Skin Care and Nail Care
Domain 3: Skin Care and Nail Care
This domain tests skin and nail anatomy, client analysis, service protocols, and contraindications. Expect questions on skin layers and types, lesion recognition, facial massage, exfoliation, nail structures, manicure/pedicure safety, and when to refer.
Skin care essentials
- The epidermis is the outer avascular layer; the dermis contains collagen, elastin, nerves, glands, and vessels; subcutaneous tissue provides fat and insulation.
- Skin types are normal, dry, oily, and combination; conditions such as dehydration, sensitivity, and acne are separate from type. Fitzpatrick scale estimates sun sensitivity.
- Primary lesions include macules, papules, pustules, vesicles, and nodules; secondary lesions include crusts, scales, fissures, and ulcers. Undiagnosed lesions are contraindications-do not treat, extract, or diagnose.
- Facial massage manipulations include effleurage, petrissage, tapotement, vibration, and friction. Avoid massage over inflammation, open lesions, recent surgery, or contraindicated areas.
- Exfoliation removes dead surface cells; over-exfoliation can impair the barrier. Extractions are limited to comedo-like openings and only where scope of practice allows.
Nail care essentials
The nail plate rests on the nail bed; the matrix produces the plate; the lunula is the visible portion of the matrix; the eponychium is living tissue at the proximal nail fold; the hyponychium seals the free edge. Cuticle is dead tissue on the plate-do not cut living eponychium. Recognize signs of infection: redness, swelling, pus, pain, dark discoloration, or separation. Refer these clients.
Worked example
A client requests a facial and extraction of a painful, red, swollen bump. Reasoning: this is not a simple comedo; it suggests inflammation or infection. Extraction could spread infection or damage tissue. The correct action is to avoid the area, perform no extraction, and refer to a physician. Document the observation and service refusal.
Traps
Don't confuse eponychium with cuticle. Don't treat skin as a diagnostic surface-recognize and refer. Don't massage over contraindications. Don't assume all nail discoloration is polish staining.