SKIN ANALYSIS

• determining factor in deciding what products to use during the service and what products to recommend for home use

• Also confirms whether the client is an appropriate candidate for the treatment

SKIN TYPE

• classification that describes a persons genetic skin type

• Determined by genetics and ethnicity

• Based primarily on how much oil is produced in the follicles from the sebaceous glands and on the amount of lipids found between the cells

• 4 skin types (normal, combination, oily, and dry)

GENETIC

• related to heredity and ancestry of origin

T-ZONE

• center area of the face

• Corresponds to the “T” shape formed by the forehead, nose, and chin

• Evaluating pores in the T zone is the first step in determining skin type

PERFORMING SKIN ANALYSIS

• all skin types need proper cleansing, exfoliating, hydrating, and protecting

• When performing a skin analysis we are using our visual abilities (often under a microscope) to note properties in the skin (such as pore size or irregularities)

• Use palpation to examine the skin through touch

• First step in providing successful skin care treatments and recommending effective skin care

• Best tool is a magnifying lamp/light or a woods lamp

WOODS LAMP

• filtered black light that is used to illuminate skin disorders, fungi, bacterial disorders, and pigmentation

STEPS TO PERFORM A SKIN ANALYSIS

1. Review health history questionnaire (looks for medical conditions, medications, allergies, or other contraindications)

2. Wash your hands

3. Look briefly at your clients skin (including neck and chest) with your naked eye or magnifying light

4. Cleanse the skin

5. Cover the eyes with eye pads

6. Use a magnifying light to examine the skin more thoroughly

7. Look closely to determine the clients skin type, the conditions present, and the overall appearance

8. Touch the skin with the fingertips to fell its texture, its oil and water content, and its elasticity (pay attention to T-zone)

9. Ask questions about the skins appearance, clients health, and their lifestyle (tell your client what you are finding)

10. Apply a toner and moisturizer or sunscreen to balance and protect the skin

11. Recommend a skin are plan that includes professional treatments and skin care products for a home care regimen

12. Record your finding and recommendations

PALPATION

• manual manipulation of tissue by touching to make an assessment of its condition

NORMAL SKIN TYPE

LOOK/FEEL

• oil = balanced

• Hydration = balanced

• Follicle size = very small

• Appearance = uniform luminosity and none or rare blemishes

• Feel = soft, smooth texture, and good elasticity

HOW IS IT TREATED

• maintenance and prevention treatments

• Use 4 steps to skin health (cleanse, exfoliate, nourish, protect)

CAUSE

• body systems functioning holistically (a system of evaluating the entire individual in an interdisciplinary style, recognizing that body system work synergistically) for balance

• Most common in twenties and thirties

EXPERT TIPS

• introduce anti-aging products as client matures

• Normal skin will often become drier with age

• Reinforce use of sunscreen

COMBINATION

LOOK/FEEL

• oil = moderate to high

• Hydration = good to dehydrated

• Follicle size = larger in T-zone than cheeks and sides of face

• Appearance = can have buildup of dead skin and oil in pores around nose but dry or flaking skin outside of T-zone, some blemishes an comodones

• Feel = oiler in center T-zone than sides of face

HOW ITS TREATED

• cleansing and regular exfoliation

• Water based products

• Avoid harsh products and rough exfoliation

CAUSE

• overproduction of oil is the T-zone

• May have normal oil production in the T-zone and dehydrated skin on the sides of the face

EXPERT TIPS

• evaluate often, as oil-hydration balance can be disrupted by hormonal and environmental

• Reinforcement use of sunscreen

OILY

LOOK/FEEL

• oil = moderate to high

• Hydration = good to dehydrated

• Follicle size = moderate to large

• Appearance = shiny, comodones and blemishes may be present

• Feel = thick and firm, uneven due to congestion

HOW ITS TREATED

• regular cleansing and exfoliation and hydrating with water based products

• Treatments to balance oil production

CAUSE

• overproduction of oil due to genetics, hormonal changes, medications, stress, or environmental factors, such as skin care products or makeup that are comedogenic

• Overexfoiliation can create oilier skin as sebaceous glands work to increase surface dryness

EXPERT TIPS

• clients with oily skin breakouts an comodones may have them on the neck, back, shoulders, and chest

• Clients with oily skin age more slowly, since the oil acts to protect the skin

• Clients will need to use SPF regularly to avoid post inflammatory hyperpigmentation, a common ailment that accompanies acne

