Acne Extraction: Which Pimples Can Be Popped and Which Cannot, How a Dermatologist Does It, Why Doing It Yourself Leaves Marks, and How Many Days to Heal
Acne extraction (comedone extraction) is a procedure in which a doctor uses sterile instruments to open the pore and push out the plug of oil and keratin blocking it. It is suitable only for blackheads and whiteheads (comedones). Red inflamed bumps, nodular acne and fungal acne should not be squeezed, because squeezing pushes the inflammation deeper, slows healing and raises the risk of dark marks or acne scars.
Extraction is only a supportive treatment, not the main treatment. Clogged pores come back within a few weeks unless you use medication that reduces clogging, such as adapalene or tretinoin. This article explains whether each type of acne can be extracted, why squeezing at home leaves marks, how a doctor performs extraction, how acne injections differ from extraction, how to care for your skin afterwards, and how many days it takes to heal. If you are not sure whether your bumps are comedones, start with the basics in Clogged pores: causes and how to tell open from closed comedones
What is acne extraction and how is it different from squeezing it yourself?
Comedonal acne occurs when abnormally shed skin cells stick to oil and form a plug at the pore opening. This plug is called a comedone. If the pore opening is open and the top of the plug is exposed to air and turns black, it is called a blackhead (open comedone). If the opening is closed and it appears as a small white or skin-colored bump, it is called a whitehead or closed comedone.
There are 3 differences between extraction by a doctor and squeezing it yourself.
Direction of force: An extractor presses around the pore opening so the plug flows out along the pore. Squeezing with fingernails applies force from two sides, which often ruptures the pore wall into the dermis.
Opening the head: A closed comedone must first be opened with a small sterile needle or blade. If it is not opened, the plug has no way out, so the pressure is pushed deeper instead.
Choosing which spots: A doctor extracts only true comedones and skips inflamed ones. Squeezing at home usually targets every spot you can see, including bumps that are not acne.
Check first: what type of bump do you have?
Before thinking about extraction, look at each bump using this list.
Not red, not painful, with a black dot in the center → probably a blackhead. Can be extracted
Small 1–3 mm white or skin-colored bump, not painful, easy to see when the skin is stretched → probably a whitehead. Can be extracted once the head is opened correctly
Red bump, painful when pressed, no head → inflamed acne. Do not squeeze
Clear yellow pus head on a red base → pustule. Should not be squeezed at home
Deep lump larger than 5 mm with a dull ache → nodular or cystic acne. Never squeeze
Small bumps of nearly identical size, itchy, on the forehead, chest or back → may be fungal acne. Extraction does not help
Hard white bump like a grain of sand that will not come out, or skin-colored bumps under the eyes → may not be acne (milia or syringoma)
1. Blackhead (Open comedone)
Appearance: A black or dark brown dot 1–2 mm wide at the pore opening, most common on the nose, chin and forehead. The surrounding skin is not red or painful. The black color is not dirt; it comes from melanin and oil that oxidize when exposed to air.
Cause: Abnormal shedding of cells inside the pore together with overactive oil glands. Triggers include heavy oily products, over-aggressive face washing and hormones.
Severity/urgency: Not dangerous, and does not leave scars unless squeezed hard. It is mainly a cosmetic concern.
Can it be extracted? Yes. It is the easiest type to extract because the pore is already open. Use clean tools, never fingernails, and stop if it does not come out with gentle pressure.
When to see a doctor: You have many blackheads, they return within 2–4 weeks after extraction, or you have used over-the-counter medication for 12 weeks with no improvement.
2. Whitehead, closed comedone (Closed comedone)
Appearance: A small white or skin-colored bump 1–3 mm wide with no black dot. It is easiest to see when the skin is stretched or lit from the side, and the skin feels rough and bumpy. Most common on the forehead, temples and chin.
Cause: The same as blackheads, but the pore opening is closed, so the plug stays under the skin. This type is the starting point for inflamed acne. If the pore ruptures, it becomes a red bump within a few days.
Severity/urgency: Not dangerous, but it is the type most often damaged by squeezing at home, because there is no exit and the pressure pushes the pore wall to rupture downward.
Can it be extracted? Yes, once the pore opening is opened first with a sterile needle or blade. Do not open it yourself with a sewing needle or safety pin, because of the risk of infection and opening too deeply.
When to see a doctor: You have dozens of whiteheads across the forehead or cheeks. Extraction alone cannot keep up, and you need a topical medication that reduces clogging alongside it.
