Skin Analysis, Conditions, and Disorders
Skin analysis, conditions, and disorders tests whether you can look at a face, separate what is stable from what is changeable, name lesions correctly, and refer what is outside your scope. Colorado expects estheticians to recognize disease, not diagnose it.
Type versus condition
Skin type is genetic and relatively stable: normal, dry, oily, combination, sensitive. A condition is changeable: dehydration, acne, rosacea, pigmentation, aging, sensitization. Fitzpatrick I–VI describes burning and tanning response and guides sun protection and light-based decisions; it is not the same as skin type.
Lesions to name
- Primary: macule, papule, pustule, nodule, cyst, vesicle, bulla, wheal.
- Secondary: crust, scale, fissure, ulcer, scar, keloid, excoriation.
- Contagious or medical: herpes simplex, impetigo, warts, molluscum, ringworm, conjunctivitis, scabies, lice. Do not treat; refer.
- Melanoma warning: ABCDE - asymmetry, border irregularity, color variation, diameter greater than 6 mm, evolving.
Contraindications
Active infection, open wounds, recent surgery, recent laser or deep peel, severe sunburn, allergic reaction, and undiagnosed lesions are reasons to stop or refer. Extractions are limited to visible comedones and suitable pustules; do not squeeze nodules, cysts, or inflamed papules.
Worked example
A client has a pearly, translucent papule with telangiectasia and a rolled border on the nose. It does not look like a comedo. The correct reasoning: this could be basal cell carcinoma, which is medical. Do not extract, do not treat with a peel, and do not reassure the client that it is 'just a pimple.' Document the location and appearance, refer to a dermatologist, and continue only with services on unaffected areas if appropriate.
Traps
- Diagnosing instead of describing and referring.
- Calling dehydration 'dry skin' - dehydration is a condition; dryness is a type.
- Treating a nodule or cyst as an extraction target.
- Using Fitzpatrick as a skin-type label.
- Missing a contagious lesion because it is small.
- Promising that a facial will 'cure' rosacea or acne.