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Shop 2, 161 New South Head Road, Edgecliff, NSW 2027 Australia
P + 61 2 9326 2211 F + 61 2 9326 2277 www.sbdi.com.au [email protected]
Nat. Prov. No 91192 / CRICOS No 02725B
© 2016 SBDI All rights reserved
SHBBSKS005
Provide Micro-dermabrasion
Treatments Learner Guide
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Learner Guide SHBBSKS005
This work is Copyright© of:
Fuss Education Pty Ltd
Shop 2/161 New South Head Road
Edgecliff NSW 2027
Created for the delivery of Vocational Education within Sydney Beauty & Dermal
Institute, RTO 91192, CRICOS 02725B
Resources have been created by Fuss Education Pty Ltd to support the SHB Hair
and Beauty Training package and are from a collection of professional, industry
representatives and resources, and reasonable effort has been made to ensure
that the material is accurate and current. Author/s takes no responsibility for act or
omission as a result of learning. Copying, reproducing, transmission or alterations
are not permitted and a license will not be granted.
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TABLE OF CONTENTS
INTRODUCTION ...................................................................................... 4
APPLICATION ......................................................................................... 4
ELEMENTS AND PERFORMANCE CRITERIA ............................................ 6
PART 1 KNOWLEDGE SUPPORT MATERIAL ........................................ 8
SECTION 1 ESTABLISH CLIENT PRIORITIES ............................................ 13
SECTION 2 DESIGN MICRO-DERMABRASION TREATMENT ................. 52
SECTION 3 PREPARE FOR MICRO-DERMABRASION TREATMENT........ 70
SECTION 4 PERFORM PATCH TEST ....................................................... 73
SECTION 5 PROVIDE MICRO-DERMABRASION .................................. 74
DIAMOND TIP MICRO-DERMABRASION ............................................. 78
CRYSTAL TIP MICRO-DERMABRASION ................................................ 80
SECTION 6 REVIEW TREATMENT AND PROVIDE POST TREATMENT
ADVICE ................................................................................................ 83
SECTION 7 CLEAN TREATMENT AREA .................................................. 87
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INTRODUCTION
This book is designed to provide a theory and assessment framework to support the
gathering of suitable evidence to prove competency in the unit.
The resource is designed for self-paced learning, as well as, distance education
settings, in a classroom or workshop setting. It is more than capable of supporting
new learners entering the industry, as well as experienced workers seeking to up-skill;
transfer to a new industry or to obtain formal qualifications.
At the completion of the learning, the Learners shall be able to demonstrate or
provide evidence of competency and understanding of the following:
Problem solving
Counselling processes and methods
Respect for client strengths or particular needs
Capacity to maintain and critique realistic limits for agency service and client
expectations
APPLICATION This unit describes the performance outcomes, skills and knowledge required to use
pre-set systems using crystals and vacuum suction to exfoliate the skin of the body or
face.
It requires the ability to establish priorities with the client and synthesise knowledge of
skin science and effects of treatment on skin structure, and to design and provide a
safe and effective treatment. Micro-dermabrasion treatment can be an individual
service or form part of a series of services.
This unit applies to beauty therapists who work in beauty salons. In this environment
they work in a team but exercise judgment in selecting and providing an
appropriate treatment.
No occupational licensing, certification or specific legislative requirements apply to
this unit at the time of publication.
This unit includes:
Establish client priorities
Design micro-dermabrasion treatment
Prepare for micro-dermabrasion treatment
Perform patch test
Provide micro-dermabrasion treatment
Review and provide post treatment advice
Clean treatment area
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FOUNDATION SKILLS
Foundation skills essential to performance in this unit, but not explicit in the
performance criteria are listed here, along with a brief context statement.
Oral communication skills to: Provide simple explanations to client that
describe the physiological processes of skin
damage and aging and how the selected
device, products and advice will impact the skin
Reading skills to: Interpret, and follow manufacturer instructions
and safety data sheets for safe use of cleaning
and treatment products, micro-dermabrasion
equipment and attachments
Numeracy skills to:
Calculate timing, treatment parameters a price
Planning and organising skills
to:
Sequence treatment delivery to maximise
benefits for client
Technology skills to:
Access credible online publications and
resources which build knowledge for providing
advice to clients
Use client software to update client notes, record
stock data and product purchases
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ELEMENTS AND PERFORMANCE CRITERIA
ELEMENTS PERFORMANCE CRITERIA
Elements describe
the essential
outcomes.
Performance criteria describe the performance needed to
demonstrate achievement of the element.
1. Establish client
priorities
Access and review client treatment plan if available
Discuss ski changes over lifetime, current skin care
regimen, lifestyle and nutrition influences to establish client
micro-dermabrasion requirements
Conduct skin analysis, assessing degree of photo aging
and pigmentation, thickness of epidermis, level of
erythema and scar tissue as required
Identify and explain contraindications to treatment, and
refer client to appropriate professional as required
Review medical history and medications, and obtain
medical approval prior to treatment, as required
Classify client’s skin, Fitzpatrick skin and explain outcomes
to client
2. Design micro-
dermabrasion
treatment
Design proposed mirco-dermabrasion for a single or a
series of treatments based on the appropriate device
parameters and treatment technique to achieve desired
results.
Discuss with client potential adverse effects, treatment
design and recommendations for duration, frequency
and treatment costs
Confirm revised treatment plan, record updates and
obtain signed consent
3. Prepare for micro-
dermabrasion
treatment
Check readiness of treatment area and availability of
equipment.
Prepare self, equipment and products
Prepare client, ensuring their comfort and modesty
throughout treatment
Position self throughout treatment to minimize fatigue and
risk of injury
Use energy, water, product and other resources efficiently
during preparation and subsequent treatment process
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ELEMENTS PERFORMANCE CRITERIA
4. Perform patch test Explain physical sensation of treatment to client.
Cleanse skin and ensure area is dry and hair free
Patch test a small area adjacent to the treatment site,
assess reaction and record results
Advise client of suitability for treatment, pre-treatment
care and preparation of skin products to use to enhance
treatment outcomes
5. Provide micro-
dermabrasion
Adjust treatment parameters according to patch test
results.
Decide on treatment procedure, number and direction of
passes
Provide micro-dermabrasion for face or body
Stretch and manipulate skin to prevent damage
Monitor client reactions and adjust treatment parameters
of cease treatment as required
Apply post-treatment products
6. Review treatment
and provide post
treatment advice
Evaluate treatment with client.
Review current skin care regiment and make
recommendations to support client priorities and maintain
skin between treatments
Advise client on how to protect skin from environmental
skin damage as required
Record treatment parameters and outcomes of
treatment on client treatment plan
Design and recommend future treatments to support
client priorities
7. Clean treatment
area
Remove used linen and clean surfaces and equipment
and attachments according to organisational policies
and procedures.
Sterilise any equipment or attachment that has come into
contact with body fluids
Restock equipment and products in preparation for next
treatment
Dispose of general waste and any hazardous waste to
minimise negative environmental impacts and according
to organisational policies and procedures
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PART 1 KNOWLEDGE SUPPORT MATERIAL
State or territory and local health and hygiene and skin penetration
regulations and requirements relevant to providing micro-dermabrasion
treatments
Within Australia and each State and Territory there is legislation that applies to
practitioners working in the beauty industry and directs the infection control
procedures for all services. The aim of this legislation is to protect you and your client
by preventing cross infection and controlling the spread of disease. Each state has
developed a set of health guidelines based on the legislation to guide infection
control in a salon setting.
The skin penetration guidelines are additional and apply to any service where there
is a risk of breaking the skin or drawing blood. Skin penetration guidelines apply to
beauty services as there is a risk that blood can be drawn in some treatments.
So why do we have such detailed regulations and guidelines covering this industry?
Infections can be spread between the client and operator, and from client to client,
from you to other employees of the salon and even from you to your family and
friends. Most people that visit your salon will be free of diseases, some will
unknowingly have come into contact with a contagious condition and in rare cases
they may know that they have a contagious condition but hope that you will
proceed with the service anyway. If you follow the recommended procedures
Organisational policies and procedures relevant to providing micro-
dermabrasion treatments
Equipment use and maintenance
As with all beauty services, it is important that the area for service is well prepared
and organised before the client arrives and the service begins. Waxing services may
be performed in a variety of places and are often provided as an additional service
in hair and laser clinics or can be a business that is dedicated solely to facial
treatments.
You may work in a salon where you simply need to ensure all the equipment and
materials are available and the service area is clean. Alternatively, you may be
expected to set up a service area in a new salon. The following is a list of what you
would need to take into account if you were setting up a new salon service area.
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Some suggested equipment includes
TOOLS LINEN EQUIPMENT
Facial bowl Sanitisable gown Treatment bed
Dappin dishes Sanitisable head band Trolley
Mask brush Two large towels Micro-dermabrasion
machine
Cotton rounds / balls Two hand towels Micro-dermabrasion hand
pieces
Cotton tips Disposable sheeting Protective goggles
Skincare products Single use paper towel
Disposable face mask
Disposable gloves
All necessary equipment and materials must be prepared and maintained
according to health requirements, manufacturers’ instructions and workplace
policies and procedures. The work area must be cleaned and waste disposed of
after each client service. It is important to become familiar with the tools of the trade
including furniture, tools, skincare products, machinery and cosmetics.
A clean, tidy workplace is essential for good health and safety. A dirty workplace
can result in slips and falls which may cause injury. More importantly, it can also
contribute to infection by providing an unhygienic environment where micro-
organisms can thrive.
Incident reporting
If you are an employee, you should report immediately to your supervisor the nature
of the incident and complete an Incident Report form which should include:
the date and time of exposure,
how the incident occurred and
the name of the source individual, if you know it
If you are the owner, manager or an employee, you should report the incident to
your doctor or the Accident and Emergency Casualty Department at the nearest
hospital.
Linen use and laundry procedures
Linen used in premises where skin penetration procedures are undertaken shall be
Stored to prevent contamination
Only fresh, clean linen shall be used on each client
Used, dirty or soiled linen shall be stored in a suitable receptacle
Household laundering procedures are adequate for processing all soiled linen
Hands shall be dried thoroughly using disposable paper towels
Clean the surface that has been contaminated with detergent and water
using disposable wipes or paper towels
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Disposable items must be used where possible
Personal hygiene and presentation
Another important part of preparation is your personal presentation which should
create a professional image. A clean and neat appearance and high standards of
personal hygiene are critical. Clients may be put off by a general lack of cleanliness
or signs of body odour which they can detect because of close contact with you.
As you are performing facial treatments clients will expect that your skin, hands and
nails are representative of the sort of care that you take and the services that you
are selling. The condition and presentation of you as a therapist are excellent
advertisements for the services of the salon.
Presentation of treatment area
When in a workplace, it is common to be asked to perform a variety of procedures,
your station should be stocked with a wide assortment of necessary tools and
supplies arranged to conform to your work habits. Since you spend so much time in
one small area, each element of your compact module should be efficient, clean
and comfortable, both for you and your clients.
Adequate lighting is essential to any job requiring visual precision. Your lighting
source should illuminate your work directly, without either getting in your way or
causing an uncomfortable glare. An adjustable lamp can be used as a moveable
heat source to help accelerate oil or cream absorption, as well.
Your chair should have ample low back support to comfortably encourage good
posture. Your station should be neatly arranged, with tools and supplies easily
accessible. Provide each client with a clean gown and headband, and make sure
that you have a wastebasket handy for
immediate disposal of used supplies.
Waste and hazardous substance disposal
Waste should be disposed of in an enclosed
waste bin fitted with a plastic line, durable
enough to resist tearing. The bin should be
regularly disinfected in a well ventilated area.
Clinical waste (contaminated waste) are items
such as cotton wool, sponges, tissues plus other
materials, that have come into contact with
blood and bodily fluids. These items should be
disposed of immediately to prevent
contamination of other clean items and
protection for both the therapist and client.
Categorised waste:
Biohazardous bin – for clinical and
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contaminated waste
Sharps container – for single-use sharp instruments that are used to penetrate
the skin, such as needles & razors
Recycle bin – for anything that may be recycled, such as paper, plastic
bottles and aluminium
General waste – for all other waste
Work health and safety
The Work Health and Safety Act 2011 is the main piece of legislation affecting WHS
issues. It clearly communicates the minimum standards of health, safety and welfare
required in each area of the workplace. It is the employers legal responsibility to
implement the Act and to ensure, so far as is reasonably practicable, the health and
safety at work of the people whom they are responsible and those who may be
affected by the work they do.
There is a WHS regulatory authority for every state and territory of Australia. The local
authority appoints workplace inspectors to enforce health and safety law by visiting
the workplace to check compliance is being met with all health and safety
legislation. Every business is required to have a health and safety representative
(HSR) available to provide advice and guidance and gather relevant data in
relation to health and safety and your business.
