Facial reoccuring postule/zit

Patient

Q: I have a handful of ?postules? (Basically zits that I can feel under the skin on my face, they just look like bumps and have no colored tip) I get white out of them if I get annoyed enough with them being there and squeeze them, but they never go away. Can I/how do I get rid of these?

Images: 
Facial reoccuring postule/zit-1 Facial reoccuring postule/zit-2
Doctor

A:   Thank you for your question. From the pictures you have provided it seems as though you are developing a mild form of cystic acne accompanied with post-inflammatory hyperpigmentation. Nodulocystic Acne (cystic acne) is one o the the more severe forms of acne vulgaris in which pustules can develop deep beneath the skin forming hard painful swellings which when ruptured can leave scarring, redness and inflammation (post -inflammatory hyperpigmentation). We want to first encourage you to refrain from trying to manually rupture (pop) these pustules as this can worsen the appearance of these lesions and increase the chances of severe, and permanent scarring. Cystic acne can be best treated by consulting a dermatologist who will provide you topical antibacterial facial cleansers which usually contains clindamycin and benzoyl peroxide, oral antibiotics, or isotretinoin. Your dermatologist once consulted will advise you further on the use of these medications as well as what types of moisturizers that you can use specific to your skin type that will help in keeping your skin from drying out while undergoing treatment.

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