Pimple. Zit. Blemish. Blackhead. Breakout…the list goes on and on.
Whatever the word of choice is, one of the biggest concerns of a new client coming in for a facial is extractions. Estheticians have the responsibility to assess, alleviate and educate clients on the do’s and dont’s of the extraction process. It is our job to provide methods of extraction that are effective, sanitary and safe for all skin types and conditions.
Let’s take a look at some of the tried and true methods of the extraction process and the tools we use to deliver results.
The definition of “extraction” is “the technique of manually removing impurities and comedones from the follicle.” The keyword of this definition is technique. It is absolutely essential that estheticians inform their clients about the importance of proper removal of impurities and why this process should be left to the experts. A client should never, and I repeat, never perform extractions at home. The risk of spreading bacteria, pushing bacteria deeper into the follicle, and damaging the surrounding skin is likely with improper extraction techniques and magnified when performed by a non-professional.
In-home extraction by clients are often performed in dimly lit bathrooms, in front of a mirror, bearing pressure straight down fiercely with the fingers…or finger nails! You can envision it, can’t you?
As skin care professionals, we are trained in the proper removal techniques and have access to the proper tools, lighting, and products to minimize the potential for spreading bacteria.
Let’s review the various professional extraction options.
Also note that as professionals, we should only be extracting low levels of acne, grades one and two primarily. As for advanced levels of acne classified as grade three or four they should be referred to a dermatologist for removal.
• Cotton Pads
Our most familiar and basic method of removal, the use of our skilled index fingers wrapped in astringent soaked cotton. Place index fingers on either side of the comedo and apply a bit of pressure at an inward and downarwd direction. If there is difficulty, move fingers side to side lifting out the impaction. Always remember to utilize the pads of your fingers versus the nails to lift out extractions, this will prevent any bacteria from being forced deeper into the skin.This method gives you a softer and more gentle approach making it a nicer experience for first time extractions. This technique is ideal for clients with both open and closed comedones (blackheads/whiteheads) or more sensitive skin. For ease of extraction and protection of the skin be sure to prep the skin with a manual exfoliant or enzyme and distant steam before beginning. For super efficacy as well as difficult impactions, the use of a desincrustation solution (ex. Sodium borate) to soften and liquify sebum is highly recommended.
The down side of the cotton method is that you are limited to your ability to access certain areas of the face easily, such as the corners and tips of the nose. Depending on where your extractions are, the tips of the fingers may be too large to precisely extract from a given location. Overall, this universal method of extraction can be used in any facial treatment situation as long as the skin has been softened and the excess dead skin removed beforehand.
• Cotton Tipped Applicators
This is a highly effective method commonly used by professional estheticians. The six inch cotton tipped applicators, or cotton swabs, allow for precise and targeted comedo removal. Applicators are held with the index finger and thumb then placed on either side of the comedo; light, inward/downward pressure is then applied. Gently move the applicators side to side and lift. This method is especially effective for extractions that are deeply impacted or in difficult to reach areas (ex. sides of the nostrils). Keep in mind that the use of these applicators requires light pressure to ensure the skin is not abraded or bruised. If the extraction will not expel after three attempts, move to a different area of the face as the impaction is clearly not yet ready to come out. As with all methods of extraction, preparation is essential to ease the process of removal and prevent damage to the skin.
• Comedone Extractors
These metal tools are designed with a loop at one end to surround the comedo, and with the application of even pressure, lift the extraction from the skin. Comedone extractors come in a variety of styles depending on the type of extraction being performed. Spoon, Loop, Angled, Small and Flat Loops are amongst the most common extractors available. They range in design from more aggressive to those that minimize the amount of damage possible to the skin. The use of these tools takes a highly trained hand and clients should absolutely be advised to refrain from using them at home. Be conscious of the fact some states regulations regarding the ability as professionals to utilize these tools can vary. Check with your State Board to review the rules and your scope of practice.
• Lancets
Common uses of lancets at home are blood draws for diabetics. In skin care, a lancet is a tool with a pointed end used for the extraction of milia. Milia is the buildup of keratin trapped under a superficial layer of skin, most commonly found in areas around the eyes and cheeks.
Extraction of milia is approached differently than that of other extractions due to the need to create an opening in the skin allowing for the debris to be removed.
Use the lancet to poke a small opening into the milia, parallel to the follicle opening. Using the lancet in a downward motion can cause damage and create a scar.