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SKIN DISORDERS AND DISEASES

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Heidi Tarman

on 16 May 2015

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Transcript of SKIN DISORDERS AND DISEASES

SKIN DISORDERS AND DISEASES
Why study skin disorders and diseases?
Disorders and diseases of the skin
Disorders of the sebaceous (sweat) glands
Disorders of the sudoriferous (sweat glands)
Inflammations and common infections of the skin
Pigment disorders of the skin
Hypertrophies of the skin
Skin cancer
Acne and problem skin
Aging skin issues
The sun and its effects
Contact dermatitis
INTRODUCTION
Skin care specialists aree in high demand in many salons and spas and earn excellent salaries. Some stylists find caring for the skin less arduous and physically demanding than styling hair and choose to balance their day by scheduling services in both areas. Skin care is an area of rapid change and growth and a topic on most clients' minds. Knowing the basics of skin care and how the skin functions will allow you to advise clients on their skin care regimens when they seek your professional opinion.
DISORDERS AND DISEASES OF THE SKIN
In your work as a practitioner, you will often see skin and scalp disorders, so you must be prepared to recognize certain common skin condition and know which you can help to treat and which must be referred to a physician. Occasionally, you may be asked to apply or use on a client a scalp treatment prescribed by a physician. These must be applied in accordance with a physician's directions.
Lesions of the Skin
A
lesion

is a mark on the skin that may indicate an injury or damage that changes the structure of tissues or organs.

A lesion can be as simple as a freckle or as dangerous as skin cancer.
Lesions can indicate skin disorders or diseases and sometimes may indicate other internal diseases.
Disorders of the Sebaceous (Oil) Glands
There are several common disorders of the sebaceous glands that the cosmetologist should be able to understand and identify.
CHAPTER OUTLINE
Learning Objectives
Recognize common skin lesions.
Describe the disorders of the sebaceous glands.
Name and describe changes in skin pigmentation.
Identify the forms of skin cancer.
Understand the two major causes of acne and how to treat them.
List the factors that contribute to the aging of the skin.
Explain the effects of overexposure to the sun on the skin.
Understand what contact dermatitis is and know how it can be prevented.
Why study skin disorders and diseases?
In order to provide even the most basic of skin care services, you must understand the underlying structure of the skin and common skin problems.
You must be able to recognize adverse conditions, including inflamed skin conditions, skin diseases and infectious skin disorders, and you must know which of these conditions are treatable by the cosmetologist and which need to be referred to a medical doctor.
Knowing about and being able to offer skin care treatments adds another dimension of service for your clients.
Cosmetologists refer clients with medical issues to dermatologists more than any other type of physician.
It is very important that a salon not serve a client who is suffering from an inflamed skin disorder, infectious or not, without a physician's note permitting the client to receive services. As a cosmetologist you should be able to recognize these conditions and sensitively suggest that proper measures be taken to prevent more serious consequences.
Primary Lesions of the Skin
Secondary Lesions
Primary lesions

are lesions that are a different color than the color of the skin and/or lesions that are raised above the surface of the skin
. Requires medical referral.
Secondary skin lesions

are characterized by piles of material on the skin surface,

such as a crust or scab, or by depressions in the skin surface, such as an ulcer.
Crust

is dead cells that form over a wound or blemish while it is healing
: an accumulation of sebum and pus, sometimes mixed with epidermal material. An example is the scab on a sore.
Bulla

is a large blister containing a watery fluid
; similar to a vesicle but larger.
Requires medical referral.
Cyst
is a closed, abnormally developed sac that contains fluid, pus, semifluid, or morbid matter, above or below the skin.
Requires medical referral.
Macule

is any flat spot or discoloration on the skin
, such as a freckle or a red spot, left after a pimple has healed.
Nodule

is a solid bump larger than .4 inches that can be easily felt.
Requires medical referral.
Papule

is a small elevation on the skin that contains no fluid but may develop pus
. Frequently seen in acne.
Pustule
is a raised,
inflamed,
papule
containing pus
, in the top of the lesion
referred to as the head of the pimple
.
Tubercle
is an
abnormal, rounded, solid lump above, within, or under the skin; larger than a papule.
Requires medical referral.
Tumor

