Not everyone who comes to see me is enrolled in my acne management program.  New clients sometimes say "I just want an acne facial" (which usually opens the door to discussing my program, fortunately.)  Occasionally, however, I hear when I follow up a couple of days later that the treatment made them "break out" even more. 

Does anyone know the physiology of what's going on when this happens?  I am not using Vitamin A-containing products, and the treatment is relatively gentle: cleanse, very gentle manual exfoliation, a light enzyme-based peel, select extractions, and then sterilize, hydrate, apply a light, non-comedogenic moisturizer and sunscreen. 

My latest experience of this was with an 11-year-old girl who has never had a facial treatment before.  When I called to follow up a couple of days later, her mom said the girl was unhappy because her skin had gotten "worse."  We sometimes say to clients "Well, the skin might just be purging, which is good."  Is that really what's going on?

Thanks!!!

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I will just talk from personal experience.  There are times when I don't get the entire lesion out; but I've irritated the pore, so it will come to a head.  One way of alleviating some of that is to put benzoyl peroxide on them like a mask (if they are not allergic) and leave it on after extracting for 5 to 10 minutes.  Wash it off and put on whatever finishing cream you use.    Another idea is to do hi frequency after a treatment, but I don't reeeeally know if that is all that effective.  Do both just to be sure.

It could be several things, one of which you already mentioned. If her skin was under oxygenated with sluggish circulation then it is going thru a sort of "shock" period. The oils have to be rebalance if there was over stimulation as well. As Laura mentioned, if there was any bacteria left on the skin then the Hy frequency would have been a wonderful tool. If you can have her return its not too late to give her a quick trt using it with a calming mist of some sort. Help her to realize that it took more than one day(more like 90) to get  to where she was and final results will take time to achieve as well. By the way do you know if she followed your recommendations for home care?  What kind of pillow case is she using? Does she wear makeup? What Kind?...

Thanks, ladies.  You've given me lots to think about.  I have sometimes wondered if these "break-outs" aren't really break-outs at all, but more irritation.  In the case of this young girl, although the treatment I gave her was mild, her perception was that many of the products I used felt strong; even my nice, mild hydrating emulsion and moisturizer.  It's possible her anxiety caused her to release stress hormones which sensitized her skin, I suppose.

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