21 replies to this topic

[heyo]

Has anyone had success at extracting closed comedones (i.e. the whiteheads that are under the skin). I know this is the source of all my breakouts and I only have a handful left and would really like to know the easiest way to do this.

I have not yet found an esthetician in my area that really is good with acne, so if anyone knows one in the metro Detroit area that would be great as well!

[Stu2u]

The best way I have found is to lance them with a lancet used by diabetics to prick their finger, and then squeeze at the base with your nails.

[heyo]

The best way I have found is to lance them with a lancet used by diabetics to prick their finger, and then squeeze at the base with your nails.

Does that method ever go bad on you? And where do you get the lancets?

[Stu2u]

No I've never had a problem, I use the lancets because they are very sharp and cheap, I throw it away after use, I bought a box of them from my local chemists. Anything sharp and serile will do.

Some can be fiddly and may need pricking more than once, my skin always heals up without a trace.

[Stu2u]

This shows a similar way

http://uk.youtube.com/watch?v=EcPGKYslrJo

I prefer to use my nails to squeeze it out, that's something a pro isn't allowed or shouldn't do.

[heyo]

Do they ever just blow up into big pimples from you messing with them? How deep do you have to press the lancet in? I tried earlier but don't think I got deep enough to get into the actual comedone.

Anyone else try this?

[mangos21]

i want to try this...but i don't know where to get an effin lancet haha. i have several large closed comedones..

where did u get urs heyo?

[heyo]

I haven't found one either but my guess would be a Drug store or pharmacy because diabetics use them.

I'm scared that I'll just make matters worse doing this but if it works it would be such a great thing.

[mangos21]

yeah..i'm afraid it'll blow up into a monstrosity or something.

[Mans]

Got to a professional. Please. Do not ever perform even the simplest and basic acne surgery at home. These things are under your skin (I have them too) and pricking them with a lancet won't do the trick. Go to an experienced dermatologist to do it for you or a facialist.

You'd probably make things worse if you do it all by yourself.

All the best !

[intoskin]

I definitely agree with Mans. I'm an esthetician and if you don't know what your doing you can cause trauma to your skin. Leaving scars or bruises. Also if you don't remove all the debris from the pore then yes you will make it worse causing an ifection in the pore making it a simple comdone into a huge infected pustule. Go to a esthi or derm. If you do do it steam your face first to at least loosen the pore you can do it in a hot shower or over a bowl of HOT water with a towel over your head and the bowl for 5 min. But i don't recommend it. I don't even remove my own. I have other estheticians do it.

[intoskin]

By the way the video on the milias is completely different than the whiteheads you get around the chin or forehead. Milias are caused by not removing your eyemakeup properly and typically are around the eye area from heavy concealers and product left on the skin. Do not remove those only dermatologists should do this.

[Stu2u]

By the way the video on the milias is completely different than the whiteheads you get around the chin or forehead. Milias are caused by not removing your eyemakeup properly and typically are around the eye area from heavy concealers and product left on the skin. Do not remove those only dermatologists should do this.

I don't wear eyemakeup and have had Milia so your post is incorrect and misleading.

I've removed all my own Milia/ whiteheads without any problems so yet again your other post is incorrect and misleading.

Of course like me you are entitled to voice your opinions on here just like me, and it is up to the individual to make up their own mind, one thing I would say is that as you do this sort of thing for a living you have a vested interest in getting people to go to a professional and part with their hard earned cash, I on the other hand am simply passing on my own personal experiences to help people to deal with their problems in a cheap and effective way.

[willow569]

Notice that the video you linked to does say "Do not attempt without proper training". I don't think the video was meant to teach people at home how to do this on themselves. It is part of a training series for skin care professionals.

The spots he is extracting in the video look very close to the surface of the skin, which makes them easier to extract. Many people who have closed (or open) comedones have spots that are much deeper under the skin than that. Trying to extract those yourself at home can be difficult and may do damage to the skin.