is an abnormal cell mass varying in size, shape and color.
Tumors are sometimes associated with cancer, but the term tumor can mean any sort of abnormal mass.
Requires medical referral.
Vesicle
is a small blister or sac containing clear fluid, lying within or just beneath the epidermis
. Poison ivy and poison oak, for example, produce vesicles.
Requires medical referral.
Wheal
is an itchy, swollen lesion that lasts only a few hours
caused by a blow or scratch, the bite of an insect, skin allergy(urticaria) or the sting of a nettle. Examples include hives and mosquito bites.
Excoriation

is a skin sore or abrasion produced by scratching or scraping.
Fissure
is a crack in the skin that penetrates the dermi
s
. Examples are
severely cracked and/or chapped hands or lips.
Keloid

is a thick scar resulting from excessive growth of fibrous tissue.
Scale

is any thin dry or oily plate of epidermal flakes
. An example is abnormal or
excessive dandruff.
Scar
, also known as
ciatrix
,
is a lightly raised mark on the skin formed after an injury or lesion of the skin has healed.
Ulcer

is an open lesion on the skin or mucous membrane of the body, accompanied by loss of skin depth and possibly weeping of fluids or pus.

Requires medical attention
.
Open comedo
, also known as a
blackhead
,
is a hair follicle filled with keratin and sebum.
Most frequently found on the face. When exposed to the environment, it oxidizes and turns black.
When the follicle is closed and not exposed to the environment, the sebum remains a white or cream color and is a
closed comedo,
also known as a
whitehead
,

and appears as a small bump just under the skin.
Comedones can be removed by trained beauty professionals as long as proper procedures are employed and the procedure is performed in a sanitary environment using extraction implements.
Milia

are benign, keratin-filled cysts that appear just under the epidermis and have no visible opening.

They resemble small sesame seeds and are almost always perfectly round. They are commonly associated with newborn babies
, but can appear on people of all ages. Found usually around the eyes, cheeks and forehead. Depending on the state, milia can be treated in the salon or spa.
Acne
, also known as
acne vulgaris,

is a skin disorder characterized by chronic inflammation of the sebaceous glands from retained secretions
and bacteria known as propionibacterium acnes (P.acnes, the scientific name for acne.)
Sebaceous

cyst

is a large protruding pocket-like lesion filled with sebum.
Sebaceous cysts are
frequently seen on the scalp and the back.
They should be removed surgically by a dermatologist.
Seborrheic dermatitis
is a skin condition caused by inflammation of the sebaceous glands.
It is often
characterized by
redness, dry or oily scaling, crusting and/or itchiness. The
red, flaky skin
often appears in the eyebrows and beard,
in the scalp and hairline
, at the middle of the forehead and along the sides of the nose. Mild cases may be treated with cortisone creams. Seborrheic dermatitis is a medical condition, but it can be helped in the salon with the application of non-fatty skin care products designed for sensitive skin. Severe cases should be referred to a dermatologist, who will often prescribe a topical anti-fungal medication.
Rosacea
, formerly called
acne rosacea,

is a chronic condition that appears primarily on the cheeks and nose
. It is characterized by flushing (redness)
, telangiectasis

(distended or dilated surface blood vessels)
, and, in some cases the formation of papules and pustules.
The cause of rosacea is unknown
, but thought to be genetic. Certain facts are known to aggravate the condition in some individuals. Exposure to heat, sun and very cold weather; ingestion of spicy foods, caffeine and alcohol; and stress.Treatment is available by, prescribed meds, using proper skin care products and avoiding the aggravating flare factors.
Disorders of the Sudoriferous (Sweat) Glands
Anhidrosis
is a deficiency in perspiration, often a result of fever or certain skin diseases.
Requires medical referral
.
Bromhidrosis

is foul-smelling perspiration,
usually noticeable in the armpits
or on the feet, and is
caused by bacteria.
Severe cases require medical referral.
Hyperhidrosis
is excessive sweating, caused by heat or general body weakness.
Requires medical referral.
Miliaraia rubra
,
also known as

prickly heat
,
is an acute inflammatory disorder of the sweat glands, characterized by the eruption of small red vesicles and accompanied by burning, itching skin.

