There are several types of extractions that a spa professional might perform on a client, depending on his or her specific needs. It’s important to remind clients that extractions should be left to a professional who has fully prepped the skin and is using a magnifying lamp. They should never attempt to perform extractions on their own, as it can lead to scarring and skin damage. Esthetician Lydia Sarfati, founder and CEO of Repêchage, explains the most common forms of extractions.
Milia, tiny white bumps that are produced when keratin becomes trapped in small skin pockets, can be removed with the use of a lancet, which is a sharp-sided tool with a point at the end. Before using this tool, be sure to check with the local state board to ensure it is allowed. “If it is permissible to use a lancet, extract a milia by holding the lancet parallel to the skin and gently piercing the skin in a horizontal motion at the follicle opening,” says Sarfati. “Remember, if you prick the skin with the lancet in a downward motion, you could scar the skin. After piercing the skin horizontally, wrap the index fingers with cotton or sterile cotton swabs, moving your fingers or the cotton swabs while gently pressing down on both sides of the milia. After using the lancet, it must be disposed of in a Sharps box.”
Comedone, the technical term for a blackhead, can be extracted using a comedone extractor in which the tool opening surrounds the blackhead, and pressure is used to help it come out. It can also be extracted using hands and fingers, according to Sarfati. “Wearing vinyl gloves, wrap your index fingers with cotton that’s been doused with astringent,” she says. “Use the sides of the fingertips to exert firm pressure on the skin surrounding the comedone, and lift the blackhead gently. Remember not to use your nails for pressure, as this will dig the impaction deeper into the skin. If it doesn’t remove immediately, with slight pressure from side to side, use alternating angles to gently lift the comedone.”
Comedone extractions can also be performed using sterile cotton swabs. “Hold the swabs with your index finger and thumb, and gently press down on both sides of the comedone,” says Sarfati. “If the contents do not expel right away, move the swabs gently from side to side, and then it will lift up. Do not apply too much pressure, as it could bruise the skin. If the contents are not expelling, leave it for the next treatment, and move to another area. The comedones did not occur in one day, and many times, it will take more than one treatment to clear them all up. Proper at-home care will help prevent future blackheads.”
It's important to remember that estheticians cannot provide medical advice, and must remain within their scope of practice. Cysts and nodules and inflamed pimples like papules and pustules must be treated by dermatologists.