Authorized Picking / Comedone Extracting
Finally, what you’ve been waiting for: permission to engage in “picking” or extraction as it is called in the doctor’s office. Picking is a double-edged sword. If you pick a new, developing lesion, you may drive it deeper and cause greater inflammation and potentially deeper scarring. On the other hand, if a lesion is a mature pustule, proper extraction will speed healing, stop tissue digestion and reduce scarring. It’s all a matter of doing it right.
First rule: Don’t even think about extracting until your regimen has been followed for at least three weeks. First give the products a chance to “open up” the skin and loosen impaction's.
Second rule: Recognize which lesions can be extracted and which ones cannot. A blackhead can be extracted rather easily because the pore opening is already dilated and the impaction has moved up to the surface. A whitehead can also be successfully extracted if it is reasonably close to the surface and you are able to dilate the pore opening with a sterile needle. Leave an inflamed papule alone. After several days when you notice a yellowish center developing in the papule, pus has moved up to the surface bringing the impaction with it. Then, it is ripe for extraction.
On the other hand, an immature nodule, which is a deep, undefined red bump, cannot be extracted by an amateur. Often it cannot be done by an expert either. Any attempt to do so will only make it worse. This is also true for most cysts. Leave them alone! Instead, employ ice applications to reduce the inflammation. However, there is one kind of cyst that can be extracted: the “ripe” cyst which features a soft, pus-filled pocket near the surface. This may benefit from extraction especially if it has an obvious center to serve as a draining point but one must be able to recognize the center. That spot will be softer and purplish or, at some point, a pore opening may become visible; then you can open the lesion with a sterile needle. However, if the cyst is a hard lump or is very deep or very sore, leave it alone or leave it to a professional therapist in a doctor’s office.