The Secret to Clearing Pores
To extract or not to extract, that is the question. Extractions were once thought to be mandatory in a facial if the skin presented comedones, milia, or blemishes. However, more and more skin care experts are questioning whether they should be performed at all. Although improperly performed extractions can cause temporary bruising and permanent scarring, if properly executed, extractions can be very beneficial in clearing comedones.
Over the years, there have been many apparatus and products designed specifically to expel comedones from the skin. Manual extraction, metal extractors, suction machines, lancets, liposolvent product formulations and adhesive styled strips are some of the methods developed for both comedone and blemish removal. With any of the methods mentioned above, proper technique is imperative to avoid skin damage.
Become A Master Extractor
The unfortunate reality is that it takes practice to master the art of extractions, and many aestheticians can recall those days in school learning to extract, causing both pain and damage to our classmates and allowing them to return the favor when they practiced on us. Many, however, became masters at the art of extraction and developed a large facial clientele for their services. Some dermatologists offer these services in their practice, but they are not covered under most medical plans. The patient is left to pay the full amount of the service, which is normally more costly than visiting an esthetician.
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Extractions can be very beneficial to the skin, as various types of blemishes left untreated can develop into more serious skin eruptions. Let’s begin with comedones:
Normally, those with oily T-zones can relate to the aggravation of comedones, which appear as black blockages in the pores. The sebum secretions oxidize, causing a black “plug” to form in the pore. If left untreated, the comedone can become larger and more visible, enlarging the pore. The sebum secretions continue, allowing bacterial proliferation to develop. This environment is especially appealing to the propioni (acne causing) bacteria, as the clogging diminishes the skin’s respiration, making this oxygen starved location the perfect location for this anerobic bacteria to flourish. This can lead to initial inflammation, followed by the development of infection and pus.
Untreated comedones do not always develop into more severe blemishes, however they can be simply annoying due to their visibility on the skin. Some think that washing the face more frequently to remove the oil with soaps or alkaline solutions is the answer, but this aggravates the problem in two ways. When an oily skin is stripped of oil and the barrier function becomes compromised, the skin reacts by producing more oil in an attempt to rebalance itself. The other problem with alkaline solutions is that they actually cause oxidation to occur, which perpetuates the comedone development.
Extraction is the preferred method of treatment for comedones. There are many liposolvent solutions that can be used to soften the comedones prior to extraction. When combined with steaming, which makes the skin more pliable, these solutions assist in making the removal more comfortable for the client.
Many professionals prefer manual extraction. Once the skin has been prepared, the esthetician will use either a finger cot or sterile gloves, and wrapping gauze or facial tissue around the fingers they will gently apply pressure to the comedone with a lifting type movement to expel the comedone from the port. If incorrect pressure is applied, the comedone will not expel. It will remain in the skin and perhaps be a little further embedded. Regular comedone removal is very important, as it will prevent the pores from becoming distended and minimize the risk of blemish development. A deep cleansing facial should always include comedone and blemish extraction.
Milia are another form of sebum that should be removed from the skin, however these generally require a lancet to be eliminated (lancets are not permitted in every state, so be aware of your own state’s regulations). Milia appearance like small, whitish “pearls” under the skin. They are solidified sebum deposits that, if left, can become larger and increasingly visible. Although they normally do not develop into a blemish or cause inflammation, they can present as a raised irregularity on the skin. To remove milia, a lancet is used to gently open the skin, then with a gentle pressure on either side of this solidified sebum, it is easily expelled from the skin.
Blemishes in the form of pustules and microcysts can also be treated by an esthetician and are normally extracted using a lancet. When extracting pustules, often the infection will be released as soon as a small opening is created in the skin or by applying a very light pressure to either side of the pustule to remove all the infection. This is often not the case with microcysts, as the infection is deeper and can be extremely painful. First, the esthetician must evaluate the condition of the microcyst to confirm that it is ready to extract. If it is not, and excessive pressure is applied, the infection can rupture the wall of the pore, causing permanent damage to the pore, scarring on the skin and an increase of the infected area.
Clearly, extraction is a technique that requires practice to be perfected. Scarring occurs when an abnormal amount of pressure is applied to the skin, which can cause damage to both the pore and the surrounding tissue. Mature skin is unable to heal as quickly as younger skin, making proper technique even more critical during extraction.
Manual extraction by a skilled professional is the most popular method of extraction. However, metal extractors and suction machines are still used by some clinics. The metal extractors pose the most risk, as they cause an inordinate amount of pressure on a very small area of the skin. These extractors are metal with loops at the ends. The loop is placed around the comedone, pressure is applied, and the comedone is released. The concern with this method is that the PSI (pounds per square inch) can be very high due to the small size of the loop and the applied leverage. This can damage the capillaries and the skin, leaving behind permanent scarring. If used correctly, with a small amount of pressure and at the correct angle, this method can be effective without damaging the skin.
When using the lancet, it is only to remove the epidermal skin. It is never used to penetrate the dermis. It is understandable why many think the lancet would be the most controversial of methods; however, since it is used only at the epidermal level, they are few consequences when used correctly.
Suction machines cause the least discomfort and can be quite effective. The risk with this method is using a suction that is too strong and keeping the suction on one area for a prolonged period, thereby risking damage to the capillaries. Thin skin is the most at risk with this method, but when it is properly executed, it is very effective with little or no discomfort experienced by the client.
Following all extractions, the esthetician must apply an antiseptic product to eliminate bacteria. High frequency is also very effective, with the electrode used dependent on the desired action. The argon gas electrode appears violet when activated and is used for treating acne. The ultra-violet light is activated when the electrode is placed on the skin, providing both healing and soothing effects as well as an anti-bacterial action. This step is performed prior to the application of the concentrates and masks.
There are many masks available specifically designed to calm and soothe the skin thereby eliminating any redness that may have been sustained during extraction. Occlusive masks that are thermo-cooling are the gold standard when it comes to eliminating redness and any associated swelling sustained from the extractions. The skin will be even toned with no evidence of the extractions post treatment. Clay masks are also a popular choice for acneic skins in the clinic and for homecare, as the clays absorb any excess oil often contains active ingredients to provide anti-bacterial and soothing actions.
The esthetician must always do a skin analysis to assess if extraction is appropriate. In targeted aging treatments or pampering facials, extraction is not the priority. Clients that require extraction should be encouraged to book a deep cleansing treatment prior to booking healthy aging and indulgent treatments.