[macdaddyz1]

i had this procedure done today by a board certified dermatologist. not to scare anybody but this was the most painful procedure ive ever had done in my life. after i got home some of the unclogged pores continued to bleed for quite a bit. i would recomend it but its not the most gentle of procedures out there!!

[kevin1995]

i went to a facialist last week...it's really a extremely painful experience..the facialist extract everything out..left red marks..but it'll fade in couple of days..or weeks..

[willow569]

Just to give the full range of experiences - I don't find extractions to be very painful most of the time. When I first started getting them, I had some soreness afterwards but I don't get that anymore. It also may differ depending on who is doing the extractions. I have been to a few different estheticians at the clinic I go to and with some are gentler with extractions than others.

[skinstudioneworleans]

I am a licensed esthetician as well. Most of my clients see me for acne. I, too, recommend not lancing your own closed comedones but for slightly different reasons.

I do think that the video linked is an accurate picture of how most estheticians or dermatologists would lance and extract a closed comedone. I do think it's physically possible to do this in a safe and sanitary way at home, preferably using diabetic lancet and two q-tips with a press-and-roll motion rather than the long needle and pro extractor tool (which can gouge skin if used overzealously). I definitely do not think it's possible to do this safely with your fingernails.

But the reasons I don't recommend doing this on yourself are #1: skin preparation and #2: line of sight.

If you have a microdermabrasion machine, ultrasonic machine, enzyme and acid peels, a steamer, and a high frequency machine to use afterward, and know how to use it all, congratulations, you probably don't have acne any more. This prep is crucial to getting good extractions.

But I have all of these things, and still don't extract my own closed comedones, and the reason is because of the line of sight. While you can get a good view of lesions on the center of the forehead, between the brows, on the nose, upper lip, and chin, you really can't get a great line of sight in a mirror on lesions that fall outside of that center 1/3 of your own face, which is where most (not all) closed comedones occur. Most of the closed comedones I extract on clients are found on the cheeks, jaw, temples, hairline, and other areas towards the sides of the face (whereas more abundant open comedones are found in the t-zone areas between the brows, on the nose, and on the chin). I do not find that I can get a clear enough line of sight to get good dilation of the pore and correctly see the slant of the pore to know what angle pressure to use. I'm 25 with perfect vision--this isn't an eyesight problem, it's a geometry problem.

As several people have mentioned, not every professional doing extractions does them exactly the same way, and experience is a factor in getting a clean extraction. After about a year of doing 4-6 facials with extractions every day, I had an "aha" moment where I finally learned, by experience, how to "see" the angle of the pore, which meant I could dilate the pore more precisely (instead of just jabbing a lancet at a random angle), and I could apply less pressure by using the natural slant of the pore as a guideline. I went from most of my extractions on clients bleeding and not being extracted completely, to most of my extractions not bleeding and a high level of confidence that I am getting the complete impaction out of the pore. This after a full year of working on primarily acne clients every day. I don't feel that I would have stumbled upon this awareness, or the subsequent nuanced technique I am able to employ, by just extracting on myself, but if you have it figured out, congrats!

In conclusion, my recommendation is to stick to open comedones and pustules with very visible white heads for home extraction. Do both of these types of extraction with a diabetic lancet and two q-tips, and very gentle, slow pressure. Dilate the pore opening if you can find it; if not (and it is a pustule with a white head), pierce it from the side and then press and roll your two q-tips in and down, towards the lesion which you have centered between the two. Get your closed comedones extracted by someone who knows what they're doing, and then by all means follow your topical routine so that you don't have to have extractions often! As a professional, I love nothing more than seeing my acne clients graduate from facial with extractions to just a peel or just a microdermabrasion... It's quicker for me, they save money, stay clear, and recommend me to their friends and family.

