Friday, 5 August 2011

Cheat Sheet - Spots


Oh Spots.

So many of the emails I receive asking for skin advice start with 'Can you help me with my spots...?' - and there are so many different types I figured it was cheat sheet time.

So without further ado:
  1. What kind of spot is it?
    Don't start poking about at your face if you don't know what you're dealing with. You'll end up scarred, bleeding and all manner of annoyed.
  2. Blackheads - not typically a spot, but No.1 on your emails for 'what can I do??'
    Blackheads do not mean you are dirty or unclean and they are not caused by germs - so no antibiotic is going to help (I hate antiobiotics for skin 'care' - more of which later). Blackheads are the result of your DNA. Blame your parents. I'm nice like that.
    I'm not a fan of trying to remove blackheads on your own. I've seen more scarring from people trying to remove blackheads than from poking at huge red spots. Obviously there are exceptions, but the best thing you can do for blackheads is to have a brilliantly, amazing cleansed skin - every day, use the right products, which do help somewhat (below) and go for a targeted facial to get them removed gently and professionally. Not all facialists are good at extraction by the way - some of them frankly, are horrendous - ask specifically when you make your appointment - 'I need extractions - who is brilliant at them?' If they umm and ahh, go somewhere else.
  3. Whiteheads - the easiest spot to deal with. Typically appear ovenight, fully formed - and have a very noticeable 'white head'. If you don't usually get them it could be the result of a too-heavy night cream, sweating while you sleep, or a big night out that involved greasy food/booze etc Or all of the above..
    Feel around the spot - whiteheads are usually not sore. If it's not sore, and you can see a large amount of sebum (the white gunk), cleanse your face as normal - sometimes - if you're doing it PROPERLY - the flannel will take care of it. If not, finish your cleanse and hold the warm flannel over the spot for a minute. Now take clean hands, split two bits of loo roll and wrap them around your forefingers and gently squeeze in from the outside. It should come away easily. If it does, great - make sure the area is clean, tone, moisturise and go on your way. If it doesn't come away, it's not ready and it's a .....
  4. Pimple (pastule) - a pimple is deciding what it wants to do - its small, red and has no head. Leave it alone. Cleanse, tone, moisturise (yes, moisturise the pimple too), conceal and be on your way. It may go away on its own, if not - and it decides it's going to grow, it's a.....
  5. Large pimple (pustule) - this one is angry and wants you to know it. Sore, red, inflamed and infuriatingly nearly always without a head. So it doesn't want you to pick.
    Do not pick.
    Step away from the spot.
    If you suffer from acne or acne rosacea this is your common irritant. Keep it clean, keep it moisturised, keep an eye on it. It will go away. It just wants to do it on its own timetable. Sometimes you can see a teeny weeny whitehead forming at the top. Normal cleansing (BM style) will remove what your skin wants you to remove. If your skin is not offering up that sebum to you - back off. Your skin will win. And you'll get a bleeding, angry spot that is ten times the size as when you started. Or maybe even a scar. Back off. For it may be a.....
  6. Cyst - deep, painful, really painful. Doesn't always look like a spot - just an angry red lump. These you do not want to play with. These are caused by all manner of things but usually hormones. No amount of picking, playing, poking will do anything to this spot. It will laugh at you. And you WILL scar if you start attempting to do anything with it. You need to take a look at your diet, your lifestyle and you need a...
  7. Dermatologist - I'm going to make a sweeping generalisation here but GP's are generally CRAP at skin issues. They'll look at you knowingly and prescribe antibiotics. Months and months of antibiotics. Antibiotics prescribed for the skin make you sun sensitive like you would not believe and completely mess with your stomach. I highly, strongly, urge you to come off them (in a controlled manner) if you are on them. Antibiotics - one of the most brilliant life-saving inventions - ever - over prescribed and given out like sweets by GP's - when there are other ways.....Ditto the Pill. Yes, you can have success treating your skin by taking the pill. Although if it works? You probably have high testosterone levels in your body - the pill has balanced you out by increasing your oestrogen. Stop taking the pill, stop eating dairy (see below).
    If you have a problem with your vajayjay you'll be told to visit a gynaecologist. If it's your throat - it's an ENT specialist. If you have a problem with your skin - go to a dermatologist. It's what they DO. Our American sisters get this. They have no reservations about going to a specialist, unfortunately our brilliant (and I do mean brilliant) NHS system means that we resent paying for professional medical services. And some of you ladies that ask me for advice? And don't want to spend money on a derm? I see that £200 handbag honey. Your life, your skin, your priorities.
    But remember this: you only get ONE SKIN. You can always buy that handbag later.
A little list of do's and don'ts. If these don't work - make that appointment.