An employer is obliged to make to workplace safe. A written Health and Safety
Policy for the business is important to ensure staffs follow safe working procedures.
The health and safety policy identifies how health and safety is managed for that
business: who does what, when and why. The policy must be issued and discussed
with each employee and should outline their safety responsibilities. It should include
idea such as:
Details of storage of chemical substances
Details of stock cupboard and dispensary
Details and records of the checks made by a qualified electrician on
specialist electrical equipment
Names and addresses of the holders of the keys
Escape routes and emergency evacuation procedures
All health and safety policies should be reviewed regularly to ensure they meet all
relevant legislation guidelines including updates.
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Management of WHS:
Scope of practice
The Scope of Practice describes the procedures, actions, and processes that a
healthcare practitioner is permitted to undertake in keeping with the terms of their
professional qualification.
When consulting with clientele, it is the therapist’s duty of care to recognise certain
conditions or disorders that may stop or alter the treatment they are about to
perform. These conditions and disorders are categorised as contraindications.
As therapists we are not qualified to state diagnosis or treat certain
contraindications, although we can refer them to appropriate practitioners to seek
further medical assistance. Specialists that a client may be referred to include:
Medical practitioner
Complimentary therapist
Dietician
Nutritionist
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SECTION 1 ESTABLISH CLIENT PRIORITIES
Client record management
On first meeting the client, greet them in a friendly, professional manner. Give them
a warm welcome by telling them your name and smiling. This will help to relax the
client and make them feel at ease. It is also very important to gain the client’s trust
and respect through your professionalism and knowledge.
The next step is to identify the client’s individual characteristics and needs in order to
make appropriate choices for the service. Each client has individual characteristics
and these all need to be taken into consideration before the treatment plan can be
formed.
Sample consultation card:
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The consultation should put the client at ease and be used to answer any questions
and explain aspects of the treatment. Post consultation a therapist must design,
record and maintain treatment plans and records for each of the treated clients,
specifying the details of:
client feedback and adverse reactions
contraindications and conditions
number and directions of passes, equipment parameters and products used
outcomes:
patch tests
previous and current treatment
post treatment care advice and products
recommended future treatments
relevant medical history and medications
treatment duration, areas treated and not treated
treatment objectives
A treatment plan is a plan that states how you are going to perform the treatment
on the client. The therapist will need to evaluate the information the client has
specified in order to recommend the most appropriate treatment to meet the
client’s needs.
Asking your client to describe exactly what they would like shows them that their
needs are important and that they will receive the best possible service from you. To
collect information about your client’s needs, you will need to ask open questions
and actively listen to the client’s needs. Clients are also encouraged to ask questions
regarding any concerns or comments they may have, including the method of
treatment, treating the hair growth in between visits and frequency of treatment.
An essential part of providing a professional service to your clients is to identify why
they want the treatment so that you can then provide accurate advice and
recommendations for the client.
Effects, risks, benefits and indications for micro-dermabrasion treatments on
the physical structure of the skin
Micro-dermabrasion is part of a suite of treatments that can be classified as non-
surgical aesthetic skin care. It uses the abrasive action of micro-crystals delivered at
pressure to the skin’s surface via a hand-piece.
The procedure is easily performed in 20 to 40 minutes and the great attraction is that
there is no ‘downtime’ – the client can go straight back to their normal
commitments with little or no skin trauma. The treatment has low complication rates,
predictable and immediate results, is not painful, is safe when applied skillfully and
requires no anesthetic.
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Micro-dermabrasion has its origins in the techniques. Known as ‘dermabrasion’,
ancient techniques were used to remove scars, tattoos, hyper - pigmentation and
to polish the skin. A static abrasive disc was used to remove the top layer of the skin.
By the mid-20th Century a rotating wire brush called a burr or fraise was being used
along with cryoanesthesia on the effected parts of the body to remove scars
caused by chicken pox, acne, disease or accidents. The wheel was gently moved
over the area wearing away the epidermis and part of the dermis.
In Italy in the early 1980’s dermabrasion techniques developed into what is known
today as microdermabrasion. Named micro –dermabrasion as small (micro) crystals
were uses to abrade the skin. The new technique was embraced by consumers,
dermatologists and the medical profession
Introduced in Europe and America 15 years ago obtaining FDA approval
microdermabrasion is a new technology that has been developed to meet the
needs of clients who are looking for a treatment to improve skin tone and texture
and reduce the signs of ageing. Many clients these days demand results with little or
no downtime, and so micro dermabrasion was created in the category of
nonsurgical aesthetic skin care. Microdermabrasion offers many of the benefits of
dermabrasion, chemical peels and laser resurfacing without significant risk. Over the
years new scientific and histological research has concluded that not only does
microdermabrasion treat the signs of ageing but also has many significant benefits
and opportunity to treat and improve the stratum corneum and the underlying
layers of the skin.
Benefits of micro-dermabrasion include:
Deep exfoliation of the epidermis
Increases cellular renewal
Reduction in acne conditions, including congestion and clogging
May assist in reduction of oil flow
Increase in firmness of skin
Increased collagen production
May assist in pore reduction
Assists with removal of toxins and waste through the lymphatic system
Increases circulation to improve oxygen and nutrient delivery
Improves hyper - pigmentation
Can reduce fine lines and wrinkles
Corrects photo damage
Flattens scars
What conditions can Microdermabrasion treat?
Active acne
Congested skin
Extraction of blackheads and white heads
Reduction of acne scars
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Oily skin
Dry, dehydrated skin
Refine pore size
Hyper pigmentation
Overall skin rejuvenation
Aging changes
Fine lines & wrinkles
Demarcation lines post laser resurfacing
Stretch marks – may improve
Sun damage, prematurely aged skin
Dull, thick (hyperkeratosis) skin
Sallow skin
Pre and post cosmetic surgery
Dark circles and puffiness around eye area
Contraindications that prevent or restrict treatment or require clearance from
a medical practitioner to proceed and their relationship to micro-
dermabrasion
“A condition or disease that can either stop or alter the treatment you are about to
perform…”
As well as identifying the client’s needs and characteristics, the client’s general
health and the condition of skin of the service area needs to be assessed before
beginning any treatment.
It is very important that all contraindications for treatments be taken into account
when recommending and providing treatments to clients. It is also important that
you are able to communicate these to the client without causing unnecessary
alarm. The client may not be aware that certain treatments can affect their
particular medical condition and you may need to explain why you are unable to
provide a particular treatment or why a treatment needs to be varied.
By explaining all relevant issues to the client and offering solutions you will further
strengthen your relationship with your client. If the client has a medical condition
and you are unsure whether treatment should start you can refer to a more senior or
experienced beauty therapist for advice. Before doing this however, make sure that
you get the client’s permission. You may also refer the client to their doctor for
permission before starting treatment. If this is the case you should make sure that the
client has all the necessary information to explain the treatment and its effects to
their doctor.
1. TOTAL contraindication: A contraindication that would completely stop the
client from receiving a beauty treatment.
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2. Condition requiring MEDICAL PERMISSION: A contraindication that requires
documented approval from the client’s doctor or specialist to proceed with
beauty treatments.
3. LOCAL contraindication: A contraindication that may change the application
of treatment, for example products used, areas covered.
Bacterial infections occur when the infection on the skin is caused by bacteria, such
as:
Pustules and boils, bacteria form in the follicle.
Acne can also be described as a bacterial infection.
Impetigo where the infection is in the epidermis
Fungal infections are caused by fungi and can occur anywhere on the body.
Tinea corporis which affects the body
Tinea capitis which affects the scalp and hair
Tinea pedis is found on the foot
Parasitic infections is an infectious disease caused or transmitted by a parasite
Scabies, a contagious skin disease marked by itching and small raised red
spots, caused by the itch mite.
Pediculosis is an infestation with lice. Generally over areas covered with hair
Fleas, a small wingless, jumping insect which feeds on the blood of mammals
and birds
Viral infections occur because of a viral infection.
Herpes Simplex type 1 (known as cold sores) found on the face mainly around
the mouth and nose as red, sore blisters.
Warts are another common viral infection.
Active acne a skin condition where pores become plugged and the surrounding skin
becomes inflamed. There are various forms of acne;
Comedone – also known as blackheads or whiteheads
Papule – red acne lump, smaller than a pustule
Pustule – an active infection pilo-sebaceous unit, presenting with white or
yellow fluid. Often contains bacteria.
Cyst – inflamed, painful and largely infected within the pilo-sebaceous unit.
Often containing pus, blood and additional fluids.
Medications that cause skin thinning or inflammation use of oral Retin A or
Accutane (Isotretinoin) medications within the last 12 months. These medications
are prescribed by medical professionals to treat aggressive, grade 4 acnes. These
medications shrink the oil glands within the skin, reduces acne bacteria
(Propionibacterium (P-acne)), reduces inflammation and slows down how fast the
skin produces its cells.
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Adverse outcomes to previous micro-dermabrasion treatments, this can present as
skin tears, blistering, extreme erythema and inflammation and/or bruising. In severe
cases post-inflammatory pigmentation can result from improper parameters for the
treatment and damage to the epidermis of the skin.
Scar tissue can be flat or raised and is generally older than 6 months. The skin has
healed and has left an un-pigmented mark where the trauma was. Hypertrophic
and keloid tendency scars take on a red, raised formation of fibrous scar tissue
caused by excessive tissue repair.
Skin trauma can be a serious and altering physical injury experienced by the skin
including multiple layers of epithelial tissues. This can be in the form of cuts, burns,
sickness or other injury.
Rosacea or telangiectasia, this is chronic redness of the skin and papules and
pustules may be present. Triggered by environment factors, continual exposure can
cause telangiectasia, also known as broken capillaries. These two conditions should
be treated with caution and in severe cases, not treated with micro-dermabrasion.
Tattoos, wait one month after application before the first microdermabrasion
treatment. If considering a tattoo diamond tip microdermabrasion may help to
improve results.
There are large range of contraindications are caused by genetic factors, possible
medical treatments, skin conditions, diseases and disorders. This is turn can have
limitations of micro-dermabrasion.
Genetics of skin disorders
The skin is affected by numerous external factors, such as your environment or your
skin care routine. But from birth, your skin is affected by a more permanent factor
underneath the skin, your genes.
Genes which are made of DNA, determine all the different characteristics of a living
thing. They are the ‘blue print’ and ‘instruction guide’ as to what that cell needs to
do. Found in the nucleus of all cells, they do this by telling your cells how to make
proteins, which in turn affects all the structures and functions in your body.
It has been read that you can't have a gene for a certain disorder. ‘Genetic
disorders’ are caused by the mutation of a regular gene or cell, which keeps it from
giving instructions to proteins properly -- or at all. Commonly you will hear that
genetic skin disorders are all congenital, or present at birth. In truth, you can get
genetic disorders as your cells get older or if they're exposed to harmful free radicals.
Of course, they can also be passed down from one generation to the next, and
sometimes can be caused by a combination of both inheritance and environment.
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Microdermabrasion CANNOT be performed if the client has received the following
services within 14 days:
• Chemical peel
• Jessner peel
• IPL
• Laser
• Phenol peel
• TCA peel
• Deep Glycolic acid peel
• Deep Salicylic acid peel
• Isotretinoin (Accutane) is contraindicated for a period of 6 – 12months
• Differin within the last 6 – 12months
• Collagen injections
• Botox injections
• Restylane or hyaluronic injections
• Retin A
• Avoid the use of solariums
Skin care containing the following for three days before treatment
Introducing the client to cosmeceutical will directly affect your objective of healthy
skin. The skin care market is flooded with products that will help to deliver visible
results in combination with microdermabrasion, some products you can choose
from include:
Vitamin A (retinoids) – regulates cell production, reduces hyperkeratinisation
Vitamin C – strengthens skin and increases fibroblast activity and collagen
production.
AHA’s (alpha hydroxyl acids) – chemically exfoliate the skin
BHA’s (beta hydroxyl acids) – chemically exfoliate the pores
Hydroquinone – assists with hyper-pigmentation, brightens skin, inhibits
melanisation process
Enzymes (papain, bromelain) – assist in exfoliation by digesting dead, dry skin
cells.
Antioxidants – free radical fighters to improve skin cell function and protect
from damage
Sunscreen SPF 30+ - protects from UVA & UVB damage
Skincare that balances the skins pH
Potential adverse effects and those contraindicated for specific clients
There are few possible side effects to microdermabrasion. However with any skin
treatments, there may be some adverse reactions:
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Skin anatomy and physiology
Gross and microscopic
Skin is the part of the body which is most visible and therefore contributes to the
development of a person’s self-esteem and wellbeing. The care, maintenance and
enhancement of the skin are the central functions of the beauty industry.
