Acne is a common skin condition affecting up to 85% of people at some point in their lives. All types of acne can be a source of frustration, but hard pimples that won't go away can be especially bothersome. You may feel tempted to squeeze the spot, but popping pimples can lead to scars, pain, more acne, and infection.
Some hard pimples may clear up with at-home and over-the-counter remedies. Other types of hard pimples should be examined and treated by a healthcare provider.
What Causes Hard Pimples?
Acne develops when skin pores and hair follicles become clogged with dead skin cells, oils, and bacteria. According to the American Academy of Dermatology, there are several types of acne:
- Blackheads develop when dead skin cells and excess oil build up inside a pore, causing a black-colored spot to appear on the skin.
- Nodules and cysts develop when dead skin cells, excess oil, and bacteria develop deep under the skin. A cyst contains pus, and a nodule does not. Cysts are typically softer than nodules because they're filled with pus.
- Papules and pustules develop when dead skin cells, excess oil, and bacteria get trapped inside a pore near the surface of the skin. The bacteria can quickly multiply and cause the affected pore and surrounding skin to become red, swollen, and inflamed. If the pimple is pus-filled, it is a pustule. If there is no pus in the pimple, it is a papule.
- Whiteheads develop when dead skin cells and excess oil block the opening of a pore, causing a raised white (or skin-colored) bump.
Hard pimples are usually acne nodules. Acne nodules are painful pimples that develop deep below the skin's surface. Some may appear large, red, and inflamed while others may be the same color as your skin. These pimples are sometimes called "blind pimples" because they aren't noticeable unless touched. You might have one acne nodule or a cluster of pimples that appear together.
How to Tell a Hard Pimple From Something Else
Sometimes, what appears to be a hard pimple may not be a pimple at all. If you have a hard bump on your skin that appears to be a pimple but isn't going away, it's important to get it checked by your doctor or a dermatologist. They can examine the bump(s) to determine if it is truly acne or another condition. Skin conditions that can cause hard, pimple-like bumps include:
- Basal cell carcinoma: A type of skin cancer, basal cell carcinoma develops on areas of the skin frequently exposed to the sun, such as the face. The tumors usually don't hurt, but feel hard when touched.
- Lipoma: A lipoma is a lump of fatty tissues that develops under the skin. They are benign (harmless) and may feel tender when touched. Lipomas range in firmness from soft and smooth to hard.
- Rosacea: Rosacea is a chronic skin condition that causes pimples, broken blood vessels, and skin redness. If left untreated, rosacea may lead to hard skin bumps that look like pustules or papules.
How Hard Pimples Are Treated
Treatments for hard pimples vary, depending on the type of acne you have. Over-the-counter products that contain benzoyl peroxide or salicylic acid are often used to treat papules and pustules. If you have a lot of papules or pustules and they don't clear up after 6 to 8 weeks, see a dermatologist about other treatment options.
Cysts and nodules that develop deep under the skin should be treated by a dermatologist. These types of pimples are more severe types of acne that may require prescription medications to treat. Your dermatologist may recommend any of the following treatments for nodular acne:
- Oral medications. Antibiotics may be prescribed to eliminate bacteria and reduce the risk of infection. Oral contraceptives (birth control pills) may be prescribed to people assigned female at birth. Isotretinoin, a synthetic form of vitamin A, may be recommended if other treatments do not help clear up the pimple(s).
- Prescription topical treatments. Medications that include benzoyl peroxide, salicylic acid, and retinoids may be prescribed. Topical treatments, such as cream, gel, or foam, are applied directly to the skin.
- Cortisone injections. Your doctor may inject a steroid medication directly into the nodule to reduce inflammation and promote healing.
Home Remedies for Hard Pimples
Your doctor or dermatologist should examine your hard pimple to determine the cause and treatment. Along with using over-the-counter solutions or prescription medications, there are things you can do at home that may reduce any pain or discomfort caused by a deep, painful pimple.
Wash Your Skin
Acne isn't a sign of poor personal hygiene, but it's important to wash your skin before applying treatments. Use a fragrance-free cleaner and be gentle with your skin. Scrubbing hard won't eliminate the pimple and may irritate the skin.
Wrap an ice cube in a paper towel or clean washcloth and apply it to the hard pimple for 5 to 10 minutes. This may help reduce inflammation and pain. You can repeat this two more times, but take 10 minute breaks in between.
Soak a soft, clean washcloth in hot water. Wring out the washcloth and make sure it is not too hot. Apply the warm compress to your pimple for 10 to 15 minutes. Repeat up to four times a day.
Green tea is rich in antioxidants and other compounds that may be beneficial for skin health. Research suggest that drinking green tea or topical application of may help reduce sebum (oil) production and reduce redness and irritation associated with acne. However, researchers also acknowledge that more research is needed to confirm this benefit.
There are a few ways to use green tea for acne:
- Enjoy it as a beverage. Drinking 2 to 3 cups of green tea per day may help reduce acne. Bonus - it also helps support your overall health.
- Make a green tea mask. Steep dry green tea leaves in hot water for 2 to 3 minutes. Remove the leaves from the water and mix with aloe vera gel to form a paste/mask. Spread the mixture on the pimple and leave the 'mask' on for up to 20 minutes. Remove by gently washing off with warm water and a clean washcloth.
- Massage the pimple. Steep dry green tea leaves in hot water for 2 to 3 minutes. Remove the leaves from the water and massage the wet leaves onto the skin for 30 seconds. This may help soothe irritated pimples.
Dos and Don'ts When You Have a Hard Pimple
When you have a hard pimple that won't go away, you may feel willing to try anything to get rid of it. But certain things can irritate the pimple, affect other areas of your skin, or even lead to scars.
Don't Use Unproven Methods
Here's what to avoid when you have a hard pimple:
- Do not squeeze it in an attempt to pop it.
- Do not apply toothpaste to the pimple.
- Do not apply at-home treatments (e.g., lemon juice) that are not scientifically proven to treat acne. Instead, talk to your doctor about what treatments are best.
Do Consider Seeing a Dermatologist
If your hard pimple does not resolve with at-home or over-the-counter remedies within 6 to 8 weeks, see your doctor or a dermatologist. They will examine your skin to determine if the spot is indeed a pimple or caused by another health condition. From there, they will recommend a safe and effective treatment.
See your doctor immediately if you have a hard pimple and any of the following symptoms:
- Signs of infection (e.g., draining pus from the pimple).
- The pimple is severely inflamed and/or painful.
- The pimple is getting worse, or other hard pimples are developing on your face.
If you're unsure if your hard pimple needs medical care, many healthcare provider allow you to email your question or set up a zoom meeting that may be easier than seeing your doctor face-to-face. Do your best to avoid touching the hard bump and give it time to heal.