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Transcript of Chapter 23
I. SKIN ANALYSIS AND CONSULTATION Skin analysis determines skin type, skin condition,
and needed treatment. The consultation allows you to ask questions about the client’s health and skin care history and to advise the client about a home care regimen.
A. HEALTH SCREENING
This is used to determine if the client has any contraindications that might prevent skin treatments.
This is a condition the client has, or a treatment the client is undergoing, that might cause a negative side effect during a facial treatment. For example: allergy to fragrance
This is an oral medication used for cystic acne that causes thinning of skin all over the body. Do not give treatments for at least six months after stopping the drug. Include any other skin-thinning or exfoliating drug, including Retin-A, Renova, Tazorac, Differin, etc. Avoid exfoliation, peeling, or stimulating treatments.
Use no electrical treatments or any other treatment without a physician’s written permission. Pregnant women may develop sensitivities.
3. Metal bones or plates
If a client has metal bones or plates, avoid all electrical treatment.
4. Pacemakers or heart irregularities
Avoid all electrical treatment.
Avoid all products or substances to which the client is allergic. Highly allergic clients should use fragrance-free products designed for sensitive skin.
6. Seizures or epilepsy
Avoid electrical and light treatments.
7. Oral steroids
Avoid stimulating or exfoliating treatment or
8. Autoimmune diseases such as lupus
Avoid any harsh or stimulating treatments.
Diabetics heal slowly; get a physician’s approval
10. Blood thinners
Avoid extraction or waxing.
11. Obvious skin abnormalities
Open sores and fever blisters (herpes simplex)
should be referred to a physician.
12. When in doubt….
C. MORE HEALTH SCREENING - The form allows you to obtain additional important
information from the client.
1. Client data - Name, address, and phone number
2. Client’s occupation
3. Medical conditions - That might affect treatment
4. Medications - Any medications the client is using including topical drugs for the skin.
5. Home care regimen What kind of products clients are using at home or prior treatments
6. How the client heard about you - This allows you to recognize a client who referred or how to focus your advertising.
D. TREATMENT RECORDS
Treatment records are kept separate from health forms. Treatment records include the client’s personal information, results of analysis, treatment records, observations, retail products purchased, treatment dates, etc.
E. ANALYSIS PROCEDURE
1. Read health screening form - Discuss questions with the client.
2. Have client change into smock
3. Seat client in chair
4. Drape client - Use a hair cap, headband, or towels.
5. Have client remove jewelry
6. Recline client in chair
7. Wash hands
8. Warm cleansing milk and apply Use an upward circular movement. Cleanse the eye area with eye makeup remover. Use damp facial
sponges or cotton pads.
9. Apply cotton eye pads to client's eyes.
F. DETERMINE SKIN TYPE
Skin type is determined by how oily or dry the skin is. Skin type is hereditary and cannot be permanently changed with treatment. Skin conditions are characteristics of the skin associated with a particular skin type.
1. Look through a magnifying lamp.
2. Observe pore size. The amount of sebum produced by the sebaceous
glands determines the size of the pores and is
hereditary. Obvious pores indicate oily skin; lack of
pores indicates dry (alipidic skin).
G. SKIN TYPES
1. Dry or alipidic - Alipidic means lack of liquids. Alipidic skin becomes dry or dehydrated because it does not produce enough sebum to prevent the evaporation of cell moisture. It is the absence of visible pores.
Oily skin produces too much sebum and will have large pores. Skin will appear shiny or even greasy. Pores may be clogged from dead cells building up in hair follicles. Open comedones (blackheads) may be present. Open comedones are a mixture of solidified sebum and dead cell buildup stuck in the follicles. Closed comedones are small bumps just underneath the skin surface. The difference between closed and open comedones is the size of the follicle opening or ostium.
Normal skin has even pore distribution. It is very soft with a smooth surface and lacks wrinkles. Normal skin is unusual.
4. Combination dry
Obvious pores down the center of the face; pores are not visible or become smaller toward the outer edges of the face. Pores may be clogged on the nose, chin, and
center of the forehead and dry and poreless toward the
outside edges of the face.
