Acne: Should You Extract or Let It Heal Naturally?

Acne

I would like to ask the doctor...
I have an issue with comedones (blackheads and whiteheads)...
so I started using alpha hydroxy acids (AHAs) for the past month or two.
During this period, I have been extracting the comedones, but after 2 to 3 days, the same area develops comedones again.
Each time I extract them, they come out in a stringy consistency, similar to squeezing toothpaste.
Should I be extracting these comedones? When using AHAs or salicylic acid, is the goal to bring the comedones to the surface and turn them into acne, or is it to allow the comedones to gradually disappear on their own?

k, 20~29 year old female. Ask Date: 2007/05/01

Dr. Huang Ruiyun reply Dermatology

Nasal comedones, from a certain perspective, are a normal occurrence for most adults, especially males.
Regardless of how they are managed, they will eventually recur.
Do not expect the impossible.

Reply Date: 2007/05/01

More Info

When it comes to managing acne, particularly with the presence of comedones (commonly referred to as blackheads and whiteheads), there are several considerations to keep in mind regarding extraction versus allowing them to heal naturally.

Firstly, it is essential to understand the nature of comedones. They form when hair follicles become clogged with oil (sebum), dead skin cells, and sometimes bacteria. The process of using acids like alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) can help exfoliate the skin, promoting cell turnover and preventing the clogging of pores. These acids can also help reduce inflammation and improve the overall texture of the skin.

Now, regarding the question of whether to extract comedones or let them heal naturally, there are pros and cons to both approaches:
1. Extraction:
- Pros: Extracting comedones can provide immediate results, clearing the clogged pores and potentially preventing the development of more severe acne lesions. When done correctly, it can lead to smoother skin and a reduction in the appearance of acne.

- Cons: If not performed properly, extraction can lead to skin irritation, inflammation, and even scarring. Additionally, if the underlying causes of acne are not addressed, new comedones may form shortly after extraction, as you have experienced.

2. Letting Them Heal Naturally:
- Pros: Allowing comedones to heal naturally can reduce the risk of irritation and scarring. The skin has a natural healing process, and sometimes, with the right skincare regimen, comedones can resolve on their own without intervention.

- Cons: This approach may take longer, and some individuals may find it frustrating to wait for the skin to clear without immediate results. Additionally, if the comedones are not addressed, they can develop into more inflamed acne lesions.

Regarding your specific situation with the use of AHAs or BHAs, these products are designed to help exfoliate the skin and can indeed help to bring comedones to the surface, making them easier to extract. However, it is crucial to use these products as directed and to allow your skin time to adjust. Over-extraction or aggressive exfoliation can lead to irritation and may worsen acne in the long run.

In conclusion, the decision to extract comedones or let them heal naturally depends on your skin type, the severity of your acne, and your overall skincare routine. If you find that you are consistently experiencing new comedones in the same areas, it may be beneficial to consult with a dermatologist. They can provide personalized advice and treatment options tailored to your skin's needs. Additionally, they can perform extractions safely in a clinical setting, reducing the risk of complications.

Ultimately, maintaining a consistent skincare routine that includes gentle cleansing, exfoliation, and non-comedogenic moisturizers can help manage acne effectively. If you are unsure about the best approach for your skin, seeking professional guidance is always a wise choice.

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