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.” 
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