  • Keep your skin clean. Cleanse properly and use good skincare.
  • You want products that contain acids. Nice acids, Salicylic, Lactic, Glycolic - all brilliant for helping your skin and they don't have to be ££££ to work.
  • Take supplements. Lots of companies now do ranges for problem skin. As a minimum take omega oils - either in fish or flax form - and quercetin (cheat sheet about supplements coming I think).
  • Eat well. Your outer is a reflection of your inner. Stay clear of white products - think flour, sugar, pasta etc. Eat a LOT of salad. Even if its just green leaves. That's a start. Don't cover them with a dressing though - they are loaded with sugar
  • Eat too much sugar. And yes that includes chocolate. It's not an old wives tale....
  • The type of chocolate that affected people usually prefer is milk chocolate. Milk contains androgen hormones - and they basically increase your testosterone levels. And thus make your skin oilier and more prone to problems. Lay off the dairy. All dairy (that doesn't include eggs - why does everyone think the chicken is dairy?!) these days contains androgen hormones.
  • Use those strip things to rip out your blackheads. First of all they RIP your skin, NICE. Secondly - they're just nasty.
  • Drink too much alcohol. Booze is loaded with sugar - see above - also raises your body temperature (hot flush anyone?) and thus raises inflammation. And massively dehydrates you. Which makes your skin look like you've just been dug up.
  • Smoke. Need I say more?
*addition - someone just tweeted me about milia. They are not spots. So I'll do them next.


  1. I have been waiting for this :D i do have quite a lot of blackheads but can't for the life of me get rid of them. I was wondering whether you have any tips about milia (at least i think they are called milia, small white "spot" not a whitehead), I have had one for about ten years, i presume i will always have it... :S

  2. Love, love, love this post. Thank you so much. The dr tried to put me on topical antibiotics for spots. I refused. So many people want a 'magic' solution, where as finding the root of the problem is the key!

    I think they should teach school kids how to to look after skin, would solve a lot of problems (not least people using those silly cleansing wipes and thinking they have properly cleansed!!) Grr!

    Thanks Mrs Hirons xx

  3. Thank you so much for this post! One additional question: what about comedonal acne/closed comedones? I have normal (and usually pretty good) skin but have been afflicted for a few months with a huge amount of tiny flesh-coloured, non-inflamed bumps on my cheeks, where I never broke out before. They are invisible in some lights but hideous in others. They refuse to go anywhere, and are neither blackheads nor whiteheads: any ideas?

  4. Ah we like rants...

    Can I also just say that those photos of your mum/gran are utterly magnificent. Love love love them

  5. Great post, hun :) I'm thinking on my part about writing a post on different spot treatments, I guess maybe it'll be helpful to some as well?

  6. You've seen my face. You know what I'm working with and although my skin has come a LONG way from what it was a few months ago, I'm still having oily skin issues.

    Stupid overactive sebacious gland!
    Any tips on how to treat that, Oh Wise Lady With Bat?


  7. Thank you that was amazing looking forward to the milia post as I suffer with them around my eyes- thanks again I am going to pass this on to all my friends xxx

  8. Miss Mathful:
    You can have it removed! :)

    You don't say how old you are - feel free to email me at the blog with a pic!

