You know how sometimes it can feel like you've been battling the same pimple for weeks on end? Well, according to Beverly Hills dermatologist Dr. Lisa Chipps, that's actually not that far from the truth. Acne develops under the skin as what dermatologists call unseen, or invisible, acne up to 10 weeks before you actually see any sort of evidence of that pimple on your face. So, no, you're not being a drama queen when you whine to all your friends about that blemish being your new roommate.
"Unseen acne is the bacteria that is living in the comedones [debris-filled pores]," says Dr. Chipps. "When you have buildup in those pores — from oil and dead skin cells — that bacteria likes to grow in there. That forms the comedone that is the precursor to a pimple."
So, why do you need to care about acne that you can't even see? Well, because if not treated, that unseen acne is going to turn into, uh, seen acne. Dr. Chipps says that using topical retinol creams, salicylic acid, and benzoyl peroxide can all be effective at cleaning out pores. "A lot of times, when you clean out the pores, they turn over rapidly enough that you won't get the pimple," she says.
But, don't go slathering these topical zit fighters all over your face just yet. All three of those ingredients can be drying on your skin and potentially cause more breakouts if you apply them in areas where you don't actually need them. Instead, you need to zero in on where exactly your unseen acne is percolating and treat those pores specifically.
Sadly, it's not easy to determine just where those problem spots will crop up (they don't call it invisible acne for nothing). But, thanks to Neutrogena, there's a tool that can study how acne forms beneath the skin’s surface.
Called the Clinical Skin Imager, it's a camera that displays clogged pores that aren't visible to the naked eye. "This Imager is helpful because it allows [us] to see where the p. acnes bacteria is hiding," says Dr. Chipps. "It helps show patients their problem areas."
When it comes to treating unseen acne, Dr. Chipps says your protocol is going to be a bit different from how you would treat a pimple you can see. "At the unseen acne stage, what you need to do is clean out those pores using medications that penetrate into them or speed up the turnover of pores so they aren't plugged up. An acne wash with benzoyl peroxide would be a great option for this."
She also notes that the majority of acne medications take about six to 10 weeks to work. "They are treating the precursor to the pimple. Once you actually have a pimple, what you are doing is trying to help it heal faster, which is why anti-inflammatories are a good option. When you are treating unseen acne, salicylic acid and benzoyl peroxide are your best bet because they work to turn over the skin more rapidly and treat what is causing the precursor to the actual pimple."
Bottom line: Stop fighting acne when it visibly shows up on your face and instead get into the habit of a daily routine that halts the acne before it can become a problem. Dr. Chipps recommends cleaning your skin every morning and evening, using sun protection in the a.m. to prevent any marks left by acne, and utilizing a retinoid at night to help with the cell turnover. Let's keep that invisible acne as it was intended to be — invisible.