Skin Analysis, Disorders, and Treatment Planning
Analysis before treatment
Skin analysis is the bridge between science and service. Assess skin type (dry, oily, combination, normal, sensitive), Fitzpatrick phototype, hydration, texture, pore size, and barrier condition. Learn primary lesions (macule, papule, pustule, vesicle, nodule, cyst, wheal) and secondary lesions (scale, crust, excoriation, scar, fissure). Estheticians identify and describe; they do not diagnose. Any lesion that is asymmetric, has irregular borders, multiple colors, is larger than a pencil eraser, or is changing should be referred to a physician-the ABCDE rule. Contraindications for exfoliation include active cystic acne, rosacea in flare, recent peels, isotretinoin use, and compromised skin.
Treatment planning means setting measurable goals, selecting products and modalities, documenting consent, and scheduling a realistic series. Traps: treating melasma with aggressive heat; extracting cysts; calling seborrheic keratosis contagious; promising a cure. Rule of thumb: if you cannot name the lesion with confidence, do not treat it-refer. Worked example: a client with melasma requests a strong peel. Explain that heat and inflammation can worsen pigmentation; recommend gentle brightening, broad-spectrum SPF, and a physician referral for medical options.