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Quizzes > Health & Medicine

Manual Comedone Removal Quiz: Test Safe Extraction Skills

Quick, free comedone extraction practice test. Instant results.

Editorial: Review CompletedCreated By: Meighan MatrasUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for a Milady facial treatments quiz on a dark blue background

This manual comedone removal quiz helps you check safe extraction steps and know when to extract comedones. Review contraindications, prep, and aftercare, then see which topics to study next with instant feedback. For broader practice, try our esthetician practice test, brush up with dermatology quiz questions, or refresh basics in the cosmetology anatomy and physiology quiz.

What is the primary purpose of manual comedone extraction in a facial treatment?
To exfoliate dead skin cells chemically
To remove blackheads and whiteheads
To induce collagen remodeling
To apply moisturizing agents deeply
Manual comedone extraction is designed to physically remove comedones (blackheads and whiteheads) from the follicle using controlled pressure. This prevents clogged pores and reduces the risk of future breakouts. Proper technique minimizes tissue trauma and scarring.
Which professional tool is most commonly used for manual comedone extraction?
Comedone extractor
Diamond tip wand
Lancet
Wooden spatula
A comedone extractor has a looped end designed to apply uniform pressure around the pore. It allows safe expulsion of debris without excessive force. Proper sanitation of the tool is critical to prevent infection.
What is the recommended initial skin preparation step before manual extraction?
High-frequency application
Direct application of antiseptic
Steam or warm towel compress
Gommage exfoliation
Applying steam or a warm towel compress softens the sebum and opens pores. This reduces tissue resistance and makes extractions gentler. Overheating should be avoided to protect the skin.
What does 'gommage' refer to in Milady facial protocols?
A mechanical scrub that gels and rolls off
An ultrasonic treatment
An enzyme peel
A clay mask
Gommage is a mechanical exfoliation method where a cream is applied and allowed to dry, then rolled away to slough off dead skin cells. It is gentle and suitable for sensitive skin. This step enhances extraction effectiveness.
Which skin type benefits most from manual comedone extraction?
Oily or acne-prone skin
Dehydrated combination skin
Mature, dry skin
Sensitive rosacea skin
Oily or acne-prone skin often has clogged pores that form comedones. Manual extraction helps clear follicles and reduce breakouts. It must be done carefully to avoid irritation.
What indicates that a closed comedone is ready for extraction?
Visible whitehead protrusion
Redness around the follicle
Firm papule under skin
Presence of black oxidation
A whitehead protrusion indicates that the follicle is near the surface and can be safely expressed. Attempting extraction too early can cause inflammation and scarring. Proper visual assessment is key.
Which of the following is a contraindication for manual comedone extraction?
Inflamed papulopustular acne
Mild blackheads
Dilated pores
Closed comedones
Inflamed papulopustular acne indicates bacterial activity and tissue inflammation. Extraction can worsen infection and lead to scarring. Such lesions require medical or chemical treatments first.
Why should a professional wear gloves during extraction?
To increase pressure during extraction
To keep the tool warm
To maintain sanitation and protect client
To better visualize the pores
Wearing gloves prevents cross-contamination and protects both the client and esthetician. It ensures a sanitary environment for invasive procedures. Non-latex or vinyl gloves are commonly used.
What is the correct direction to apply pressure with a comedone extractor?
Outward from the follicle in all directions
Upward towards hair growth
Circular motion around the loop
Downward only
Applying even outward pressure around the follicle opening expels debris without tearing skin. Excessive or directional force can bruise or scar. A steady, balanced technique is essential.
Which post-extraction step helps soothe the skin?
Microdermabrasion
Mechanical scrub
Calming mask or lotion
High-frequency current
A calming mask containing aloe or chamomile soothes redness and inflammation after extractions. It helps restore the skin barrier and comfort the client. High-frequency may be used later to disinfect but not immediately.
What is an ampoule commonly used for during a Milady facial?
Physical exfoliation
Steam generation
Intensive skin treatment concentrate
Mechanical extraction
Ampoules contain concentrated active ingredients like vitamins or peptides. They are applied after extraction to deliver targeted benefits. Their small volume ensures potency and fast absorption.
Which type of comedone appears as a black dot due to oxidation?
Closed comedone
Open comedone
Papule
Cyst
Open comedones (blackheads) have an exposed plug that oxidizes and turns black. They respond well to extraction when softened. Proper technique avoids tearing the follicular wall.
When should you avoid gommage before extraction?
During high-frequency treatment
On overly sensitive skin
After steaming
When skin is oily
Gommage can irritate sensitive skin, so it's contraindicated in such cases. Gentle methods like warm towels are preferred. Always assess skin condition before exfoliation.
Which sign suggests you should stop extraction immediately?
Minimal resistance
Slight redness
Sharp client pain or bleeding
Clear comedone removal
Sharp pain or bleeding indicates tissue damage or that you've gone too deep. Extractions should be gentle and bloodless. Stop and apply antiseptic if this occurs.
How long should you typically steam the face before extractions?
20 - 30 minutes
1 - 2 minutes
Over 30 minutes
5 - 10 minutes
Steaming for 5 - 10 minutes softens sebum and opens pores without overheating. Extended steaming can dehydrate or irritate the skin. Monitor client comfort throughout.
Which product layer follows extraction in a Milady facial?
Mechanical scrub
Clay mask
