Skin Analysis, Skin Types, and Skin Conditions
Analysis sequence
Skin analysis is observation plus history, not a guess. Cleanse, then assess under good light and magnification: oiliness, pore size, texture, hydration, erythema, pigmentation, lesions, and laxity. Palpation checks tone and moisture. Fitzpatrick typing guides UV risk. Classify type, such as normal, dry, oily, combination, or sensitive, separately from conditions such as acne, rosacea, dehydration, hyperpigmentation, aging, and dermatitis.
What the exam tests
- Distinguishing type from condition: oily skin can be dehydrated; dry skin can be sensitive.
- Recognizing when to treat, adjust, or refer.
- Using a Wood's lamp cautiously. It highlights porphyrins and pigmentation but is not diagnostic.
- Avoiding diagnosis. Rosacea and acne vulgaris are medical diagnoses; an esthetician describes findings and refers.
Worked example
A client has an oily T-zone, tight cheeks after cleansing, and visible flaking under makeup. Is this simply oily skin? No. The tightness and flaking suggest dehydration with combination oiliness. The plan should not be a strong astringent. Use a gentle cleanser, a light humectant, and a noncomedogenic moisturizer, then reassess. Harsh stripping would worsen barrier loss and rebound oil.
Traps
- Treating sensitive as a disease rather than a reactivity pattern.
- Assuming large pores mean dirty pores.
- Over-reading a Wood's lamp as a diagnosis.
- Missing medication-related fragility from retinoids or isotretinoin.
- Promising to cure pigmentation or acne.