How to tell if your extractions for acne are done properly
Extractions are the process of manually removing debris from the skin. If you have ever picked or popped your own pimples, you were basically performing an extraction. Depending on the state that you live in, you might receive extractions from an Esthetician or a Dermatologist and if extractions are performed properly, they can significantly accelerate the clearing process. If they are not done properly, they can slow down the clearing process and also contribute to scarring, infection and pigmentation so it’s crucial to find someone who can do them the right way. If you cannot find someone to do them properly, receiving bad extractions is actually worse than not receiving them at all. Read on for the important things to pay attention to.
ARE THE RIGHT TYPES OF ACNE BEING EXTRACTED?
There are 7 types of acne and not all of them are appropriate to extract. Papules, cysts, and nodules should never be extracted because there is such a high level of inflammation blocking the actual acne “seed” that the level of trauma that would need to be inflicted on the skin in order to thoroughly clear out the follicle is very likely to cause scarring. The three types of non-inflamed lesions (microcomedones, blackheads, and whiteheads) can all be extracted safely and one type of inflamed lesion, pustules, can usually be extracted because the comedone is essentially sitting on top of the inflammation which is why you see a head. If your Esthetician or Dermatologist is extracting everything on your face without being methodical about which types are appropriate, you should find someone else.
ARE THEY THOROUGHLY EXTRACTING THE ENTIRE FOLLICLE?
One of the most common extraction mistakes people and even professionals like Estheticians and Dermatologists make is that they leave debris in the follicle which can then lead to further infection and inflammation (which can then create scarring and severe pigmentation). It can be hard to tell right away if the entire follicle has been emptied because even if the extractions are done correctly, you will likely have scabbing that forms and creates a slight bump over extracted areas. But it should be relatively flat still immediately after the extractions and once the spot heals, it should be completely flat and you should not feel or see any big or small bumps left in it.
HOW MUCH DAMAGE IS BEING DONE TO THE SKIN?
Extractions are traumatic for the skin regardless of whether or not they are done properly so there are some negative side effects that I list below that you should be prepared for regardless of who is performing them. The question you should be asking is how much damage is being inflicted on the skin, how long is it lasting, and whether or not the pros outweigh the cons. As I mention below, most of the side effects should last a few days to two weeks. These normal side effects are basically the price of manually pulling acne out of the skin but there are some side effects that are not normal. Scarring is not normal so if you have actual scars after extractions, your extractions were not done properly and you should find someone else. Just be careful to not confuse scars with dark marks because dark marks are a normal side effect of any trauma to the skin and they are temporary.
NORMAL SIDE EFFECTS OF EXTRACTIONS
With the exception of PIH which can last months, most of these side effects should last up to a week but it can take up to two weeks if your body has a really slow healing response. If they last more than two weeks, whoever performed them isn’t skilled enough to extract in a way that causes the minimum amount of trauma necessary so you should find someone else. Here are the most common side effects:
Scabbing
Redness
Soreness
Bleeding
Oozing
Dryness + flaking
Post inflammatory hyperpigmentation (PIH) which is darkening of the skin
WHY EXTRACT THEN? THE PROS SHOULD OUTWEIGH THE CONS
Even though these side effects are not pleasant, the benefit of manually clearing the follicles should far outweigh the temporary side effects because properly extracting acne can significantly speed up the clearing process. If your skin is not manually cleared of acne, it can take years for those lesions to work their way out of the skin which is significantly longer than the week or two most of these side effects usually last. Dark marks leftover in the spots that were extracted (PIH) are the side effect that usually takes the longest but it should take just a few months since whoever is performing the extractions should be approaching your acne using a multitargeted approach that works to clear AND even out your skin tone simultaneously anyways. Plus, acne takes at least 3-4 months to clear in the best case scenario so a few dark marks shouldn’t make that much of a difference in the grand scheme of things.
EXTRACTIONS ARE NOT ENOUGH FOR ACNE
Extractions clear the skin temporarily but if you are not on a program that helps you eliminate all of the various triggers that clog up the follicles, it is just a matter of time before your follicles become congested again. The only way to clear acne in a long term and sustainable way is to use a multi targeted approach that not only works on clearing acne that has already formed on the surface of the skin but that works on preventing new acne seeds from being planted in the skin. So extractions should be one part of a comprehensive program like our acne program that targets acne from multiple angles. Check out our 8 Steps To Clear Skin E-course and our in-person and virtual acne programs to learn more.