好。但是，有什么方法可以在损害最小的情况下做到这一点吗？

福克斯说：“疼痛的丘疹最好在医生办公室治疗，在那里可以引流和/或注射少量皮质类固醇来帮助减轻炎症。”

对于那些没有时间或资源定期去看皮肤科医生的人来说，有些事情你可以自己做。

Bunimovich说，如果你在丘疹上看到脓液，并且脓液就在皮肤水平，你可以用干净的手或干净、消毒过的针头打开顶部，然后擦掉一些脓液。但她警告说，“几乎不要施加任何压力”。

如果你有一个深而痛苦的粉刺，美国皮肤病学会（AAD）建议每天用一块干净、温暖、潮湿的毛巾敷在粉刺上10到15分钟，每天三次。他们在一篇博客文章中解释说：“这将有助于深层粉刺更靠近皮肤表面，从而愈合。”。每次都要用一块干净的毛巾，“不要让痘痘冒出来”。

局部治疗也可能有所帮助。杨推荐使用过氧化苯甲酰凝胶，这是一种非处方痤疮治疗方法，他说这种方法“非常适合治疗个人粉刺”。根据AAD的说法，含有阿达帕林和水杨酸等抗痤疮成分的产品也有帮助，水胶体痤疮贴片也是如此，它“保护你的皮肤，促进愈合”。

How can you prevent acne?

如何预防痤疮？

One way to stop picking at pimples is to prevent acne from forming in the first place.

Bunimovich says she recommends dietary modifications, especially reducing intake of sugar and dairy. For patients who wear a lot of makeup, she also suggests wearing slightly less, as heavy makeup can block pores and contribute to acne formation.

Yeung also warns about over-exfoliating. “Even though exfoliation is popular on social media, I generally don’t love using it for people who have acne-prone skin,” he says. Excessive exfoliation can remove sebum, and thus make the skin produce even more of it, leading to more acne.

If one is struggling with acne, experts recommend working with a board-certified dermatologist. “We have so many good treatments for acne,” Yeung says.

停止粉刺的一种方法是从一开始就防止粉刺的形成。

Bunimovich说，她建议调整饮食，特别是减少糖和乳制品的摄入。对于浓妆的患者，她还建议稍微少化妆，因为浓妆会堵塞毛孔，导致痤疮形成。

杨还警告过度去角质。他说：“尽管去角质在社交媒体上很受欢迎，但我通常不喜欢用它来治疗容易长痤疮的皮肤。”。过度去角质会去除皮脂，从而使皮肤产生更多的皮脂，导致更多的痤疮。

如果一个人正在与痤疮作斗争，专家建议与董事会认证的皮肤科医生合作。杨说：“我们有很多治疗痤疮的好方法。”。