Skin Analysis, Disorders, and Conditions
Analyze before you treat
A complete analysis includes consultation and intake (medications, allergies, pregnancy, recent peels or waxing, retinoid or isotretinoin use), visual and tactile assessment under good light, and Fitzpatrick typing (I–VI) to judge burn risk and pigment response. Classify skin as normal, dry, oily, combination, or sensitive, and note congestion, dehydration, texture, and vascularity.
Lesion language
Primary lesions arise first: macule (flat color change), papule (raised, solid), pustule (pus-filled), vesicle (small blister), bulla (large blister), wheal (edema, as in hives), nodule, cyst, tumor. Secondary lesions evolve from primary or from scratching: crust, scale, scar, excoriation, fissure, ulcer, atrophy.
Treat vs. refer
Estheticians may work with cosmetic concerns - comedones, milia, mild acne, hyperpigmentation, photoaging, dryness. Refer to a physician: any suspected skin cancer (asymmetry, irregular border, varied color, diameter over 6 mm, evolving), open or oozing lesions, undiagnosed rashes, and contagious conditions including herpes simplex, impetigo, tinea (ringworm), verruca (warts), scabies, pediculosis, and conjunctivitis. Know common triggers for rosacea (heat, alcohol, spice, sun) and that telangiectasia and active eczema or psoriasis are not candidates for aggressive exfoliation or heat.
Rule of thumb: if a lesion is crusted, oozing, bleeding, painful, or changing, stop and refer - do not extract, wax, or peel over it.
Trap: milia are keratin-filled cysts, not comedones, and do not respond to ordinary extraction pressure; a pustule is an inflamed lesion and should not be squeezed.