Caused by exposure to excessive heat
and usually clears in a short time without treatment.
Inflammations and Common Infections of the Skin
Conjunctivitis
, also known as
pinkeye
,
is a common bacterial infection of the eyes. It is extremely contagious
, and clients who have conjunctivitis or obviously irritated eyes should be rescheduled and referred to a physician immediately. Any product or implements touching the infected eyes must be thrown away.
Dermatitis
is a term broadly used to describe any inflammatory condition of the skin.
Eczema

is an inflammatory, uncomfortable and often chronic disease of the skin, characterized by moderate to severe inflammation, scaling and sometimes severe itching.
There are several different types of eczema. The most common type is atopic eczema, which is an inherited genetic disorder. All cases should be referred to a physician for treatment, which is often a topical cortisone. Eczema is
not
contagious.
Herpes Simplex
is a recurring viral infection that often presents as a fever blister or cold sore.
It is characterized by the eruption of a single vesicle or group of vesicles on a red swollen base. Usually appear on the lips, nostrils or other parts of the face. Sores can last up to 3 weeks.
Herpes simplex is contagious and requires medical referral.
Medications are available to control the symptoms, but the virus always remains in the body of an infected person.
Impetigo

is a contagious bacterial skin infection characterized by weeping lesions.
Impetigo normally occurs on the face(especially the chin area) and is most frequently seen in children.
Clients with any type of weeping open facial lesions should be politely rescheduled and referred to a physician immediately.

Psoriasis
is a skin disease characterized by red patches covered with silver-white scales
and is usually found on the scalp, elbows, knees, chest and lower back. It is caused by the skin cells turning over faster than normal.
Psoriasis is not contagious, but does require medical referral.
Treatable but not curable.
Pigment Disorders of the Skin
Pigment can be affected by internal factors such as heredity or hormonal fluctuations, or by outside factors such as prolonged exposure to the sun.
Abnormal colorations, know as
dyschromias,
accompany skin disorders and many systemic disorders.
A change in pigmentation can also be observed when certain drugs are being taken internally. The following terms relate to changes in the pigmentation of the skin;
Hyperpigmentation
means darker than normal pigmentation, appearing as dark splotches.
Hypopigmentation
is the absence of pigment, resulting in light or white splotches.
Albinism
is congenital hypopigmentation, or
absence of melanin pigment in the body,
including the skin, hair and eyes. Hair is silky white. Teh skin is pinkish white and will not tan. The eyes are pink and the skin is sensitive to light and ages early.
Cholsma
, also known as
liver spots,
is a condition characterized by hyperpigmentation on the skin in spots that are not elevated. This is a commonly used term; the spots have nothing to do with the liver. Generally caused by cumulative sun exposure. Can be helped by exfoliation treatments or can be treated by a dermatologist.
Lentiginesis
the technical term for freckles, small yellow-colored to brown-colored spots on skin exposed to sunlight and air.
Leukoderma
is a skin disorder characterized by light abnormal patches
(hypopigmentation); it is caused by a burn or congenital disease that destroys the pigment producing cells. Examples vitiligo and albinsim.
Nevus
, also known as
birthmar
k, is a small or large malformation of the skin due to abnormal pigmentation or dilated capillaries.
Stain
is an abnormal brown-colored or wine-colored skin discoloration with a circular or irregular shape.
Its permanent color is due to the presence of darker pigment. Stains can be present at birth, or they cna appear during aging, after certain diseases or after the disappearance of moles, freckles and liver spots. The cause is often unknown.
Tan
is the change in pigmentation of skin caused by exposure to the sun or ultraviolet light.
Vitiligo
is a hereditary condition that causes hypopigmented spots and splotches on the skin that may be related to thyroid conditions. Skin with vitiligo must be protected from overexposure to the sun.
Hypertrophies of the Skin
A
hypertrophy
of the skin is an abnormal growth of the skin. Many hypertrophies are benign, which means they are harmless.
A
keratoma
is an acquired, superficial, thickened patch of epidermis.
A callus is a keratoma
that is caused by continued repeated pressure or friction on any part of the skin especially the hands and feet. If the thickening grows inward, it is called a corn.
A
mole
is a small brownish spot or blemish on the skin, ranging in color from pale tan to brown or bluish black. Some moles are small and flat, others are raised and darker in color. Large dark hairs often occur in moles. Any change in mole requires medical attention.
A
skin tag