[Naef Basile]

The solution to opening a pustule is in SEEING the opening, which is closed by an overgrowth of dead skin cells. While this is easy with regard to a whitehead, it can be very tricky if the pustule is below the skinline, presenting itself as as a "bump" which feels like a nodule if you press it lightly. A nodule is a mass of infected material which is trapped lower within the follicular canal. It is CRUCIAL
that both types of pustules come out. Why? Because the bacteria release toxins which DESTROY TISSUE. There is just so long that the pus can remain in the follicle before the bacterial toxins destroy the inner wall of the follicle (this is the pore emanating from the sebaceous gland below) and go on to destroy the dermis below the surface of the skin. That is the process which causes the scar. Once the bacterial toxins have detroyed tissue, the skin will eventually collapse, leaving a depression which then heals below the surface of the skin.
To detect the pore openings above these deeper, closed pustules, one must remove absolutely all oil and dead skin debris in order to see them. Buy small gauze pads and a bottle of 90% isopropyl alcohol at the pharmacy. Wash your hands and completely soak a gauze pad with the alcohol. Using moderate force, press down as you pull the gauze pad across the area where you felt the pustule (or multiple pustules). This has to be be done multiple times, turning the pad over after 3-4 wipes, and using the other side. It is likely that the first pad will become slightly discolored. Completely soak a second pad with the alcohol and continue to wipe the same area, again using moderate pressure and turning the pad. The goal here is to remove absolutely anything and everything that could prevent you from seeing the closed pores above the deeper pustules.
Now, (and this is very important) soak another gauze pad with alcohol and clean YOUR FINGERTIPS
thoroughly. There cannot be any oils on your fingertips. At this point, your skin and your fingertips should both feel as dry as possible. Why? Because now, you must stretch the skin to make the closed pores visible. Simply use your finger tip to feel for a closed pustule. Then, place two fingers on one side of it, and two fingers on the opposite side of it. Stretch the skin as much as necessary to locate a tiny opening above where you felt the nodule. If you close-range vision is not good, you will need to purchase an inexpensive pair of magnifier glasses (at least +2.5 strength). I would not buy a magnifying glass, because you will need one hand to keep the skin stretched. Here is where you will have to place some trust in an old, formerly ignorant victim of acne scarring. The truth is that the diabetic lancets are too sharp to open a closed pore. They are okay for opening the tip of a whitehead, but for a closed pustule, they are so sharp that in attempting to break through the dead skin which closes off the follicle, you could easily cut into tissue surrounding the opening. Then, you have a mess on your hands; (a red one). The pore's opening is a tiny target, even when stretched.
This is when you go German. There is this place in Germany called Solingen. This town is world reknowned for making extremely precise stainless steel instruments and cutlery. The Germans have a well known propensity for detail, and in Solingen, they make the best acne lances in the world, using surgical-grade steel. Yes, the lance costs more than a box of diabetic testing lancets, but this is your face; You don't want the scarring to occur because----there is no second chance other than CO2 laser resurfacing, a chemical peel or the new fraxel laser. Unless you have $2000. that you can spare, the scarring doesn't go away.
The tip of the curved blade at the end of the lance's handle is very sharp, but not ridiculously sharp, as is the the diabetic's lancets. It is more forgiving of mistakes. Notice that I said CURVED blade. Know why? because the lance allows you to PULL at the closed opening with the curved tip pointing downward. There is no jabbing going on here. In fact, you are not holding the instrument directly above your stretched skin; You hold it at an angle. Using only the lightest touch, touch the tip of the lance to the perceived opening, and very lightly scrape at the surface of the opening, to dislodge any dead skin cells which may be hindering your view. Remember to use your other hand to keep your skin stretched. Carefully try to insert the downward-curved tip of the lance into the surface of the pore, and use the least pressure possible to pull the top of the follicle open. DO
NOT push deeper if you are unable to break open the dead skin at the top. Rather, re-stretch the skin and again insert only the tip of the downward-curved blade. If you are not sure if the lance's tip is really in the pore, STOP! Again, restretch the skin and using only as much pressure as necessary, pull the blade just enough to try to pull open the top of the closed follicle. When it opens, you should not see blood. If you see blood on your first couple of tries it doesn't mean that you won't eventually succeed. Just practice. Keep the skin void of any oils, as well as your fingertips. The stretching must be optimal, and that is difficult to achieve with slick skin.

