The Thursday before my wedding, I woke up at 6 a.m. panicked. The right side of my face was throbbing thanks to a "lurker." We refer to "lurkers" as those painful, cystic acne spots that live under the skin. I had cut alcohol, gluten, dairy, and sugar from my diet for two weeks and was drinking one dark green juice every day. My skincare game was on point (I only used oil-free products for the last few weeks to avoid breakouts), and I received plenty of facials. My period even ended the day earlier, which is the usual suspect for these hormonal spots. So why the F was there a massive — and painful! — critter eating away at my skin?
That I can't answer, but likely it was from nerves and stress. What I can tell you is how I successfully got rid of it. After researching the case, I decided to try an at-home product containing sulphur (the Dr. Dennis Gross Skincare Clarifying Colloidal Sulphur Mask) and had a Joanna Vargas esthetician zap the area with an antibacterial wand. Yet the spot did not budge. I had two days until I needed to walk down the aisle, and I needed it gone.
All of the advice I kept receiving from pros was that I needed to get the spot injected with cortisone. So I called in a favour and made an early-morning dermatologist appointment with Dr. Neal Schultz.
Dr. Schultz is a trusted NYC doctor (another beauty editor recommended him) with an impressive background, being the host of DermTV.com and creator of BeautyRx. Even though he is experienced, I was nervous! I had never done this procedure before. His calm demeanour was soothing as he popped the spot, sucked out the pus (he said there was enough to feed a family!), and then gave me a light cortisone injection (half the amount he normally would as per my request).
He was also honest with me. I had heard that this treatment can leave an indent in your face, and he told me earnestly that it does sometimes happen and there's no clear answer why, but he had not seen it happen in his practice in a few years. The procedure completely worked for me, and in two days — as promised — the skin was completely flattened. The area where the spot had been was darkened, but makeup easily covered it. You can see in the photo up top of my makeup-free skin that the right side of my face looks clear! About a month later, there was no trace of it (and thankfully, no indent).
When I returned from my honeymoon — acne-free! — I emailed him to find out the science behind why this works.
"If you find yourself with a monster spot on the days leading up to your wedding, go directly to your dermatologist to get it opened, have the pus drained (so it doesn't dilute and thereby reduce the efficacy of the cortisone shot), and have the cyst injected with cortisone (which will shrink the swollen wall of the cyst)," he explained. "That will do the most to improve it in the next 12-24 hours."
Dr. Schultz emphasised that for results this quick, a derm needs to physically extract the pus. Normally the gunk would take about a week or longer to be absorbed by the body on its own. Under your skin there is a hard swollen wall of cyst, and it can clear up naturally, but it takes time. "No oral or topical medicines can work this quickly," he added.
He described the process from beginning to end for me:
"We start by taking an alcohol-soaked pad and wipe the skin to make sure that everything is as sterile as it can be. With a sterile needle, I make a hole in the middle of the cyst. With an instrument called a comedone extractor, I push the pus out of the cyst. To shrink the cyst so it goes away much faster, I inject a tiny amount of cortisone into the wall and cavity of the emptied cyst. A bandaid is then applied (it stays on for an hour)."
After receiving the morning treatment, I was able to get an hour-long facial with Joanna Vargas that afternoon. I felt no pain or inflammation, and she simply avoided the area.
According to Dr. Schultz, you see results from the procedure within 12-24 hours.
"If you squeeze it yourself, you may as well cancel the photographer," he advised. I'm a classic face picker, and I pay the price with acne scars. "Don't take matters into your own hands. Seek out your derm."
I felt relief the morning of my wedding, which you can see below, getting my makeup done knowing my Big Fat Spot was demolished!