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There are few things more frustrating than going to bed with clear skin and waking up with a mammoth zit on your face. And if it’s a cystic blemish — the kind that’s super sore and swollen and never comes to a head — it can be especially maddening since it seems like all you can do is wait, spackle it with concealer, and tell people it’s a mosquito bite. While it’s true that nothing short of a dermatologist-administered cortisone shot will get rid of a deep zit, there are some at-home steps you can take to bring down the swelling and redness.
These steps are best followed at night, since benzoyl peroxide and hydrocortisone creams dry white and you can’t apply makeup over them.
1. Start with salicylic acid.
Slathering on traditional acne meds won’t have the same effect on a cystic pimple, which lives below the surface of your skin. Instead, you want to gently exfoliate with a salicylic cleanser, like Philosophy Clear Days Ahead, to get rid of excess oil and create a clean slate for the rest of the products, says Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. If you have dry skin, stick to your normal cleanser and use the salicylic cleanser (like Murad’s Clarifying face wash) only on the blemish.
2. Then tackle the swelling.
“Ice-cold temperatures help constrict blood vessels, so wrap an ice cube in a paper towel and hold it against the bump to reduce redness and bring down the swelling a bit,” says Zeichner, who recommends icing three times an hour in ten-minute intervals, i.e., ten minutes on, ten minutes off. (You want to do this after you wash your face since washing after icing would warm the skin right back up.)
3. Kill the bacteria.
“Benzoyl peroxide destroys the acne-causing bacteria that are trapped within the follicle, causing inflammation,” says Zeichner. To prevent irritation, make sure you prime the skin with a light moisturizer first, then spot-treat the cyst with a super thin layer — seriously, less is more here — of the lowest percentage of benzoyl peroxide. “If any burning or stinging occurs when you apply it, you’ll know it’s too strong and you should wash it off immediately.” Try the Clearasil Ultra Rapid Action Vanishing Treatment Cream.
4. Reduce the redness.
An over-the-counter hydrocortisone cream (like this soothing Aveeno version) contains a low dose of steroids that can help shrink pimples and soothe redness. The more you pile on and the longer you let it sit, the more effective it will be, says Zeichner. Just wait for the benzoyl peroxide to dry first. (We like this gentle spot treatment from Neutrogena.)