Knowledge of the structure and function of the skin will give you an understanding of
how a range of beauty treatments affects the skin and its functions. The skin itself is
an organ – a combination of tissues that performs a specific function in the body.
A group of organs that operate together in the body is called a system. The skin is
commonly recognised as the Integumentary System. The integumentary system or
skin covers the whole body and made up of two layers of skin and includes the hair
and nails.
The skin is a cell-making factory containing approximately 4.5 meters of blood
vessels, 1300 nerve endings, 650 sweat glands, 100 sebaceous glands; it can cover
20 square feet and accounts for 15% of our body weight.
Epidermis, dermis and subcutaneous
The epidermis is composed of four or five layers. The skin of the palms and the soles
of the feet have five layers due to their greater exposure to friction. These five layers
include (from most superficial to deepest layer):
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Stratum corneum – The barrier properties of the skin are mainly due to the
remarkable stratum corneum. It provides a barrier to the entry of light, heat, water,
bacteria and a range of chemicals.
Stratum lucidum - this layer is made up of clear flat dead cells and layer is only visible
in the skin of palms and soles. It contains a clear substance called eleiden which
eventually becomes keratin. Eleiden is translucent, therefore giving the layer its
name, lucidum, which means clear.
Stratum granulosom – contains a substance called keratohyalin, which eventually
forms the keratin found in the topmost layer of the epidermis. This layer is made up of
between three and five rows of cells in various stages of degeneration.
Stratum spinosum – is formed of eight to ten rows of many-sided (polyhedral) cells.
When viewed under a microscope these cells may have a prickly appearance, this
layer is also known as the ‘spikey’ layer.
Stratum basale – cells in this layer are continually dividing and multiplying –this layer is
the source of new cells. The cells are cuboidal to columnar in shape and as they
multiply they push their way up through the other skin layers. This layer is also called
the stratum germinativum.
Phases of skin growth, cell renewal, wound healing and factors affecting
epidermal mitosis
From conception to foetus, baby, child, teen and adult our body goes through
stages of growth and development. Within these processes the cells within our skin
follow through.
It all starts with the basic unit of life, an atom. From here, a cell is formed, from a cell
tissue and organs can be made, tissues and organs then form bodily systems,
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creating a human being. As we grow we are continually making cells, yet as we age
the cells that have formed the tissue and organs will slowly decline in reproduction.
The process by which new cells are made is called cell division or mitosis.
Cell division and differentiation
Mitosis is used when a cell needs to be replicated into exact copies of itself.
Everything in the cell is duplicated. The two new cells have the same DNA, functions,
and genetic code. The original cell is called the mother cell and the two new cells
are called daughter cells.
Cells go through different phases called the cell cycle. The "normal" state of a cell is
called the "interphase" where genetic material is duplicated. When a cell gets the
signal that it is to duplicate, it will enter the first state
of mitosis called the "prophase".
1. Prophase - During this phase the chromatin
condenses into chromosomes and the
nuclear membrane and nucleolus break
down.
2. Metaphase - During metaphase the
chromosomes line up along the middle of
the cell.
3. Anaphase - During anaphase the
chromosomes separate and move to
opposite sides of the cell.
4. Telophase - During telophase the cell forms
two nuclear membranes around each set of
chromosomes and the chromosomes uncoil.
The cell walls then pinch off and split down
the middle. The two new cells, or daughter
cells, are formed. The splitting of the cells is
called cytokinesis or cell cleavage
Epidermal cells
The cells in the epidermis layer are flat, dead
and completely filled with keratin. They are
continually shed at the rate of 20,000 per hour
and are replaced from below. These
keratinized cells or keratinocytes are
arranged like the bricks in a wall. The narrow
spaces between these ‘bricks’ are filled by a
protein and lipid substances that acts like
cement holding the cells together. The
surface of the stratum corneum is flat and
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continuous and is pierced by the opening of the hair follicles and sweat glands. It
fulfils its remarkable role despite being only 15-150 microns thick – about the
thickness of two sheets of paper.
The cells which make up the epidermis are known as stratified squamous epithelium.
The most numerous is the Keratinocyte
This cell undergoes the process of keratinisation. The keratinocyte’s function is to
produce the protein, keratin. This protects the skin, makes it less permeable to water
and other substances. It also plays a role in immunity.
Keratinisation
An organised rotational production line that converts living cells at the base of the
epidermis, basale layer, into dead, hardened, compacted layers of protein (keratin)
on the outer surface, corneum layer, this process taking approximately 200 days for
a cell to mature in the epidermis. The life time of a mature cell is between 7-20 days
and the replacement time for the stratum corneum (top layer) between 32-36 days.
Every day millions of dead skin cells are sloughed off or worn away from the surface
of the skin. As the dead cells are worn away, the skin will naturally trigger itself to
produce more. The name for this process is called desquamation.
The Langerhans cell and Melanocyte cell are additional cells to the epidermis where
they play roles in immunity, UV filtering and reproduction.
The Dermis is the second layer. The skin gets its thickness and toughness from this
layer; making it roughly 25 times thicker than the epidermis, these features come
from its collagen and elastin fibres. The dermis consists of two (2) layers; the papillary
layer and the reticular layer. This layer also contains blood and lymph vessels, which
supply nourishment to the skin, sebaceous (oil) and sudoriferous (sweat) glands,
nerves, hair follicles, arrector pili muscle and large protein molecules such as
glycosaminoglycan’s and hyaluronic acid forming connective tissue.
Dermal structures
Collagen is a protein produced by fibroblasts and accounts for about 75% of the
weight of the skin. This is what gives the skin its tensile or flexible strength and is able
to scatter some of the light entering this layer. It looks like little ropes in the skin.
Elastin fibres interweave with the collagen fibres and are named after the function
they perform in the skin - it is the elastin which pulls the skin back to its natural shape
after stretching. Collagen and elastin are classified an ‘insoluble proteins’ meaning
they’re unable to dissolve in water, as cosmetic ingredients meaning they will rarely
penetrate the skin and should be transported into the skin within another molecule
or injection.
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As we age, these fibres break down and become depleted, therefore causing the
surface appearance of fine and deep set wrinkles. Unfortunately, these two fibres do
not reproduce at the same rate throughout our lives so prevention, lifestyle and use
of appropriate skincare are key ways to ensure the dermis maintains its structural
integrity.
Furthermore the dermis provides insulation and resistance to mechanical injury. It
provides the supporting framework of the skin and also contains numerous hair
follicles, nerves, glands and blood vessels.
The vascular (containing the blood) system in the skin is a fine, branching network
composed of venous and arterial blood vessels. These supply the skin with oxygen
and nutrients and together with the lymphatic system remove waste materials. The
vascular tissue within the dermis also helps to regulate temperature. The blood
supply to the skin is most concentrated in the scalp, hands, feet and nipples. The
blood vessels contain blood which contains haemoglobin. This is bright red in colour
when it is carrying oxygen and a blue-red colour when it is on its way back to the
heart.
Arteries carry oxygenated
blood
Veins carry deoxygenated
blood
The dermis is composed of
two layers, the papillary
layer and the reticular
layer.
The papillary layer connects the dermis to the epidermis. Located within the layer
are dermal papillae, small projections which greatly increase the surface area. The
dermal papillae also contain nerve endings, which are sensitive to touch. These
projections are what give the epidermis fingerprints.
Underneath this is the reticular layer. It sits below the papillary layer and here is
where you will find the thick connective tissue of collagen and elastic fibres. The
word ‘reticular’ means net-like and refers to this network of fibres. Around the fibres is
a gel like substance made up of salts and large protein and sugar molecules called
glycosaminoglycan’s which can bind to themselves large quantities. You will also
find hyaluronic acid, a natural fluid promoting the reproduction of the above fibres.
Hyaluronic is now a common ingredient in skincare products for anti-aging.
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The Hypodermis is at the bottom of the dermis and composed of adipose (fat) tissue.
This creates a protective cushion that gives contour and smoothness to the body, as
well as providing a source of energy.
Function of the skin
Protection
The skin provides protection from abrasion and slows the loss of water from the body.
It stops most chemicals entering the skin and is an effective barrier preventing
microorganisms from entering the body. It shields us from the most harmful rays of
the sun. The stratum corneum is laminated and is infused with an oil and protein
substance that repels water and many chemicals and micro-organisms. It also
prevents water loss from the deeper layers of the skin. The stratum corneum is an
important layer in understanding the effects of skin care products such as
moisturisers which are applied as part of facial and body treatments to reinforce the
skin’s protective functions.
Hair provides a feedback mechanism to the body. When the hairs of the skin are
touched, even very lightly, the sensation is detected by the touch receptors in the
skin and you react to the stimulus. Protection from UV rays is performed by the
melanocytes located in the skin.
Role in skin of tissues
‘Tissue’ is a collection of similar cells that perform a particular function. Each tissue
has a specific function and can be recognised by its characteristic appearance.
Body tissues are composed of approximately 60-90% water, along with other
substances. There are five (5) main types within the body:
1. Connective – Supports, protects and binds other tissue together. For example
collagen. Collagen is the most abundant type of connective tissue within the
body. Not only found in the skin, but also in ligaments and cartilage and
tendons.
2. Nervous – carries messages to and from the brain and controls and
coordinates the bodily functions. Nerve tissue is composed of special cells
known as neurons, which make up the nerves (touch receptors), brain and
spinal cord.
3. Vascular/Liquid – includes lymph and blood. Carries food, waste products
and hormones through the body.
4. Epithelial – is the protective covering of the body, primary example is skin, but
also mucous membranes, lining of the heart, digestive and respiratory organs
and glands (sebaceous and sudoriferous).
5. Muscular – sit below the skin and attach to bone. Muscular tissue creates
movement, contraction and expansion to various parts of the body.
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Sensation
Abundant nerve endings and specialised receptors detect changes on the outside
of the skin and give information about pain, temperature, touch and pressure. This
allows us to interact with the environment safely.
Thermoregulation
During temperature homeostasis, or thermoregulation, the skin and homeostasis
cause the body to sweat. When the skin senses that the body is heating up because
of the environment's temperature, the hypothalamus sends a signal via nerves to
sweat glands and blood vessels in the skin. The blood vessels dilate to allow more
blood flow through the skin, which — in tandem with sweating — lowers body heat.
Body temperature regulation done by skin and homeostasis also informs the
hypothalamus of when the body is cold. This causes the hypothalamus to send
signals to the body to tell it to raise its temperature. The body then begins shivering,
constricting blood vessels and forming goose bumps in a process called
piloerection. Piloerection is when hair follicles make the hair stand up in an effort to
warm the body.
The body creates its own heat through involuntary actions such as cellular activity
and reproduction, contraction of muscles and the heat produced by organs such as
the liver, brain and heart. In other circumstances, outside influences such as hot
food and drink, digestion and absorption of heat from UV, warm water, saunas and
steam trigger thermoregulation throughout the body.
To stay cool, the body has four pathways – convection, conduction, radiation and
evaporation.
Convection is getting rid of the heat by physically transferring it to another liquid or
gas. For example to cool air circulating over the body.
Conduction is almost the same process but in this case the heat is transferred to an
object by direct contact, for example, through the urine and faeces. Or it may
mean that the heat is moved around the body.
Radiation, the loss of heat through electromagnetic radiation. This is when the
surface blood vessels dilate and heat radiates into the surrounding air. This only
works if the surrounding air is cooler than the body.
Evaporation, through the production and evaporation of sweat from the skin
surface. This is particularly important when the temperature of the surrounding air is
higher than the temperature of the body and radiation doesn’t work. That is
sweating only works if it has the opportunity to evaporate. Evaporation works
efficiently in dryer air. It is harder to achieve in high humidity. The last two methods of
heat reduction are the most predominant ways to keep your body at the right
temperature in hot weather.
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Vitamin D production
Ultra-violet light from the sun activates the production of vitamin D. The skin contains
a substance call provitamin D3 that reacts with UVB (ultraviolet-B) rays in sunlight. This
produces vitamin D3. From here, vitamin is travels to and through the liver and
kidneys, converting it into the form that the body needs. It is recommended that 10
minutes of protected sun exposure each day is an appropriate amount to increase
and sustain vitamin D3 within the body.
Differences depending on location
It has been known that the skin varies in thickness, appendages and content
depending on:
Age
Gender
skin type
pigment
blood content
body size
location
Also, the appearance of skin varies on
different areas around the body according to
the job it is required to do. The depth of the
epidermis is thicker on the soles of the feet and
in the palms of the hand for example than on
the eyelid where it is extremely thin. This has
implications for beauty treatments in these
areas. The hands and feet take a large
amount of ‘wear and tear’ and so the skin is
thicker and ‘tougher’ as a result of this friction.