    Thanks - :) I love them too.

    It all helps!

    I need to see your face and have a chat next time we bump into each other! Or you can email here with what you're currently using?

    Thanks! Milia coming!

  9. -Sighs- I have an awful forehead. The rest of my face is fine, no blackheads thank goodness, but I should really cut a huge fringe or something.
    Do you know if rosehip oil does help reduce scarring? I remember reading a study that said it reduced it when used for 6 weeks or more, but it was conducted by Trilogy, so hardly unbiased...
    Thank you!

  10. I'm happy to see you too believe in the art of properly popping a spot when the situation (and right kind of spot) call for it! I second that and all the rest about not bothering those that need to be left to fester before disappearing (hard as it may be).

    Can say that being an adult with acne rosacea is a nightmare, though. What I recommend to hide it during the day? Dermablend or CoverFX. Seriously. It's like stage makeup with a lighter feel.

  11. I in genreal have pretty good skin, yes of course there are the occasional spots, i am a teenager after all, but that's not were the problem lies. I have an issue with body acne, my chest is covered in small spots and my shoulder blades have a few large and red spots, also a small amount of scarring. Do you have any tips to stop 'bacne' ?? Please Help!!!

  12. Excellent post thank you! I was on the pill for ages to combat bad skin and having come off of it I still, in my mid-30s, get loads of spots. Presume they are hormone related as mainly on my chin (nice). Nothing seems to work on them and I get loads of little whiteheads coming up during the day :( groo

  13. Great post. Can I also recommend how important washing your make-up brushes are to keep them clean and bacteria free. I wash mine every 2-3 days with baby shampoo. I used to get terrible spots but as soon as I threw away my old concealer (1 year old), which I believe had spot causing bacteria in it, AND washed my brushes, my skin has cleared up. :)

  14. Best spot advice I've read in ages. I really like using the Witch blemish stick to try to get some of the redness down if I can't get rid of it. Still my thirties and get spots *sigh*

  15. Caroline,

    Nice article, I must say. As we age our skin begins to develop mysterious, "out of nowhere" spots and marks on it. Your skin will not stay in the same condition for your entire life - you must work for beauty, many won't! Dark patches will show up, lines will show up, and sagging will occur. But putting together a daily skin care regime and sticking with it will prove to be advantageous. Drinking 6-10 glasses of water daily, eliminating soda/sugary drinks, eating fruits/vegetables, moisturizing twice daily, using SPF daily, exfoliating twice a week among others will all provide you with skin that is in a healthier condition. Thanks for writing, and have a great day!

  16. I have just discoverd you blog and I must say...I'm so impressed! At last someone who knows what their talking about!!!!!! I'd say I know what I'm talking about when it comes to make up but with skincare I'm clueless. Luckily I rarely get spots however my skin is so blackhead prone, especially around my chin and nose, and like you said I'm sadly starting to see scaring :-(
    Is professional extracting my best bet or is there anything else that would work just as well?
    I recently purchased a very pricey BHA and it made no difference to the blackheads, would an AHA be more effective or would I just be wasting my money again?
    Thanks Caroline!

  17. Oh and also your comment about blackheads being genetic made me feel alot better! I no longer blame myself for my dirty looking skin....I blame my parents!

  18. I have a red lump in between my eyebrows that I've had now for a few days. It's not prominent, has no head, and is quite sore. I don't have a dermatologist I can go to. I keep clean and eat a healthy diet. I don't know what I should try?

  19. Spots are a very typical bother of my daily life. Is there any permanent solution which can stop them occurring specially on my face.

  20. You are just fantastic and your suggestion seem wise and useful but I am really scared to try out any new products without knowing or recommendations. I have oily skin, pimples blackheads, acne around my jaws and chin and lots of scaring. I have oily skin but loads of dry peeling skin as well. I cleanse, exfoliate and moisturize but isn't helping much. Is there any specific product you would recommend ?