DRY

LOOK/FEEL

• oil = minimal production

• Hydration = minimal production

• Follicle size = difficult to visualize, fine pores

• Appearance = dull, lack of luminosity, flaking, blotchy

• Feel = rough, thin, tight

CAUSE

• underproduction of oil due to genetics, environmental factors, hormones

HOW ITS TREATED

• oil based products to provide protection of the acid mantle and increase the barrier function

• Dry skin often has compromised TEWL (abbreviation for transepidermal water loss ; water loss caused by evaporation on the skins surface)

• Treatments to provide nourishment and protection

EXPERT TIPS

• dry skin may often be dehydrated

• Reinforce use of sunscreen

FITZPATRICK SCALE

• scale used to measure the skin types ability to tolerate sun exposure

• 6 levels (1 lightest and 6 darkest)

• Higher Fitzpatrick skin types have melanocytes that produce more melanin

FITZPATRICK TYPE 1

• eyes = blue or green

• Hair = blonde or red

• Unexposed skin = very white, almost translucent, freckles

• Heritage heredity = English, Irish, Scottish, Northern European

• Skin reaction in UV exposure = always burns, peels with burn, does not tan

FITZPATRICK TYPE 2

• eyes = blue, hazel, and brown

• Hair = red, blonde, and brown

• Unexposed skin = light

• Heritage heredity = Scandinavian and same as Fitzpatrick 1

• Skin reaction in UV exposure = burns easily, usually peels, tans minimally

FITZPATRICK TYPE 3

• eyes = dark

• Hair = dark

• Unexposed skin = fair to olive

• Heritage heredity = Spanish, Greek, and Italian

• Skin reaction in UV exposure = tans well, burns moderately

FITZPATRICK TYPE 4

• eyes = dark

• Hair = dark

• Unexposed skin = light brown

• Heritage heredity = Mediterranean, Asian, Hispanic

• Skin exaction in UV exposure = tans easily, burns minimally, experiences immediate pigment response

FITZPATRICK TYPE 5

• eyes = dark

• Hair = dark

• Unexposed skin = dark brown

• Heritage heredity = East Indian, American Indian, Hispanic , Latin American, African American

• Skin reaction in UV exposure = rarely burns, tans easily and significantly

FITZPATRICK TYPE 6

• eyes = dark

• Hair = dark

• Unexposed skin = dark brown , black

• Heritage heredity = African American, aboriginal

• Skin reaction in UV = rarely/ never burns, tans easily

CLASSIFICATION SYSTEM

• Fitzpatrick scale

• Glogau scale

• Rubin scale

SENSITIVE SKIN

• characterized by fragility, thin skin, and redness

• Is a condition but can also be genetically predisposed

• Easily irritated by products, exposure to heat, or exposure to sun

• Can be a result of age or medications

• Skin an become reactive and sensitive from exposure to things such as harsh products, heat, or even become dehydrated and chapped from cold weather

• Can be difficult to treat because of its low tolerance to products and stimulation

• Needs to be treated gently with no irritating, calming products and treatments

• Main treatment goals are tot soothe, calm, and protect

• Typically Fitzpatrick 1

• Telangiectasia may be noticeable on sensitive skin

TELANGIECTASIA

• visible, broken, or distended capillaries less that 0.5 mm due to intrinsic or extrinsic causes

FITZPATRICK SCALE TYPE 4 CHARACTERISTICS

• considered to be one of the most challenging skin types to treat well

• Has great elasticity and firmness and does not show signs of against as quickly as type 1 and 2

• Can become hyperpigmentation from treatments or aggressive exfoliating agents (gentle exfoliates)

• Requires sun protection to slow down hyperpigmentation (sunscreen daily)

• Typically have thicker skin that is usually characterized by more oil production and needs more deep cleansing treatments

FITZPATRICK SCALE TYPE 5 AND 6 CHARACTERISTICS

• generally have oilier and thicker skin (dermis) but can have the same level of reactivity as lower Fitzpatrick skin types

• Reactions may be more challenging to see on darker skin (may be just as intense as on lighter skin)

• Prone to a form of hyperkeratosis known as ichthyosis and dead skin-cell buildup (need more exfoliation and deep pore cleansing)

• May have abnormal hypertrophic scarring (keloids)

