Which facial is best for treating blackheads on the nose and cheeks?

Question

I have oily skin and a lot of blackheads, not only on nose but also on my cheeks. What would be the best facial to clear out these blackheads? I have tanned skin and my skin is very sensitive. I had a standard facial at a salon before and manual extractions were done with a blackhead removal tool. The blackheads were very stubborn and my skin was left damaged after this facial. I've researched hydrafacial, microdermabrasion and microneedling but I'm still not sure which is best for me.

Falguni Patel, MD, FACOG · Answer

It sounds like Hydrafacial would be an ideal treatment for your skin! It is safe for most skin types sensitive, oily, and congested. Hydrafacial uses a vortex suction to help remove blackheads, whiteheads, oil, dirt, and product build up in the skin for painless extractions. During a hydrafacial glysal (glycolic acid and salicylic acid) is used as light chemical exfoliation to get your skin ready for easier extractions.

Anil R. Shah, MD · Answer

Hello, Soph! I'm Landry - an aesthetician from Shah Aesthetics located in the Chicago area. Manual extractions can be helpful in removing blackheads; however, the right technique is key as this technique can cause skin damage. It sounds like the latter has occurred. I'd focus on the right skincare protocol to keep oil at bay. Ingredients that come to mind include: Niacinamide (between 2-5%), BHA (such as Salicylic Acid) and Retinoids.

Niacinamide will help control sebum production and therefore reduce pore size as well as inflammation. Salicylic acid exfoliates inside the pores to help clear buildup and reduce the changes of new acne appearing. Finally, the addition of Vitamin A is important to increase cell turnover. This means less build up within the pores which helps lead to healthy new cells.

Building a good routine will help support your skin barrier and therefore lead to more controlled oil production. With acne at bay, then you can focus on treatments such as microneedling to even out skin texture due to acne scarring or even the misuse of manual extractions.

Joe Gryskiewicz, MD, FACS · Answer

Hello, 
I recommend getting a HydraFacial to help clean your pores. HydraFacial will use suction to help clear the pores and the provider can also go in a manually extract as well. The solutions used will help soften the skin and bring dirt and debris to the surface to be extracted. I then would suggest doing a series of chemical peels to keep the skin healthy and minimize breakouts.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for your question. Given your description of oily, sensitive, and tanned skin with stubborn blackheads, it’s essential to choose a treatment that effectively clears blackheads without causing further irritation or damage.

HydraFacial: This treatment is highly recommended for sensitive skin types. It involves a multi-step process that cleanses, exfoliates, and extracts impurities while simultaneously infusing the skin with hydrating serums. The gentle nature of the HydraFacial can help remove blackheads without the harshness of manual extractions, making it suitable for your sensitive skin.

Microdermabrasion: While effective for exfoliating and removing dead skin cells, microdermabrasion can sometimes be too abrasive for sensitive skin, especially if your skin is prone to damage. Given your previous experience with skin damage, this might not be the best option for you.

Microneedling: This treatment is less about blackhead removal and more about improving overall skin texture and stimulating collagen production. It’s not typically used for blackhead extraction and may not address your primary concern effectively.

Considering your skin type and concerns, I would recommend starting with a HydraFacial. It is gentle yet effective in clearing out blackheads and can be customized to suit your skin sensitivity. Additionally, always ensure that any procedure is performed by a licensed and experienced professional to minimize the risk of skin damage.

Lisa M. Jukes, MD · Answer

Hi there! Your esthetician should have prepped your skin to help with easier extractions. Many factors need to be considered however as to why you are getting these recurring blackheads. I'd say our girls would ask you the following:

1. What is your current skincare routine? What brands are you using?
2. Do you double cleanse? If not, typically how often do you wash?
3. Do you work out often? 
4. What kind of makeup products are you using on your skin?
5. Have you ever been on any medications or new changes to medications for you skin/health?
6. What is your diet like?

Another factor we always consider outside of these elements is pillowcases, if you're using too many stripping ingredients, and the best way for you to maintain skin health.

We love a Fire and Ice Facial, Deep Cleaning Facial, or Diamond Glow Deluxe facial. Some patients opt to add dermaplaning (to help get rid of hairs and dead skin cells trapping bacteria). With all these facials, skin prep is as follows:

Double Cleanse, Exfoliation, Extractions (manual and machine), Lymphatic Massage, Mask.

Consider finding a licensed esthetician or dermatologist who can tackle oil production concerns and pigment at the same time. Typically, we opt for microneedling once active acne has subsided. Once you are on your clear skin journey, we like to rotate treatments. 1 month facial, 1 month microneedle.

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