Areas of skin also differ in their features such as
the type and amount of hair, glands, nerves
and blood supply. The soles of the feet and
the palms of the hands, also known as ‘volar skin’ have no hair follicles, many sweat
glands and a high density of nerve receptors. The palms and the soles are smooth
areas of skin in most people due to the continual abrasions from shoes, walking and
manual activities.
The areas of the hands and feet exposed to the sun such as the top of the feet and
the back of the hands will often show the effects of ultra-violet radiation. The skin will
darken when exposed to the sun and may also show the effects of sun damage and
photo ageing. Skin that is not dry or damaged has a glossy appearance.
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The lips are composed of skin, muscle and
mucous membranes; no bones and no
infrastructure, making them unique pliable.
The skin of the lip is made up of 3 to 5
cellular layers and is very thin compared to
the skin on the rest of the face. The mucous
membrane of the lip is full of capillaries (tiny
blood vessels) that are close to the
translucent surface, giving it a reddish
colour.
The lips are also somewhat fragile when
compared to other areas of skin on the
body. With no hair, sweat glands or
sebaceous glands of their own, they lack the usual protective layer of sweat and
body oils that keeps skin smooth, kills pathogens and regulates warmth. That's why
lips tend to dry out faster and loose hydration more easily.
Homeostasis
Homeostasis (homeo – the same, and stasis – standing still) refers to keeping a
constant internal body environment while the outside environment is changing.
There are many factors in the body which need to be kept constant. Temperature is
one of these, some of the others include:
blood sugar levels
carbon dioxide levels
body water
acidity/alkalinity
Skin and homeostasis work together to help the body maintain a constant internal
environment. The relationship between them consists of three parts: a receptor, a
control center and an effector. Human skin contains receptor cells that sense a
change in the environment. These receptors send information to the control center,
the hypothalamus in the brain. The hypothalamus then tells an effector, such as
sweat glands or blood vessels in the skin, to react in order to maintain a stable body
temperature.
Structure and distribution of skin glands
There are between 2 and 4 million sudoriferous (sweat) glands found across the
human body. These are coiled tubular glands that are found in the dermis or lower
part of the skin.
They produce a watery secretion and open on to the skin to help control body
temperature and provide an emotional response to stimulus. When you sweat the
moisture on your body evaporates and provides a cooling effect for the body.
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There are two types of sweat glands, eccrine sweat glands and apocrine sweat
glands. Both types of glands are controlled by the sympathetic nervous system,
which controls many of our involuntary actions such as breathing, heartbeat and
sweating.
The sebaceous (oil) glands are widely distributed throughout the skin, except in the
palms and soles and some mucous membranes, but most of them open to the
upper hair follicles at hair follicle sites. Sites where multiple individual sebaceous
glands congregate are called sebaceous zones. They are seen in the scalp, face
(the “T zone,” which includes the forehead, regions of the glabella and the
nasolabial groove), sternal regions, armpits, naval, and external genitals.
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Production, composition, functions and control of skin gland secretions
Sebum
Sebum consists of lipids, cell membrane fragments, cytoplasmic remains, enzymes
and protein fragments. The most important of these are the lipids. The sebaceous
lipids are quite different in both function and composition to epidermal lipids.
Epidermal lipids are derived from the keratinocytes and account for only 5% of skin
surface lipids while sebaceous lipids account for 95%.
Sebaceous lipids are a constituent of sebum. They form a more or less occlusive film
or sealing on the skin. The addition of sebaceous lipids to dry, oil-deficient skin,
restores the normal skin condition.
Epidermal lipids primarily contain ceramides, cholesterol and free fatty acids,
especially linoleic acid, are found among the lipids of the stratum corneum. They
make up the corneum permeability membrane, which is mostly determined by the
content of these epidermal lipids. The balance of lipids on the stratum corneum can
be improved by the topical application of skin related lipids through facial
treatments and specialised skin care products.
Sebum or oil protects the surface of the skin and lubricates both the skin and hair. Oil
is secreted by the sebaceous gland, located all over the skin except for the palms
and soles and follows hair growth and are almost always paired with the hair follicle.
The sebaceous gland, the hair, the hair follicle and the arrector pili muscle are
grouped together and are called the pilo-sebaceous unit.
Sebum keeps the skin soft and protected from outside elements as it balances the
skin pH level. This oil also slows down trans-epidermal water loss, allowing the skins
cells to reproduce in a water dense environment.
Sebaceous glands are continually active in sebum production but then cease
production and shrink. The oil producing period is varied but is estimated to be
between several weeks to several months. It is unknown as to whether the gland
regenerates after this period but the likelihood is low, rather a new lobe is thought to
develop.
The duct of the sebaceous gland is usually small or absent. The sebum is excreted
into the mouth of the hair follicle. It coats the hair and exudes onto the skin surface.
Moderate levels of sebum leave the hair nice and shiny, too much makes it oily. All
hair follicles contain a sebaceous gland. Sometimes however, the sebaceous gland
exists by itself in the skin, especially in menopausal women.
At the onset of puberty there is a surge in the production of androgens (hormones),
which stimulate sebum production. Between the ages of 10 years and 19 years the
production increases at six (6) times the average rate. Production then decreases
steadily with increasing age.
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The sebaceous glands are most concentrated on the forehead and cheeks (900 to
100 per square centimetre) and the scalp and chin (400 to 700 per square
centimetre). The rest of the skin averages 100 per square centimetre. There are also
high concentrations of quite large glands for lubrication on the vermilion margins of
the lips, the labia minora, the glans, penis and the eyelids.
Eccrine and apocrine sweat fluids
There are two types, the apocrine glands and the eccrine glands.
The eccrine gland consists of secretory and tubular sections. The secretory portion is
formed of closed coils and is present in the hypodermis. It consists of two layers of
cells: the inner or ‘luminal’ layer and the outer or ‘basal’ layer. These layers are
capable of reabsorbing secretions. The tubular portion of duct winds its way up from
the dermis through the epidermis to the opening on the skin’s surface known as a
sweat pore.
The eccrine sweat glands are distributed throughout the skin in humans and are
particularly concentrated on ‘volar’ skin (skin of the palms of hands and soles of
feet). Eccrine sweat glands are by far the dominant type of sweat glands in humans.
In an adult human there are approximately 2-4 million sweat glands and these are
fully developed but very shallow and non-functional by the 28th week of life. The
density of the glands is reduced from birth through to adulthood. The number of
actual glands does not change but the growth of the body and expansion of body
surface reduces the number of glands per square centimetre of skin.
Apocrine glands are quite separate from the eccrine sweat glands and are
connected to the pilo-sebaceous unit in the same way as the sebaceous glands –
they do not have a separate duct opening to the skin surface, they are also much
larger than eccrine glands. The heaviest concentration of apocrine sweat glands is
in the axilla (underarm) where they are also large and very active, and in the
perineum or genital region. The external auditory canal (ear canal) and areola
(nipple area) of mammary skin contains apocrine glands in more limited numbers
and they are rarely activated at these sites. Apocrine glands develop from and are
associated with the hair follicles and their ducts open into the upper portion of the
hair shaft.
The eccrine and apocrine sweat glands produce different types of sweat.
Unlike the sebaceous gland, the eccrine gland is not connected to a hair follicle.
The coils within the secretory section of the gland contain a sodium pump, which
actively secretes the sweat through the cell membrane. The composition of the
sweat is modified as it travels up the intradermal portion of the duct through the
process of reabsorption. When it exudes onto the surface of the skin, the
composition of sweat is similar to that of urine. Production is controlled by the
autonomic nervous system but can also be stimulated by drugs, heat and exercise.
The role of eccrine sweat production is to provide thermoregulation and excretion.
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Apocrine sweat glands are larger than eccrine. They continuously secrete a fatty
sweat into the gland tubule. Emotional stress causes the tubule wall to contract,
expelling the fatty secretion to the skin, where local bacteria break it down into
odorous fatty acids. Characteristics of eccrine and apocrine sweat:
ECCRINE SWEAT APOCRINE SWEAT Thin watery fluid Sticky, milky coloured fluid
pH sits between 4 and 6 Slightly acidic
Contains sodium, potassium, chloride,
lactate, urea and ammonia
Contains the same as eccrine plus EFA’s
and proteins
Evaporates quickly Odourless when first secreted
Produces odour when met with bacteria
and dries like glue
Normal skin responses to irritation and trauma
Stages in wound healing, origin and evolution of scars
Wound healing is a complex subject although we give it little thought and take it for
granted. Skin damage or injury stimulates a process that aims at returning the injured
tissue to its normal structure and function. Two kinds of wound healing can occur,
depending on the depth of the wound. Epidermal wound healing occurs following
wounds that only affect the epidermis. Deep wound healing occurs following
wounds that penetrate the dermis or deeper tissue layers.
The following information is brief outline based on the scientific fact that cells
communicate by electrical signals. When the skin is wounded cells react by
changing their usual electrical signaling. These changes stimulate skin cells to release
chemical compositions, proteins, growth factors and the proliferation of fibroblasts
(collagen cells), which in turn create new stronger, healthier collagen.
The factors of wound healing can be altered when dealing with clients who:
Are in poor health
Smoke
Consume excessive amounts of alcohol and caffeine
Circulatory disorders
Diabetes
Epidermal Wound Healing
Common types of epidermal wounds include abrasions (skin has been scraped
away) and minor burns (superficial blisters). Epidermal wound healing also occurs in
deep wound healing and is seen in the migratory and proliferation stages.
In response to epidermal damage,
basal cells of the epidermis surrounding the wound break contact with the
basement membrane
they enlarge and migrate across the wound
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the cells appear to migrate as a sheet until they meet with cells from the
opposite sides of the wound
at this point they stop migration (contact inhibition)
a hormone called epidermal growth factor stimulates basal stem cells to
divide and replace the ones that have moved into the wound
the relocated basal epidermal cells divide to build new cells in this way
thickening the new epidermis
Deep Wound Healing
This occurs when an injury extends to the dermis and subcutaneous layer. This
healing process is more complex because different tissue layers need to be
repaired.
The wound healing process can take months, even years and in some case may
never actually end.
Deep wound healing occurs in four phases
1. Inflammatory phase 1 – 3 days: Following injury a blood clot (coagulation)
forms in the wound and loosely unites the wound edges. Vasoconstriction
reduces bleeding and blood loss. Early inflammatory wounds are red, warm
and swollen, and usually painful. Blood flow and fluid increase in the injured
area. This enhances the delivery of helpful cells such as white blood cells.
2. Migratory phase 3 – 5 days: Epithelial cells start to migrate. Fibroblasts migrate
into the area and begin to synthesize new tissue (collagen fibres and
glycoproteins).
3. Proliferative / Fibroplastic phase 5- 20 days: Damaged blood vessels begin to
regrow. Hyaluronic acid also plays a role in providing a flexible and resilient
base.
4. Maturation phase 20 days – 2 years: collagen fibres become more organised,
fibroblasts decrease in numbers, and blood vessels are restored to normal.
During maturation collagen, which is prevalent during proliferation, is
gradually degraded and built stronger.
Wound healing
Wound healing can result in the skin re- forming with a distorted or different
appearance. Factors which may delay wound healing include:
Poor diet. Vitamin A is needed for re-epithelisation and collagen synthesis,
vitamin C for collagen synthesis, and the minerals zinc, copper, iron and
manganese to support immune response and collagen and protein synthesis.
The influence of certain drugs such as high doses of corticosteroid and
anticoagulants.
Poor surgical technique including rough handling and too tight sutures.
Infection – this lengthens the inflammation stage and produces toxins and
proteases that cause damage to the cells.
Foreign material left in the wound. This will activate the immune system and
add to inflammation.
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Disruption to the blood flow including hematoma which is bleeding into the
wound, and ischemia which is restriction of the blood flow to the wound.
Genetic factors
Recent scars are a contraindication to many treatments due to the danger of
unsettling the tissues which are healing below the visible surface of the skin.
Hypertrophic
A hypertrophic scar is a cutaneous condition characterized by deposits of excessive
amounts of collagen which gives rise to a raised scar, but not to the degree
observed with keloids. Like keloids, they form most often at the sites of pimples, body
piercings, cuts and burns.
Keloid
This type of scarring is caused by an increase of collagen fibres, resulting in an
overgrowth of scar tissue. The raised scar is initially red, fading from pink to white,
and may be ridged, smooth or shiny. This condition can affect all skin types. The scar
occurs over the site of a previous lesion or along a surgical incision. These convex
areas will need to be smoothed and diminished using darker colours.
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Physiological basis of skin colour
The pigment that gives colour to your skin is melanin. It is also responsible for the
colour of your eyes and hair. Melanin protects our skin from harmful ultraviolet
radiation of the sun by absorbing the rays. The quantity and type of melanin are
determined by a handful of genes. We inherit one copy of each of these genes from
each of our parents and each gene comes in several different versions known as
alleles. It's this that's responsible for the sheer variety of skin tones.