• Sun protection still necessary for these skin types

DÉCOLLETÉ

• Also referred to as décolletage

• Pertaining to a woman’s lower neck and chest

NECK AND DÉCOLLETÉ

• not the same skin as the skin on the face

• Have fewer sebaceous glands than the face (show again more quickly)

• More susceptible to irritation

• Photo damage, broken capillaries, fine lines, and rhytids (wrinkles) develop just as much as the face

• Needs SPF just as much as the face

• Be cautious using vitamin a or alpha hydroxy acid (AHA) because they can cause excess irritation

TECH NECK

• rhytids that develop due to the repeated movement of looking down at a cell phone or other electronic device

• Has created a demand for specialty topical treatments that include antioxidants, growth factor serums, and additional moisture

ACNE

• sebaceous breakouts from hormonal changes or other factors

ACTINIC KERATOSIS

• a rough area resulting from chronic sun exposure, sometimes with a layered scale or scab that sometimes falls off

• Can be precancerous

AGING

• characterized by skin laxity due to collagen and bone loss, thinner skin, dryness, photo damage, and fine line or wrinkles (rhytids)

ASPHYXIATED

• smokers have asphyxiated skin from lack of oxygen

• Characterized by clogged pores and wrinkles, dull and lifeless-looking, can be yellowish or gray in color

COMEDONES

• open comedones are blackheads and clogged pores caused b buildup of debris, oil and dead skin cells in the follicles

• Closed comedones are whiteheads are not open to the air or oxygen and are trapped by dead skin cells and need to be exfoliated and extracted

COUPEROSE SKIN

• redness in the skin with no visible vascularity because the matting of blood vessels is so small and fine

• Often seen with Telangiectasia

CYSTS

• fluid, infection, or other matter under the skin that is encapsulated into a palpable firm mass of varying sizes (from pea to a golf ball)

DEHYDRATED

• lack of water caused by the environment, medications, topical agents, against, or dehydrating drink (caffeine and alcohol)

ENLARGED PORES

• larger follicles due to excess oil and debris trapped in the follicles or expansion due to elasticity loss or trauma

ERYTHEMA

• redness caused by inflammation

GROWTHS

• skin cells and underlying tissue that overproduce and create an area tat could be raised or flat but can be distinguished by palpation

• May be the same color as surrounding tissue or may be pigmented

• Can be present at birth or develop later

HERPES SIMPLEX 1

• a communicable virus that appears as a vesicle on the lip similar to a blister

HIRSUTISM

• excess body hair located in regions where hair is not normally present (facial hair on women)

• Commonly caused by hormonal imbalance, PCOS is also a cause

HYPERKERITINIZATION

• an excessive buildup of dead skin cells/keratinized cells

HYPERPIGMENTATION

• overproduction of melanin due to at least 1 of 3 factors

• (1) uv exposure ; usually appears as diffuse brown spots of various shades on the skin

• (2) hormonally induced ; also called melasma

• (3) post inflammatory hyperpigmentation also called PIH ; appear deep red almost purple, to dark brown in color and can gradually fade

HYPERTRICHOSIS

• refers to any excess hair growth, whether it is caused from a hormonal imbalance or heredity

HYPOPIGMENTATION

• lack of melanin production due to 4 possible factors

• (1) UV induced ; intermingled with UV-induced hyperpigmentation ; no treatment options but lightening the hyperpigmentation will usually blend the areas

• (2) posttraumatic ; lack of melanocyte production due to an injury, burn, or other trauma including a deep chemical peel

• (3) vitiligo ; an autoimmune disorder that stops melanocyte production, creating patches of depigmented skin

• (4) albinism ; a hereditary disorder clung lack of pigment in the eyes, skin, and hair

IRRITATION

• usually redness or inflammation from a variety of causes

KERATOSIS PILARIS

• a buildup of cells ; a rough texture

MELASMA

• a form of hyperpigmentation that is characterized by bilateral patches of brown pigmentation on the cheeks, jawline, forehead, and upper lip

• Due to hormonal imbalances such as, pregnancy, birth control, or hormone replacement therapy

• Gets worse with sun exposure

MILIA

• hardened, pearl-like collections of oil and dead ski cells trapped beneath the surface of the skin

• Not exposed to oxygen and have to be lanced to open and remove them

• Typically the size of a pin

PAPULES

• raised lesions

• Also called blemishes

POIKILODERMA OF CIVATTE

• a result of chronic sun exposure, specifically along the sides of the neck, which turns a reddish brown color with clear demarcation of untamed skin under the chin

