From products we use to use hormone fluctuations, stress levels, lifestyles and more, acne can manifest for different reasons. I often work on an intuitive level with acne clients combined with a good amount of questions and investigation. Taking a holistic approach to acne helps to discover the root cause and no matter what, there are foundational practices to further prevent inflammation happening on the surface and that’s what we are diving into today.
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, 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 in reference to extractions.
The 4 Grades of Acne
Grade 1. Mild acne, blackheads, whiteheads, little 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. Can be 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 can stem 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.
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 aggravated or not but attempting to extract them or pick at them will increase the likely hood of scarring, further breakouts and tissue damage.
These are infections in the dermis of the skin. They are created and heal in the dermis. Adding the unnecessary pressure and irritation from aggravating the skin will further inflame 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.
When working with clients, this grading system really never comes to mind, as I 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 either lessen or worsen the area.
Treating Acne Skin
I highly recommend reading my blog post on The Skin Barrier. Understanding the Skin Barrier is a massive aspect in the foundation of a healthy complexion and is our guide in choosing the best external products and practices for our skin.
This 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.
There is absolutely not a once size fits all approach to acne. However, if I had to choose a universal and minimal baseline for an external approach, it would consist of:
- Linoleic acid based oil cleanser or minimal ingredient milky cleanser for AM use (removed properly)
- Non-stripping salicylic acid cleanser for PM use
- Organic Rosewater toner for AM/PM use
- Clean, water based, minimal ingredient salicylic acid based serum (use pm)
- Minimal ingredient Linoleic acid based facial oil (use am and use over pm salicylic serum)
- Zinc oxide, minimal ingredient SPF for daytime use and/or large sun hat. Skin must stay out of sun when using active, hydroxy acid based products
Lymphatic movement is an extremely effective method when treating acne and cysts. Cooling Gua Sha stones are beneficial to calm inflamed skin and can be gently placed over skin inflammations to cool skin. In the case of non-extractable blemishes and cysts, use the placement of the cool stones on and around inflamed areas to support lymphatic drainage. Use drainage techniques when practicing Gua Sha to support clearing and healing acne and inflammatory concerns.
The habit of touching the skin during breakouts can be just that, a habit. Work on breaking the habit of touching the face throughout the day. During your skin rituals and practices, if the need to start touching our picking at the skin comes up, instead of using your hands, which tend to cause damage and the urge to pick, use a jade roller or gua sha stone and lightly work around the skin 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 (sugar, gluten, dairy) and check my stress levels and sleeping patterns. Certain foods can cause accelerated inflammation, this differs for each of us, which can manifest quickly throughout our complexions. I recommend to watch my masterclass GLOW to learn more about my all encompassing internal approaches to acne and skin health in general.
Because if you’re going to do them, do them right. It’s cute in theory to tell others not to do extractions at home but I’ve worked with clients long enough to know that it’s inevitable and often done incorrectly, causing further inflammation and damage to the skin. Not to mention, the habit can turn psychological which takes takes time to break. If you insist on doing extractions, I hope this information assists you in doing them as correctly as possible to prevent you from damaging your skin.
If and 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 never be extreme picking or extreme extraction required.
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. Picking and incorrect extractions increase inflammation, redness, tissue and follicle damage, scarring and spread bacteria under the skin, leading to more breakouts. This is also how the grades of acne can move from subtle to severe.
For any extractions, I recommend to wrap your finger tips in soft cotton soaked in organic rosewater, and give absolutely no more that 3 gentle, quick squeezes on properly prepped skin which includes cleansed, heat softened, and lightly exfoliated skin. Anymore pressure and length of time or done on non-prepped skin and you are increasing the likely hood of more breakouts, damaged skin and increased scarring and furthering inflammation cycles 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. You can dab of a clean source of clay on the skin for an overnight treatment to draw anything to the surface of the skin. Be sure the whitehead has surfaced equal to or above the surface of the skin before extraction. Gently extract and add a soothing, non-pore clogging topical agent.
A gentle salicylic acid formula will assist through its anti-microbial and anti-inflammatory properties and can be used in more chronic cases of breaking out. If your breakout is more of a one off, a stabilized Vitamin C will assist to heal skin and lessen appearance of scarring once the blemish is cleared.
There are no extractions of cysts but there are ways to soothe them. You can use a warm compress on freshly cleansed skin for a couple nights after a steam shower. Apply a gentle rosewater toner and a light salicylic acid formula to assist with its anti-microbial and anti-inflammatory properties. Follow with placement of cold stones or light ice massage for lymphatic movement.
You can also use light clay masks, as again, the clay is drawing to impurities so this will help. Continue nightly until area has calmed. Do not ever attempt to extract cysts, at all.
These practices are an effective place to start in understanding the foundations of a holistic approach to acne and I promise they will help. If you’d like to learn more about my holistic skin and lifestyle approach to all things skin related, be sure to check out Radiant Beauty Collective to learn more.