It starts with understanding the type of lesion you
are working with and the client’s skin, along with a
knowledge of the tools, products and techniques that
support proper extraction—and which to avoid.
Types of Acne
There are many different types of acne, and
understanding the root cause and how each displays
in the skin will help you diagnose which type you are
working with. It will be clear cut in some cases, but
other times it may be a process of elimination. The
primary types are explained here.
Hormonal acne (Acne vulgaris). This is the most
common type of acne, primarily among adolescents. It is
characterized by comedones, papules, pustules, nodules,
cysts and sequelae, such as pitted or hypertrophic
scars. Acne vulgaris is caused by Propionibacterium
acnes (P. acnes). It typically allows for good extractions;
however, the right enzymes, AHAs and other exfoliating
ingredients can help do most of the work. A quality
at-home system and lifestyle changes will be important
to remedying this type of acne.
Cystic acne. This type is typically triggered from
an excess build-up of sebum and dead skin cells. This
combination blocks oxygen from reaching the cells and
increases the P. acnes bacteria. Due to the tightness
of the keratin in some cases, it will start to grow
underneath the skin. Cystic acne can become painful and
infected if you are not careful. Typically, these lesions
are not extractable and forcing this can lead to scarring,
which is why using ingredients that help draw bacteria
to the surface is recommended. Clays, for instance, are
a great partner with cystic acne. Exfoliation a few times
per week and professional treatments are crucial to
Acne cosmetica. This type of acne is caused
or stimulated by cosmetics. These are usually
non-inflammatory, and indicated by small and slightly
raised red lesions, whiteheads and occasional pustules.
This type of acne is not as common, as cosmetics have
improved significantly and many products are now
labeled as “non-comedogenic.” It is still important;
however, to know every product your client is using to rule
this out. This can usually be corrected by eliminating the
acne-producing cosmetic and replacing it with a home
regimen focused on cleansing and protecting.
Acne mechanica. Constant pressure, friction or
repetitive physical trauma to the skin—such as rubbing
from hats or other materials, phones, sunglasses,
etc.—causes this type of acne. Professional enzyme
treatments and a home care regimen that includes a
blemish serum and all-purpose cleansing pads will help
to restore skin health.
Acne rosacea. This primarily impacts adults and
is more likely to occur in women than men. It is
characterized by erythema with telangiectasia (small,
dilated blood vessels near the surface of the skin).
Lesions tend to follow the blood vessel dilation with
papules and pustules forming in the center of the face,
cheeks and chin. They are typically large and painful.
Acne rosacea is genetic, chronic and progressive.
Eliminating irritants such as excessive spicy foods,
caffeine, tobacco, alcohol, saunas and stress will support
the healing of this type of acne; professional peel
treatments and consistent home care are also essential.
Pseudofolliculitis barbae. This is more common
in men and occurs when coarse, curved hair
penetrates into the skin before it leaves the follicle
(also known as ingrown hairs). Salicylic acid is a
key ingredient to help prevent the formation of this
type acne. Mandelic acid is also a great alternative
for a gentler approach. For treatment, focus on
exfoliation—both physical and chemical.
Types of Acne Lesions
Along with the different types of acne, there are
also varying types of lesions. These will typically
fall under one of two categories: inflammatory and
Non-inflammatory acne. Non-inflammatory
lesions are considered comedones and may be closed
[MASTER] THE ART OF EXTRACTIONS
lesions are typically