Moisturizing cream
Calming mask or serum
After extraction, a calming mask or serum helps soothe irritation and restore hydration. This supports barrier repair and prevents over-drying. Moisturizer follows once the mask is removed.
What angle should the loop of a comedone extractor be held at to the skin?
Parallel (0°)
Moderate (45°)
Shallow (10 - 20°)
Perpendicular (90°)
Holding the loop at a 45° angle provides optimal pressure distribution and reduces skin trauma. Too steep or flat can cause tearing or ineffective extraction. Consistent angle aids client comfort.
Which grading scale is used to determine acne severity before extraction?
Petrissage grading
Glogau scale
Fitzpatrick scale
Acne grading scale (I - IV)
The Acne grading scale I - IV assesses lesion type and distribution to guide treatment. Grades I and II are appropriate for extractions, while higher grades require medical intervention first. Proper evaluation prevents complications.
Which of these steps ensures sanitation of a comedone extractor between clients?
Autoclave sterilization or EPA-registered disinfectant
Wiping with dry cloth
UV exposure for 2 minutes
Soaking in soap solution only
Autoclave sterilization or EPA-registered disinfectant kills bacteria, viruses, and fungi. This complies with infection control protocols. Inadequate sanitation risks cross-contamination.
High-frequency treatment is often used after extractions to:
Disinfect follicles and calm inflammation
Mechanically exfoliate remaining cells
Open pores further
Deliver moisturizing agents
High-frequency current generates ozone which has antibacterial effects. It helps disinfect extraction sites and reduce inflammation. It also promotes circulation and healing.
When extracting milia, you should:
Apply high-frequency only
Refer to a physician for proper removal
Use firm pressure as with blackheads
Extract with steam alone
Milia are keratin-filled cysts under the skin that require incision or professional surgical removal. Attempting forceful extraction can cause scarring. Referral to a medical professional is safest.
Which ingredient in a pre-extraction gel aids in softening sebum?
Zinc oxide
Titanium dioxide
Hyaluronic acid
Salicylic acid
Salicylic acid is lipophilic and penetrates into pores to dissolve sebum plugs. It softens keratin and facilitates easier extraction. It also has mild anti-inflammatory properties.
Which massage movement provides skin tension for easier extraction?
Compression with thumbs
Petrissage kneading
Tapotement
Effleurage
Thumb compression around the pore creates counter-tension, stabilizing the skin for extraction. This reduces trauma to the surrounding tissue. It increases client comfort and extraction efficiency.
Which Fitzpatrick skin type may be more prone to post-inflammatory hyperpigmentation after extraction?
Type II
Type VI
Type I
Type III
Darker skin types (Fitzpatrick V - VI) have higher melanin activity, increasing the risk of PIH when the skin is traumatized. Gentle extraction and proper aftercare minimize this risk. Sunscreen post-treatment is essential.
Which acne grade is typically safe for manual extraction according to Milady?
Grade IV only
All grades
Grade III only
Grade I and II
Grades I and II involve non-inflamed comedones and mild papules. These respond well to manual extraction. Higher grades involve cysts or nodules which need medical treatment first.
During extraction, which of these indicates the debris is fully expelled?
Pus only
Continuous bleeding
Clear fluid and plug removal
Increased skin tension
A successful extraction yields the keratin plug and sebum, leaving minimal residue. Bleeding indicates overexertion. Pus suggests infection, which requires different treatment.
What is the next step if a comedone won't express after two attempts?
Use lancet immediately
Continue until it releases
Stop and move to another area
Apply more pressure
Persistent pressure can damage tissue and cause scarring. Stop and come back later or refer to a specialist. Overworking the same spot increases risk of irritation.
Which antiseptic spray is commonly used post-extraction?
Mineral oil
70% isopropyl alcohol
Plain water
Chlorhexidine gluconate
Chlorhexidine gluconate effectively kills bacteria and is gentle on the skin. It reduces infection risk after extractions. Isopropyl alcohol can be too harsh and drying.
Why is it important to explain aftercare to clients post-extraction?
To extend appointment time
To ensure proper healing and prevent infection
It is not necessary
To upsell products
Proper aftercare instructions help clients care for extraction sites and minimize complications. This includes keeping the area clean and avoiding makeup for a short period. Client compliance improves treatment outcomes.
Histologically, what differentiates a closed comedone from an open comedone?
Open comedone has an oxidized keratin plug at the surface
They are identical histologically
Closed comedone has a dilated follicle; open does not
Closed comedone contains sebum only; open contains keratin
Open comedones show a keratin plug exposed to air, causing oxidation. Closed comedones remain beneath the stratum corneum, appearing as small flesh-colored bumps. Histology confirms the location of the plug relative to the epidermis.
Which hormonal factor can exacerbate comedone formation?
Low cortisol
High progesterone
Elevated androgens
Estrogen dominance
Androgens increase sebum production, contributing to follicular blockage. Excess sebum promotes comedone and acne formation. Hormonal fluctuations during puberty or pregnancy can trigger breakouts.
What risk increases if manual extraction is performed aggressively?
Temporary pore enlargement only
Increased sebum production exclusively
Permanent scarring and hyperpigmentation
Immediate collagen production
Overly aggressive extraction can tear dermal tissue leading to scar formation. Post-inflammatory hyperpigmentation is common in aggressive extractions. Gentle technique limits these adverse effects.
Which advanced modality can be combined with extraction to treat mild acne?
Laser resurfacing
High-frequency and blue light therapy
Cryotherapy
Photodynamic therapy
