From products we use, hormones fluctuations, stress levels, lifestyles and more, acne can manifest for different reasons. I often work on an intuitive level with my acne clients through alot of questions and investigation. I believe the process of elimination works best when healing acne and helps to discover triggers that may be causing flare-ups to begin with. People breakout for different reasons and what works for your friend, is the latest trend or is endorsed by some celebrity (just don’t) may very well not work for you. Treating, healing and preventing acne is about understanding your own skin and your own triggers, so don’t worry about what everyone else is doing.
There is a universal scale of Acne levels that I will lightly touch on lightly, as well as one of the most common concerns I see when dealing with acne and breakouts that turns into a larger issue when not addressed, skin picking. Today I am sharing what to do when breakouts are present, ways to prevent more from showing up and tips on what not to do when they do arrive, all in reference to extracting and picking.
The 4 Grades of Acne
Grade 1. Mild acne, blackheads, whiteheads, no inflammation present, mostly found on nose and forehead. Prevalent in adolescent skin.
Grade 2. Larger and more moderate amounts of blackheads and whiteheads, along with some larger pustules and slight inflammation becoming more obvious. Areas of concern found on nose and forehead, as well as chin, cheeks and jaw.
Grade 3. Considered more severe and can stem from grade 2 being left untreated. Made worse by picking, squeezing and spreading bacteria. Inflammation is higher, skin is more red and there are a greater amount of blackheads, whiteheads, pustules and papules. Risk of scarring becomes greater.
Grade 4. Most serious level and stems from grade 3 left untreated. This grade includes cystic breakouts, stemming from deep under the skin, along with highest amounts of blackheads, whiteheads, papules and pustules. Can be severely painful due to the depth of the cysts being deep within the skin close to nerves and skin tissues.
When working with clients, this grading system really never comes to mind, as I do work more intuitively but it is important to understand the levels, as they share how acne can build and spread. Do I see clients that have cysts pop-up here and there? Absolutely and I certainly do myself if I stray from my own healthy skin habits. Does that mean we all have Grade 4 acne? Definitely not but we do all have our own triggers and every cyst or pimple, induced by whatever internal or external trigger, is caused by a blockage and clogged pore of sebum and dead skin. Regardless of the trigger, the congestion has now shown up and how we treat it on the surface can lessen or worsen the problem area.
When congestion is ready to extract out the skin, it shows. A whitehead with visible pus at the surface, a blackhead that is especially raised and most importantly, there will be no extreme picking or extraction required. 1-3 gentle nudges on cleansed, heat softened, exfoliated skin and our unwanted friend should vacate the premises. Any more provoking leads to aggravation and a cycle of inflammation. Extracting and picking are 2 different actions. A ready extraction is quick, picking is continuing to bother and irritate a breakout whether it is necessary to remove or not. This only increases inflammation, redness, tissue and follicle damage, scarring and spreads bacteria under the skin leading to more breakouts. This is also how the Grades of Acne can move from subtle to severe.
Cystic breakouts under the skin can be extremely irritating and painful and often may not come to a head. Cysts are deep in the surface of the skin. Trying to dig and pop out these types of cysts causes an extreme amount of inflammation and in no way helps to alleviate the existing cyst or prevent more. Cysts can unfortunately leave scars, whether picked or not but picking will increase the likely hood of scarring. These are infections in the dermis of the skin. They are created and heal in the dermis. Adding the unnecessary pressure and irritation from picking at the skin will further rupture the follicle, again, increasing tissue damage and spreading bacteria under the skin. More inflammation causes more destruction of tissue and the chance of textured, pitted scarring is increased.
Post Inflammatory Hyperpigmentation
PIH is another form of scarring that is increased by picking the skin. Part of the skins response to healing inflammation is to release melanosomes/melanin, which gives skin its color. Melanin is released in response to healing a blemish where inflammation exists and the more inflammation, the more melanin is released. By picking and increasing inflammation, you are also increasing the likely hood of darker scarring, as more PIH is left over.
How to Care for Acne
I highly recommend reading my blog posts on Skin Microbiome and Cleansing and Hormones and Skin. These will help answer questions needed in order to curate your own personalized, effective skin practices and how to discover your own skin triggers. Once you have a deeper understanding of your own skin and have refined your practices for your individual needs, you can also incorporate the tips below. For any extractions, I recommend no more that 3 gentle squeezes on cleansed and prepared skin. Anymore pressure and length of time, you are increasing the likely hood of more breakouts, damaged skin and scarring as explained above.
Start treating the blemished area a few days before extraction. Use a warm compress on freshly cleansed skin for a couple nights after a steam shower. I apply a dab of lavender for its anti-microbial and inflammatory properties and a dab of a clean source of clay. This will help to draw the infection to the surface of the skin. Be sure the whitehead has surfaced equal to or above the surface of the skin before extraction. Use fingers wrapped in a cotton compress soaked with an anti-bacterial toner and give no more than 3 gentle squeezes. Drain and add a soothing, non-pore clogging topical agent. A stabilized Vitamin C will assist to heal skin and lessen appearance of scarring once the blemish is cleared.
| Follow the same treatment of a warm compress on freshly cleansed skin for a couple nights after a steam shower. Apply a gentle hydroxy toner or dab of lavender, rosewater and clean source of clay each night. Again, the clay is drawing so if there is a chance of gently drawing some of the infection out, this will help. Continue nightly until area has calmed. Unless the cysts forms an extremely noticeable whitehead that can be gently removed as explained above, do not ever attempt to extract cysts.
Lymphatic movement is an extremely effective method when treating acne and cysts. I find the rose quartz gua sha spoon and jade roller are beneficial and gentle tools to calm inflamed skin and can be gently placed over any post extractions. In the case of non-extractable blemishes and cycts, use the placement of the cool stones on and around inflamed areas to support lymphatic drainage.
The habit of touching the skin during breakouts can be just that, a habit. Instead of using your hands, which tend to cause damage and the urge to pick, use the jade roller and placement of crystals to satisfy the physiological need of touching the skin
Treat your inflammation from the inside out. When I feel my skin getting out of balance, I knows it is time to refine my diet and check my stress levels and sleeping patterns. I’m may be consuming too much dairy, sugar, caffeine, not drinking enough water or maybe it’s time to add in some extra turmeric and a good, sweat inducing workout. Certain foods can cause accelerated inflammation which can manifest quickly throughout our complexions.