We Singaporean women have a love-hate relationship with extractions.
We love the idea that it helps us unclog our pores and clear the dirt on our face but we hate the pain that is associated with extractions.
As much as we love them, however, did you know that NOT ALL dirt / pimples / blackheads should be extracted?
1. Blackheads / Whiteheads
Blackheads are pores that has become clogged with excess sebum and dead skin cells.
It tends to be a hardened ball of oil which resembles a sesame seed coming out of the skin.
It feels really hard and almost just rolls off the skin once it’s extracted, except when your face is hydrated. In that case, the blackheads will be really soft and just wiggle out easily.
Blackheads are often referred to as open comedones as the opening of the hair follicle is not completely blocked. This allows for air to penetrate the pore, causing oxidation of the melanin and turning the head black. Once developed, a blackhead can remain on the skin for several weeks or even months. Blackheads are the easiest and least complicated for extraction as they have not been aggravated by bacteria and so are unlikely to cause further acne.
Whiteheads on the other hand are closed comedones as the opening of the hair follicle is completely blocked. When the sebum cannot escape the pore, it accumulates, giving the whitehead its characteristic white hue. Once developed, a whitehead remains on the skin for 3 - 12 days. After this time, it will either heal on its own, which occurs in about 25% of whiteheads, or develop into an inflammatory acne lesion that becomes red and sore, which occurs in about 75% of whiteheads.
Although pores are self-cleaning, the process takes quite some time. That is why Winnie from The Bund Beauty therefore suggests for blackheads and whiteheads to be removed to prevent it from developing into the more serious papule (inflamed comedone).
We've all heard of blackheads and know that they should be removed... but what about Milia?
Milia are keratin filled cysts under the skin that cause white or yellowish bumps under the skin.
Unlike a blackhead or pimple however, milia do not go away on their own. The cysts are usually deep below the skin’s surface and so require an incision to remove it.
It is OK to leave it there but if it doesn't get expelled naturally, it can evolve into bigger cysts.
What experienced facial therapists at Geranium Skin Boutique do therefore is to make a tiny incision at the top to excise the cyst.
Don't try to squeeze this out yourself as you'll tend to injure the skin tissues around the milia instead.
Grace from Geranium Skin Boutique shares that it is best to get the milia extracted professionally in a salon as broken skin and scar tissue can be pigmented quickly under the sun and cause lasting scars!
Pustules is what is known as "ripe" pimples.
The reason why we call it "ripe" is because you can actually see the head at the surface of your skin. They can be small or large and are formed when there is a rupture in the pore and the body sends white blood cells to heal the wound, creating pus. The mixture of pus, dead skin cells and excess oil then creates the white head at the top - these are also the things facial therapists squeeze out of the pore when they pop a pimple.
Pustules are more complicated to treat as these are inflammatory acne that have been aggravated by bacteria. Extracting them runs a risk of further bacterial infection, which is why skilled facial therapists have to take extra steps to prevent it from happening.
Apple, an extraction specialist from Apple Queen Beauty, shared that a good beautician will use a finely tipped lancet needle to create a canal and then use cotton swabs to gently squeeze out all the pus from the opening.
It is important for all the instruments to be sterilized and for the beautician to be precise to prevent further bacterial infection and cause minimum damage. That's not all though. Apple also uses an electroporation machine to further kill any bacteria on the skin
and apply serums and masks after that to accelerate healing.
Papules are the precursor to Pustules, basically pimples that are not yet "ripe".
Papules develop when the pores becomes clogged with skin cells and excess oil. The environment makes it easy for the propioni acnes bacteria to grow and they multiply really quickly. As these material accumulate over time, they pressure on the follicle and causes the follicle wall to rupture as the material spills out to surrounding skin. This causes the skin to become inflamed and sore; the resulting bump is called a papule.
Papules and pustules happen closer to the skin surface while nodules are considered more serious acne pimples that occur from deeper within the skin. Nodules appear as large, red, painful lesions over 5 millimeters in diameter and develops when the follicle wall ruptures deep within the dermis. Contaminated debris from the follicle empties into the dermis and infects adjoining follicles. The area swells considerably due to the damage and irritation, so nodules are quite painful.
Similar with pustules, nodules can be filled with pus but because they occur so deeply within the skin you can't see a white head.
Nodules develop when there is an extensive rupture of the pore especially deep within the skin, which dermatologists often refer to as a "complete explosion of a pore" and is most often seen on the back, neck, forehead adn the chest.
Due to the extensive damage caused by the pore rupture, nodules may remain for weeks or months before healing.
This is commonly triggered by hormone changes so you'll find that women are especially prone to getting them before menstruation.
Failure to treat the nodule can lead to further inflammation which can damage surrounding skin cells. More significant scarring can develop if you pick or try to pop nodular acne. You’ll also likely be left with a scab and an enlarged pore.
Cysts are considered the most serious form of acne. They are large inflamed lesions between 7 - 15 millimeters in diameter.
Unlike nodules, they are filled with pus that can be felt as it moves beneath the skin when touched.
As the above 3 acne types happen deeper beneath the skin, immediate extraction tends to cause more damage. It doesn't mean that they are not treatable though. A lot of acne sufferers choose to go dermatologists which tends to prescribe antibiotics. This helps to control the acne in the short term but for a number also find that the acne tends to return when you stop the antibiotics.
For those who feel like you've run out of options, consider to go to acne specialists like Indulgence Beauty. This may be a facial salon but they deal with such serious acne issues very systematically with a comprehensive plan to eliminate acne triggers one by one.
While such cases take a longer period of time, Indulgence Beauty managed to help many customers recover from even the most difficult cases of cystic acne.
Recovery from Cystic and Nodular Acne after Regular Facials at Indulgence Beauty
Do you have an acne story to share?