High-frequency and blue light therapy have antibacterial effects and reduce inflammation. Combining them with extraction enhances treatment of mild acne. They also promote healing post-procedure.
In Milady protocol, what is the recommended sequence when combining microdermabrasion with extraction?
Extraction first, then microdermabrasion
Only extraction if microdermabrasion is chosen
Microdermabrasion first, then extraction
Done simultaneously
Microdermabrasion removes superficial layers, unclogs pores, and softens plugs. This makes subsequent extraction easier and less traumatic. Doing extraction first would disrupt the skin surface for abrasion.
What is a potential complication when extracting comedones near the mouth area?
Dull skin temporarily
Increased sebum flow
No special risk
Risk of scarring and lip swelling
The perioral area has thinner skin and numerous blood vessels. Aggressive extraction can cause swelling, bruising, or scarring. Special care and lighter pressure are required.
Which parameter of microdermabrasion should be adjusted for oily skin post-extraction?
Lower pressure and shorter duration
Always avoid microdermabrasion
Higher pressure with minimal passes
Use diamond tip only
Oily skin tolerates higher pressure but requires fewer passes to avoid irritation. Adjusting settings prevents over-exfoliation while effectively removing sebum. Always assess skin response in real time.
What is the key difference between chemical peeling and manual extraction?
Extraction physically removes plugs, peeling dissolves keratin
Extraction uses acids, peels use instruments
They are identical processes
Chemical peels are more painful
Manual extraction physically extrudes debris from follicles. Chemical peels use acids to break down keratin bonds and exfoliate. Both can be complementary in advanced facials.
Which factor in sebum composition affects extraction ease?
Viscosity due to lipid chain length
Protein concentration
Sweat admixture
Water content only
Long-chain lipids increase sebum viscosity, making plugs more resistant to extraction. Softer, less viscous sebum is easier to express. Pre-treatment with softening agents helps.
When adjusting extraction for mature skin, which modification is recommended?
Extract only open comedones
Avoid any extraction
Use gentle tension and lighter pressure
Use heavier pressure
Mature skin is thinner and less elastic, requiring gentler handling and lighter pressure. Tensioning the skin provides support for extraction without trauma. This minimizes risk of tearing or bruising.
Which type of mask best follows extraction in oily/acne-prone skin?
Gel collagen mask
Paraffin warming mask
Clay or charcoal purifying mask
Hydrogel hydration mask
Clay or charcoal masks absorb excess oil and draw out impurities post-extraction. They help tighten pores and control shine. Hydrogel is better suited for dry or mature skin.
What is the advantage of using a single-loop comedone extractor versus double loop?
Fits all pore sizes
Simpler control for precision extractions
Less sanitation required
Cheaper for salons
A single-loop extractor offers better tactile feedback and control for targeted extractions. It allows estheticians to choose loop size according to pore diameter. Double loops are versatile but can be bulkier.
Which contraindication is specific to extractions on rosacea-prone skin?
Presence of comedones only
Fragile capillaries and heightened sensitivity
Excess sebum production
Thickened epidermis
Rosacea skin has fragile capillaries that can burst under pressure. Manual extraction can exacerbate redness and cause telangiectasia. Such skin requires non-invasive treatments instead.
How does manual comedone extraction influence the pathophysiology of acne compared to pharmacologic treatment?
Extraction addresses bacterial colonization directly
Extraction physically removes follicular plugs, while pharmacologics modulate sebum or inflammation
Extraction dissolves keratin bonds chemically
They have identical mechanisms
Manual extraction clears the physical obstruction in follicles, reducing comedone formation. Pharmacologic treatments (retinoids, antibiotics) alter sebum production or inflammation. Together they provide complementary benefits.
Recent studies compare manual extraction with enzymatic debridement; what is a key finding?
Combined protocols yield superior comedone clearance and reduced irritation
Enzymatic methods always outperform manual extraction
Enzymes prevent all post-inflammatory hyperpigmentation
Manual extraction is obsolete
Research indicates combining enzymatic peeling with manual extraction enhances results while minimizing tissue trauma. Enzymes soften keratin plugs and manual technique ensures complete removal. This synergy improves patient outcomes.
How can sebum lipidomic profiling guide customization of extraction protocols?
It replaces the need for extractions
It identifies bacterial strains
It determines sebum viscosity and optimal pre-softening agents
It predicts client pain threshold
Lipidomic profiling reveals chain lengths and saturation affecting sebum consistency. Practitioners can tailor pre-treatment with specific softening agents. This precision enhances extraction ease and comfort.
What is the impact of manual comedone extraction on transepidermal water loss (TEWL)?
Proper technique minimizes TEWL increase, preserving barrier
Extraction has no effect on TEWL
Extraction always doubles TEWL
Extraction drastically reduces TEWL
Gentle, precise extraction preserves surrounding tissue integrity and barrier function. Overly aggressive extraction disrupts the stratum corneum, raising TEWL. Monitoring TEWL can guide technique adjustments.
Which advanced technique aids in extracting deep microcomedones that aren't visible?
Simple steam alone
High-powered laser
Multi-depth ultrasonic cavitation
Standard manual loop only
Ultrasonic cavitation at varied depths disrupts subclinical keratin plugs, bringing them closer to the surface. This enhances manual extraction of nonvisible microcomedones. It's an advanced option for stubborn cases.
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Study Outcomes