5. Combination oily
Wider distribution of obvious or large pores down the center of the face extending to the outer cheeks. Pores
become smaller toward the edges of the face. There are comedones, clogged pores, or obvious pores in the center of face.
6. Acne - Pores are very large in all areas. Acne is considered a skin type because it is hereditary. There is a presence of numerous open and closed comedones, clogged pores, and red papules and pustules (pimples).
a. Follicles become clogged
b. Infection results
c. Bacteria are anaerobic Bacteria cannot survive without oxygen.
d. Breakdown sebum into fatty acids. Severe cases should be referred to a physician.
H. ANAYLISIS OF SKIN CONDITIONS Conditions are generally treatable, not hereditary, and are associated with a particular skin type.
1. Dehydration This is indicated by flaky areas or skin that wrinkles easily on the surface. Gently pinching the skin surface may result in the formation of many fine lines. This indicates dehydration. Dehydrated skin may be caused by lack of care, improper skin care products, sun exposure, etc. Treat by using hydrators appropriate
for the skin type.
Dark blotches of color; most are caused by sun exposure or hormone imbalances. The use of mild exfoliants, sunscreen and avoidance of sun exposure can help.
3. Sensitive skin
Characterized by a thin, red-pink look; the skin turns red and is easily inflamed by skin care products. Avoid use of strong products.
a. Rosacea - Rosacea is a chronic hereditary disorder that can be indicated by constant or frequent facial blushing.
b. Dilated capillaries - This is also known as telangiectasias or couperose. Avoid use of treatment that releases heat or stimulates the skin.
4. Aging skin
Indicated by loss of elasticity; the skin tends to sag in areas around the eyes and jaw line. Wrinkles may appear. Treatments that hydrate and exfoliate will improve skin appearance.
5. Sun-damaged skin
This skin has been chronically exposed to sun over the client’s lifetime. Hyperpigmentation, wrinkles, and sagging skin will be present.
II. SKIN CARE PRODUCTS
Most skin care products are designed for specific skin types or conditions. There are several major
A. CLEANSERS - Formulated to cleanse the surface of skin and remove makeup.
1. Cleansing milks - Nonfoaming lotions designed to cleanse dry and sensitive skin types and remove makeup; they can be applied with hands but must be removed with dampened facial sponges, a soft cloth, or cotton pads.
2. Foaming cleansers - Wash-off type products; they contain surfactants (also known as detergents) that cause the product to foam and rinse easily.
B. TONERS Also known as fresheners or astringents
1. Lower pH
2. Remove excess cleanser
3. Hydrate and soothe They may contain an exfoliating ingredient to help remove dead cells. Some contain a higher alcohol content for oilier skin types. They are applied with cotton pads. Alcohol-free toners can be sprayed on the face.
These are designed to exfoliate or remove excess cells from the skin surface. Removing dead skin cells makes skin look smoother and clearer.
1. Mechanical exfoliants - These work by physically “bumping off” dead cellbuildup.
a. Granular scrubs
b. Gommages - Gommage is a French word meaning “erase.” It is a peeling cream that is rubbed off, removing dead skin cells through friction.
c. Microdermabrasion These are mechanical exfoliation scrubs that contain aluminum oxide crystals.
2. Chemical exfoliants These contain chemicals that loosen or dissolve dead cell buildup. Popular exfoliating chemicals are alphahydroxy acids which dissolve the bonds and “intercellular cement” between cells.
a. Salon AHA exfoliants - These are often referred to as peels. Salon products contain around 20 to 30 percent alphahydroxy acids.
b. Prior home use required -They shouldn’t be used in the salon unless the client has been using a 10 percent product at home for at least two weeks prior to the salon treatment.
