Client Consultation, Skin Analysis and Contraindications
Consultation items test judgment: did you gather the right history, analyze the skin correctly, identify the contraindication, obtain consent, and document it? Expect intake-form content, analysis tools, and absolute versus relative contraindications.
Intake and consent
A complete intake covers medications (isotretinoin, retinoids, blood thinners, photosensitizing drugs), allergies, pregnancies, surgeries, dermatologic history, sun exposure, current home care, and prior professional treatments. Consent is informed, specific to the service, and recorded. Records are objective, dated, and factual - quote the client rather than diagnosing.
Analysis tools
Visual inspection under magnification, palpation for oiliness and texture, and Wood's lamp for surface hydration, pigmentation, and follicular bacteria. Classify by oiliness and hydration, then add Fitzpatrick type for UV risk.
Contraindications
- Absolute for most services: active infection, open lesions, fever, recent surgery in the area, undiagnosed rash.
- Relative or modified: pregnancy (avoid high-percentage salicylic, certain essential oils, and electrical modalities), pacemaker or metal implants (no electrical current), photosensitivity (no peels, LED, or laser), isotretinoin (defer waxing six months and aggressive exfoliation), autoimmune or keloid history (patch test, conservative plan).
Worked example
A client on isotretinoin books a brow wax three weeks after her last dose. Reasoning: the drug reduces sebum and thins the skin for months, so waxing risks epidermal stripping and scarring. Correct answer: decline the wax, document, offer tweezing, and advise waiting at least six months after the final dose.
Traps
Relying on a signed form as a substitute for asking questions. Accepting "I think I stopped that medication." And treating a relative contraindication as absolute when a modified service is appropriate - or the reverse.