DC Esthetician cheat sheet

Washington State requires an esthetician license for anyone performing skin care services for compensation; a salon license or shop license is also required for the business location.

Infection control hierarchy: sanitation (cleaning, reduces microbes) < disinfection (kills most pathogens on nonporous surfaces) < sterilization (destroys all microbial life including spores).

EPA-registered hospital-grade disinfectant must be used on implements that contact skin or body fluids; implements must be cleaned before immersion, and contact time per label (commonly 10 minutes) must be observed.

Porous items (cotton, sponges, wooden spatulas, nail files) are single-use only; they cannot be disinfected and must be discarded after one client.

Handwashing with soap and water for at least 20 seconds is required before and after each client; alcohol-based sanitizer is a supplement, not a substitute when hands are visibly soiled.

Standard precautions treat all blood and body fluids as infectious: gloves for any contact with non-intact skin, blood, or mucous membranes, plus eye protection if splash risk exists.

Bloodborne pathogen exposure protocol: wash the exposed area with soap and water, flush mucous membranes, report to supervisor, and seek medical evaluation; HBV vaccination is offered to at-risk workers.

Contraindications to treatment include active herpes simplex lesion, impetigo, conjunctivitis, ringworm, undiagnosed rash, sunburn, and recent chemical peel or waxing on compromised skin.

Washington requires continuing education for license renewal (esthetics: 10 hours per year in Washington, including at least 3 hours of infection control and 1 hour of Washington law and rules).

Epidermis layers from deep to superficial: stratum basale, stratum spinosum, stratum granulosum, stratum lucidum (palms and soles only), stratum corneum.

Keratinocyte turnover averages about 28 days in healthy young skin and lengthens with age and photodamage; the stratum corneum is the primary barrier, formed of corneocytes in a lipid matrix (brick-and-mortar model).

Melanin is produced by melanocytes in the stratum basale; UV exposure stimulates melanogenesis, and melanin protects keratinocyte DNA by absorbing UV.

Dermis contains collagen (tensile strength), elastin (recoil), and glycosaminoglycans such as hyaluronic acid (hydration); fibroblasts synthesize these components.

Skin types: Fitzpatrick I–VI scale estimates UV response risk; type I burns easily and never tans, type VI rarely burns and tans deeply.

Skin conditions are not the same as skin types: dehydration, sensitivity, acne, and photoaging are conditions that can coexist with any type.

Sebaceous glands are concentrated on the face, scalp, and upper trunk; sebum production is androgen-influenced, which is why acne often begins at puberty.

Barrier impairment presents as tightness, stinging, erythema, and flaking; transepidermal water loss rises and treatment should shift to barrier repair rather than exfoliation.

Skin analysis sequence: cleanse, observe under magnification and appropriate lighting, palpate for texture and hydration, document lesions, then select products and modalities.

Standard facial sequence: consultation and skin analysis, cleansing, exfoliation, steam or warm towel, extractions if indicated, massage, mask, toner, moisturizer, sun protection.

Steam is typically used 5–10 minutes at a comfortable distance; it softens sebum and keratin but is contraindicated for rosacea, sensitive skin, and clients prone to broken capillaries.

Extractions are performed only on pustules and open comedones with gentle pressure and gloved fingers or extractors; never extract cystic lesions, moles, or inflamed papules.

Massage movements (effleurage, petrissage, tapotement, friction, vibration) are always directed toward the lymph nodes; light pressure and upward direction support venous and lymphatic return and reduce puffiness.

Contraindications to facial massage include active acne, skin infection, recent surgery, uncontrolled hypertension, thrombosis, and known malignancy in the area.

Manual lymphatic drainage uses very light pressure (about the weight of a coin) and is contraindicated with acute infection, congestive heart failure, or blood clots.

High-frequency current uses alternating current; indirect application (client holds the electrode) is used for general stimulation, direct application for spot treatment, and it is contraindicated with pacemakers and pregnancy.

Galvanic current drives water-soluble products into skin (desincrustation uses the negative pole to soften sebum; iontophoresis uses polarity to push actives) and is contraindicated with metal implants in the treatment area.

A treatment record should document skin analysis findings, products used, modalities, extraction sites, and any adverse reaction; it is both a clinical and legal record.

Waxing removes hair by pulling the shaft from the follicle; because hair grows in cycles, regrowth is expected in 3–6 weeks and multiple sessions are needed for lasting reduction.

Anagen (growth phase) hair responds best to waxing; telogen (resting) hair is more likely to break at the surface rather than release from the follicle.

Wax temperature should be tested on the inner wrist; hard wax melts around 55–65 °C and soft wax is applied warm but never hot enough to cause burns.

Waxing is contraindicated over varicose veins, moles, warts, active herpes, sunburn, recent retinoid or isotretinoin use, and on clients taking blood thinners or photosensitizing medications.

Client aftercare: avoid heat, sun, tight clothing, and exfoliation for 24–48 hours; use a gentle moisturizer and sun protection to reduce irritation and post-inflammatory pigmentation.

Contraindication timing rules: discontinue topical retinoids about 5–7 days before waxing, and clients on isotretinoin should generally avoid waxing for 6 months after stopping.

Double-dipping a wax stick into a pot contaminates the whole container; use a fresh stick per application or a disposable roll-on system.

Threading uses twisted cotton thread to trap and remove hair at the follicle; it is suitable for sensitive skin and brows but requires skill to avoid skin injury.

Laser hair removal targets melanin in the follicle, so it works best on dark hair with light skin; it is not effective on white, gray, or very light hair and requires eye protection for client and operator.

pH scale: skin surface averages about 4.5–5.5 (acid mantle); alpha hydroxy acids exfoliate because low pH increases free-acid concentration, and neutralizing raises pH to stop the action.

AHAs (glycolic, lactic, mandelic) are water-soluble and act at the stratum corneum; BHAs (salicylic acid) are lipid-soluble and penetrate pores, making them better for oily and acne-prone skin.

Emulsion types: oil-in-water (O/W) is lighter and absorbs quickly; water-in-oil (W/O) is heavier and more occlusive; an emulsifier keeps the two phases from separating.

Surfactants have a hydrophilic head and lipophilic tail; they remove oil and debris but overuse disrupts the lipid barrier, causing tightness and irritation.

Antioxidants (vitamin C, vitamin E, ferulic acid) neutralize free radicals from UV and pollution; vitamin C also inhibits tyrosinase and is formulated at acidic pH for stability and penetration.

Sunscreen terms: SPF measures UVB protection, broad-spectrum indicates UVA coverage, and PA or PPD ratings quantify UVA protection; reapplication every 2 hours is required with sun exposure.

Retinoids bind retinoic acid receptors to increase cell turnover and collagen synthesis; they cause photosensitivity and are contraindicated in pregnancy.

Hyaluronic acid is a humectant that holds water; occlusives such as petrolatum and dimethicone reduce water loss; emollients soften and smooth the stratum corneum.

Makeup color theory: complementary colors neutralize (green cancels redness, peach/orange cancels blue-purple under-eye circles, yellow cancels purple bruising), and foundation shade should be matched to the jawline in natural light.