is a small brown-colored outgrowth of the skin.
Skin tags occur most frequently on the neck of an older person. They can be easily removed by a dermatologist.
A v
erruca
, also known as
wart
,
is a hypertrophy of the papillae and epidermis.
It is caused by a virus and is infectious. Verruca can spread from one location to another, particularly along a scratch in the skin.
Requires medical referral.
Skin Cancer
Skin cancer--primarily caused from overexposure to the sun---comes in 3 distinct forms that vary in severity. Each is named for the type of cells that it affects.
Basal cell carcinoma

is the most common and the least severe type of skin cancer;
it is often characterized by light or pearly nodules.
Squamous cell carcinoma
is more serious and often is characterized by scaly red papules or nodules.
Malignant melanoma
is the most serious form of skin cancer and is
often characterized by black or dark brown patches on the skin that may appear uneven in texture, jagged, or raised.
Malignant melanoma is the least common type of skin cancer.
Cosmetologists serve a unique role by being able to recognize the appearance of serious skin disorders and referring the client to a dermatologist for diagnosis and treatment.
According to the American Cancer Society, professionals should use the ABCDE Cancer Checklist to spot signs of change in existing moles.
Acne and Problem Skin
Common skin problems taht affect clients' appearance, such as acne, can become a source of great concern. Most people have acne or another skin issue at some time in their lives. Acne is both a skin disorder and an esthetic problem. Because it affects the appearance, it is of interest to cosmetologists and estheticians, who are in a position to help their clients with treatment for minor cases or to provide dermatological referral for more severe acne.
Acne is a disorder affected by two major factors; heredity and hormones.
People with acne inherit the tendency to retain cells that gather on the walls of the follicle, eventually clumping and obstructing the follicle.
Retention hyperkeratosis
is the hereditary tendency for acne-prone skin to retain dead cells in the follicle, forming an obstruction that clogs follicles and exacerbates inflammatory acne lesions such as papules and pustules.
The oiliness of the skin is also hereditary. Overproduction of sebum by the sebaceous glands contributes to the development of acne by coating the dead cell buildup in the follicle with sebum, which hardens due to oxidation. This conglomeration of dead cells and solidified sebum obstruct the follicle.
Propionibacterium (P. acne)acnes are
anaerobic
, which means that these bacteria cannot survive in the presence of oxygen. When the follicles are obstructed, oxygen is blocked from the bottom of the follicles, allowing acne bacteria to multiply.
The main food source for acne bacteria is fatty acids
, which are easily obtained from the abundance of sebum in the follicle. The bacteria multiply, causing inflammation and swelling in the follicle, and eventually rupture the follicle wall. When the follicle wall erupts, the immune system is alerted, causing blood to rush to the ruptured follicle, caring white blood cells to fight the bacteria. Blood will surround and engulf the follicle, which is what causes the redness in pimples.
An acne papule is an inflammatory acne lesion resulting from this wall rupture and infusion of blood. A pustule forms from the papule when enough white blood cells accumulate to form pus, which is primarily composed of dead white blood cells.
Acne Treatment
Minor forms of acne can be treated without medical referral. The basics of acne treatment involve:
Use of cleansers formulated for oily skin. Toners designed for oily skin help to furter remove excess sebum.
Follicle exfoliants are leave-on products taht help to remove cell buildup from the follicles, allowing oxygen to penetrate the follicles, killing bacteria.
Avoidance of fatty skin care and cosmetic products. Make sure all makeup and skin care products used on acne-prone skin are
noncomedogenic
,
which means the product has been designed and proven not to clog the follicles.
Do not use harsh products or over clean acne-prone skin as this can cause inflammation that can worsen the condition.
Mild and moderate cases of acne are often treated by trained salon and spa professionals who have received specialized education in acne treatment.
Aging Skin Issues
Aging of the skin is a concern of almost every client over thirty years of age. There are two types of factors that influence aging of the skin:
Intrinsic factor are skin-aging factors over which we have little control:
Genetic aging is how our parents' skin aged, their coloring and resistance to sun damage.
Gravity is the constant pulling downward on our skin and bodies.
Facial expressions are the repeated movements of the face that result in the formation of expression lines.
Crow's feet lines that form around the eyes
Nasolabial folds that form from the corners of the nose to the corners of the mouth
Scowl lines that form between the eyes

