WA Master Esthetician cheat sheet

Fitzpatrick phototype I–VI is assigned by the burn/tan response to first sun exposure: type I always burns and never tans, type VI rarely burns and tans deeply.

Glogau photoaging scale: I = mild, no wrinkles; II = wrinkles in motion only; III = wrinkles at rest; IV = severe with total facial involvement.

A Wood's lamp emits ~365 nm UVA; coral-red fluorescence indicates porphyrins from Cutibacterium acnes, yellow-white indicates sebum, brown indicates melanin, and blue-white indicates normal stratum corneum.

The consultation record must capture medications, allergies, pregnancy status, prior cosmetic procedures, sun exposure, and current home-care actives before any peel or device treatment.

Isotretinoin use is a resurfacing contraindication; standard practice waits about six months after the last dose before chemical or mechanical resurfacing.

Informed consent documentation includes risks, benefits, alternatives, expected downtime, aftercare instructions, and the client's signature with date.

Skin type (normal, dry, oily, combination, sensitive) describes current condition and is assessed separately from Fitzpatrick phototype, which predicts UV and pigment risk.

Patch testing a peel solution or new product on a small area 24–48 hours before treatment reduces the risk of an unexpected reaction.

Epidermal layers deep to superficial: basale, spinosum, granulosum, corneum; the lucidum layer exists only on palms and soles.

Melanocytes sit in the stratum basale and transfer melanin to keratinocytes via melanosomes; eumelanin is brown-black and pheomelanin is red-yellow.

The dermis has a papillary layer (loose connective tissue, capillary loops) and a reticular layer (dense type I collagen, elastin, glycosaminoglycans, fibroblasts).

Barrier function follows the brick-and-mortar model: corneocytes are the bricks and intercellular lipids (ceramides, cholesterol, fatty acids) are the mortar.

The acid mantle sits at pH ~4.5–5.5; alkaline cleansers raise surface pH, which slows barrier lipid recovery and reduces microbial defense.

Epidermal turnover is roughly 28 days in a young adult and lengthens with age and photodamage.

Wound healing sequence: hemostasis (minutes to hours), inflammation (days 1–3), proliferation with granulation tissue (days 3–21), remodeling (up to 1 year).

Langerhans cells in the epidermis are antigen-presenting immune cells; dermal mast cells release histamine during inflammation.

Skin functions include barrier protection, sensation, thermoregulation, vitamin D synthesis, excretion, and immune surveillance.

Glycolic acid has the smallest molecule of the common AHAs (~76 Da) and penetrates fastest; lactic is ~90 Da and mandelic ~152 Da, the largest and slowest.

Salicylic acid is the principal BHA: lipid-soluble, keratolytic, and follicular-penetrating; it is contraindicated with aspirin allergy.

Peel strength tracks free-acid concentration, which rises as pH falls below the molecule's pKa (glycolic pKa ~3.8, so effective peels sit near pH 3 or lower).

L-ascorbic acid needs low pH (below ~3.5) and 10–20% concentration to penetrate; vitamin E and ferulic acid improve its stability.

Retinoids accelerate turnover and thin the stratum corneum, so they are discontinued 5–7 days before waxing, peels, or resurfacing.

Humectants (hyaluronic acid, glycerin) bind water, emollients (oils, esters) soften and add flexibility, occlusives (petrolatum, dimethicone) reduce transepidermal water loss.

Niacinamide supports ceramide synthesis and sebum regulation and is not an exfoliating acid.

Emulsion type is set by the continuous phase: oil-in-water is light and non-greasy; water-in-oil is heavier and more occlusive.

Peel depth: superficial reaches stratum corneum to papillary dermis; medium reaches papillary to upper reticular dermis; deep reaches mid-reticular dermis.

Jessner's solution contains resorcinol 14%, salicylic acid 14%, and lactic acid 14% in ethanol.

TCA at 10–20% is typically superficial, ~35% is medium depth, and 50% or higher is deep with systemic toxicity risk; deep peels exceed esthetic scope.

Glycolic acid peels are stopped with a sodium bicarbonate neutralizer; salicylic acid is self-limiting and needs no neutralizing agent.

Frosting is coagulated protein and serves as an endpoint indicator for medium and deep peels, not for superficial peels.

Contraindications: pregnancy or lactation (avoid salicylic), isotretinoin within six months, active infection, keloid history, recent waxing or laser, photosensitizing drugs, and sunburn.

Salicylism presents as tinnitus, nausea, vomiting, dizziness, and rapid breathing; stop the peel, remove product, and refer for medical care.

Control application by visible endpoint and layer count, protect the eyes and mucosae, and avoid the eyelid margins.

Allow at least two weeks between resurfacing and significant sun exposure or tanning bed use.

Laser light is monochromatic, coherent, and collimated; IPL is non-coherent and polychromatic, typically 500–1200 nm with cutoff filters.

Selective photothermolysis requires a wavelength absorbed by the target chromophore and a pulse duration at or below that target's thermal relaxation time.

Principal chromophores: melanin (hair removal, pigmentation), hemoglobin (vascular lesions), and water (ablative and non-ablative resurfacing).