3. When to avoid mechanical peeling
a. Skin with visible capillaries This indicates fragile blood vessels.
b. Thin skin that reddens easily
c. Older skin - If it is thin and bruises easily
d. Skin being medically treated With tretinoin (retinoic acid or Retin-A), azelaic
acid, adapalene (Differin), alphydroxy acid (AHA), isotretinoin, or salicylic acid
e. Acne-prone skin - If it has inflamed papules and pustules
CAUTION: You must have hands-on, supervised training before attempting chemical exfoliation treatments.
D. ENZYME PEELS Dissolve keratin protein in surface cells. Enzyme products are often from papaya fruit or pineapple. They may also be made of beef by products (pancreatin).
1. Cream type - Usually contain papain; they are applied to the skin, allowed to dry to a crust, and then “rolled” off.
2. Powder type - Powder is mixed with water and applied to the face; it does not dry and can even be used during a steam treatment.
E. PROPER EXFOLIATION - Proper exfoliation may improve the appearance of the following skin conditions.
1. Clogged and oily skin
2. Skin smoothness
3. Moisture content and hydration
5. Uneven skin color
6. Wrinkles and fine lines
7. Poor elasticity - Proper exfoliation speeds up cell turnover and allows for better penetration of treatment creams and serums.
These help increase moisture content of skin surface. They are mixtures of humectants (hydrators/waterbinding agents) and emollients (hold moisture in).
1. Dry skin - Moisturizers for dry skin use heavier cream and contain more emollients.
2. Oily skin Moisturizers for oily skin use lotions that contain smaller amounts of emollient.
Day protection products and sunscreens are necessary to help prevent premature aging and skin cancers. Daily moisturizers should contain broadspectrum sunscreens.
H. NIGHT TREATMENT PRODUCTS
Heavier than day products and may contain a
higher level of conditioning ingredients
I. SERUMS AND AMPOULES
Concentrated products that contain higher amounts
of ingredients; they are applied under moisturizer or
J. MASSAGE CREAMS These are lubricants to make the skin slippery during massage. They often contain oils.
K. MASKS - Masks are a combination of ingredients for the purpose of toning, tightening, hydrating, and nourishing the skin.
1. Clay-based masks Oil-absorbing, used for oily and combination skin
2. Cream masks Often used for dry skin as they contain oils and emollients and humectants
3. Gel masks Used for sensitive or dehydrated skin; contain hydrators and soothing ingredients
4. Alginate masks - Often seaweed-based; they come in powder form to be mixed with water or serums. They form a rubberized texture. They are generally used only in the salon.
5. Paraffin wax masks They are melted at a little more than body temperature before application. They quickly cool to lukewarm temperature and harden to a candle-like consistency. They are used with treatment creams. Eye pads and gauze are used to protect facial and eyebrow hair.
6. Modelage masks These contain special crystals of gypsum, a plasterlike ingredient. They are used with treatment cream. The product hardens on the skin; setting time is about 20 minutes. They are beneficial for dry, mature skin or skin that looks dull or lifeless. Massage is not recommended before or after modelage masks.
7. Gauze - Gauze is a thin, open-meshed fabric of loosely woven cotton. It holds the mask on the face while allowing ingredients to seep through and benefit the skin. Gauze should be cut in a size to fit the entire face, with cutouts for the nose, mouth, and eyes.
III. CLIENT CONSULTATION - The salon should designate a quiet area for facial treatments and client consultations.
A. RECORD KEEPING - Consultation Card.
1. Client personal information - Name, address, phone number
2. Client’s occupation and date of birth
3. Client’s medical history
5. Facial treatment history
6. Products being used
7. How client was referred
8. Observations - Skin type, skin condition, skin abnormalities.
IV. FACIAL MASSAGE - Massage is the manual or mechanical manipulation of the body by rubbing, pinching, kneading, tapping, and other movements to increase metabolism and circulation, promote absorption, and relieve pain.
A. THE PRACTITIONER - The practitioner must have the following qualities.
1. Anatomy & physiology
2. Firm and sure touch
3. Flexible hands Keep them soft by using creams, oils, and lotions.
4. Quiet temperament
6. Filed and shaped nails REMEMBER: As a licensed cosmetologist, your services are limited to certain areas of the body.
B. BASIC MASSAGE The impact of massage treatment depends on the
pressure, direction of movements, and duration of each manipulation.
