Dermatologist Dr. Amy Wechsler gives you the facts on flare-ups and mild acne, and how to deal with them.

WHAT'S THE CAUSE?
Sebum. The difference between black heads and white heads is that blackheads are sebum clogged pores that have been exposed to the air and oxidized turning the spot black. There has been no scientific evidence proving diet has anything to do with outbreaks, but I completely believe stress is a factor.

WHAT'S THE TREATMENT?
You should never squeeze, but I know better than to expect y'all to listen. People love to see the schmutz pop, so let's talk about the right way to do it. First, the pimple has to be ready with a white or green pustule head. Forcing one that isn't ready is asking for problems. Schmutz can travel under the skin if pressed too hard, causing an outbreak somewhere else. NEVER squeeze with your fingers. I don't even recommend using a tissue because your nails can poke through and cause scarring. Take two Q-tips, on either side of the pimple, and apply equal pressure. Q-tips give you more leverage and make it easier to squeeze all around including the sides of the nose and other hard to reach spaces. The sebum will ooze out onto the Q-tips, but the moment you see blood you should stop. Apply a hydrocortisone on the spot. NEVER smear it all over the face. Only apply it on the spot you're trying to treat. For special occasions like "prom night" or wedding day, pimple disasters can be treated in the dermatologist office by injecting a steroid called an ILK (intra legional kenlog) directly into the pimple to make it go away. It will go down the next day.

HOW DO YOU DEAL WITH A CYSTIC PIMPLE?
Cystic pimples are much larger and more painful than your usual pimple, and usually appear as bumps under the skin. DO NOT squeeze these under any circumstance. Back in the day, I would try so hard to work the stupid thing to the surface. The problem is there is no connection; they are walled off. It's a ball of sebum with goop that is so thick, it wouldn't be able to drain out of a tiny hole even if it could reach the surface of the skin. Needles don't help; you're just screwing with the surface and will cause scarring. Also, often times if you "drain" it; it will fill back up. So see a dermatologist and have it injected, or leave it alone. They will go away on their own.

WHAT CAN YOU BUY OVER THE COUNTER TO TREAT SPOT PIMPLES?
Generic benzyl peroxides and products with salicylic acid. They don't have to be fancy name brands to work on mild acne. An added plus, Neutrogena makes some great makeup cover-ups that have percentages of these healing ingredients. Anything you put on your face should be oil free and non-comedogenic. That means NO cocoa butter on your face - ever. So many young women of color do this and it's horrible for your skin.

HOW DO YOU TREAT HARD TO REACH "BACNE"?
It's not so much the new things on the market you can buy; it's the new vehicles to direct the treatment. There are now foams and sprays you can use to reach areas creams can't. I prescribe a spray cortisone in the office, but Murad makes a body spray with salicylic acid that you can buy online.

For more information about Dr. Amy Wechsler, visit www.dramywechsler.com