I always ask. I have been doing facials for 13 years and only extraction since esty school & license and 2 or 3 clients not want them in 1 1/2 years. In one case the client's aunt asked me why I didn't do them on her niece (she was paying) and I said that I did ask and she said no. She came back with that was the only reason to get a facial! I use PCA detox gel and steam to loosen and the extraction tool or wrapped fingers.