Hello Group!

Your expertise is much needed!

I have an acne client who is Philippino (this matters because of his skin pigmentation). He is in his mid-30s and just started seeing me two months ago. He has had two facials with extractions and one peel in between. With the first facial I extracted a pore on his upper right cheek. It came out easily and there was a lot; mostly soft yellow/white sebum. I wear gloves during extractions and wrap my fingers in thick cotton 4x4s. I told him after the treatment, he could ice it and start using his products regularly by the third day. A week later he contacted me saying that it had ended up scarring and discoloring. I told him to come in so I could have a look. It was dark and had hardened. When I say hardened, it was more of a hard nodule than a scab. It was still a little red, so I had told him to not use his astringent or exfoliant and to just put an antibiotic ointment on it to allow it to soften. The darkness has since lightened, but it is still there and still hard.

With his second facial, I was sure not to extract as hard. I was gentle with this other pore, which was on his upper left cheek. Again, I used very gentle pressure since it was ready to go. I cleaned the pore out completely. No bruising, scabbing or unusual amount of blood. 

A week later, I was contacted by the client saying that this dark, very hard scar came up again. He has revealed that he picked, scrubbed and exfoliated both areas.

All I had recommended to him was that he not touch it and to ice it again. 

Esties; ARE THERE ANY WAYS TO COMBAT AND LIGHTEN THIS CREATION?

Thank you for your help!

Tags: acne, discoloring, extraction, picking, scarring

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I wish you had pictures to post for this one....

Sounds like post inflammatory hyperpigmentation to me, but it is hard to say. I'll be interested to see what others have to say on this one. If it were me, I would get this man on a melanin suppressant for home care and explain to him that I cannot do any more extractions unless he can assure me that he will not pick, scrub, etc. He must be compliant to get the desired results. 

The other thing I'm wondering is what exactly were you extracting? Are we talking a closed or open comedone, papule, cyst?

The level of exsisting inflammation might be a clue asto why thisoccured.  

Thank you for your response Andrea.

It was just a simple, run-of-the-mill open comedone. I wrote this post, going off of his description of what I had done to his skin (I was blamed completely). When he came in for his treatment afterwards, it was not bad at all. Slight discoloration, no hardening, not even a scab. I had panicked and was looking for any advice about it before I had the full/real story.

Thanks again.

Do you have a picture? Sounds like it definately may be some non compliance. Possible staph is also a concern. lightening could be done depending on his daily activities and home care program.

i thought staph too...  that the inflammation from, and actual extraction aggitated area, and got infdcted.  ni way to know with out pic....

i am curious, was it a large open comedone?

ive had some clients with blackheads as wide as pencil leads or bigger, that leave behind a very over sized pore.  like looking all the way down to dermis..

get him on a good quality vit c serum, and a tyrosene hibibitor before further extraction.  he has to use it everyday for a month before id exrract again.

also, instead of a manual exfoliant, perhaps monthly enzymes.  not enzyme peels, but papaya or pineapple (parovic, bromoline,pardon spelling)

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