Skin Care and Esthetics
Anatomy you must be able to locate
The epidermis is the outer, avascular layer; its deepest part (stratum basale) is where new cells form, and the surface (stratum corneum) is dead keratinized cells. Beneath it sit the dermis - collagen, elastin, blood vessels, nerves, glands - and subcutaneous tissue. The acid mantle on the surface sits around pH 4.5–5.5 and helps suppress bacteria. Estheticians work on the epidermis; anything that bleeds or requires penetration is outside scope.
Analysis and treatment
Skin typing (normal, dry, oily, combination, sensitive) is separate from the Fitzpatrick scale (I–VI), which estimates sun response and melanoma risk. A skin analysis under magnifying lamp looks at pore size, oiliness, hydration, elasticity, pigmentation, and lesions. Massage manipulations are frequently tested: effleurage (light gliding strokes used to open and close), petrissage (kneading), tapotement (percussion), friction (small circular rubbing), and vibration.
Contraindications and referral
Do not treat contagious conditions, open or weeping lesions, sunburn, windburn, recent peels or waxing, or skin on isotretinoin or prescription retinoids. Refer suspected melanoma using the ABCDE signs (asymmetry, border irregularity, color variation, diameter, evolving) and any new or changing growth.
Rule of thumb and example
When in doubt, refer - an esthetician describes what she sees; she does not diagnose. Waxing: test temperature on your inner wrist, apply in the direction of hair growth and remove against it, never double-dip the applicator, and patch test first. A client on a retinoid who asks for a lip and brow wax should be rescheduled, not merely waxed gently.