Now, you DO NOT SQUEEZE it! You should purchase a Schamberg-type comedone extractor. This is an extractor with loops on each end, rather than the circular shape. It is a type which is now widely favored by dermatologist MDs. An excellent one is made by Miltex. Unless you have large closed pustules, go with a small x-fine Schamberg. It has one larger loop on one end, and small one on the other end. If the closed pustules are very large, buy a medium size one.
Again, stretch your skin if you have lost track of the follicle which you opened. Depending on the perceived size from your initial touching of the pustule, position the small loop or the larger loop
on the skin so that the opened pore is centered within the loop. These loops have a very slight curve to them, and the outer side of the curve should be against your skin, with the tip of the loop curved up and AWAY from the skin, not pointing downward. Using only a moderate amount of pressure, press the the loop down, making sure that the opening is accurately centered. If you do not see anything come out, use a slight increase in pressure. Remember, if the pustules are small, you should be using a small size x-fine Schamberg extractor and employing the small loop. A large loop on a small pustule accomplishes nothing, and a small loop on a large pustule will result in trauma to the tissue around the distended follicle, as if pressing the edges of a small soup ladle down on a large water balloon. In short, don't use the wrong size loop!
The curvature of the Schamberg-type loop allows you to slide the tip slightly forward and backward, and"rock" the tip so as to "milk" all of the infectious material. This not at all like squeezing, because you are still pressing DOWN, not from the sides. The dermatologists state that the common urge to squeeze deep closed pustules from the sides results in the trapped pus rupturing into the surrounding dermis and even down into the connective tissue below. That is why they use comedone extractors.
Once you have expelled all of the whitish pus, you may see blood, possibly mixed with transparent plasma, exiting the the follicle. This is simply the result of capillaries having been broken open by the bacterial toxins. It should not be viewed as evidence that you have done something wrong. In fact, a bit of blood is usually an accurate sign of whether all of the pus has been expelled from within the follicle. Soak another gauze pad with the 90% alcohol, and wipe away the residual blood.
By the way, you must use the alcohol and a gauze pad to sterilize the lance and extractor before and after a session of extraction!
Immediately after this, wipe the spot with a salicylic acid cleaning pad. (OXY max is a good one.)
These pads come in small airtight cylindrical jars and number approximately 60 pads per container.The jar must be kept TIGHTLY CLOSED so as not to allow the alcohol-based pads to dry out. You may feel a slight sting, only because a tiny bit will access the evacuated pore. Once you feel that tiny sting, you are home free. Salicylic acid is effective even on small plugged blackheads that are completely blocked. However, when it is applied to the site of an evacuated pustule, "the door is open", and you are sending in something very potent.
It is essential that you use an exfoliative scrub to wash your face every day. I buy a ton of "Clean&Clear Deep Cleaning Scrub" for my teenage kids, as well as a ton of "OXY max" salicylic acid cleansing pads; (yes, the German lances and small Miltex x-fine extractors too.) I buy the lances from Zamberg.com. If the $98. for the lance is too much for your budget, try to find an American-made one. DO NOT buy one that costs $4.95! Remember that it is supposed to qualify as a surgical instrument, not a poorly-formed knock-off that looks okay on your monitor, but was
fabricated with the accuracy used for a $1. box of nails.
I wish you luck. My face was destroyed in 1972, at the age of 18. It would not have happened had I known what I know now. Even after the CO2 laser and several surgeries, all of the tissue below my cheekbones is sunken in and scarred from cystic acne. Don't procrastinate. The emotional consequences are life-altering-----------not in a good way.

Edited by Naef Basile, 03 October 2010 - 02:47 AM.

[Hexie]

The best way I have found is to lance them with a lancet used by diabetics to prick their finger, and then squeeze at the base with your nails.

Nooo! Squeezing with nails is very bad idea! I've done that in the past and ended up taking huge chunks out my face.

As for the closed comdones, they work their way to the surface with time and become big blackheads then you can gently remove them and all of it will come out. If you try to remove them as closed comdones they will keep coming back. Thats what happened for me anyway.