I hope this is not a silly question… What type of acne lesions can we extract? I was taught at school that we should extract only blackheads. Extracting whiteheads or other types of acne lesions can damage the skin. Is this true?

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No question is silly. That is my understanding as well, although it was also a legal issue as to what estheticians are permitted to do in my state (similar to most states, I believe).

Even whiteheads that appear to be so surface are actually not. They are in the dermal layer (Ellen Marmur, MD) and as such are not our domain; our domain being the epidermal layers.

There is much in the way of varing opinions when it comes to extractions, but first make sure you know the your  estheticians' license perameters in your state. This is a great area for further reading, studying and continued ed. 

You really cannot help acne clients by just extracting blackheads.  I never heard of not being able to extract white heads while in school.  I'm in CA.

 I have my clients ice after treatments twice a day for 3-5 minutes only.  I freeze water balloons and keep them in sandwich bags and give them to my clients. I found that many clients would not ice on their own so when I started giving them out my clients were seeing clear skin.  Be sure to explain that the inflammation is what causes scaring.  You need to reduce the inflammation after extractions and anytime they feel a pimple coming on. 

Take a course on extractions, this always helps.  What state are you in?

Hi Denise - I do think states may differ a bit in what type of extractions their estheticians are licensed to perform. The thing about white heads (closed comedons) that differs from black heads (open comedons) is that you would be breaking through the skin instead of just coaxing  a softened plug out of an already open pore.

Icing is a great addition to help treat inflammed pores.

Thanks for the great information ladies
@ Denise- I am in the state of California. I am looking for a class in extractions, but I can't find any. I watch tons of YouTube videos, but everyone does it different and some of the videos contradict itself. I was working with a client at school and she have several whiteheads. I was getting ready to extract them, but my professor stop me. She mentioned whiteheads should not be touch. The whiteheads will eventually heal itself.
Well, I must confess that I extract them all with the exception of big cysts. I don't really know what we are "supposed" to extract or not - I just know what I do..... sorry. I don't feel like the skin gets damaged.

I do as Laura, however I'm extremely selective about the whiteheads. I don't mess with them unless they are so close to the surface that they start to come out /bleed and ooozzzz just from cleansing:)

@Liz - do you mean pustules? Whiteheads are a non inflamed lesion, a closed comedone.

If you do not extract inflammed papules or pustules, you can actually cause more damage to the skin- The P bacteria can multiply so much in the follicle, that the follicle can rupture and spread bacteria throughout the epidermis- This can lead to further breakouts and cystic ance. When you extract, you need to make sure you are doing it properly. Using steam or an enzyme to soften the skin before is best. If your state allows you to use a lancet, make sure you are lancing properly. Holding the skin tight, and using wiggling motions can help the build up extract easier. Make sure you clean up the area properly, and it is best to use a soothing masque after.

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