Factors that contribute to skin colour
The colour of the skin is determined by the concentrations of three main pigments:
melanin, carotene and haemoglobin. These are found in the dermis and combine to
produce the pigmentation of all surface tissues including the skin, mucous
membranes, and even the eyes. Abnormal concentrations of these substances can
cause distinctive colour changes in the skin or other visible body tissues and may
help in diagnosis certain illnesses or skin conditions.
Melanin is a protective substance or pigment created by the melanocyte cell and
produced in the basale layer of the epidermis. Assisting in UV protection it utilises the
dendrites from the cell to transfer colour into the keratinocyte when stimulated by
UV or heat.
Carotene is a pigment found in the stratum corneum in Asiatic ethnic groups.
Carotene and melanin together form the yellow-ish colour of the skin.
Haemoglobin is the colour matter within blood. As the body carries oxygenated
(red) blood and deoxygenated (blue) it combines with lowered levels of brown
pigmentation from melanin contribute to the pinkish colour of skin.
In addition, skin colour can also be affected by:
• surface reflection of light
• absorption of light
• scattering of light
• type of light
• thickness of the skin layers
• presence of light absorbing
materials (collagen, elastin,
melanin, carotenes,
haemoglobins, lipids)
• melanosomes (number,
size, type, distribution)
Structure and location of
melanocytes and keratinocytes
and responses to ultraviolet
radiation
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Approximately one in every 10 cells in the basale layer is a melanocyte. The
melanocyte is the colour component of the skin, producing melanin when
stimulated by ultra violet radiation (UVA & UVB). Melanocytes utilise the amino acid
tyrosine in the presence of the enzyme tyrosinase to produce melanin. Once the
melanin has been produced, it is taken up by the epidermal cells and distributed
through the skin. Continued exposure to ultraviolet radiation then produces the
present amount, stimulating the dendrites of the melanocyte to stain and darken
the melanin within the keratinocytes,
resulting in a tanned skin. To some skin
types, this can then provide some
protection against UV.
Melanisation process
1. From UV exposure, the Pituitary
Gland is stimulated
2. This gland then produces and
releases MSH (Melanin Stimulating
Hormone)
1. These hormones then adhere to the receptors of the melanocyte cells and
stimulates melanin production
2. The amino acid Tyrosine & enzyme Tyrosinase prepares to form within the
newly produced melanocyte
3. Tyrosine then converts into Melanin and creates pigment within the
melanosome.
4. The newly formed melanocytes then make their regular journey up the
epidermal layers to desquamate. It is here where pigment is transferred to the
keratinocytes and colour develops with UV exposure.
Electromagnetic spectrum and effect of light on skin
Visible light is electromagnetic radiation that we can see. Electromagnetic radiation
can also be call ‘radiant energy’; it carries or radiates energy through space on
waves.
Characteristics of a wave
There can be long waves and short waves but to be able to identify the strength
and frequency, we need to look at four (4) different components:
1. Wavelength - defined as the distance from a particular height on the wave to
the next spot on the wave where it is at the same height and going in the
same direction.
2. Crest – highest point of a wave
3. Trough – lowest point of a wave
4. Amplitude - When you measure the amplitude of a wave, you are really
looking at the energy of the wave.
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The entire range of wavelengths of electromagnetic radiation is known as the
‘Electromagnetic Spectrum’. The electromagnetic spectrum ranges from cosmic
rays to radio waves. The length of the waves can vary from a fraction of the size of
an atom to thousands of kilometres.
Visible light is just one small part of the spectrum. The part of the spectrum that is of
interest to those in the beauty industry ranges from ultraviolet at the higher end of
the spectrum, to infrared at the lower end. Each of these waves are measured in
nanometres (nm). The following table gives the approximate depth of penetration
for radiation of various wavelengths. As a general rule, it can be seen that the longer
the wavelength of the radiation, the greater its ability to penetrate the skin:
UVC – 250NM
UVB – 280 – 300NM
UVA – 350 – 400NM
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Relationship between skin type, minimal erythemal dose, skin protection
factor and sunscreen use
Sunburn can be measured! Dermatology does this by recording the amount of time
of a single exposure to sunlight that result in reddening of the skin after 24 hours. This
measurement is called a minimum erythema dose (MED).
Minimal erythema dose is defined as the amount of UV radiation that will produce
minimal erythema (sunburn or redness) of an individual's skin within a few hours
following exposure.
MED exposures will vary with Fitzpatrick skin type but the end result is always the
same – the beginnings of erythema. For example, MED for a type I skin may be only
10 minutes whereas MED for a type III may be 20 to 30 minutes.
To prevent sunburn, SPF can be utilised. There are two forms of sunscreen:
1. Chemical – can absorb 98% of a specific wavelength of light, being UVA or
UVB. Once absorbed the chemicals filter and reduce the penetration to the
skin.
2. Physical – are also known as ‘sunblock’. They work by reflecting, blocking and
scattering light. Zinc oxide and titanium are common ingredients used.
The performance of a sunscreen basically depends on:
the composition and selection of chemicals: UVA only, UVB only or both
the solvent they are dissolved in (often lowers the SPF)
timing of application
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wear and tear while you have it on, for example, how much rubs off on
clothes
presence of any interfering chemicals in the preparation (preservatives) or in
your skin including cosmetics
SPF – sun protection factor. Sunscreens have a rating system from 2 to 30+.
The higher the number the greater the sun protection
Clients should be advised to wear a sunscreen, a hat and protective clothing
when in the sun
Many product ranges include a sunscreen and these are recommended in
Australia.
SPF measures sunscreen protection factor from UVB rays, the kind that cause
sunburn and contribute to skin cancer. To measure the SPF provided by sunscreens
you must first find your MED. This amount can then be timed by the SPF rating. For
example, if your MED was 10 minutes, and you applied a SPF30 sunscreen, you have
300 minutes (5 hours) protection until MED is reached. In knowing this, it is
recommended to reapply every two hours, or according to the directions on the
bottle.
Function, formation and behaviour of major skin chemicals
Two major classes of organic chemicals dominate the skin surface:
Proteins and their associated products
Lipids and their associated products
Cosmetic manufacturers often attempt to replicate the useful effects of some of
these skin chemicals by incorporating them or their substitutes into their skin care
products.
Complex fatty acids
Fatty acids are a component of fats (triglycerides) where they are combined with
glycerine. Fats serve as the body's energy reserve and as a biochemical element.
Free fatty acids are an important component of both the skin barrier and the acid
layer of the skin. Fatty acids include compounds such as glycerides (humectant),
sterols (lubricant), and phospholipids (moisturiser).
They are used in cosmetics as emollients, thickening agents and cleansing agents.
Fatty acids are natural components of skin and are components of a complex
mixture that makes up the outermost layer that protects the body against oxidative
damage.
Fatty acids can help supplement the skin’s intercellular matrix (material that is
between cells) and plays a major role in the skins Natural moisturizing factor (NMF).
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Complex lipids
Phospholipids - Phospholipids are important molecules that provide structure and
protection to cells. Phospholipids consist of a hydrophilic (or 'water loving') head and
a hydrophobic (or 'water fearing') tail. Phospholipids like to line up and arrange
themselves into two parallel layers, called a phospholipid bilayer. This layer makes up
your cell membranes and is critical to a cell's ability to function.
Since lipids do not get broken down by water, the bilayer provides a barrier around
the cell and only lets in certain molecules. Some small molecules, like carbon dioxide
and oxygen, pass through the phospholipid bilayer quite easily. This is good because
these gases are involved in the cells ability to reproduce, which is how your body
makes energy from the food you eat.
Sphingolipids - Sphingolipids are complex, long chain lipids (fats) that function as
skin-repairing and conditioning ingredients. An example of a sphingolipid is
ceramides. Found throughout cells in the human body, sphingolipids have cell-
communicating ability due to their innate involvement in protecting the skin from
outside harm. They are considered critical to the maintenance and repair of skin's
barrier function.
Glycosaminoglycans
Glycosaminoglycans are the fillers and water-binding substances between the fibres
of the dermis and natural protein fibres collagen, elastin and hyaluronic acid. Also
known as GAGs, they are used in cosmetics as they replicate the natural production
in the skin, such as fibroblast and bind or attract water.
Lipids
The range of chemicals grouped as lipids is large and complex. They are all
characterised by being insoluble in water but soluble in other solvents such as
chloroform. Lipids are capable of mixing with water providing a third type of
chemical is involved - a surface active agent, also known as a surfactant. This can
be a chemical such as soap or detergent which can bind water and lipids as one.
Lipids can be broken into two categories:
Saponifiable – the oil can be broken down and into a soap substance by alkali. Both
phospholipids and sphingolipids are saponifyable,
Non-saponifiable – the oil cannot be broken down at all by alkali. Non-saponifiable
lipids are the basis of many body chemicals such as cortisone, vitamin D,
testosterone and progesterone.
Proteins
Proteins are the important building blocks of all living tissue and their function. Amino
acids make up these long, organic protein chains in the skin and help to make
collagen, elastin and keratin. There are two classifications to proteins:
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1. Soluble – they contain amino acids that interact and dissolve with water,
hydrophilic. They can be found inside a cell or in blood and other bodily
fluids. Enzymes are also soluble proteins. These are what you will find in
cosmetic products to promote cell reproduction and desquamation. For
example, papain (natural enzyme in papaya) once applied to the skin breaks
down the proteins and keratin to encourage natural exfoliation.
2. Insoluble – these are the opposite. They’re unable to interact or dissolve in
water, hydrophobic. These are strong and fibrous proteins such as collagen,
elastin and keratin and as we know, these three proteins allow for strength
and stability within the skin, providing a youthful appearance.
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Interdependence of body systems and their relationship to a healthy body
and skin
The muscular system is the second part of the systems that provide the face with
support and movement. It is of interest to the beauty therapist because this is the
system that is benefited by massage.
The body has three types of muscles:
cardiac muscles, found only in the heart, power the action that pumps blood
throughout the body
smooth muscles surround or are part of the internal organs. Both cardiac and
smooth muscles are called involuntary muscles, because they cannot be
consciously controlled
skeletal muscles carry out voluntary movements
All in all, your face has about 43 skeletal muscles in it, working hand-in-hand to co-
ordinate the face. All of these muscles are used for things like:
chewing
talking
facial expressions
seeing
Within and wrapping around the neck, these muscles help support and move your
head and neck, additionally aiding side-to-side, forwards and back movement and
maintaining posture. Front on, these muscles aid those situated in the face and
moving the jaw.
Position and action of superficial muscles in the face, throat and chest
There are over forty (40) muscles in the face alone. These muscles are utilised to
smile, frown, express emotion and complete simple tasks such as blinking, chewing
and sneezing.
MUSCLE ACTION
Temporalis Draws from the temple down to the jaw, raising the lower
jaw. This muscle helps with chewing.
Procerus
Spans from the top of the nose and between the eyes.
This muscle depresses the eyebrow and causes wrinkles
across the bridge of the nose.
Nasalis Lies immediately below the procerus, across the bridge
of the nose. Compresses the nasal openings.
Masseter
Draws from the cheekbone down to the jaw. Aiding the
temporalis, this muscle raises the jaw and helps with
chewing.
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Risorius
Spans from the corner of the mouth, across the cheek.
This muscle draws the corners of the mouth out and back
– creating a grin or smile!
Platysma
Covers the lower jaw and front of the neck. This muscle
helps draw down the (mandible) jaw bone and lower lip
and wrinkles the skin of the neck.
Corrugator
Found at the inside corner of each eyebrow. An
‘expression’ muscle, it draws the eyebrows together
causing vertical furrows
Orbicularis oculi Appears around each eye. Closes the eyes tightly and
aid blinking.
Zygomatic minor
Draws diagonal from the zygomatic bone to the upper
lip. Works with the zygomatic major to raise the lips for
laughing.
Zygomatic major
Draws diagonal from the zygomatic bone to the upper
lip. Works with the zygomatic minor to raise the lips for
laughing.
Orbicularis oris
Appears around the mouth. This muscle causes the
mouth and lips to wrinkle. Also puckers the lips as in
kissing.
Depressor labii Lies from the lower lip to the chin. This muscle pulls the
lower lip down and to one side.
Mentalis Spans over the chin. The mentalis pushes the lower up
causing the chin to wrinkle.
Sternocleidomastoid
Appears on both sides of the neck and draws from the
ear to the clavicle and sternum. Together they flex the
neck, and each side alone bends the head sideways.
Trapezius
This muscle predominantly over the back covering all
thoracic vertebrae. This muscle then tapers towards and
over the shoulder. This major muscle elevates and braces
the shoulder as well as rotates the scapula.