  1. Identify Manual Comedone Removal Technique -

    Recognize what technique involves manually removing comedones from follicles and differentiate it from other extraction methods. You'll reinforce when and how to perform this essential facial modality.

  2. Explain Milady Ampoule Applications -

    Define what an ampoule Milady is and describe its purpose in facial treatments. You'll clarify how ampoules enhance skin penetration and boost treatment effectiveness.

  3. Describe Gommage Treatment -

    Understand what a gommage Milady involves and how this exfoliation method improves skin texture. You'll learn when to apply gommage for optimal results.

  4. Analyze Iontophoresis Principles -

    Determine what is the best explanation of iontophoresis Milady and outline how it facilitates product delivery. You'll assess its benefits in enhancing active ingredient penetration.

  5. Assess Modelage Mask Recommendations -

    Identify why modelage masks are recommended for clients with specific skin concerns and how to select the right mask formula. You'll connect mask characteristics to client needs for targeted treatment.

  6. Apply Quiz Insights -

    Gauge your mastery of these facial techniques through scored quiz questions and use feedback to fill knowledge gaps. You'll build confidence in essential Milady facial modalities.

Cheat Sheet

  1. Manual Comedone Extraction Technique -

    Manual comedone removal involves using gentle pressure and a sterile extraction tool to clear follicles of blackheads and whiteheads without damaging surrounding tissue. Remember the CLEAN mnemonic: Cleanse, Locate, Extract, Apply antiseptic, Nurture skin to prevent post-extraction irritation (Milady Professional Esthetics, 2021).

  2. Ampoule Application Essentials -

    An ampoule Milady treatment uses a single-dose, highly concentrated serum designed to target specific skin concerns; apply 2 - 3 drops and pat gently to enhance absorption. Think "One Shot Wonder" for ampoules: quick, focused results with minimal product wastage (Academy of Skin Care Science, 2020).

  3. Gommage Exfoliation Breakdown -

    Gommage Milady is a French rolling exfoliant that applies as a cream then dries to form little "crumbs" you roll off, sloughing away dead cells and debris. This gentle mechanical peel is perfect for sensitive skin, offering both physical and enzymatic exfoliation in one step (Journal of Cosmetic Science, 2019).

  4. Iontophoresis Deep Delivery -

    What is the best explanation of iontophoresis Milady? It's the use of a low-level galvanic current to drive water-soluble ions of active products deep into the dermis. Remember the GO TIME mnemonic: Galvanic On - Time Infuses Moisturizer Effectively (University Skin Research, 2022).

  5. Modelage Mask Recommendations -

    Modelage masks are recommended for clients with dry or mature skin because their heat-activated, mineral-rich cast increases circulation and boosts moisture retention. The slightly warm, plaster-like texture creates a snug seal, making it ideal for targeted nutrient delivery (American Spa Association, 2021).

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