NC Esthetician cheat sheet

Pathogenic bacteria cause disease; nonpathogenic bacteria are harmless or beneficial. Bacteria appear in three shapes: cocci (round), bacilli (rod), and spirilla (spiral or corkscrew).

Bloodborne pathogens of concern in esthetics are hepatitis B, hepatitis C, and HIV. Hepatitis B is the most contagious of the three and survives longest on surfaces; vaccination is recommended for estheticians.

Clean before you disinfect: scrub nonporous implements with soap and water to remove all debris, dry them, then fully submerge them in an EPA-registered hospital-grade disinfectant for the contact time stated on the label.

A hospital-grade disinfectant must carry bactericidal, virucidal, and fungicidal claims. For blood or body-fluid spills, use a tuberculocidal product or a 1:10 dilution of household bleach.

Sterilization (autoclave at about 15 psi, 250 degrees F / 121 degrees C, for 15-20 minutes) destroys all microorganisms including spores; routine esthetic implements require disinfection, not sterilization.

Porous items such as wooden spatulas, cotton, gauze, sponges, and nail files cannot be disinfected and must be discarded after a single use.

Wash hands with soap and warm water for at least 20 seconds before and after every client, and wear gloves whenever contact with blood, body fluids, or non-intact skin is possible.

Refuse service when a client shows a contagious condition (impetigo, ringworm, conjunctivitis, lice, scabies, active herpes lesion) or signs of local infection: redness, heat, swelling, pain, or pus.

Electrical and chemical safety: use only UL-listed grounded equipment, keep cords away from water and heat, never immerse a plugged-in device, and keep a Safety Data Sheet on file for every chemical in the salon.

Epidermal layers from deep to superficial: stratum basale (mitosis and melanocytes), stratum spinosum, stratum granulosum, stratum lucidum (palms and soles only), stratum corneum (dead, keratinized cells).

Dermis has two layers: papillary (upper; capillaries and nerve endings) and reticular (lower; collagen, elastin, glands). The subcutaneous layer stores fat for insulation and shock absorption.

Epidermal turnover averages about 28 days. Keratin is the protein that waterproofs and protects the stratum corneum, and keratinocytes are its primary cells.

Seven functions of the skin: protection, sensation, heat regulation, excretion, secretion, absorption, and respiration.

Fibroblasts produce collagen (strength), elastin (elasticity), and glycosaminoglycans including hyaluronic acid (hydration); UV exposure degrades all three.

Sebaceous glands secrete sebum into hair follicles; eccrine glands produce watery sweat for temperature control; apocrine glands are found in the axillae and groin.

pH scale runs 0-14: below 7 is acidic, 7 is neutral, above 7 is alkaline. The skin's acid mantle sits at about pH 4.5-5.5, and alkaline cleansers disrupt it.

Alpha hydroxy acids (glycolic, lactic) are water-soluble and act at the surface; beta hydroxy acid (salicylic) is oil-soluble and penetrates follicles. Both increase photosensitivity.

UVA has longer wavelengths, penetrates deeper, and drives photoaging; UVB is shorter, affects the epidermis, and causes burning. Fitzpatrick types I-VI predict burning and tanning response.

Consultation sequence: intake form and health history, skin analysis, identification of contraindications, treatment plan with informed consent, service, then home-care recommendation.

Postpone service for: isotretinoin (Accutane) within about 6 months, active infection or open lesions, recent surgery or peel, sunburn, uncontrolled diabetes, and pregnancy when ingredients or electrical devices are involved.

Medications and products that increase sensitivity: retinoids, AHAs and BHAs, blood thinners, photosensitizing antibiotics such as tetracyclines, and recent chemical peels.

Standard facial order: cleanse, analyze, exfoliate, steam and extract, massage, mask, moisturize, then sun protection.

Waxing rules: hair should be about 1/4 inch (6 mm); apply wax in the direction of hair growth and remove against it; test temperature first; never wax over moles, varicose veins, broken or inflamed skin, or areas outside your training.

Massage movements: effleurage (gliding), petrissage (kneading), tapotement (percussion), friction (circular), and vibration; strokes move toward the lymph nodes.

Patch test tints, dyes, and chemical peels 24-48 hours before the service and record the result in the client's chart.

Chart with SOAP notes: Subjective (client's own words), Objective (what you observe), Assessment (skin type and condition), Plan (treatment and home care).

Refer to a physician rather than treat suspected skin cancer (ABCDE: asymmetry, irregular border, varied color, diameter over 6 mm, evolving), cysts, or any undiagnosed rash.

North Carolina licenses estheticians through the Board of Cosmetic Art Examiners; licensure requires completing a Board-approved esthetics program, passing written and practical exams, and keeping the license current and displayed.

Scope of practice: estheticians may not diagnose skin disease, prescribe medication, or perform medical procedures; all services must fall within the cosmetic art scope defined by the Board.

Practicing without a license, violating sanitation rules, or using false advertising are grounds for Board discipline, including fines, suspension, or license revocation.

Keep client records confidential and secure, and obtain written informed consent before services, especially for minors, who need a parent or guardian signature.

Business structures include sole proprietorship, partnership, LLC, and corporation; each differs in liability exposure and tax treatment.

An employee esthetician receives wages or commission with the employer paying half of FICA; an independent contractor or booth renter pays the full 15.3% self-employment tax and supplies their own insurance.

Carry professional liability (malpractice) insurance, which covers injury claims from services and is separate from general business and property coverage.

OSHA's Hazard Communication Standard requires a Safety Data Sheet for every chemical on site, proper container labeling, and staff training on safe handling.

Federal and state consumer protection laws prohibit deceptive pricing and advertising; service claims and before-and-after photos must be truthful and used only with the client's written permission.