Esthetics
Esthetics covers skin analysis, facial protocols, hair removal, makeup, electrical devices, and the sanitation and contraindication rules behind them. Exam items are often built around a decision: when to treat, when to modify, and when to refuse and refer.
Skin analysis
- Fitzpatrick I–VI grades sun response and guides peel and light-treatment selection; a type I burns easily and never tans.
- Skin types: normal, dry, oily, combination (oily T-zone), and sensitive. Classify by what you observe after cleansing, not by what the client says.
- Lesion vocabulary: primary lesions (macule, papule, pustule, vesicle, wheal, nodule, cyst) arise first; secondary lesions (scale, crust, excoriation, fissure, scar, keloid) evolve from them. Contagious conditions - impetigo, tinea, herpes simplex, conjunctivitis - are not treated; cleanse and refer.
Facial sequence and massage
- Standard order: cleanse, analyse, exfoliate, steam, extract, massage, mask, tone, moisturise, sunscreen.
- Massage movements: effleurage (gliding), petrissage (kneading), tapotement (percussion), vibration, and friction.
Hair removal
- Hair cycles through anagen (growth), catagen (transition), and telogen (rest); only anagen hair responds well to light-based removal.
- Wax is applied in the direction of growth and removed against it with the skin held taut; hair should be about 1/4 inch. Hard wax suits sensitive and bikini areas.
- Contraindications: isotretinoin (Accutane), topical retinoids, recent peels or laser, varicose veins, moles, abrasions, and sunburn.
Electrical devices
- Galvanic (direct) current: desincrustation with the negative pole (alkaline), iontophoresis with the positive pole (acidic).
- High frequency (Tesla) produces ozone and violet rays and does not stimulate muscle; microcurrent works below the level of sensation.
Worked example
A client on isotretinoin books a facial with extractions and brow waxing. Reason it out: the drug thins and sensitises skin for months after the last dose, so waxing can strip skin and extractions can scar. Postpone both, offer a gentle cleanse and massage with no exfoliation, and record the reason.
Traps that cost marks
- Double-dipping a wax stick or spatula.
- Extracting over inflamed or contagious lesions.
- Treating electrical modalities as interchangeable.