Pectoralis
Lies across the upper chest from the ribs to the humerus
(upper arm). This muscle adducts and rotates the arm
inwards
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Nervous system and its relationship to skin sensations
Nervous tissue is found in the brain, spinal cord, and nerves. It rapidly responds to
stimulus and integrates the activities of the different parts of the body. It can do this
because it has more developed excitability and conductivity than other tissue types.
Nervous tissue is composed of:
nerve cells or neurons, which are the conducting cells of the system
neuroglia or glial cells, which are supporting, connecting and protective cells
Neurons are cells which specialise in the properties of irritability and conductivity.
Irritability is the ability to respond to stimulation by a change in structure and activity
at the point of stimulation.
Within the skin our sensory receptors lie in the epidermis and dermis. Identifying and
responding to temperature, pain, pressure, tickle, light touch and vibration. This
message then travels via the CNS (central nervous system) to the brain, instantly
responding via movement or change.
Skin as a sense organ and relationship to each device used
Types of stimuli that the skin responds to are:
hot
cold
pressure/touch
vibration/touch
pain
These stimuli are applied to the skin in a range of beauty treatments. For example
hot stimuli are applied in hydrotherapy spa treatments, pressure or touch is applied
as part of facial and body massages while pain stimuli may result from hair removal
treatments, such as waxing.
Stimuli and skin receptors
The skin is our interface with the external world. It is through the skin that we make
contact with and interpret what is happening around us. The skin does not and
cannot respond to every kind of external stimulus but to a selected range of stimuli
that seem to provide us with adequate information about the world. The inputs allow
us to learn, manipulate, avoid or seek further stimuli. The systems involved are very
complex.
In general they involve:
1. Some types of specialised receptor organs
2. Conducting Pathways of sensory nerves to the central nervous system (CNS).
These may be myelinated or unmyelinated. Myelin is a fatty substance that
covers some parts of the nerve fibre
3. The Central Nervous System (CNS) – segments of the brain and the spinal
cord.
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Systems and pathways of
sensory and motor neuronal
conduction
The basic units of the nervous
system are called neurons.
Neurons are too small to be
seen without a microscope.
They are the mechanical
means by which your thoughts,
movements and responses to
everyday living are controlled
and monitored. Neurons carry
messages from part of the
body to another in the form of
impulses.
The impulse that travels along a neuron is like a tiny electrical charge. The impulses
travel quickly – in fact, an impulse could cover the length of a football field in less
than one second. As an impulse arrives at the end of an axon, it is passed across the
synapse gap to a dendrite by neurotransmitters. These are chemicals found naturally
in the body located in the synapse that help in the transmission of impulses from
neuron to neuron.
Within beauty treatments, we are predominantly looking at two (2) different types of
neurons:
Sensory (afferent) neurons: detect changes in the environment, from both inside and
outside of the body. They carry nerve impulses from the sense organs, skin, muscles
and internal organs to the spinal cord or brain. As an example, when you touch
something cold, the cold-sensing neurons send this message to your brain.
Motor (efferent) neurons: carry a response from the interneurons to the muscles,
glands and internal organs of the body. Every muscular body movement is
controlled by messages carried by motor neurons to the muscles.
Types of receptors
There are many types of specialised skin receptors. The exact function and activity
of them is at best uncertain. Different parts of the body are sometimes endowed
with collections of special receptors. For example: the tips of the fingers have dense
collections of particular touch and pressure receptors. The back is relatively poor in
these receptors.
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SENSE ORGAN RESPONSE STRUCTURE OF THE SKIN
Merkle cells Constant pressure Basale layer, epidermis
Paccinian corpuscles Deep pressure and
vibration Deep dermis
Kraus receptors Cold Dermis
Ruffini organs Varied temperature Dermis
Meissner corpuscles Light touch Dermis
Free nerve endings Pain Superficial dermis
Variations in sensory perception and their significance to facials
The interpretation of stimuli depends on:
intensity and frequency; for example the intensity of pressure applied during a
body massage or the intensity of an electrical current used in a facial or hair
removal treatment
type and number of sensory fibres; for example in a hair removal treatment
which involves the dermis, pain receptors found here will provide the stimuli
duration and habituation (or how used you are to the stimulation)
areas covered by sensory nerves
brain pathways utilized and activated
Lymphatic, digestive, respiratory, and circulatory systems and their relationship to
skin functions, thermoregulation and homeostasis
The cardiovascular system is the main circulatory
system. It is composed of blood tissue that
transports respiratory gases and nutrients around
the body. It is moved through a closed circuit by
the pumping action of the heart. Its function is
to:
transport oxygen, nutritive materials and
water to the cells
transport carbon dioxide and other waste
products to the organs of excretion
regulate and coordinate the body
through the distribution of hormones from the
endocrine system to the cells they influence
regulate water and other substances in
the body
regulate body temperature
maintain the constancy of the internal
environment of the body
protect through the action of white blood cells and through the production
and transportation of antibodies
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The lymphatic system is the body’s secondary system of circulation. Throughout the
body, plasma-like fluid called lymph fills the spaces between the cells. The lymphatic
system collects this lymph and carries it to the bloodstream. The system functions as
one of the body’s major defences against infection. Also, lymphatic capillaries pick
up nutrients and filter wastes that cannot be absorbed by blood capillaries.
Functions of the lymphatic system:
Maintenance of fluid balance in the body
Immunity
Shares some of the functions of the
cardiovascular system
Collection of materials from the tissue fluid and
returns it to the blood
Filtration of lymph by the lymph nodes which
help prevent the spread of infection
Absorption of fats from the digestive system
through the lymph capillaries of the intestinal
tract
Every tissue in the body requires oxygen to survive.
The respiratory system, which includes air passages,
pulmonary vessels, the lungs, and breathing muscles,
aids the body in the exchange of gases between the
air and blood, and between the blood and the
body’s billions of cells. Most of the organs of the
respiratory system help to distribute air.
The main functions of the digestive system are the breakdown of food into simpler
substances, and the absorption of these substances into your bloodstream. The
digestive system also eliminates the wastes that are left after the nutrients in food
have been absorbed. Digestion is the process by which the body breaks down
carbohydrates, proteins and fats into substances the cells can absorb and use. There
are two types of digestion, mechanical and chemical. Mechanical digestion is
chewing and breaking food particles into smaller pieces. Chemical digestion occurs
when food is changed into simpler substances, mainly through the action of
enzymes. Enzymes are proteins that cause a quick chemical breakdown of complex
food substances into simple ones. Absorption is the process by which nutrients from
digested food move into the bloodstream. Elimination is the process by which the
body gets rid of waste material remaining in the intestine after absorption has
occurred. The process ends in the body releasing solid waste from the body through
the anus.
Endocrine and reproductive systems in relationship to hormonal influences on skin
This system provides communication, control and integration to the functions of the
body. It is a collection of glands that produce hormones that regulate the body’s
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growth, metabolism, and sexual development and function. It plays a very
important role in development and health by communicating with and controlling
other functions.
All the organs of the endocrine system are glands but not all glands in the body are
endocrine glands. The other types of gland are exocrine glands, which include
sweat, salivary, and sebaceous glands. Major organs are reproductive systems of
men and women, and additionally the thyroid, pituitary and hypothalamus.
Normal hormone function is vital to the healthy survival of the individual both
internally and topically. They are the main regulators of development and growth,
reproduction and many other body functions and also play a role in maintaining
homeostasis. There are many diseases, which can affect the endocrine glands.
Sometimes these abnormalities can release too much hormone (hypersecretion) or
too little hormone (hypo secretion).
Age related changes
There are two biological changes that occur due to the endocrine system:
Puberty – occurring at different times and ages (generally between ages 11 –
19) the pituitary and hypothalamus glands in the brain start sending out new
hormones that trigger the changes. These include physical, hormonal, and
sexual, inclusive of becoming capable of reproduction. For women, this
process is also responsible for the initiation of the menstrual cycle.
Menopause – is the process of ovulation and menstruation ceasing and the
production of the hormones oestrogen and progesterone drops considerably.
This occurs only in women from ages 48 – 55.
Pregnancy can also be considered a voluntary biological change, the fertilisation of
the female egg and male sperm, developing from embryo to foetus to new born.
Effect of hormones on skin
There are numerous effects the skin will encounter throughout one’s life, both
externally and internally. Those that the body self-regulates can be hard to diagnose
and treat; yet having a current understanding of the hormonal effects the skin relays
can be vital to prevention, recommendation and treatment.
Hair growth and loss
Menstrual cycle skin changes
Pigmentation
Sebaceous and sweat gland secretion
The above effects can be seen through major hormones produced in the body.
Specifically these hormones include oestrogen, testosterone, thyroxine and
tyrosinase.
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Oestrogen – Is the major hormone produced within the ovaries of a female and in all
is what keeps our skin youthful and young. Increased through puberty and abundant
throughout pregnancy it plays a major role, not only in systemic development but
within the skin. Oestrogens affect skin thickness, wrinkle formation and skin moisture.
Oestrogens can increase glycosaminoglycan’s (GAGs), such as Hyaluronic Acid, to
maintain fluid balance and structural integrity. They can also increase collagen
production in the skin, where they maintain epidermal thickness and allow skin to
remain plump, hydrated and ‘wrinkle-free’.
As well as the above ‘pros’ of oestrogen there can be additional side effects. When
oestrogen is at its peak, for example pregnancy or contraceptive intake, the skin
can become sun-sensitive and produce hyperpigmentation on certain parts of the
skin, known as melisma and commonly seen over the forehead and cheeks.
Furthermore the role of oestrogen and the hair growth pattern are impacted. At
times hair growth can excel, producing stronger, darker and additional growth
areas.
In summary:
Increases the rate of cell turnover in the basal layer of the epidermis
Reduces the size and activity of the sebaceous glands
Keeps sebaceous secretion thin and less fatty
Slows the rate of hair growth
Increases the action of the enzyme hyaluronidase, which produces
hyaluronic acid
Keeps the skin metabolically active
It also appears to stimulate fibroblast activity however study is continuing into
this area. (Fibroblasts contain oestrogen and produce hyaluronic acid.
Testosterone – predominantly found in men, this hormone is what makes a boy a
man. This means course, thick, dark hair, as well as thicker and oilier skin. Also
recognised as ‘androgens’ females hold a delicate balance of androgens and
oestrogen, and when an imbalance occurs or is one hormone heavy, different traits
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can replay on the skin. Testosterone is involved in skin sebum production; females
may experience increased oiliness or even adult acne during menstruation or
menopause.
In summary:
Increase the rate of cell turnover in the basal layer of the epidermis
Increase the size and activity of the sebaceous glands
Increase collagen production through the stimulation of fibroblast cells to
produce the proteins needed for collagen synthesis
Increase hair growth
Thyroxine & Tyrosinase - balance is key when it comes to these hormones. Too
much, and skin can become warm, sweaty and flushed. Too little, and skin becomes
dry, coarse, thick and even sweating is decreased. Thyroid dysfunction can also
lead to thinning hair and eventual hair loss.
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SECTION 2 DESIGN MICRO-DERMABRASION TREATMENT
Client characteristics
After completing a thorough consultation and detailed plan of treatment it is
essential to accurately identify their personal characteristics. Identifying a client’s
characteristics involves analysing and assessing
1. Skin type and condition
2. Fitzpatrick skin type
3. Lifestyle
4. Equipment selection and use
5. Suitability and limitations
Appearance and characteristics of skin types
Information on the skin type is essential in order to recommend the appropriate
formulations of skincare and associated products to suit the client’s requirements.
Skin can be diagnosed to contain both a ‘type and condition’. This is identified by
examining the client’s skin. Before you do this, wash your hands thoroughly or sanitise
them with alcohol and dry with a paper towel or tissue. It is important to allow the
client to see that sanitary practices are being observed so that they feel confident
that hygiene procedures are being followed.
Skin type: You are born with; it will only change with age.
There are many factors that can affect skin function and appearance, these
include:
climate and changes in weather
exposure to the sun
cosmetics
moisturisers, cleansers and other skin care products
emotion and stress
hormonal cycles, including menstruation and menopause
medical conditions
pregnancy
overall health
There are three ways to identify skin type and condition:
1. Initial observation
2. Visual analysis
3. Analysis by touch
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Analysis equipment
1. Has a built in mirror enabling the client to visualise what is happening
underneath the skin. Depending on the brand, some can take a photo
providing good measure to track skin treatment results.
2. This is a hand held ultraviolet lamp that is used in a dark room. The light is
shone on the client’s skin and the different conditions will ‘fluoresce’ in
different colours. For example, orange spots represent sebum (oil) secretion.
3. A round lamp with magnifying glass in the centre. The lamp maybe clamped
to the trolley or be free standing. Either way you place it over the area of the
skin you want to analyse. The light and the magnifying glass make it easy to
see the skin clearly. The bulbs on some lamps get hot so you need to ensure
that the bulb does not touch the client’s skin. The light is bright so cover the
client’s eyes with damp cotton wool squares as you complete the analysis.
