Skin Analysis, Conditions, and Disorders
Collect before you look
Analysis starts with an intake form: health history, medications (isotretinoin, topical retinoids, blood thinners, photosensitizers), allergies, pregnancy, recent peels or lasers, sun exposure, and current home care. Then the visual exam: cleanse the skin, use a magnifying lamp, palpate with gloved hands, and use a Wood's lamp only after cleansing so product residue does not fluoresce and mislead you.
Types, conditions, disorders
Skin type is stable - normal, dry, oily, combination, sensitive. Conditions change - dehydration, acne grade, pigmentation, texture. Fitzpatrick I–VI estimates UV response. Disorders are medical and are referred, not treated: impetigo, herpes simplex, conjunctivitis, tinea, scabies, undiagnosed rashes, and suspicious lesions.
Melanoma screening uses ABCDE: Asymmetry, Border irregularity, Color variation, Diameter over 6 mm, Evolving. Basal cell carcinoma often appears as a pearly nodule with visible capillaries; squamous cell carcinoma as a rough, scaly, persistent patch.
Worked example
A 48-year-old client has a pearly bump with tiny vessels beside her nose and asks you to "extract it." Reasoning: this is not a comedone, and squeezing a vascular lesion risks bleeding and delay in care. Do not treat; document the location and appearance, describe what you observed without diagnosing, and refer to a dermatologist.
Traps
Diagnosing instead of identifying and referring; treating over an active cold sore; calling dehydration a dry skin type (oily skin can be dehydrated); assuming oily skin needs no moisturizer; blaming all redness on rosacea without a referral for new or spreading symptoms.