What To Do When… You Wake Up With A Massive Breakout

It’s the morning of a big event, and just as you glance in the mirror, you spot it. A red, angry, massive breakout has decided to make an uninvited appearance. Cue the panic. But before you reach for the toothpaste (please don’t!) or consider cancelling your plans, take a deep breath – help is at hand.

Hip & Healthy tapped Dr. Stefanie Williams, specialist dermatologist, founder of London’s Eudelo clinic, and creator of the Delo Rx skincare range, for her expert advice on how to tackle last-minute breakouts like a pro. From quick fixes to calming inflammation (and what not to do), here’s your step-by-step SOS guide to rescuing your skin before the big moment.

LEAVE IT ALONE!

The golden rule of acne breakouts is never to pick or squeeze spots with your hands. This can push bacteria deeper into the skin, increase inflammation, and raise the risk of permanent scarring. Your hands also carry bacteria that can make the situation worse.

REACH FOR TARGETED TREATMENTS
If you have salicylic acid or benzoyl peroxide products (for example Acnecide 5% gel) to hand, gently massage a tiny amount directly to the spot using a cotton bud. These ingredients help dry out a spot, but use sparingly to avoid over-drying. If you have a history of this happening, you may want to ask your doctor for some prescription strength Duac gel. It contains benzoyl peroxide and an anti-inflammatory antibacterial ingredient, so you have something at home should this happen again.

ADD A SPOT PLASTER

The above may work even better if you cover it with a hydrocolloid acne patch. Make sure the topical treatment has sunken in fully first before applying your acne patch. This way your topical works ‘under occlusion’ which means the ingredients penetrate the skin better.
Tip: Use spot patches with salicylic acid (for example Galderma’s Purifide Power Patches, but avoid those containing any oils, including tea tree oil!)

AVOID OILS AND SILICONE

Facial oils, oil-based serums, rich moisturisers and cleansing oils and balms will likely aggravate the situation. Stick to lightweight formulations low in silicones and oils – and that includes tea tree oil!

COOL IT DOWN

This may backfire if not done properly, but try gently cooling the cyst if it’s very inflamed (i.e. red, raised and painful). The cold constricts blood vessels and can reduce redness and swelling. Do this by wrapping an ice pad from the freezer in a clean, thick kitchen towel (never apply ice directly to the skin!) and cooling for short periods of only one or two minutes each cycle, before letting the skin rest for at least 10 or 20 minutes. You can repeat this up to six times, but always make sure your skin is clean and, most importantly, completely dry, when you cool it.

SHINE A (LED) LIGHT
A combination of blue (anti-bacterial) and red (anti-inflammatory) LED light may help calm the skin, but strictly stick to recommended times and frequency – longer is not always better!

EXPERT EXTRATION

If the inflamed acne lesion has come to a head and you can see a pus filled top (this is called a ‘pustule’), an expert such as a dermatologist may be able to release the pressure by gently lancing the pustule’s head with a sterile needle. This may be followed by application of a non-alcohol based skin disinfectant (for example Clinisept spray), an antibacterial prescription cream, or they may prescribe you an oral acne antibiotic to follow up. Never do this yourself though, as you may make matters worse!

TRY A STEROID INJECTION

If you have access to a private dermatologist, consider an intra-lesional injection of a diluted steroid solution directly into the acne cyst. This is a very powerful treatment that can lead to significant reduction of the pimple over the next 24-48 hours but needs to be done by an experienced doctor and paid for privately.

AVOID AGGRESSIVE SCRUBBING

When you’re panicking about a breakout, it’s tempting to scrub harder, but this will only irritate the skin further and potentially spread bacteria to other areas, so don’t do it!

SPOT CONCEAL, DON’T CAKE

Use a concealer that matches your skin tone and apply with a disposable applicator. Pat gently rather than rub. Use a salicylic acid-containing concealer for added benefits. I like to use the Oxygenetix Blemish Control Foundation.

AVOID THICK FOUNDATIONS

Heavy, long-wearing foundations may seem like the obvious solution, but they often contain oils and silicones that can worsen breakouts and are difficult to remove properly.

BOOK A FACIAL

If you have access to a dermatology-grade facial (not a high street or spa treatment!), this can help clear congestion safely. However, avoid regular high street and spa facials which often use products unsuitable for breakout-prone skin.

ASK ABOUT PRESCRIPTION OPTIONS

For severe or persistent breakouts, topical or oral antibiotics, anti-inflammatories or prescription strength retinoids from a dermatologist can be highly effective, though these work best as part of a longer-term strategy.

AVOID ‘MIRACLE CURES’

Alcohol based disinfectants, toothpaste, baking soda, lemon juice, and other household items can cause skin irritation or even chemical burns. Stick to products designed for facial skin.

DON’T OVERDRY YOUR SKIN

Using multiple drying products or applying spot treatments too frequently can cause severe irritation with more redness, flaking, or scaling, which may be more obvious than a well-covered blemish, so don’t be over zealous.

RETHINK YOUR SKINCARE

Many skincare products, even those marketed as ‘oil-free’, contain pore-clogging ingredients. Look beyond marketing claims and check ingredient lists for oils and silicone derivatives like dimethicone. A dermatologist can help you to identify products that might be triggering breakouts and create a regime that prevents future emergencies.

ADDRESS THE ROOT CAUSE

If over-the-counter skincare solutions aren’t enough, consult a dermatologist for prescription treatment. Adult breakouts often require a combination approach including proper diagnosis, prescription treatments where needed, and optimised skincare. There are prescription treatments available that can switch off your acne for good, so don’t accept recurring breakouts as ‘just one of those things’.