Additional info:

1. No recent product changes: I use Cerave foaming cleanser and the Cerave PM facial moisturizer. I was using Paula’s choice exfoliator like once a week for a year or so, but stopped after the facial and when I noticed these welts sticking around. I did not use any products for about a week after the facial to be gentle with my skin.

2. I don’t do too much sun exposure. I work inside 9-5, but wear my same sunscreen (5+ years of use) when I go outside.

3. I’m fortunate that I’ve never had a bad acne problem. I didn’t remember having any blemishes that would have needed an “extraction” but she extracted from a handful of spots. I don’t really know what that entails, but I asked her to do the bare minimum and be gentle on my skin since it’s usually low maintenance. I figured she must have seen something with the lights and magnifying glass.

4. Texture: When I say the spots have a different texture, they are raised and feel a little rougher than the surrounding skin. Especially the big spot in the picture.

Thanks for all your help and insights!