3. Large comedone (Macrocomedone)
Appearance: A comedone larger than 1 mm, up to several millimeters, usually closed, lasting for months. Seen on the forehead, cheeks and chin.
Cause: A keratin plug builds up for a long time until it hardens and sticks firmly to the pore wall. Sometimes seen after long-term use of heavy oily cosmetics.
Severity/urgency: Not dangerous, but hard to extract. Squeezing hard causes bruising and a higher chance of inflammation than with ordinary comedones.
Can it be extracted? Usually it will not come out with normal pressure. A doctor may first prescribe a topical retinoid for 2–4 weeks to loosen the plug, or use light cautery to destroy the plug inside the pore instead of extracting it.
When to see a doctor: A large spot has lasted more than 1 month, or you tried to extract it and it would not come out. Stop and see a doctor.
4. Inflamed red bump (Inflammatory papule)
Appearance: A raised red bump 2–5 mm wide, painful when pressed, with no pus head.
Cause: The wall of a blocked pore ruptures, and oil and Cutibacterium acnes bacteria leak into the dermis. The body then sends white blood cells, causing inflammation.
Severity/urgency: Not harmful to health, but it is the main cause of red marks, dark marks and acne scars.
Can it be extracted? Do not squeeze. There is no plug to push out, only inflammation in the dermis. Pressure spreads the inflammation wider and deeper. Left alone, these bumps usually settle in 5–10 days, whereas squeezed ones often swell and last longer. Treatment is with topical and oral medication. See details in Inflamed acne: causes and which medication to use
When to see a doctor: You have more than 10–20 inflamed bumps, or dark marks and scars are starting to appear.
5. Pustule (Pustule)
Appearance: A red bump with a clear yellow or white pus head on top, 2–5 mm wide.
Cause: Inflammation after the pore ruptures, with white blood cells collecting as pus near the surface.
Severity/urgency: Mostly mild. The pus dries up and settles by itself in 3–7 days.
Can it be extracted? Should not be squeezed at home. A doctor may open only those pustules where the pus is shallow and clearly visible, and gently blot it away without pressing the base, which is different from squeezing as hard as possible until it bleeds. If the head bursts on its own, blot with clean cotton and let it dry.
When to see a doctor: You have several pustules at once, a bump keeps getting bigger, or the surrounding skin becomes swollen, red and hot, and the redness spreads.
6. Nodular acne, cystic acne and cysts (Nodule and Cyst)
Appearance: A deep red lump 5 mm or larger, firm or springy, with a dull ache and usually no head. It can last for weeks and is common on the cheeks, jawline and back.
Cause: Deep inflammation in the dermis, often linked to genetics and hormones.
Severity/urgency: This is the type with the highest risk of leaving permanent acne scars, so it should be treated early.
Can it be extracted? Never squeeze. The lump is too deep to push out. Squeezing makes the pus burst and spread under the skin, forming tracts and then scars. The right options are an acne injection or oral medication. See more in Nodular acne: causes and can it be squeezed?
When to see a doctor: Every time you have a deep, painful lump, especially if several come back repeatedly.
7. Fungal acne (Malassezia folliculitis)
Appearance: Small red bumps or pustules of nearly identical size, 1–2 mm, usually itchy, appearing in clusters on the forehead, hairline, chest and back.
Cause: Malassezia yeast, which normally lives on the skin, overgrows inside the hair follicles. It is triggered by sweat, heat and humidity, and long-term antibiotic use.
Severity/urgency: Not dangerous, but it is often mistaken for ordinary acne and treated wrongly for months.
Can it be extracted? Extraction does not help, because these are not plugs. Squeezing only makes the skin redder. Treatment is an antifungal such as ketoconazole 2% shampoo, lathered on wet skin, left for 5 minutes and rinsed off, once a day for 2–4 weeks. Some people are given an oral antifungal by their doctor. Read more on how to tell them apart in Back acne: telling true acne from fungal acne
When to see a doctor: Itchy acne of equal size that has not improved after 4–6 weeks of regular acne medication.
8. Bumps that are not acne but often get squeezed
Appearance: There are 3 common types. Milia are hard white 1–2 mm bumps like grains of sand with no pore opening. Syringoma are skin-colored raised bumps of equal size under the eyes. Trichostasis spinulosa are tiny black dots on the nose that are many fine hairs packed together in one follicle.
