DO you or someone you know struggle with acne? If so, one of the biggest challenges with acne is getting rid of them, and in doing so, knowing the extraction techniques and tools vital for not creating lifelong scars as a result of bad extraction techniques.

Acneic skin tends to have a tougher cellular wall that traps the oil and sebum, and does not allow oxygen to get in, thus creating a breeding ground for more bacteria.

It is also important to understand that acne is a wound. The cells need to be healed, but the bacteria also needs to be eliminated, which is why the right tools and techniques are imperative.

Common extraction tools

Lancet: This sharp-sided tool with a point at the end must be used with caution, as it can create damage if inserted too far. It can be beneficial for closed comedones.

Hypodermic needles: The 26.5 gauge is generally recommended as it is more delicate and easier to control. When using a hypodermic needle, it is important to insert it in the direction of the follicle to open the comedone.

Comedone extractors: Since your hands are not in direct contact with the skin, it can be easy to apply too much pressure with this tool. When too much pressure is applied, it may result in broken capillaries and bruising. Comedone extractors are generally best used on acne lesions occurring in the ears. If using on the face, exercise extreme caution.

Cotton swabs and tips: These do take some practice, but offer one of the gentlest approaches. When done correctly, it is a great technique for the nose area.

2×2 inch gauze: This is our recommended method, as it is typically one of the safest and best methods to ensure good control and pressure.

Extraction protocol

Prior to turning to the aforementioned tools, prepping the skin correctly can make for much easier extractions and help prevent further or permanent damage to the skin. In other words, you can let products do the hard work for you.

Step 1: Cleanse

Cleansers with green tea and salicylic acid help reduce inflammation and remove surface bacteria and excess oil. For dry skin or those with comedones, a goat milk-based cleanser blended with natural minerals such as zeolite and essential oils support with antiseptic and antibacterial properties without stripping the skin of hydration.

Step 2: Steam

Steam may also be added during the cleansing phase to help loosen the skin and prepare it for extractions.

Step 3: Tone

After drying the skin, a toner will help remove excess lipids and continue the softening process. AHAs, BHAs and mandelic acid aid in loosening the glue-like substances (hardened keratin) around the cells, which makes it easier to extract, particularly when dealing with tighter comedones.

Salicylic, lactic acid and green tea are ideal for someone with pustules, as these ingredients provide stronger antibacterial and anti-inflammatory support. A cell conditioner with salicylic, lactic acid is also good to use at this point, as it will act as anti-inflammatory support and is a highly beneficial lipid reducer.

Step 4: Exfoliate (for non-inflammatory acne)

When performing comedone extractions, softening the skin prior will be key. You might start with an enzyme with papaya fruit extract and papain to begin the process and soften comedones for easier extraction. This may also be combined with steam, or followed with a grape seed oil hydrating serum massaged into the skin with steam to aid in cell renewal and softening. Glycolic and lactic acids are also good for softening, opening and loosening skin cells.

Exfoliate (for inflammatory acne)

For pustule or cystic acne, AHAs or BHAs combined with hydrogen peroxide are ideal as they will help bring oxygen to the skin while stimulating the dissolving process. Alternatively, a pumpkin-based enzyme with an acid strength equivalent to 10 per cent glycolic will usher the bacteria to the surface and ready the skin for extraction.

Use caution with steam, as it could over-stimulate the skin. Clay-based masks will further help draw out impurities in cystic and nodule lesions; however, if the bacteria is still reluctant to surface, peels also work well, particularly for cystic lesions.

Step 5: Oxygen therapy

Oxygen therapy is also effective for acneic skin, since oxygen is often lacking as a result of keratin hardening below the surface, causing blockages. Of course, treatment will depend greatly on your client’s skin, the root cause of the acne and any other conditions present in the skin. For instance, you will want to use a lighter approach when the skin is more dry or sensitive.

Step 6: Extraction

If using the recommended 2×2 inch gauze, be sure that your nails are short, always wear gloves and extract everything out (especially with pustules). The goal is to reach the clear fluid after the blood. This is a sign that you have got everything out. Once you reach that point of blood, use a gentler pressure and rock back and forth. Fully eliminating everything is imperative. If anything is left behind, the problem can worsen.

If too much pressure is applied or an overly aggressive approach is taken on the wound, it could result in deeper damage or scarring. Start slow, focus on removing the bacteria and, when in doubt, opt for a gentler approach. The goal is to remove bacteria, reduce inflammation, heal the wounds, and begin to stimulate the growth of new, healthy cells.

Step 7: Sanitise and soothe

Immediately following any extraction, sanitation is a must. Properly sanitising the skin will ensure that you remove any infection that may have seeped to the surface. Post-extraction support is essential. The goal is to reduce the bacteria and inflammation, and begin to soothe the skin.

A toner or lotion containing green tea, lactic acid and salicylic acid or a mandelic acid with arginine formula (particularly for comedones) will provide antibacterial, antioxidant and cellular repair.

For pustules, a green tea toner or all-purpose cleansing pads will provide gentle cleansing. Be careful to not be too aggressive with the skin post-extraction, avoiding acids and high-strength enzymes.

For anti-inflammatory and healing support, a soothing balm containing Arnica montana extract or a vitamin E serum will reduce redness and promote healing. Ice therapy, such as chilled ice globes rolled gently over the skin, is also highly beneficial at this point for soothing support.

Step 8: Mask

You may finish with a clay and salicylic acid-based mask for healing and detoxification. Wasabi root and rosemary are also great anti-inflammatories; however, if you have performed a lot of extractions, a milk-based mask will replenish skin nutrients and provide soothing support.

Step 9: Follow up

In the initial phases, frequency is critical. Extractions may be performed once month for up to six months. If done consistently, clients will begin to see inflammation significantly reduce and conditions dramatically improve.

Home care

Home care leading up to the treatment will also aid in efficient extraction. A good pre-treatment for impacted skin might include a salicylic acid-based serum or vitamin A formula to stimulate cellular turnover. A gel with glycolic and lactic acid may also be used to soften comedones and reduce cellular build-up. These may be used three to four nights per week for one week leading up the treatment.

For clients with dryer skin or with more sensitive skin, a mandelic acid and arginine serum is ideal as it will still provide rejuvenating support without being too aggressive. Topicals and frequency should be adjusted based on oil level dryness and when the extractions will be performed.

Michelle Vernon is a phlebotomist medical aesthetician who operates the Body Studio Skincare, located at 20 Constant Spring Road, Mall Plaza, Kingston 10, and Fairview Shopping Centre, Montego Bay. She may be reached at telephone 908-0438 or 684-9800; IG @ bodystudioskincare; E-mail: bodystudioskincare@gmail.com; Website: www.bodystudioskincare.com.

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