1. Begin at the insertion This is the point where the muscle is attached to another muscle or to a movable bone or joint.
2. Move toward the origin The origin is the fixed attachment on one end of the muscle or bone or tissue. Massaging in the wrong direction can result in sagging of skin and muscles.
C. MASSAGE MANIPULATIONS
1. Effleurage This is a light, continuous, stroking movement applied with fingers or palms in a slow, rhythmic manner; no pressure is used; palms work large surfaces and cushions of fingertips work small surfaces (such as around eyes). Don’t use the ends of fingertips. It is frequently used on the forehead, face, scalp, back, shoulders, neck, chest, arms, and hands for its soothing and relaxing effects. Every massage should
begin and end with effleurage.
2. Petrissage This is a kneading movement performed by lifting, squeezing, and pressing the tissue with a light, firm pressure. Petrissage offers deeper stimulation to the muscles, nerves, and skin glands; it improves circulation. It is usually limited to the back, shoulders, and arms. Digital kneading can be done on the cheeks with light pinching movements. Pressure is light but firm; movements should be rhythmic, not jerky.
3. Fulling This is a form of petrissage wherein tissue is grasped, gently lifted, and spread out; it is used mostly for arms. With the fingers of both hands grasping the arm, a kneading movement is applied across the flesh; light pressure is used on the underside of the client’s forearm and between the shoulder and elbow.
4. Friction This is a deep rubbing movement; pressure is applied on the skin with fingers or palm while moving it over an underlying structure. It benefits circulation and glandular activity on the skin. It is usually used on the scalp, arms, and hands; light circular movements are used on the face and neck. Chucking, rolling, and wringing are variations of friction and are used principally to massage the arms and legs.
a. Chucking This is accomplished by grasping the flesh firmly in one hand and moving the hand up and down along the bone while other hand keeps arm or leg in a steady position.
b. Rolling Tissues are pressed and twisted using a fast backand- forth movement.
c. Wringing This is a vigorous movement in which the hands, placed a little distance apart on both sides of the client’s arm or leg and working downward, apply a twisting motion against bones in the opposition direction.
5. Tapotement or Percussion This consists of short, quick tapping, slapping, and hacking movements; it is the most stimulating and should be applied with care and discretion. It tones muscles and imparts a healthy glow. In facial massage, use only light digital tapping. In slapping movement, keep wrists flexible and lift flesh slightly with each slapping stroke.
a. Hacking This is a chopping movement performed with the edges of the hands (like a karate chop); both wrists and hands move alternately in fast, light, firm, and flexible motions against the skin. It is used only on the back, shoulders, and arms.
6. Vibration This is a rapid shaking of a body part while the balls of fingertips are pressed firmly on the point of application; it is accomplished by rapid muscular contractions in arms. It is highly relaxing and should be applied at the end of a massage. Deep vibration, when combined with other massage movements, can be produced with a mechanical vibrator to stimulate blood circulation and increase muscle tone.
CAUTION: Do not massage a client with high blood pressure, a heart condition, or a stroke victim. If the client has arthritis, be careful to avoid vigorous massage of the joints. Maintain constant communication with the client during the massage and adjust your touch according to his/her needs.
D. PHYSIOLOGICAL EFFECTS OF MASSAGE
Every muscle has a motor point, which is the point on the skin over the muscle where pressure or stimulation will cause contraction of the muscle.
1. Motor points - Location of motor points varies among individuals due to differences in body structure.
2. Relaxation - This is achieved through light but firm, slow, rhythmic movements, or very slow, light hand vibrations over motor points for a short time.