  21. Hi I was wondering if you have any tips on broken capillaries on the skin or red thread like tiny veins? I have some and would like to get rid of them however I am not hopeful. Also whether you had any opinions on face exfoliating pads such as loofah ones and on evening oils such as The Sanctuary one and normal edible coconut oil. Thank you very much.

  22. Hello Caroline !I really hope you can help me!Im 21 and for last 4 years I'm suffering from very sensetive skin I would say or allergy I even don't know.i have combination skin,oily t-zone,blackheads ,large pores ,breakouts and capillaries on my chicks!After using most of the products I have red irritations all over my face that itching and little bumps that itching too.I ve tried everything from La Mer till organic Ren and juicy beauty.Beauty balms too.(ren,emma hardie,eve lom)uriage helped for a while to take off irrataion but breackouts even gave me a few scars .I got read of them using liquid gold.However if something feels good at the beginning after a month my skin getting use to it and getting crazy again.Taking vitamins coz I have anemia ,not enought zinc and iron exactly like my mum.Im not eating bread for several years,milk,no sweet and coffee.Doing everything what I can ,writhing for you desperate mail scratching my cheek!
    Adore your blog!

    Regards Ekaterina

  23. Great post but i have 2 huge spots on my cheek! my skin is pretty why so it is noticeable.. its been on my cheek for a week and i dont know what to do :( also i have spot marks which are visible too.. i do want clear skin but not with any more products as i have tried absolute evrything and nothing is working :(
    what do i do?!?! btw doctors are no use tbh..

  24. Great overview! I've been suffering from quite a few hormonal breakouts due to a change in birthcontrol, and what I've found really helps with the macadamia sized (I'm not kidding!) cysts on my jaw and neck is what we call 'trekzalf' in Dutch. It contains sulfobituminose ammonium 10%
    It sort of draws them out and gives them a 'nice' whitehead.

  25. I'm 19 and have had small to large spots on my face for 6 years now I gave tried over the counter things and nothing works I have found that I'm getting quite depressed and it is affecting me getting a job I was wondering if anyone knew of homemade natural things I could use to help.

    1. How's everything now? Just wondering because it's been 3 years now

  26. Just getting to know your page - liking it a lot so far. However, would you have any contacts(in or near London) as who to go to to deal with these facial problems? A name of a dermatologist? A facialist, who does extractions(every time I went for a facial, they only gave me a mask and massage... if only that would deal with the blackheads...) and uses products that are not tested on animals? Any names? please. :). Jennifer.

  27. Please help! I have tiny little colourless bumps all over my forehead, they're not milia, they're not red and they don't hurt. You can only see them close up, and when the hit the light they look awful. I've always had them and they never seem to leave! I look after my face, I cleanse twice a day along with toning, moisturising and a face mask once or twice a week. Does anyone have any solutions or suggestions to get rid of these bumps that cover my forehead?

    Thank you!

  28. Alex you could be describing me in my forehead is exactly the same, and I also look after my face the same as you do! I've not come accross anyone else with this problem either it is so frustrating isn't it. Hope Caroline sees this and can suggest something. Thank you for posting :-)
    Lisa H, (age 41)

  29. I am covered in spots and i currently use a foaming cleanser, I know that a foaming cleanser is really bad for blemish prone skin but I can't find a cleanser that works on my skin! Does anyone have any recommendations of good cleansers that work on spot prone skin?! thanks:)

  30. This comment has been removed by a blog administrator.

  31. Can you do anything to prevent skin discoloration during pregnancy or after pregnancy ? Skin pigmentation changes usually disappear on their own after delivery . You can remove your fade skin easy way .Use stria fade that contain vitamin E and alpha hydroxy acids .Get instant solution in short time.

  32. Can you do anything to prevent skin discoloration during pregnancy or after pregnancy ? Skin pigmentation changes usually disappear on their own after delivery . You can remove your fade skin easy way .Use stria fade that contain vitamin E and alpha hydroxy acids .Get instant solution in short time.