Cause: Milia are tiny keratin cysts under the skin. Syringoma are benign tumors of the sweat glands. Trichostasis spinulosa is hair that does not shed on its normal cycle.
Severity/urgency: All three are harmless, but squeezing causes bruising and marks and does not work.
Can it be extracted? Milia need the skin opened with a sterile needle and then lifted out; squeezing alone will not remove them. See Milia: what they are and how to remove them correctly. Syringoma cannot be squeezed out at all because they are tissue, and need laser or cautery. See Syringoma: why they will not squeeze out. Trichostasis spinulosa can be pulled out temporarily but returns in 2–4 weeks. See Trichostasis spinulosa: the truth about this not-quite-acne
When to see a doctor: A bump that will not come out when squeezed, you are not sure what it is, it keeps growing, or it bleeds easily. Always have a doctor check it first.
Why does squeezing acne yourself cause dark marks, red marks or scars?
Marks after squeezing do not come from the pressure itself but from the increased inflammation after the pore wall ruptures. There are 3 possible results.
Dark marks (post-inflammatory hyperpigmentation, PIH): Inflammation stimulates pigment-producing cells. Very common in darker skin tones such as those of Thai people. They usually fade by themselves in 3–6 months, but for some people it takes up to 12 months.
Red marks (post-inflammatory erythema, PIE): Tiny blood vessels widen after inflammation. They usually fade in 1–3 months.
Acne scars (atrophic scars): Collagen tissue is damaged by deep inflammation. This can happen when inflamed acne or nodular acne is squeezed repeatedly. Scars do not go away on their own and need procedures to treat. See Acne scars: can they really be filled in?
Factors that commonly lead to marks from squeezing at home include using fingernails, squeezing acne that is still inflamed, squeezing the same spot repeatedly, picking off scabs before they fall off, and not applying sunscreen afterwards. To learn how to tell the different marks apart and treat each one, read Acne marks: causes and how to tell red marks from dark marks
How a doctor does acne extraction at the clinic
Acne extraction by a dermatologist follows these main steps.
Examine and choose spots. The doctor separates comedones from inflamed acne, fungal acne and non-acne bumps, and extracts only the suitable spots.
Clean the skin. The face is washed and wiped with antiseptic. The practitioner wears gloves.
Open the head. Closed comedones are opened at the pore with a small sterile needle or blade, only shallowly at the outer layer of skin.
Press with the instrument. The loop of the extractor is placed around the pore opening and pressed straight down with just enough force for the plug to flow out. If it does not come out after 1–2 presses, the doctor stops and does not keep pushing.
Aftercare. The skin is wiped with saline or a mild antiseptic. Some people may be given a cold compress or an anti-inflammatory gel.
Every instrument must be sterilized or single-use. Extraction of the whole face takes about 15–30 minutes, depending on the number of spots. This procedure should always be assessed and performed by a doctor or under a doctor's supervision.
How is an acne injection different from extraction?
An acne injection (intralesional corticosteroid injection) means injecting a small amount of steroid directly into an inflamed acne lump. It is used for acne that cannot be extracted, namely large inflamed lumps, nodular acne and cysts. It is not used for comedones.
Medication used: Triamcinolone acetonide diluted to about 2.5 mg/ml for facial skin, about 0.05–0.1 ml per spot.
Expected result: The lump begins to shrink and hurt less within 24–72 hours. It suits cases where you want the lump to settle quickly, and it helps reduce the chance of scarring.
Side effects: A dent in the skin at the injection site (steroid atrophy) or lighter skin color, which mostly improves by itself over 2–6 months. The risk is higher with a strong concentration or a large amount, so a doctor must assess the dose.
Limitations: An acne injection treats only that one spot and does not prevent new ones. If nodular acne keeps recurring, it needs continued treatment with oral or topical medication.
Extraction alone is not enough: the medication that actually reduces clogging
An extracted spot will not return to the same place right away, but the neighboring pores keep forming new comedones, because the root cause is abnormal cell shedding. The medication that treats this root cause is a topical retinoid. The ones doctors commonly use include:
Adapalene 0.1% or 0.3% gel: Apply a thin layer over the whole acne-prone area once a day at bedtime. Effects on comedones appear in 8–12 weeks. In the first 2–4 weeks it may sting, dry and peel.
Tretinoin 0.025–0.05% cream: Similar effectiveness, slightly more irritating. Usually started every other night and increased gradually.