E. BENEFITS OF PROPER FACIALAND SCALP MASSAGE
1. Skin nourishment
3. Increased blood circulation
4. Gland stimulation
5. Stimulated and strengthened
6. Soothed and rested nerves
7. Relieved pain
F. FACIAL EQUIPMENT Hands-on, supervised experience and training is required before using equipment.
1. Facial steamer Steaming softens tissues, making the skin more receptive to moisturizers and treatments.
2. Brushing machine - This is a rotating electric appliance with interchangeable brushes that can be attached to the rotating head. Heads come in different sizes and textures. Avoid brushing on clients with rosacea, sensitive skin, pustular acne, or other skin inflammation.
3. Skin suction/cold spray This is used to increase circulation and to jetspray lotions and toners onto the skin. Do not use on sensitive or inflamed skin. It is often used to hydrate skin or remove mask treatments.
V. ELECTROTHERAPY AND LIGHT THERAPY
Galvanic and high-frequency are types of electrotherapy. Do not use on clients with metal implants, a pacemaker, heart insufficiency, epilepsy, pregnancy, high blood pressure, fever, infection, insufficient nerve sensibility, open or broken skin, or fear of the procedure.
This is an applicator for directing the electric current from the machine to the client’s skin.
1. Galvanic machines - Use two electrodes.
a. Anode - Positive electrode with red plug and cord
b. Cathode - Negative electrode with a black plug and cord
2. Galvanic current - Accomplishes two basic tasks
a. Desincrustation - This is the process of softening and emulsifying hardened sebum stuck in hair follicles.
b. Iontophoresis This is the process of using galvanic current to penetrate water-soluble products that contain ions into the skin
3. Microcurrent - A type of galvanic treatment using a very low level of electrical current; it has many applications in skin care and is best known for helping to tone the skin, producing a lifting effect for aging skin that lacks elasticity.
4. High frequency - This uses only one electrode. An electrode is an applicator for directing electric current from the machine to the client’s skin. It was discovered by Nikolas Tesla. It is used to stimulate blood flow and help penetrate products. It can be used for acne-prone skin because of its germicidal effect. The most common is the
mushroom-shaped mushroom electrode.
a. Direct application - The electrode is applied directly to the skin.
b. Indirect application - The client holds the electrode creating an electrical stimulating massage. This is also called Viennese massage.
B. LIGHT THERAPY Several types of light are used for skin care treatments.
1. Infrared lamps - Used to heat skin and increase blood flow
2. LED Light- this treatment uses concentrated light that flashes very rapidly. It helps with wound healing. In our field it is used to minimize redness, warm lower level tissues, stimulate blood flow, improve skin smoothness, and help acne prone skin. Red lights are used to treat aging and redness; blue lights are used for acne-prone skin.
This is a type of mechanical exfoliation. It uses
a closed vacuum to shoot crystals onto the skin,
bumping off cell buildup.
D. FACIAL TREATMENTS
1. Preservative - Maintain the health of facial skin
2. Corrective - Correct some skin conditions such as dryness, oiliness, comedones, aging lines, and minor conditions of acne.
E. FACIAL TREATMENT GUIDELINES
1. Speak quietly and professionally.
2. Explain benefits and answer questions.
3. Provide a quiet atmosphere. Work quietly and efficiently.
4. Maintain a clean environment.
5. Follow systematic procedures.
6. Warm your hands.
7. Keep your nails smooth and short.
8. Analyze the skin.
F. SPECIAL PROBLEMS - Skin type
1. Dry skin - Caused by an insufficient flow of sebum from the sebaceous glands; facial for dry skin will help correct this condition.
2. Oily skin Characterized by comedones which are caused by hardened masses of sebum formed in the ducts of the sebaceous glands (sometimes requires medical attention)
3. Limited measures for acne - Generally the cosmetologist is limited to skin cleansing; reducing oiliness by local applications; removing comedones; and using special medicated preparations. Work under the advisement of a physician.
G. CONSULTATION AND HOME CARE
Home care is the most important factor in a successful skin care program. Consult thoroughly
regarding home care. Discuss treatment in a well lit environment with mirror. Organize products for purchase and use.
Aromatherapy is the therapeutic use of essential oils such as lemon, verbena, rosemary, and rose. They can enhance a person’s physical, emotional, mental, and spiritual well-being.