Don’t Let Your Aesthetician Do This

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An aesthetician is one of the first people we turn to when our skin isn’t up to par. However, when it comes to milia, those stubborn small bumps that look like whiteheads on your face, you may want to rethink who you go to. In fact, it’s actually against the law in many states for an aesthetician to extract milia.

“First of all, milia are small epidermal inclusion cysts that have no opening to the skin's surface,” says San Antonio dermatologist Vivian Bucay, MD. “Extracting them usually involves using a needle or the tip of a scalpel blade to create an opening in the skin and then applying pressure to force the milium through the small opening that has been created.” 

“If you don’t go to someone who is familiar with the use of the lancet, you are running the risk of scarring the patient,” says Smithtown, NY, dermatologist Marina Peredo, MD. That’s why it’s important to only go to a physician, physician’s assistant or a licensed nurse to do the procedure. 

Of course, it’s always better to avoid getting milia in the first place. “The best way to prevent milia is to keep cell renewal and turnover at its optimum with nightly use of a retinoid like over the counter retinol or prescription tretinoin, tazarotene or adapalene,” says Dr. Bucay. “Regular exfoliation with a gentle scrub and/or a glycolic or salicylic acid based facial product like a cleanser, cream or lotion is also helpful.”

22 Comments
  • Krystal
    Posted on

    So glad other "estheticians/aestheticians" are standing up to this article. What a shame! Who's approving these articles promoting misinformation? I work under a licensed Dr. and he trusts me 100% with the removal of milia. Most aestheticians do this type of work because the Dr.'s feel that this work is too simple or their too embarrassed to say they haven't been trained on such. So after a potential client reads this article they will be misinformed or better yet uncomfortable with me treating their skin condition which I am 100% trained and qualified to perform. Please rethink these articles you promote.

  • Michelle
    Posted on

    I've been a medical esthetician and laser technician for over 5 years . Agree with most here - most estheticians are more than capable of extracting milia - with the exception of those that are located in high risk areas like close to the eyes or on the vermillion border of the lip . I myself do not use lancets - I find them old fashioned and way less efficient than removal with a Lamprobe. To me that is the ideal tool for milia removal .

  • Lisa
    Posted on

    Please!!!! Give "qualified Aestheticians " more credit then that. Truth is, they can do a better job with less down time and discomfort then most. The ownership of this industry is getting way out of hand. New Beauty Magazine, lets rethink the articles you post. I'll bet if you took a poll on your readers and people that recommend your magazine, they are aestheticians of all levels.

  • Margot
    Posted on

    I am an Esthetician in Illinois. Licensed. It is illegal in the state of Illinois to use lancets. Period. And there is no difference between what an Esthetician and an asthetcian does. It's the spelling. If you are a medical Esthetician though you work under the license of the Dr as well. Even in the state of Illinois. And in that case the use of a lancet may be allowed.

  • Monica
    Posted on

    Same as Angela mentioned above in CO Drs wont do milia extractions. I used to work for one and she and the other drs referred all patients to the estheticians to remove their milia. I also heard about other estheticians whom do not want to extract them because are afraid of scaring. Before I became an esthetician I asked my dermatologist to remove a milia (this was in a different state) and I got charged $86 for surgery, which its insane since it took him 5 min. When I do extractions I don't charge extra for them. It would of be nice to being able to just add on $86 for each milia removed.

  • Anonymous
    Posted on

    It is illegal to use lancets in the state of Illinois. Under a medical Dr in a Dr office it would be under that license. And if something went wrong they would hold the liability. I don't believe Retinoids or mild exfoliating would help.

  • Carly
    Posted on

    To Vicki - I am a licensed Esthetician and certified Medical Esthetician. I took a course for it. I work in a medical clinic and am considered part of the team there. I most certainly am in the medical field and currently am in school for more medical classes. I follow all state guidelines as an Esthetician. You are not in my state so I don't understand what your problem is. LED is still used in California as far as I know, however I don't use it because I don't believe in it and think it's outdated. If you can call yourself a Master Esthetician (Virginia sounds like a sad state to be an Esthetician in) then I can call myself a Medical Esthetician.