  33. Just wondered what you think of the Biotherm pure-fect skin range? I've been using it for a few weeks and haven't noticed a difference yet...should I persevere with it?

  34. Absolutely fantastic post - just love reading your blog! Your advice is by far the best I have heard on the internet! Keep up the good work :) x

  35. Caroline I'm 15 and have a few spots and usually get them around my nose,cheeks and chin do you have any any skincare products for my age or teens?

  36. Caroline I'm 15 and have a few spots i usually get them around my nose,cheeks and chin and i have dry skin also is there any skincare products you recommend for my age or teens thankyou:)

  37. I have come to the conclusion that my occational pimples must be of a uncommonly friendly and good-natured specie! The various pimples you describe sound absolutely horrible!

  38. My GP gave me antibiotics for a year, they did nothing except make me feel crap. Your advice is 2nd to none. THANKYOU caroline x

  39. Unfortunately some dermatologist s also just work on giving antibiotics and cortisone cream. My son has been seeing a dermatologist for over a year and this is all she is doing so now we back at the doctor. Not all dermatologist s help and not all doctors can help.

  40. I am 30 years old and have had trouble with spots and red skin on my chin area since about the age of 25. I never really got spots as a teenager but I seem to really struggle now I am in my 30s! It really gets me down and i have tried all sorts - diet, supplements etc. The problem never seems to go away. It is very localised to the chin area which I believe is hormonal? but what can I use on my skin to help finally get rid of this chin acne and redness? I would say I generally have quite dry skin but sometimes my chin looks like an oil slick - i hate what it looks like will foundation on and it just seems to slip off. Do you have any advice on products or a face regime? Thank you :-)

  41. Have you watched "the food hospital" on 4OD? All about getting rid of pills and making conditions better through food. There was an amazing difference with their acne and PCOS patients.

  42. Hi,

    Could you recommend a good place to tart looking for a dermatologist? I don't mind investing in my skin (even though it will take me time to save) but I'm scared to spend a small fortune on someone that wants to sell me a load of rubbish. Are there any do's and don'ts for finding the right dermatologist?

  43. I find this post really helpful but I am a bit clueless when it comes to identifying a spot. I am still a little unsure about how to properly do a skin care routine and I have no idea what to do! Please Help me!!

  44. Dear Caroline,
    I'm 22 years old and I'm italian, so i apologize for my really bad english :) I never comment the blog i read, but i'll make an exception, hoping You'll answer me. I know that you can't understand what's wrong with me without seeing me, but i thought that maybe showing You the products I use for my skincare routine would help : i don't have a terrible skin at all, but i suffer from these spots (or sudden breakouts, as you call them), especially in my forehead and in other part of my face (randomly). I'm really interesting in skincare and I'm always reaching the perfect products. At the moment I'm using the Oskia Reneissance Cleansing Gel (obviously as cleanser), then La Roche Posay Effaclar Duo + in my t-zone, and the Cetaphil Moisturizer (recommended by a dermatologist months ago and which is so thick it actually feels like whale grease when i put it on) , the Toning Lotion from Clarins for combination/oily skin (the one with iris-something), and the Chamomille concentrate anti blemish mask from Aesop (a recent purchase actually). I still have this spots in my forehead and often at the side of my face. I don't know if the problem are maybe ingredients from different products that together are just not good. I'd love to find a moisturizer that doesn't break me out..please, can you help me? Do you think these products are good for my problem?
    Really hope You'll answer.
    For now, thank you!


  45. My young daughter has really terrible blackheads on her nose and they are getting biggerd despite cleansing. Been using La Roche Posay products but as I said, getting worse. She is a fair haired 11 year old, at a loss as to what to use on her. How strong, what to avoid. Help, feeling sad for her. Your blog has turned my ageing skin around but feel at a loss with her. A good brand recommendation would be godsend. Thanks so much for any advice.

