Facials: Fact and fantasy
Acne surgery and run-of-the-mill facials are not the same. By Charmaine Mercado

To some, facials are as indispensable as haircuts. To others, they are luxuries. Facials are medically therapeutic for many, while others attest to their powers of rejuvenation and relaxation. Still others feel that facials are fads that will soon die natural deaths.

Facts or fantasies?

What are facials?
Facials are procedures that mechanically clean the outer layer of the skin, remove whiteheads and blackheads and treat acne. "Among dermatologists it's called acne surgery or cleaning," says Dr. Mercedita Marcelino, a dermatologist at the Medical Plaza Makati. "'Facial' is the common and commercial term for it. That's what they call it in the parlor."

But there is a big difference between facials at salons and facials by dermatologists. According to Marcelino, facials done in salons could remove blackheads because these are open comedones, hair follicles plugged with dead skin cells, oil and bacteria that are accessible even without special instruments. Often the "debris" appears black, from the oxidation of melanin, hence the name.

Whiteheads develop the same way but have only microscopic openings. The hair follicles are filled with the same material but because it is not exposed, the debris remains white. These lesions are best left for dermatologists to prick. "Whiteheads, or closed comedones, need special instruments to open the pores and remove what's inside," says Marcelino. "The dermatologist is trained to do this."

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The inflammation and infection in acne often requires medication for control. Doctors are trained and experienced in identifying which pimples need pricking and medication. Steroid injections are one of them. Diluted triamcinolone, for instance, is used to reduce the inflammation. In the wrong hands, these drugs are harmful.

Should I get a facial?
Anyone can get a facial. But there are factors to consider, such as skin type. For instance, those with dry skin should not have facials as often as those who have normal skin do. "You have to be more careful because dry skin can react more strongly to medicines," says Marcelino. "You have to be more conservative." Those with oily skin can also enjoy facials every 2 to 6 months in the absence of skin problems.

"Older people with dry skin can go as long as they use a moisturizer regularly," says Marcelino. According to her, even 60- and 70-year-olds can go for a facial. "Shedding old skin is still different if you have it thoroughly cleaned." For the very young and the very old, see a dermatologist before getting a facial.

But those who have acne-prone skin stand to benefit the most. "You want to remove whiteheads before they even become acne," says Marcelino. "In fact, the primary lesion in acne is the whitehead that will eventually become a focus for inflammation, that's why it becomes a red pimple." Initial treatment may require weekly facials and the use of antibiotics. With improvement, the need for facials decreases.

Mechanical cleansing leaves skin smoother and suppler, but these effects will not last indefinitely. Facials in combination with proper dermatology medication will have longer-lasting effects on skin, says Marcelino.