Benzoyl peroxide 2.5–5%: Reduces acne bacteria and partly reduces clogging. Often used together with adapalene.
Azelaic acid 15–20%: Reduces clogging and helps dark marks. An alternative when a retinoid cannot be used, for example during pregnancy.
Salicylic acid 0.5–2%: In wash or wipe form, helps reduce mild clogging.
If there is moderate inflammatory acne as well, a doctor may add an oral medication such as doxycycline 100 mg once a day for about 6–12 weeks, always together with topical medication. For severe acne or recurring nodular acne, a doctor may consider oral isotretinoin, which requires monitoring and must not be used in pregnancy. For details on each topical medication, see Acne spot treatments: how each group works and why treating single spots is not enough. The choice of medication, strength and duration is the doctor's decision after examining your skin.
Can you extract acne at home, and how far can you go?
Most dermatologists do not recommend extracting acne yourself, because it is hard to tell acne types apart by eye and opening the head requires sterile instruments. The things you can safely do yourself are as follows.
Use medication that reduces clogging consistently, which lets blackheads and whiteheads clear on their own without extraction.
If a pustule bursts by itself, blot it with clean cotton, do not keep squeezing the base, and let it dry.
Apply a warm compress with a clean cloth for 5–10 minutes to help a pustule that is about to burst drain more easily by itself.
Do not use fingernails, sewing needles, safety pins, or harsh pore strips every day.
If you gently try to extract a blackhead with a clean tool and it does not come out after 1–2 tries, stop immediately.
Skin care for the first 7 days after extraction
Day 1: Spotty redness is normal. Wash your face with clean water and a gentle cleanser. Avoid heavy makeup for at least 12–24 hours.
Days 1–3: Avoid scrubs, avoid high-strength exfoliating acids, and avoid retinoids on the treated area for about 2–3 nights, or as your doctor advises.
Every day: Apply sunscreen SPF 30 or higher, because sunlight makes dark marks darker.
Small scabs: Let them fall off by themselves within 3–7 days. Do not pick them.
Moisturizer: Use a non-comedogenic type to reduce irritation.
Return to your acne medication: Once the skin no longer stings, go back to your anti-clogging medication as before, which matters more than extraction in the long run.
How many days does it take for extracted acne to settle and marks to fade?
Comedones fully extracted: The spotty redness settles in 1–2 days.
Opening marks: They form small scabs that fall off in 3–7 days.
Acne that was already starting to inflame during extraction: It may stay swollen and red for another 3–7 days before settling.
After an acne injection: The lump settles in 24–72 hours and flattens in 1–2 weeks.
Red marks after acne: Fade in 1–3 months.
Dark marks after acne: Fade in 3–6 months, up to 12 months for some people. Consistent sun protection helps them fade faster.
If after extraction you have increasing pain, swelling, redness and heat that spreads, more pus, or a fever, it may be an infection. See a doctor.
How often should you have acne extracted?
Doctors generally space each extraction at least 3–4 weeks apart to let the skin recover and let the topical medication work. Extracting more often does not clear acne faster but increases the chance of irritation and marks.
The right goal is needing less and less extraction. If you use anti-clogging medication consistently, after 2–3 months the number of comedones should fall until you hardly need extraction. If you still need extraction every month indefinitely, it means the root cause has not been addressed, and a doctor should review your medication and products.
Who should avoid or postpone acne extraction
Taking isotretinoin: The skin is thinner and drier than normal and wounds heal slowly. The doctor will assess whether to do very gentle extraction or postpone it.
Cold sore (herpes) flare on the lips or face: Wait until it heals, because extraction could spread the virus.
History of raised scars or keloids: Tell your doctor, because there is a risk of a raised scar at the spot where the skin is opened.
Taking blood-thinning medication: You may bleed and bruise easily. Tell your doctor beforehand.
Skin inflamed from an allergic rash or sunburn: Wait for the skin to calm down first.
Almost all of your acne is inflamed: The inflammation should be treated with medication first, not extraction.
When should you see a dermatologist?
See a doctor promptly if:
After squeezing acne you have swelling, redness and heat that spreads, increasing pain, or a fever.
After squeezing acne on the nose or upper lip you have swelling around the eyes, a severe headache, or abnormal vision. This is very rare but needs urgent examination.
Book an appointment with a dermatologist if:
You have nodular acne or deep, painful lumps.
You are starting to get acne scars, or dark marks increase every time you have acne.
You have used over-the-counter acne medication for 12 weeks with no improvement.
