Skin Analysis, Disorders, and Contraindications
Separate type from condition
Skin type is genetic and stable - normal, dry, oily, combination, sensitive. A condition is changeable - dehydration, aging, hyperpigmentation, acne, sensitization. Fitzpatrick I–VI describes burn-and-tan response, not oiliness, so do not confuse the two systems. Tools: magnifying lamp, palpation of the T-zone, and a Wood's lamp - blue-white is normal, yellow indicates oil, violet/purple suggests dehydration, brown shows pigmentation.
Name the lesion correctly
Primary lesions appear first: macule (flat color change), papule (raised, no fluid), pustule (contains pus), vesicle (small blister), bulla (large blister), wheal (edema, like hives), nodule (solid, deep), tumor, cyst. Secondary lesions are changes to existing lesions: scale, crust, excoriation, fissure, scar, ulcer, atrophy. A pustule called a papule is a classic wrong answer.
When to refer, not treat
Contagious conditions end the service: impetigo, ringworm, active cold sores, conjunctivitis, lice. Open, weeping, or undiagnosed lesions, sunburn, recent chemical peel or laser, and any suspicious mole go to a physician. Use ABCDE for moles: asymmetry, border irregularity, color variation, diameter, evolving. Rosacea clients need gentle care, no heat or friction. Do not extract inflamed pustules or squeeze cysts.
Traps
Questions often present a client who "wants" a treatment despite a contraindication - the correct answer is always to decline and refer. Also watch for Fitzpatrick versus skin type confusion and for product recommendations offered before analysis.
Rule of thumb
If you cannot name a lesion and it was not there last visit, do not treat it - document it and refer.