Odds are, you’ve got big questions if you’ve got acne. What’s the right way to make a pimple pop? Why do I still get breakouts as an adult? Can you get rid of blackheads?

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We know you’ve got this question because we’ve got it too, let’s face it. That’s why we turned to Sandra Lee, M.D., an adult acne expert. (Better referred to as Dr. Pimple Popper). She’s answered 23 questions below so that in the free and clear ASAP you can get your skin.

Is there any way to close my pores?

Pores do not open and close, but they may appear smaller if they are kept unblocked and clean. My SLMD Acne Cleanser ($ 25, Buy It Here) exfoliates with salicylic acid that helps de-gunk pores as well as decrease bacteria that cause acne. Every time you wash your face, you can use it unless you experience irritation or dryness— then reduce your use to once a day or every other day.

Will splashing my face with cold water shrink my pores?

Yes, but it’s temporary—only about five minutes.

How often should I wash my face to maintain clear skin?

At night is the most important time. You don’t need to scrub away in the morning if your skin is clean. People with acne tend to wash too frequently and rub too hard because they feel their skin looks dirty, but this can make the skin red and flaky.

Is there a way to avoid blackheads?

No, but with acne treatments such as salicylic acid and retinoids, you can minimize them. Wash once or twice a day with salicylic acid and use a retinoid such as Differin Adapalene Gel Acne Treatment ($ 12, Buy It Here) every night. If you have sensitive skin or notice redness or flaking, use it only every other night to start.

I eat clean, drink water, and sleep well. Why do I still break out?

Despite the fact that your lifestyle can affect your teint, it is hormones and genetics that dictate your skin condition.

Will eating sugar cause acne?

There is a belief that a high intake of sugar can encourage acne. A high – glycemic diet — one with many refined carbohydrates, including sugar, that raise your blood glucose and insulin levels rapidly — can be associated with more frequent breakouts, and recent small studies reinforce that.

Why do I keep getting the same pimple on my cheek?

Sometimes a pimple never heals completely, and when hormones increase the production of oil in the skin, it can be activated again. I recommend using a spot treatment with salicylic acid, such as Philosophy Clear Days Ahead Acne Spot Treatment ($ 25, Buy It Here), whenever a zit occurs.

How can I prevent dark spots?

Stay out of the sun — UV exposure may continue to obscure acne spots — and wear a daily SPF 30 or higher. And don’t pick up on your acne, which can lead to skin trauma and hyperpigmentation.

Can I get rid of dark spots?

It will mostly resolve itself over time, unless you repeatedly cause hyperpigmentation from exposure to the sun or from picking at the same spot. The rate of resolution of hyperpigmentation depends on the trauma and how deep it is. You can also get skin-lighting creams with hydroquinone from your derm at the prescription level. Over – the-counter formulas can work, but with higher creams per person

What will treat my existing acne and dark spots at the same time?

Azelaic acid, an anti-acne ingredient, blocks an enzyme that leads to the darkening of skin after a pimple. Try it in The Ordinary’s Azelaic Acid Suspension 10% ($14, Buy It Here). Retinol can help with both, too.

Can I treat acne if I have sensitive skin?

Most people can tolerate salicylic acid. The most common cause of irritation is benzoyl peroxide, and then retinol. Both are drying.

How can I treat cystic acne?

Cysts are a severe form of acne that’s deeper under the skin than other types of pimples. Go to a dermatologist, who will likely put you on one or a combination of prescription medications, because with cystic acne there’s a chance for permanent scarring, and you don’t want to play around with that.

Is there a home remedy for acne?

Crush a tablet of aspirin, add tap water until a paste is created and apply it to any active red pimples. It has salicylates, a salicylic acid derivative that helps to reduce inflammation. (If you are allergic to aspirin, do not do this.)

I change my underwear daily and also post-workout, wash with salicylic acid, gently exfoliate, and have switched laundry detergents. Why can’t I clear up my buttne?

That’s not true acne— it’s folliculitis, a hair follicle infection. Of course, it can happen on the ass, especially if you wear tight jeans or pants and sit for long periods of time. Typically, if you see a dermatologist, we prescribe antibiotics or topical antibiotic creams, but you may also succeed in standard over – the-counter topical acne treatments. People with folliculitis on their butt tend to have small bumps called inflammatory papules, which respond best to the prescription treatments that target the bacterial component.

Will extractions help my acne?

They can do that. If you have a lot of blackheads, getting monthly extractions can help clean out the pores. But extractions will not help if you only have red pimples and no noticeable blackheads or whiteheads, and cystic acne will not help.

How do I fix acne scarring?

Consult a cosmetic dermatologist about the best method, as different acne scars respond to different treatments. Three types of acne scars generally occur: a rolling scar (a slight indent), an ice-pick depression scar (a deep dent), and a boxcar scar (a flat skin depression). People sometimes have multiple types of scars, so they need treatment combinations.

Options include laser treatments, subcisions (a needle is inserted under the skin, parallel to the surface of the skin to break up scar tissue), microneedling (creating tiny skin punctures to stimulate collagen to fill dents), fillers, and chemical peels.

Once acne’s cleared, can you wean yourself off harsh acne treatments?

Yes, yes. You can decrease or completely stop the frequency. However, if it returns, you may need to stay on them. It depends on what your acne is causing.

What can I do about stress-related breakouts?

Stress can exacerbate acne, especially if you’re predisposed to it genetically, but it’s not the primary cause. Stress depresses your immune system, and the ability of your body to fight inflammation may make your acne worse. Also, when we’re stressed, many of us start picking at our skin. Not only will a good spot treatment treat the area, it will also prevent you from putting your hands over it. If you’re not in public, you can also use a small bandage to cover the area, because you may not even notice you’re picking.

Are there alternatives to Accutane—without its side effects?

There’s nothing close to what Accutane, a treatment for oral isotretinoin, can do. It is used primarily for treating severe acne with a high risk of scarring.

Do face masks help with acne?

Any such as charcoal, acids, or clay that contains anti-acne ingredients can. A clay mask like Dermalogica Sebum Clearing Masque ($ 50, Buy It Here), when applied to the skin, can create a mild vacuum so it can help pull blackheads out. It also has a drying effect that can help clear breakouts.

My face breaks out when I moisturize. What’s the problem?

If you have a heavy or rich moisturizer, it can obstruct your pores and cause acne. Switch to a light or oil – free moisturizer such as Aveeno Positive Radiant Sheer Daily Moisturizer SPF 30 ($ 15, purchase it here).

Should I use a toner or an astringent for breakouts?

A toner or astringent with salicylic acid twice a day can help you if you have very oily skin — which is sometimes the case for people with acne. It draws the excess oil that can obstruct pores and is gentle for all types of skin.

How do you suggest I treat painful, under-the-skin pimples?

These are similar to, but not as deep as, cystic acne. Put a warm compress on them to help increase the velocity at which they reach the surface, where they can then pop. Don’t pinch or squeeze that can make them bigger. Or visit a dermatoligist for an injection of corticosteroids that can cause a bump to go away within 24 hours.

This article was originally published in the issue of Women’s Health in January / February 2018.

Article 27 Major Acne Questions Everyone Has — Answered by Dr. Pimple Popper was originally published on Women’s Health.

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