You have a bump that will not come out and you are not sure whether it is acne.
You cannot resist squeezing and often end up with open sores. A doctor can help plan your treatment.
Common myths about acne extraction
"Acne must have its head squeezed out to go away." Not true. Most inflamed acne settles by itself in 5–10 days without squeezing, and squeezing makes it last longer.
"If it bleeds, it means everything has come out." Not true. Bleeding means the pore wall and tiny blood vessels are injured. It is a sign to stop.
"Extracting acne often makes pores wider." Proper extraction does not permanently widen pores, but hard repeated squeezing that ends in scarring can make the skin look uneven.
"Steaming for a long time before extraction makes it come out easily." Warmth helps a little, but steaming too hot or too long makes the skin red and irritated. What really helps is opening the head correctly.
"Dabbing toothpaste on a pimple makes it shrink." Not recommended. Toothpaste contains ingredients that irritate the skin and may make dark marks darker.
Quick summary
Extraction suits only blackheads and whiteheads (comedones).
Do not squeeze inflamed red bumps, nodular acne, cysts and fungal acne.
Closed comedones must first be opened with a sterile instrument. Squeezing with fingernails is the main cause of dark marks and scars.
Large inflamed lumps are treated with an acne injection instead of extraction. The lump usually settles in 24–72 hours.
Extraction is a supportive treatment. The main medication is adapalene or tretinoin, which shows results in 8–12 weeks.
Leave at least 3–4 weeks between extractions, and apply sunscreen every day afterwards.
Frequently asked questions about acne extraction
Should I extract my acne?
It depends on the type of acne. For blackheads or whiteheads that are not red or painful, proper extraction with sterile instruments can help skin become smooth faster. But for inflamed red bumps, nodular acne or fungal acne, you should not squeeze, because it deepens the inflammation and raises the risk of dark marks or scars. Extraction is only a supportive treatment. Without anti-clogging medication alongside it, acne comes back within a few weeks.
Can I extract acne myself?
Only to a very limited extent, and most doctors do not recommend it, because it is hard to tell comedones from inflamed acne or non-acne bumps by eye, and closed comedones must first be opened with a sterile needle or blade. Using fingernails or sewing needles risks infection and marks. If you do it yourself, limit it to easy blackheads with a clean tool, pressing gently no more than 1–2 times, and stop if nothing comes out. Rely mainly on anti-clogging medication.
How many times a month should I extract acne?
Generally no more than once a month, with at least 3–4 weeks between extractions so the skin can recover. Extracting more often does not clear acne faster but adds irritation and dark marks. The goal is to need less and less extraction as anti-clogging medication starts working in months 2–3. If you still need extraction every month, the root cause has not been addressed, and a doctor should review your treatment.
How many days does it take for extracted acne to heal?
When a comedone is fully extracted, the spotty redness usually settles in 1–2 days. The opening marks form small scabs and fall off in 3–7 days. If that spot was already starting to inflame, it may stay swollen for another 3–7 days. Leftover red marks fade in 1–3 months and dark marks in 3–6 months. If after extraction you have more pain, spreading swelling and redness, or a fever, see a doctor, because it may be an infection.
Can I squeeze inflamed acne?
No. An inflamed red bump has no oil plug to come out, only inflammation in the dermis. Pressure pushes the inflammation deeper, so it settles more slowly and carries a risk of dark marks or acne scars. Left alone it usually settles in 5–10 days. Treatment is with topical medication such as benzoyl peroxide together with adapalene, or oral medication for more severe cases. For a large, painful lump, a doctor may consider an acne injection to help it settle faster.
I squeezed acne and now have dark marks. What should I do?
Dark marks after squeezing acne are post-inflammatory hyperpigmentation (PIH), which can fade by itself in 3–6 months. What helps them fade faster is applying sunscreen every day, stopping squeezing and picking, and using medication that helps both acne and marks, such as azelaic acid 15–20% or a retinoid as your doctor advises. If the marks have not faded after 6 months, or you have pitted scars, see a dermatologist to assess further treatment.
Read other skin condition articles at All skin condition articles. And if your acne is mostly on the forehead, see Forehead acne: causes and 7 types to tell apart
Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed October 19, 2026
The information in this article is general knowledge, not a diagnosis or a personal prescription. Acne extraction, acne injections and the choice of medication must be assessed and performed by a doctor. Treatment results vary from person to person, and side effects may occur.
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