We've all had them, felt them, picked at them — it starts as a little lump beneath the skin before getting tender, redder, and, worst of all, often coming to a white, puss-filled head.

Pimples are a normal part of puberty, with more than 85% of teenagers getting them, but that doesn't make them a welcome or easy part of life to deal with [1].

Your skin is what you live in — often an indicator of both your health and your identity — so blemishes and acne can have a harmful effect on your confidence and self-esteem, particularly when those pesky pimples follow you out of adolescence and into adulthood.

So how do you deal with them? And what do you do when a hard pimple forms with no sign of release?

What are we talking about when we talk about acne?

Acne vulgaris, known more commonly as acne, is a common skin disease involving hormones, bacteria, dead skin cells, and an inflamed hair follicle [1].

It's not a surprise to anyone that puberty announces itself with a flood of hormones, but what might surprise some is that one of these hormones is the hormone androgen.

While androgen is a male hormone, it occurs naturally in both men and women, and during the hormonal fluctuations of adolescence, it's this hormone that helps your skin's oil glands grow, and gets those glands producing more oil (also known as sebum) [2].

Your skin's surface is naturally covered in bacteria, and it's this bacteria that feeds off this oil. If the amount of oil is thrown out of whack, which it is by changes in your hormone levels, it's only natural that your entire skin's ecosystem is sent for a spin.

Dead skin cells clog pores and hair follicles are filled with excess sebum, and both of these things physically manifest in acne [1].

What this looks like varies depending on where and how that excess oil is pooling, and the extent of the blockage, but the main types include:

• Whiteheads
• Blackheads
• Pimples; and
• Papules, nodules and cysts, also known as blind pimples, which can be especially painful [3].

What is a blind pimple?

A form of cystic acne, blind pimples are a cyst that doesn't have a connection to the surface of the skin [4]. In other words, it's a deeply buried pimple that exists beneath the skin's surface.

They usually appear as a large, red, raised, and often painful lump, and in severe cases, can appear on the skin in acne patches.

Severe cystic acne can last for 10 years and cause permanent acne scarring if left untreated, so identifying how many blind pimples you have and starting treatment quickly will help prevent the affected area from getting worse [5].

Are all pimples caused by hormonal fluctuations?

Generally speaking, yes, but there are many reasons why your hormone levels might change, and similarly, there are many reasons why your facial oil levels might ramp up.

Deep pimples and acne can be caused by any number of things, and while puberty is always the main stressor, changes to your period, birth control pills, hormone therapy for gender transitioning and health conditions such as endometriosis and polycystic ovarian syndrome (PCOS) can also cause acne breakouts [3].

Blind pimples and acne can also be caused by anything that interferes with the skin barrier, such as oil-based makeup or sunscreen, certain toners or cleansers, face masks and clothing, smoking (and vaping), or picking at pimples [3].

If you have sensitive skin or dry skin, you may be particularly susceptible to inflammatory acne, skin diseases or recurring blind pimples.

Why are blind pimples so painful?

If you have a hard pimple under your skin that won't go away, the odds are you have a cyst. Like with any blockage, a clogged pore can cause real inflammation, particularly of the hair follicle, making for hard and painful pimples.

These hard pimples tend to last a bit longer, even up to a few weeks, in no small part because they're often larger than most other types of pimples, and are frequently a part of a broader condition such as cystic acne.

You can reduce inflammation and address the pain by using any number of over-the-counter creams (more on that in a sec!), a warm compress, tea tree oil or a vitamin-based cream.

Should I try and pop a blind pimple?

While friendly advice can often be to pop pimples, it's really something to avoid, especially when it comes to blind pimples.

As they don't have a connection to the surface of the skin, to pop them, you have to break through your skin's surface to reach the puss, which opens you up to a world of hurt in terms of the potential for infection or scarring [4].

On top of that, you run the risk of pushing that puss deeper, which can ultimately make acne worse.

It's important to remember that hard pimples are a disease, and how you get rid of them isn't through impatience or picking, but rather through the use of medical treatment that will help you to keep your skin barrier healthy.

What's the best way to treat blind pimples?

Treatments for acne vulgaris can sometimes feel like they have a monopoly on ad space, particularly if you're a teen or in your early twenties, but how do you know what's going to help you get rid of hard pimples and flare-ups in a way that keeps your skin fresh and clear?

Well, that's a bit of a how-long-is-a-piece of string question.

Depending on your skin's qualities, your family history and your lifestyle, the best treatment for you won't necessarily be the best for others. Luckily, there are lots of medically reviewed options at your fingertips to try, including:

Face wash and cleanser

A quick and easy place to start, a gentle, soap-free wash is a great way to prevent blind pimples and reduce inflammation. Use it twice a day with warm water, and you'll feel this at-home treatment has you feeling fresher in no time.

Over-the-counter treatments

Topical treatments are often the way to go when it comes to deep pimples. These treatments have anti-inflammatory properties and serve to dry the pimple out and lower the levels of acne-causing bacteria [4].

Look for over-the-counter treatments (OTC) with ingredients such as salicylic acid, AHAs, BHAS, benzoyl peroxide or glycolic acid to target acne [3].

Software's Acne Kit combines four acne-busting products that work to reduce inflammation, balance oil production, control emerging breakouts and repair the skin barrier.

Oral medications

Oral medications such as oral antibiotics, anti-androgen medicines and birth control pil can have a significant effect on blind pimples and acne patients with severe cases.

Other methods

Natural treatments such as tea tree oil, green tea extract and olive oil can also be beneficial in combatting blind pimples [3]. But, never put undiluted tea tree oil on your skin — instead, look for products formula with tea tree oil.

Other treatments such as light microdermabrasion, chemical peels and light therapy can be effective with mild to moderate acne too.

Personalised prescription treatments

If you're not sure what's likely to work best for you, Software has your back! Our personalised prescription acne treatment contains medical-grade ingredients like prescription retinoids, hyaluronic acid, niacinamide and azelaic acid in a formula that is designed for your personal skin concerns.

Simply complete our online consult and our Australian health practitioners will create a prescription formula just for you. This is compounded at our partner pharmacy and delivered straight to your door and it'll help you get rid of blind pimples in no time.