SKIN TYPE DESCRIPTION
Normal
Normal skin has a good oil/water balance. The
pores are normal size and the skin is usually free
of blemishes. If you can see the pore size change
from medium to smaller just on the edge of the T-
zone by the nose, measuring outward from the
center of the face, this is a normal skin type.
Maintenance and preventative care is the goal
for this skin type.
Characteristics of normal skin:
• even in colour
• clear complexion
• sebum and moisture levels balanced
• epidermis has even thickness
• no enlarged follicles
• good elasticity
1. SKIN SCANNER 2. WOODS LAMP 3. MAGGI LAMP
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Oily
Oily skin is characterized by excess sebum (oil)
production. The pore size is larger and contains
more oil. If the pore size is large over most of the
face, this indicates an oily skin type. Oily skin
requires more cleansing and exfoliating than
other skins and is prone to blemishes because the
pores often get clogged with sebum and dead
skin build up. This can make the skin appear
thicker and very shiny.
Characteristics of oily skin include:
• thick epidermis, coarse texture
• open follicles, particularly on the T-zone
(forehead, nose and chin)
• comedones and pustules are often present
• shiny in appearance
• oily to touch
• increased sebaceous secretion
• more resistant to wrinkles
• can be dehydrated
• make-up can change in colour due to
increased acidity of the skin
Dry
Dry skin does not produce enough oil (lipids). The
pores are generally very small and the sebum
production is minimal. If you can barely see the
pores or they are small, this indicates a dry skin
type.
Characteristics of dry (lack of oil) skin:
• scaly or flaky appearance
• follicles are small and mostly not visible
• insufficient sebaceous secretion
• ages faster
• thin epidermis/fine texture
• fine lines appear around eyes and mouth
prematurely
• shows tiny surface wrinkles that disappear
when moisturiser is applied
• can be sensitive
• can have dilated capillaries
• has roughened or reddish patches
• feels itchy
• feels tight
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Combination
Combination skin can be both oily and dry at the
same time. The T-zone through the middle of the
face (forehead, nose and chin) is oiler. This area
has more sebaceous glands and larger pores.
The outer areas of the face can be dry and
appear flakey. From the center of the face, if
you can see the pore size change from larger to
medium/small just outside the T-zone on the
cheeks next to the nose, this is a combination skin
type.
Characteristics of combination skin:
• normal cheeks, eye area and the throat
• excessive oil on the T-zone
• affected by climatic conditions
• prone to comedones, pustules (acne)
• shiny appearance in the T-zone
• oily to touch
• imbalance in sebaceous secretions
• coarse texture
• can be dehydrated
Skin conditions
Skin type and the Fitzpatrick Phototype are hereditary; you cannot change them
and treatment and product recommendations are designed to assist the skin to
perform optimally. The condition of the skin however, is often a direct result of
external environmental factors and internal factors. You are able to apply
treatments and products to cause a real change in some conditions of the skin. For
example, exfoliation and extractions will assist in the removal of closed and open
comedones.
Skin conditions have been grouped below according to the appearance. When
you do a skin analysis you should record on the client card any of these conditions
that appear on the client’s skin.
Skin condition: Can come and go, also can change throughout one’s life
depending of lifestyle factors and environmental impact.
1. Acne
2. Eczema and atopic dermatitis
3. Pigmentation disorders
4. Vascular disorders
5. Pre-mature / Aged
6. Stretch marks / Scar tissue
7. Skin texture / keratosis
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1. Acne / Blemished
Acne is a disease of the hair follicles.
The outer layer of the skin consists of many layers of skin cells, held together by glue like
substance. The cells move from the bottom up to the top where they shed as dead skin
cells. The cells of the hair follicle shed into the follicle and are a major course of
obstruction.
Every hair follicle has a gland attached that produces oil to lubricate the skin and hair.
People with acne usually produce more oil than those without acne.
The principal cause of acne is blockage of the opening of the follicles (pore) by
dead skin cells and oil.
Despite the obstruction the gland keeps producing oil causing the follicle to swell,
resulting in small cysts (comedones).
The oil gland can swell and rupture, releasing oil and skin cells into the dermis. This is
very irritating, causing an inflammatory reaction (redness and swelling).
The bacteria in the hair follicle create infection which causes the white top of
acne pustules.
There are four types of acne:
Grade 1: the least severe, consists of open and closed comedones with little or no
inflammation.
Grade 2: the most deceptive and stubborn consists or only closed comedones, no
inflammation. Difficult to treat as we have to work on opening the follicles, needs more
aggressive treatment
Grade 3: the most typical, consists of papules, pustules, nodules, open and closed
comedones; very inflamed and usually spreads over the entire face.
Grade 4: the most severe case of acne and includes all symptoms of grade 3 plus cystic
lesions which often lead to scarring. Generally needs other forms of treatment such as
antibiotics.
All the above grades can present in
mild
moderate
severe forms
2. Eczema and atopic dermatitis
Eczema is a common skin condition and affects 5% or more of children, 85% of
whom will grow out of eczema before they reach 5 years old. Atopic
dermatitis/eczema applies to a form of allergy and group of people who may have
a family history of hay fever, asthma, and/or very dry skin. There is an unexplained
association between these diseases and eczema. It is not contagious.
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Atopic dermatitis follows a pattern of flare-ups and remissions. Almost any part of the
body can be affected at any time, but the distribution tends to follow distinct
patterns during infancy, childhood and adult life.
Cause: The cause is unknown. It is believed to be a genetic disorder with increased
formation of IgE (immunoglobulin) antibodies. One theory is that there is a defect in
the T-cell system. The infantile type of atopic eczema may be aggravated by foods
such as egg whites, wheat, milk and oranges or by inhalants such as wool, house
dust mites, cat and dog hair, feathers and pollens. In adolescents and adults
emotional stress and seasonal changes are primary aggravating factors.
Appearance: There are dry, flaky patches of skin that overlay red, inflamed areas.
There is an associated burning and itching.
Seborrheic dermatitis is a very common skin condition. It is more common in men
than women and is worse in winter.
The eruption typically begins at puberty and continues through adult life. It is rare in
old age.
Cause: The cause of seborrheic dermatitis is unknown. It is found in genetically pre-
disposed individuals and occurs without obvious provoking factors. Nutrition,
hormones, emotional stress and infection appear to play important roles in the
occurrence and relapse of the condition. Overgrowth of the yeast pityrosporum
(lipophilic) occurs in the scales.
Appearance: The eruption is formed by yellowish or greyish sharply marginated
macules covered with greasy scales. Lesions may group to form irregular patches.
Advanced lesions may fissure or crust. The eruption is greater where there are more
sebaceous glands and is usually bilateral or symmetrical.
3. Pigmentation disorders
Hyper pigmentation is the only type of pigmentation that micro-dermabrasion can treat.
Hyperpigmentation is an accumulation of melanin within the skin. This irregular
pigmentation may be seen as:
Freckles/lentigo
melasma
Age/liver spots
Tan
Nevus/birthmark
Mole
Stain
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Hyper - pigmentation may be caused by:
UV - radiation
Pregnancy
Oral contraceptive pill
Menopause
Chemical peels
Antibiotics
Post laser / IPL
Medication
Drug induced (minocycline,
tetracycline etc.)
Burns
Post-surgery
Aggressive treatments
Post inflammatory response
The advantage of Microdermabrasion is that it works on the surface of the skin and does
not stimulate or aggravating the Melanocytes. Certain pigment (e.g. deep seated,
hormonal pigment) can be difficult to treat (like a Zebra losing its stripes).
4. Vascular disorders
Conditions that affect the circulatory system
This skin exhibits a red colour which is due to the increase in blood circulation in the
skin. The irritation could be the result of physical irritants (environment and
uncontrollable) or may be a chemical sensitivity (product or topical, controllable).
Either way, the irritant needs to be eliminated and suitable product
recommendations made.
Couperose Redness of the skin usually on the most exposed parts, for example, the
cheeks. This redness is due to dilated capillaries. When the skin is exposed to an
irritant, such as cold winds or extreme heat, the minute capillaries dilate and then
contract when the irritant is removed. In couperose, these minute capillaries do not
contract again and this leaves the skin looking red. Skin that is thin or structurally
weak and blood vessels that are weak contribute to this condition. It is more often
found in older skin than young skin. Removal of the irritant is important to reduce the
appearance.
Telangiectasia These are pronounced red, dilated capillaries and are larger in
appearance than those seen in couperose. A common example is those that
appear on the sides of the nose if they client suffers from hay fever.
Rosacea This is chronic redness of the skin and papules and pustules may be
present. Rosacea can be classified into three stages:
Stage 1: redness in the naso-labial folds, cheeks and forehead. Skin can be sensitive
to unsuitable cosmetics.
Stage 2: The same as above but inflammation is present, and often papules and
pustules. The condition may be spread wider than in Stage 1.
Stage 3: Same as 2 above, but the skin is coarse, large nodules are present and the
pores are enlarged (orange peel look). This stage should be referred to the medical
practitioner for treatment.
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5. Pre-mature / Aged
Fine lines
Deep set wrinkles
Thinned skin
Dry
Dehydrated
Loss of elasticity
As we age, our bodies change in many ways that affect the function of individual cells as
well as organ systems. These changes occur little by little and progress inevitably over
time. We expose our skin to mild trauma which over time accumulates and is seen as
premature ageing. Although the actual aging process starts in our mid-20s, the actual
signs of aging often are not apparent until people reach their late forties. How quickly
someone ages depends on a number of factors including genetics, lifestyle and
environment. Skin ages intrinsically and extrinsically.
As we all have a biological clock, this is one major influence on the aging process the
epidermis thickens and the dermis thins due to loss of collagen and elastin. Within the skin,
collagen and elastin production slows, dead skin cells shed less quickly and turnover of
new skin cells slows down. This is known as intrinsic aging.
A number of external factors also act together with the normal aging process to
prematurely age our skin. The most common factor of extrinsic aging is UV exposure.
Environmental factors, recognized as ‘free radicals’ also have an effect on our bodies
and the aging process. These include severe temperature changes, smoking, drinking,
pollution, diet and stress levels. This is known as extrinsic aging.
Abnormal and premature skin ageing and structural skin changes
Normal ageing and photo-ageing
Normal aging classifies that of our biological clock, something we cannot prevent.
Photo-ageing relates to changes promoted by exposure to sunlight and UV rays.
Both normal ageing and photo-ageing involve changes over time; therefore they
share some outcomes. However, many features are very different. The distinction
between normally aged and photo-aged skin is confused because most people,
depending on the level of sun exposure, experience degrees of both.
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NORMAL AGING PHOTO-AGING
smooth, unblemished
some deepening of wrinkles
some loss of elasticity
epidermis is thinner
fewer cells participate in mitosis
cells are generally regular
dermis is thinner
elastin is thicker and cross-linked
collagen bundles heavily
GAGs (specifically Hyaluronic
Acid) overall decreases
Hypo cellular activity
leathery, blotchy
quite extensive deep wrinkling
quite significant loss of elasticity
Epidermis is thicker
more cells participate in mitosis
cells can grow irregular
Dermis becomes thicker
elastin is in thick, tangled,
disorganised lumps
decrease in bundles and fibres of
elastin
GAGs: large increase; change in
‘gel’ thickness
Hyper cellular activity
Theories about ageing
There are many theories to try and decipher the changes as we degenerate and
age. Some base this on facts; others base it on experience and appearance. As
beauty therapists we recognise three (3) prominent theories:
1. Genetic / Biological clock
This theory states that our DNA determines the maximum lifespan of our cells;
it only has so many times it can divide and multiply. Consequently, slowing the
preproduction of all living tissue in the body.
2. Free radical
This theory argues that there is an environmental cause of ageing as opposed
to an internal or genetic cause. The major difference between this theory and
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the genetic theory is that there is no fixed lifespan and cells are incapable of
remaining healthy.
Some free radicals, such as unsaturated fatty acids are produced in the body
as an internal response, others are produced by environmental factors such
as light, radiation, smoking and pollutants. A major defence against free
radicals are anti-oxidants.
3. Immunological response
The immune system fights disease by recognising and removing or destroying
foreign substances and damaged or cancerous cells.
In the aged, the immune function decreases. The ability of the immune
system to recognise any abnormal cells or foreign substances in the body is
reduced; therefore, the aged suffer a high incidence of cancer, infectious
disease and degenerative auto-immune disease
6. Stretch marks / Scar tissue
Scar tissue, is when the surface of
the skin has been broken. The skin at
the site of the break may leave a
scar with ‘scar tissue’ lying beneath.
