When our least-favorite, uninvited houseguest shows up — acne — we know it’s time to book a facial. There’s something about a professional skincare treatment that leaves our skin looking fresh and healthy again. However, these days, the task of achieving clear skin lies with us. That said, a proper pore cleanup almost always involves the often-unpleasant extraction. And while most dread this part of the service, no one can deny it’s crucial. Yep, from prodding to de-gunking, check out what leading estheticians have to say about the facial extraction process, how to properly do it at home, and why it’s a necessary part of our skincare journey.
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What Exactly Are Facial Extractions?
"Extractions refer to the process of clearing clogged or obstructed pores, also known as comedones, from the skin," shares Nandi Wagner, lead esthetician at Bliss Spa. "There are two types of comedones: open, blackheads, and closed, whiteheads. Blackheads are impacted sebum in the pores and are most common in the T-zone, while closed comedones are usually a result of bacteria buildup in the pore, which result in inflammation. Both open and closed comedones can happen in other areas of the face, depending on skin type and your skincare habits." You know it’s time for extractions when the “pores are congested, and you can see impurities or feel them under your skin,” says Olga Lorencin, celebrity esthetician and founder of Olga Lorencin Skin Care Clinic. Typically, this is detected in acne-prone or oily skin types, but that doesn’t mean other skin types don’t need a thorough inspection and cleaning, as well.
"The forehead, nose, cheek and chin are the easiest areas from which to remove buildup because they typically consist of blackheads, due to greater oil production. Blackheads live at the top of your pores, so they are less complicated to extract and don't involve breaking the surface of the skin," shares Nandi. She notes that breakouts that are infected and have no opening won’t be extracted because the disturbance will worsen the infection. Think those “red and tender areas that haven't turned into a pustule yet,” Athena Hewett, founder of Monastery and esthetician at Athena Ellen Esthetics explains.
How To Do Facial Extractions: Prep
The most crucial component to safe and effective extractions is proper skin prep. When you are consulting with your esthetician, make sure they explain how they plan to proceed. Celebrity esthetician Renee Rouleau mentions that "steam must be used before the extraction process to heat the skin and melt the debris inside the pore down to the consistency of soft butter. Then, during the extraction, it’s important to keep the skin moist. After steaming, a thick moisturizer is often applied to retain the heat and make debris easier to remove. If the skin isn’t kept moist and warm, it will tighten up, and the debris will be hard to take out." (According to Olga, those with rosacea or eczema should ask the esthetician to skip the steaming and heat up the face using a warm cloth to prevent over-drying of the skin.)
Because so much professional prep and precautions are involved, it's not recommended that you try extractions at home. "Extractions are best performed by professionals, as doing it yourself results in picking and squeezing, which leads to scarring," shares Arielle N.B. Kauvar, MD, director of New York Laser & Skin Care. Also, clients should, "avoid using at-home peel treatments or prescription topical treatments like Retin A, Differin or Tazorac three days before an appointment, to prevent redness and irritation," Nandi states.
How To Do Facial Extractions: What To Expect
“Proper extractions should not cause redness for days," notes Olga. "Maybe a few hours or 24 hours at the most, if you had tons of work done. Knowledgeable estheticians will limit extractions to 20 minutes at a time in order to avoid inflaming the skin too much."
Also, while extractions will help speed up the recovery process, they can’t magically banish all bumps and pimples. Nandi reminds us that it’s the home care that really impacts the results of a facial. Those with oily skin need to avoid pore-clogging ingredients like mineral and coconut oils, which will reinfect the skin and lead to more open and closed comedones. She also begs clients to look for, the magic word — non-comedogenic — because it means the product is formulated with ingredients that don't cause comedones or clog the pores. Also, a regular exfoliation routine can keep clogging at bay and extend the time between trips to your esthetician. Renee also encourages clients who need extra soothing to "apply a cooling gel mask to reduce any redness caused by the treatment."
How To Do Facial Extractions: At-Home Precautions
"The most important thing to remember is that if you are thinking 'I shouldn’t be doing this' then you shouldn’t," Dr. Elliot Weiss, MD, board-certified dermatologist of the Laser & Skin Surgery Center of New York says. Improper at-home extraction can lead to extreme scarring if the skin is broken prematurely or too harshly, that said, for adequate extractions, Dr. Weiss suggests an extensive skin prep process. "If you are going to attempt an at-home extraction, then follow these simple rules: First, wash the skin and hands, and wash any comedone extractor tools you may be using. The area to be extracted should be warmed with a wet compress before attempting to extract. After warmed, one can gentle apply pressure with a comedones extractor. If unsuccessful, reposition and gently try again."
However, it's important to note that every bump is not ready for extraction. Dr. Weiss insists that when a bump is ready for extraction it will form a white head when ready to be released. That also includes a dilated pore that is clogged with a visible blackhead. If the extraction is seeming unsuccessful, give your skin another day and try again.
And when it comes to cystic acne, it's important to leave the breakout alone completely. "Do not touch the deep, cystic blemishes," Dr. Charlotte Birnbaum, MD of Spring Street Dermatology in New York City says. "You may recognize these as the painful, under-the-skin, pink bumps. By extracting these, you are more likely to make things worse, increasing pain and possibly create a scar." Instead, you can try treating cystic acne bumps with topicals heavy in ingredients like salicylic acid.
The best way to avoid having to execute at-home extractions, however, is to try to prevent the breakouts all-together. "In general, I recommend using a retinol (if not pregnant or breastfeeding) to reduce whiteheads and blackheads and to break up dead skin cells in order to make extractions easier," Dr. Birnbaum says.
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