1064 nm Nd:YAG is relatively sparing of epidermal melanin and preferred for darker phototypes; 755 nm alexandrite and 800–810 nm diode absorb melanin strongly.

Fractional non-ablative wavelengths (1440, 1550, 1927 nm) create microscopic treatment zones; CO2 at 10,600 nm is ablative.

Fitzpatrick III–VI skin carries higher risk of post-inflammatory hyperpigmentation and blistering from melanin-absorbing devices, so lower fluence, longer pulse, and aggressive cooling are used.

Wavelength-specific eyewear is required for both client and operator; the beam is never viewed directly and eye shields are never omitted near the treatment field.

Cooling options include contact handpieces, cryogen spray (DCD), and forced cold air; cooling protects the epidermis while the target structure is heated.

Tanning and photosensitizing medications (tetracyclines, isotretinoin, some antibiotics) are avoided for 2–4 weeks before and after treatment.

Microneedling creates controlled epidermal and dermal micro-channels that trigger growth factor release and remodeling of collagen III toward collagen I.

Typical depths: 0.25–0.5 mm for epidermal effects and product delivery; 1.0–1.5 mm or deeper for scars and wrinkles, with proportionally higher risk.

Contraindications include active acne or infection, open lesions, keloid tendency, anticoagulant therapy, pregnancy, and immunosuppression.

Needle cartridges are single-use; never reuse a cartridge and dispose of it in a rigid sharps container.

Post-treatment: no makeup or active ingredients for 24 hours, strict sun protection, and avoidance of sweating, pools, and heat for 24–48 hours.

Radiofrequency microneedling delivers energy at a set depth, adding thermal injury; avoid over electronic implants without physician clearance.

Microdermabrasion is avoided over active acne, rosacea with telangiectasia, thin fragile skin, and open lesions; it removes only superficial stratum corneum.

Galvanic current: desincrustation uses the negative pole for saponification, while iontophoresis uses the pole matching the product's ionic charge.

High-frequency (Tesla) current produces ozone and has a mild germicidal, drying effect on the skin surface.

Sanitation reduces bioburden, disinfection destroys most pathogens on surfaces and implements, and sterilization destroys all microorganisms including spores.

Use an EPA-registered hospital-grade tuberculocidal disinfectant and honor the labeled contact time, commonly 10 minutes.

Wash hands with soap and water for at least 20 seconds before and after every client; hand sanitizer is for hands that are not visibly soiled.

Single-use items include needles, blades, gloves, cotton, wooden applicators, and porous files; discard them after one client.

Never double-dip; remove product with a clean spatula onto a secondary surface before applying to the client.

Autoclave parameters: 250°F (121°C) at 15 psi for 15–20 minutes; verify with biological spore testing at least weekly.

Used sharps go directly into a rigid, labeled sharps container; never recap a used needle by hand.

Pathogens of concern include hepatitis B, hepatitis C, and HIV; standard precautions treat all blood and body fluids as infectious.

Store clean and soiled linens separately and keep soiled linens in a closed receptacle.

Post-inflammatory hyperpigmentation is the most common adverse outcome of peels and light devices in Fitzpatrick III–VI; management is sun protection, tyrosinase inhibitors, and time.

Erythema lasting more than 24 hours, blistering, or crusting after a superficial procedure indicates an excessive reaction requiring cooling, soothing, and referral if unresolved.

Herpes simplex reactivation begins with tingling followed by grouped vesicles; defer further treatment and refer for antiviral therapy.

A keloid or hypertrophic scar is raised and firm and may extend beyond the wound margin; refer to a physician.

Allergic contact dermatitis is a delayed type IV reaction appearing 24–72 hours later; remove the product, apply cool compresses, and refer.

Infection warning signs are spreading redness, warmth, purulent drainage, and fever; refer immediately.

Salicylism signs include tinnitus, nausea, vomiting, dizziness, and hyperventilation and require emergency medical care.

Absolute resurfacing contraindications: pregnancy (elective), active infection, isotretinoin within six months, keloid history, immunosuppression, and recent sunburn.

For clients with a pacemaker or electronic implant, avoid electrical and radiofrequency modalities near the device without physician clearance.

Esthetics is regulated in Washington under RCW 18.16 (cosmetology, barbering, esthetics, manicuring) with implementing rules in WAC 308-20, administered by the Department of Licensing.

Training requirements are 750 clock hours for the esthetician license and 1,200 clock hours for the master esthetician license.

The license must be current, posted or available for inspection at the place of business; practicing on a lapsed license is unlicensed practice.

Performing services outside the scope of the license is prohibited and is grounds for disciplinary action regardless of client consent.

Advanced procedures outside the statutory scope for master estheticians must be referred to a physician or other appropriately licensed professional.

Client records and treatment information are confidential and may be disclosed only with written authorization or as required by law.

Washington requires reporting of suspected child abuse or neglect (RCW 26.44) and abuse of vulnerable adults.

False or misleading advertising, guarantees of results, and unsubstantiated medical claims violate professional ethics rules.

Informed consent must be obtained and documented before any advanced treatment is performed.