    1. hi swiss is the life!

      Apologies for interfering here, I don´t mean to be rude and I certainly do not have the same experence as our beloved Mrs Hirons here.
      But I think I might have had the same issue your daughter has.
      Ditch the LRP products! They are usually really harsh on the skin (at least for cleansing and toning aspects) and , for my sensitive, oily skin, contain to many irritating ingredients such as alcohol. Even when they claimed to be for sensitive skin. As a result, I had even more and nastier blackheads than before using it.
      I´m still testing stuff but I exprienced some big improvement with Bioderma - I´m living in Germany, so getting hold of these products is quite easy, idk about UK though. And clinique TTDO Balm.
      But again, watch out for alcohol/ alcohol denat.! I think I also might have overdone it when I started with puberty and made things worse... Try not to do so. :)
      I hope this is of any help!

    2. Thanks for the reply, much appreciated. We are neighbours, I live in Switzerland. Not sure if we can get Bioderma here, have not seen it, perhaps online. do you have any specific products you would recommend from their range? Any help most appreciated. I know to avoid foaming cleansers, Ms Hirons said, too much SLS is also bad. Thanks for any suggestions, so in need of help for her. Poor little thing. makes me sad. Though she is a happy girl.

    3. I really really love the Sensibio light and the Hydrabio light, maybe the last is a bit too much for her skin. I wrote the Bioderma customer service and received some sample sizes or you can check online phamacies. The Sebamed gel for blemished skin is great for the summer, I find it not moisturizing enough for colder days.
      And since you live in a country where you can buy dm-stuff, try the pink basic toner by balea for dry skin. There are times when I have to be careful with that because of the fragrance but it is a really good toner.
      For cleansing I´m using the TBS Nutriganics cleanser, Clinique TTDO Balm or the Garnier 2in1 Cleanser with the pump (this one can be a bit drying) on a rotating basis. And flanels, loads and loads of flanels, thanks to Mrs Hirons. ;)
      This really works for my skin but I´m 29, so I would suggest to start slow and test carefully. Take your time, don´t be too quick with introducing new products!
      All the best for the happy little girl (and you)!

  46. hi! I've just discovered your blog and have been obsessively reading it. I suffer from spots on my back and have done for a number of years and they just don't seem to go away! I was wondering whether you have any advice for me? Should I treat them the same way as spots on my face-I'm a bit clueless to be honest so any help would really be appreciated!
    Thanks so much

  47. 3 years of medication left my VERY SENSITIVE facial skin rather ragged with dryness, red spots & uneven marks etc. I have been using this Somaluxe Redness Repair Cream after cleaning my face - twice a day for a few weeks and I can definitely see a difference. The skin tone is clearing & balancing, the redness & marks are fading or gone & my skin feels soft, clear & lovely. I will be getting the Lady Soma Serum too methinks, for even more active vitamins A & C - as I'm turning 50 this year & realise maturing skin needs extra care.

  48. What I've figured out from my own experience. If it's going to work you will see results quickly. The day after. Little by little. Your skin will get better and better as the weeks go by. Take anything back the very next week if it doesn't. You don't have to throw good money after bad. Listen to Caroline and buy the products she says works for your skin type. Key is to treat your skin gently and avoid applying anything harsh. To my mind that usually means anything that says for acne or is mattifying. Regardless. Spend up on a great moisturizing serum and a good cleanser recommended here. Exfoliate properly with retinols and acids as Caroline suggests. And never use supermarket shampoos and cleansers. They do so much damage. I rescued my skin by binning the lot.

  49. I've been noticing a lot of bumps on my cheeks- I think they're whiteheads. I've switched night creams multiple times but these bumps remain and I'm not sure what to do! Is it definitely a heavy night cream? I use the Nip + Fab pads at night with the Avene retinol treatment Dr. Sam recommends. In the morning I use the La Roche Posay Effacer Duo. Just getting stumped on this night cream bit!