Extrinsic factors are primarily environmental factors that contribute to aging and the appearance of aging. Many scientists and dermatologists believe that these extrinsic factors are responsible for up to 85% of skin aging:
Exposure to the sun.
Smoking
Overuse of alcoholic beverages.
Illegal drugs
Cumulative stress
Poor nutrition
Exposure to pollution - The best defense against pollutants is the simplest one: follow a good daily skin care routine.
The Sun and Its Effects
The sun and its ultraviolet (UV) light have the greatest impact of all extrinsic factors on how skin ages.
Approximately 80 - 85% of the symptoms of aging skin are caused by the rays of the sun.
As we age, the collagen and elastin fibers of the skin naturally weaken. This happens faster the more frequently the skin is exposed to UV light without proper protection.
UV light reaches he skin in two ways: UVA and UVB rays.
UVA rays
, also known as
aging rays
, are deep-penetrating rays that can even go through a glass window. They weaken the collagen and elastin fibers, causing wrinkling and sagging of the tissues.
UVB rays
,
also known a burning rays, cause sunburns, tanning of the skin and the majority of skin cancers.
These are shorter rays that stop at the base of the epidermis.
The number one way to prevent premature skin aging is to avoid deliberate sun exposure and
to use a broad spectrum sunscreen, which is one that filters both UVA and UVB rays
and has a SPF (Sun Protection Factor) of at least 15, on a daily basis.
See more tips and facts on pages 189 & 190.
Contact Dermatitis
Contact dermatitis is the most common work-related skin disorder for all cosmetology professionals.
Contact dermatitis

is an inflammation of the skin caused by having contact with certain chemicals or substances.
Many of these substances are commonly used in cosmetology. There are two types of contact dermatitis:
Allergic contact dermatitis
, abbreviated ACD, occurs when the person (cosmetologist or client) develops an allergy to an ingredient of a chemical, usually caused by repeated skin contact with the chemical.
Sensitization

is an allergic reaction created by repeated exposure to a chemical or a substance.
Monomer liquids, haircolor and chemical texture solutions are all capable of causing allergic reactions with repeated exposures.

Once an allergy has been established, all services must be discontinued until the allergic symptoms clear. The person affected by the allergy must stop using that particular product. In severe or chronic cases, affected people should see a dermatologist for allergy testing.

Common places for allergic contact dermatitis are:
On the fingers, palms or back of the hand
On the face, especially the cheeks
On the scalp, hairline, forehead or neckline
Irritant contact dermatitis
,
abbreviated ICD, occurs when irritating substances temporarily damage the epidermis.
Unlike allergic contact dermatitis, ICD is not usually chronic if precautions are taken.

Corrosive substances or exfoliating agents are examples of products with irritant potential. These chemicals can cause damage to the epidermis because the irritant can enter the skin surface and cause possible inflammation, redness, swelling, itching and burning. Repeated exposure can worsen the condition.
The way to prevent both types of occupational contact dermatitis is to use gloves or utensils when working with irritation chemical.


Frequent hand washing can result in dry hands, with cracks in the skin that can cause more irritation and that can allow penetration of irritant chemicals. Hand washing is imortant to prevent the spread of disease, but it should be followed by the frequent use of protective hand creams to keep the hands in good condition.
Protect Yourself
Taking the time to keep your implements, tools, equipment and surfaces clean and disinfected is an important step in protecting yourself and avoiding a skin problem. Practice these suggestions with great diligence:
Take exteme care to keep brush handles, containers and table tops clean and fee from product, dust and residue.
Wear protective gloves whenever using products known to cause irritant or allergic contact dermatitis.
Keep your hands clean and moisturized.
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