  • Anonymous
    Posted on

    Way to promote physicians only... New beauty must have forgotten estheticians read their mags and suggest their clients to read it as well. Terrible article, milias are so easy to extract if your esthetician cant extract them properly (if they are in a state that its legal) you need to find a new esthetician because i would not trust them with my face in general.

  • GlamGal
    Posted on

    I agree with Meg above, this article is inflammatory to the beauty industry professionals out there. I am licensed medical esthetician and have been trained to use a lancet as well as the training to know when not to use it. To say that only a doctor should remove milia is really a strong statement that offends me and my professional training and skills.

  • Anna
    Posted on

    Please rethink deleting this post--it is untrue and incorrect on all counts.

  • Meg
    Posted on

    You really ought to remove this article. It disparages the professionalism and training of estheticians, and also promotes products that have been proven to cause damage to the skin. Dr. Peredo is right, you can get scars from improperly used implements, but I have scars from medical procedures and none from my esthetician. This article is truly inflammatory, and your summary line, "That’s why it’s important to only go to a physician, physician’s assistant or a licensed nurse to do the procedure." is simply incorrect. It is important to go to a TRAINED, EXPERIENCED, LICENSED professional for this. Estheticians are.

  • sally d
    Posted on

    I have a few milia on my face. I was wondering what they were. Thanks to your post I now know what they are. Is extracting them the only way to get rid of them?

  • Sharon
    Posted on

    That is such bull. Any trained esthetician can do millia extractions. I was trained by a doctor and the doctors in the area send their patients to me to do. It's not brain surgery for god sakes. Who makes up these stupid laws. If they don't want estheticians to do anything. Just pull the dam thing from the state board and stop pumping out esthetician out of beauty school. stupid statement

  • Vicki
    Posted on

    As far as I know there is no medical esthetician licensing in any state! Calling yourself a medical esthetician implies that one is a part of the medical field. This is what has caused issues with estheticias such as the elimination of LED in California by estheticians. However I am an experienced Master Esthetician (that is my license in my state of Virginia) and I am experienced in using lancets to extract milia. Also preventing them is not as easy as this article states.

  • Liliana
    Posted on

    One thing should be noted, the difference between "esthetician" and "aesthetician" also determines which services each can perform.

  • Angela
    Posted on

    I'm a medical esthetician in Colorado and I have so many clients come to me for this. Why? Because dermatologists here DON'T DO IT. They think it is below them to do this and tell women Retin A will reduce them. Hahaha.

  • Carly
    Posted on

    I am a medical Esthetician in California and it is illegal for us to do this in the "sue happy" state. Rules and regulations are very strict here. Any time one of my patients wants me to extract something like this, I let them know it is not allowed and refer them to a dermatologist. Sometimes it is unfortunate the things we are not allowed to do but it can also be a good thing. I love doing treatments that can make a big difference (such as chemical peels, micoderms, and body sculpting machines) but not doing anything too invasive keeps me out of trouble.

  • Ja'Mel
    Posted on

    I agree with you Felicia & India. I work at a Medical Aesthetics/Spa in Maryland & I just asked this question to our Aesthetician, she advised that she was trained to removed Milia's & does do so in our practice at the PT request. So, this should be more specific and not generalized.

  • India
    Posted on

    Yes Felicia I totally agree. I am in educator of Aesthetics in Indiana and we are also legally allowed the use of lancets. Yes it is true that damage can be done if used incorrectly. But making sure my students are trained correctly is something I take strong pride in. If an Aesthetician is not extracting w/a lancet correctly I fault the instructor/school.

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  • Missy
    Posted on

    What does the scarring look like if the extractions were done incorrectly?

  • Felicia
    Posted on

    In Wisconsin it is legal. I am a licensed awthetician and I have neen trained to extract milia. It os a simple extraction technique that many are trained to do i need my field. It is not fair to say that you should never have an aesthetician to do this.

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