Client Consultation, Contraindications, and Informed Consent
This domain tests whether you screen before you touch the skin, document consent properly, and recognize when to defer or refer.
Core rules
- Take a focused history: medications, allergies, bleeding disorders, immunosuppression, diabetes control, prior cosmetic tattoos, keloids, active skin disease, pregnancy/breastfeeding, and herpes labialis history for lip work.
- Separate absolute from relative contraindications. Active infection or infected skin at the site is absolute; pregnancy, recent isotretinoin, blood thinners, and uncontrolled diabetes are usually relative-defer and coordinate with the prescriber.
- Informed consent must cover the procedure, realistic outcomes, risks (infection, scarring, asymmetry, color change, need for touch-up), alternatives, aftercare, photography, and the fact that no result is guaranteed. It is documentation, not a waiver of liability.
- Patch tests are not fully predictive; document any test and any reaction. Verify age and follow New Mexico rules for minors.
Worked example
A client wants lip blush but reports a cold sore two weeks ago. Reasoning: lip trauma can trigger herpes simplex reactivation. Defer until healed and, if appropriate, have the prescriber approve antiviral prophylaxis before rescheduling.
Traps
Treating a signed form as a substitute for consultation; promising a patch test prevents all allergy; ignoring a keloid history; assuming a client’s “okay” means no medical risk.