POOR ELASTICITY

• skin laxity from damage, sun, and aging

PUSTULES

• An infected papule with fluid inside

SCAR

• a mark on the skin where a wound, burn, or sore has healed and left a fibrous band of connective tissue, sometimes hyperpigmented or hypopigmented

SEBACOUS HYPERPLASIA

• benign lesions seen in oilier areas of the face

• Described as looking like doughnut holes

• Cannot be extracted

SEBBORRHEA

• also known as seborrheic dermatitis

• Excess oil production that causes redness, irritation, and flaking

• Occurs mostly in the hair as dandruff

SENSITIVITIES

• physical reactions, such as erythema, edema, wheals, itching, stinging, or discomfort, from internal or external influence

SOLOR COMEDONES

• large open comedones

• Usually around the eyes due to sun exposure

STRIAE OR STRETCH MARKS

• dermal scars due to rapid expansion or stretching of connective tissue leaving deep red, pink, or purple linear marks on the skin that gradually fade to light pink or silver over time

SUN DMAAGE

• UV damage to the epidermis and dermis

• Primary effects are wrinkles, collagen, and elastin breakdown, pigmentation, and cancer

TELANGIECTASIA

• visible broken or distended capillaries less than 0.5 mm due to intrinsic or extrinsic factors

WRINKLES/RHYTIDS

• lines and damage from the internal or external cause

INTRINSIC AGING

• the natural aging process, collagen production decreases, cell turnover slows down

• Skin aging factors over which we have little control because they are a part of genetics and familial heredity

• Genetics and ethnicity-influenced conditions

• Free radicals

• Dehydration

• Vitamin deficiencies

• Hormones

• Medical conditions, such as chronic illness, cancer, systemic diseases, impaired immune function

• Puberty

• Aging

• Glycation (alters protein structures and decreased biological activity)

• Pregnancy

• Menopause

EXTRINSIC AGING

• External or outside factors that speed up the hole against process

• UV exposure, sun damage

• Tanning beds

• Environmental exposure, pollutants, air quality

• Environment, climate, humidity

• Poor maintenance, inappropriate skin care

• Misuse of products or treatments, over exfoliation, harsh products

• Allergies and reactions to environmental factors or products

• Photosensitivity to the sun fro medications or products

HEALTHY SKIN HABITS

1. Avoid sun exposure ; use sunscreen daily

2. Eat balanced diet

3. Do not smoke

4. Avoid excessive alcohol

5. Drink plenty of water

6. Get plenty of rest

7. Stay active and exercise regularly

8. Use beneficial skin care products and a reglar home care routine

9. Get professional skin care treatments

10. Implement stress relievers and maintain a calm positive attitude

CONTRAINDICATIONS

• factor that prohibits a treatment due to a condition

• Treatments could cause harmful or negative side effects to those who have specific medical or skin conditions

• Skin diseases, disorders, or irritations

• Use of isotretinoin (need to complete 6 months prior)

• Skin thinning or exfoliating topical medication (retinol, renova, differin ; avoid waxing, exfoliation, and peels)

• Pregnancy (no electrical treatments, chemical peels, or aggressive ingredients)

• Metal bone pins or plates in the body (avoid all electrical treatments in the area where it is)

• Pacemakers or heart irregularities (avoid all electrical treatments that require a grounding pad)

• Allergies

• Seizures or epilepsy (avoid electrical and light based treatments)

• Use or oral steroids (avoid stimulating exfoliating treatments or waxing)

• Autoimmune diseases (avoid harsh or stimulating treatments and products)

• Diabetes (slow healing)

• Blood thinners including NSAIDs (caution with waxing and extractions)

CLIENT CONSULTATION

• determine that a treatment is appropriate for the client or that the skin care products will benefit the clients skin

INTAKE FORMS

• a confidential intake form that should be updated at each visit

• Discloses health history, all products and medications, medical conditions, any known allergies or sensitivities, their at home skin care, and recent skin care treatments

CONSENT FORM

• written agreement between the esthetician and the client for applying a treatment

• Client reads and signs acknowledging that they understand what is being done to them as well as any risks involved and releasing you from liability before you preform services

CLIENT CHART OR SERVICE RECORD

• a record of all your notes from the skin analysis, the type of treatment performed, products used in the treatment, goals you are working toward, your home care recommendations, and other consultation notes