Scar tissue is the result of the skins
natural wound healing process. It is
known as scar tissue because of the
way the connective tissue and fibres
are arranged. A common example
is acne scarring. When extractions
are performed incorrectly, client has
picked at the acne spot or when an
infection has been present, the pore
swells from the damage causing a break in the follicle wall. This in turn can create
scar tissue instead of the skin healing as normal.
In regular, undamaged skin, the collagen proteins overlap in many different
directions giving a youthful, bouncy and supported skin, but in scar tissue, they
generally align in one direction. This makes the scar have a different texture and
feel. It also impacts the skins regular structures such as elastin (flexibility), blood
supply, sweat glands, oil glands, hair follicles and melanin. Wound healing can also
be impacted by cause of the wound, location, skin health and skin type.
Stretch marks, Also known as ‘striations’ stretch marks are a form of scar tissue. They
are generally long and quite faint across the skin, appearing as a white or pink
colour. Striations are a result of the skin ‘breaking’ or ‘tearing’ within the dermal layer
of the skin from bodily changes such as weight gain, muscle gain and pregnancy.
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They make up bands of scar tissue which is a strong form of collagen making them
difficult to target and remove. Stretch marks are generally permanent if left
untreated but can be reduced by with treatments such as micro-dermabrasion,
micro-current and micro-skin needling and further from a beauty therapist can be
referred to a qualified laser/IPL technician, dermatologist or cosmetic surgeon.
7. Skin texture / keratosis
Skin texture is a common concern for many clients. Skin texture can vary dependant
on skin type and care regimen, natural desquamation and encouraged exfoliation.
Desquamation is the skins natural process to ‘shed’. Per day it can shed
approximately one million corneal skin cells. Certain conditions, injuries and
medications accelerate this process, where as others slow it down. Encouraged
exfoliation is the clients manual removal of corneal skin cells, the most popular being
use of a cosmetic exfoliant (scrub) product. Additional methods incorporate
machinery (micro-dermabrasion) and cloth products such as a loofah.
When the dead skin cells are not removed, and the skin continues to produce new
cells the skin will take on a dry, scaly, dull and lack-lustre appearance. Surplus
conditions such as seborrheic dermatitis and keratosis pilaris can also occur.
Keratosis Pilaris appears as small, hard bumps covering areas such as the cheeks,
upper arms, thighs. It is cause by a build-up or keratin that plugs the pores and
openings of hair follicles. Often it has redness or swelling and affects clients of any
age and of any skin type, but common in those who suffer from dry skin and
conditions such as eczema and dermatitis. There is no known cure for keratosis
pilaris, but can be managed and appearance improved with regular micro-
dermabrasion treatments and appropriate at home skincare regimen.
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Fitzpatrick skin types and how to classify skin
Assessment of a client’s skin type is most important when selecting the initial
treatment, equipment and products. To help identify skin types, some classification
systems have been developed and adapted. Some include eye colour, tanning
habits, skin colour, etc.
The Fitzpatrick classification system was developed by Dr.Thomas Fitzpatrick of
Harvard Medical School in 1975. He developed the chart to help estimate people’s
skin tolerance to UV light and work out their potential risk for skin cancer. Ranging
from skin type I (1) to skin type VI (6), it was later used as a tool to determine skin
colour for beauty treatments and now laser/intense pulsed light treatments.
Assessing skin types
Clients should always complete a consultation form which includes the Fitzpatrick
Skin Type Chart for self-assessment. It is important though for the practitioner to
further assess and question the client. When using the Fitzpatrick classification, the
emphasis should be on the ‘burn’ response of the client rather than their ability to
tan. Why is this important for micro-dermabrasion? To ensure the correct type,
strength and parameters are used to reduce risk of post-inflammatory pigmentation.
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FITZPATRICK SKIN TYPE SKIN APPEARANCE PHYSCIAL
CHARACTERISTICS I
Very white coloured skin
that always burns as it has
almost zero natural
melanin. This skin type
never tans and is
extremely sun sensitive.
Red-haired, natural
blonde, freckles, (Irish,
Scottish, Celtic, Northern
European) or very fair hair,
fair skin
II
White to pink coloured
skin. This skin has little
melanin and results in skin
burning and premature
aging. Skin type II burns,
sometimes tans and can
be sun sensitive
Fair haired, fair skinned,
blue-eyed, Caucasian
(with variations)
III
Slight olive / tan coloured
skin. It has a moderate
amount of melanin
present. Still able to burn,
but can tan easily.
Medium skin and hair
colour, eye colour varies,
oriental and Asian
background, also many
Europeans fall into this
category.
IV
Tan to brown coloured
skin with minimal natural
freckles. Rarely burns and
tans well. This skin type
has a tendency to hyper
pigment, appearing in
medium to dark patches
Dark skin and hair colour –
Mediterranean, islander,
lighter Indian and some
Asian.
V - VI
Dark brown to almost
black coloured skin. This
skin has a lot of natural
melanin providing a
screen against UV rays. It
never burns and tans
extremely well.
African, Indian, Middle
Eastern, some Hispanic and
Indigenous Australians.
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Equipment selection and use
Advantages and disadvantages of crystal and diamond tips
In the microdermabrasion market is the introduction of two alternative methods to
mechanically exfoliate the skin.
1. Crystal based
2. Diamond based
The difference between crystal and diamond microdermabrasion technology
The original microdermabrasion unit Crystal microdermabrasion involves the use of a
hand held device to direct and propel a high speed flow of aluminium oxide crystals onto
the skin, whilst a vacuum suction removes debris, skin cells and used crystals. The angles
at which the crystals impact on the skin differs with some practitioners and manufactures.
Diamond microdermabrasion involves the use of a diamond tipped wand. In some cases
the diamond tip is reusable or disposable.
Each system works functionally in the same way to abrade the skin. The eye and mouth
area is sometimes easier to abrade with the diamond tip as there is no risk of crystals
entering these areas and causing irritation.
The original microdermabrasion unit Crystal
microdermabrasion involves the use of a
hand held device to direct and propel a
high speed flow of aluminium oxide crystals
onto the skin, whilst a vacuum suction
removes debris, skin cells and used crystals.
The angles at which the crystals impact on the skin differs with some practitioners
and manufactures prefer 90- degree angle whist others prefer 45 – degree, however
90 – degree impact seems to be harsher on the skin with less exfoliation.
Aluminium oxide crystals have been the most commonly used abrasive agent for the
last 20yrs being the second hardest mineral after diamond.
Irregular crystal shape makes a more affective abrader and is an inert material
which makes it less likely to cause irritation and allergic reactions. It is nontoxic when
ingested and non-carcinogenic. A fresh supply of crystals needs to be used after
every treatment. The crystals are very hard, rating 9, next to a diamond, 10.
Slower movement and more frequent passes allow abrasive action to work longer
therefore cause a deeper abrasion.
Sodium bicarbonate crystals (salt) are an organic alternative to Aluminium oxide but
are a lot softer and less effective however may be used with clients who are at risk of
hypo pigmentation. Sodium bicarbonate crystals are water soluble and can be
easily washed off the skin. Salt particles are softer than aluminium oxide crystals and
may give less exfoliation therefore treatments may not achieve required results.
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Diamond microdermabrasion involves the use of a diamond tipped wand. Originally
developed in Australia, these crystal free tips reflect advancements in technology
and are easier to use without residue being left on the skin, in the eyes or in the
mouth and nose. Bacteria however can be accumulated on the tip and therefore
there is a risk of spending infection from one part of the face or body to another
without knowing. It may also be difficult to reach irregular surface areas of the skin
with the diamond tip. The tips vary in coarseness and give a depth of resurfacing.
The coarseness of the wand or tip is determined by the consultation, the client’s
main concern and the treatment plan. A major consideration is the client’s skin type
and condition. Diamond microdermabrasion is considered easier to control and less
irritating by some professionals however this is not always the case.
A vacuum suction removes debris and dead skin cells from the skin through a filter
which is removed and disposed of after the treatment. The vacuum also lifts the skin
to allow contact with the diamond tip.
These are flat metal tips encrusted with fine diamonds which come in various
degrees of coarseness, allowing lighter or stronger abrasive action. These tips may
be labelled 1 – 5, one being the coarsest tip and five being the finest tip for use on
sensitive areas such as eye area or upper lip.
Slower movement does not increase abrasion as there is no crystal flow. The number
of passes and the amount of suction determines the depth of abrasion. Results may
not be as intense as crystal techniques.
It is important to use the Microdermabrasion equipment correctly in order not to
damage the skin or make the treatment uncomfortable for the client.
The depth of treatment is controlled by the following variables:
1. the strength of the flow of crystals
2. the coarseness of the diamond head
3. the amount of suction used
4. the rate of movement
5. the number of passes
Flow of crystals
All machines will have a speed control that can be varied to alter the speed at
which the microcrystals are delivered to the skin. Additionally there will be a control
which regulates the volume of crystals delivered to the skin. The volume of crystals
will determine the level of ablation per pass on the skin.
Whatever type of crystal is used you should also use those that are recommended
by the device manufacturer. Two dominant type of crystals within industry are:
Aluminium oxide (corundum) crystals are the original crystals used for micro-
dermabrasion. They are stable and does not cause skin irritations.
Organic crystals (e .g salt) can also be used. They are non-toxic, water soluble
and claim to cause a deeper exfoliation.
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Diamond heads
These are flat metal tips encrusted with fine diamonds which come in various
degrees of coarseness, allowing lighter or stronger abrasive action. These tips may
be labelled 1 – 5, one being the coarsest tip and five being the finest tip for use on
sensitive areas such as eye area or upper lip.
Vacuum
Suction is used to stimulate the blood flow and lymph action this in return helps to
realign the collagen and elastin. The suction is required to remove crystals and skin
cells from the skin and to lift the skin towards the Diamond Head to allow abrasion.
The setting is adjustable and is responsible of eth rate the crystals strike the skin as
well as elimination of used crystals and waste particles.
Rate of movement
Slower movement does not increase abrasion as there is no crystal flow. An even,
flowing pace should be applied to all areas being treated. Ensure when the
handpiece is gliding over the skin to work parallel and with the shapes and
curvatures.
Number of passes
The number of passes and the amount of suction determines the depth of abrasion.
Results may not be as intense as crystal techniques. As a general rule, you will pass
over the skin 2 – 3 times. Always check manufactures instructions and always work
until the suitable end point appears.
The micro-crystals remove between 0.06mm or 60 microns of stratum corneum in a
superficial micro-dermabrasion. It is always best to treat any area for the first time
conservatively and observe the visual effects.
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Recommended parameters
SKIN CONDITION RECOMMENDED SETTING
Sensitive skin
Set vacuum at 200 -300
Select #4 fine or #5 finest diamond tip
Low crystal flow
Pigmentation or ageing skin
Set vacuum at 300 -400
Select #3 medium or #4 fine
Moderate crystal flow
Stretch marks
Set vacuum at 400 -500
Select #1 extra coarse or #2 coarse
Strong crystal flow
Acne
Set vacuum at 500 -600
Select #2 coarse or #3 medium
Moderate crystal flow
Acne scars
Set vacuum at 400 -500
Select #2 coarse or #3 medium
Strong crystal flow
Scar tissue or cracked skin
Set vacuum at 400 -500
Select #1 extra coarse or #2 coarse
Strong crystal flow
Skin texture
Set vacuum at 500 -600
Select #5 finest
Low crystal flow
*Always follow manufactures instructions when setting and recommending
parameters. A skin sensitivity test is also completed prior to full treatment application.
Limitations to micro-dermabrasion treatments
As skin treatments are effective in maintaining health and aiding the treatment of
skin conditions, a micro-dermabrasion treatment isn't a magic cure, and the client
must be willing to take proper care of themselves to look and feel healthy overall.
Even the world's greatest micro-dermabrasion won't do much good if bad diet,
lifestyle and no homecare routine are present.
A micro-dermabrasion treatment will not restructure the skin, lift the face, or stop
aging. Some cells cannot be reproduced once lost, but they can provide the
support for change and a youthful appearance. It is preferable for clients to prevent
the effects of free radicals and environmental damage by caring for and protecting
the skin from an early age. After all, prevention is better than cure.
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Factors likely to affect suitability of treatment for client
Results of a skin treatment regime will depend on:
Client commitment
Budgetary and time constraints
Outcomes of previous treatment
Client skin biology or genetics
Client skin condition and concern
Client willingness to follow home care advice
The above factors influence the effectiveness and results gained from a micro-
dermabrasion regime. These should all be taken into account when designing a
treatment plan, recommending products and services and future treatment
recommendations.
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SECTION 3 PREPARE FOR
MICRO-DERMABRASION
TREATMENT
Pre-treatment advice
By preparing the skin for
Microdermabrasion, the results a
treatment can give are increased
dramatically. Products containing
Glycolic Acid will help to soften dead skin cells and loosen up the glue-like
substance that holds the skin cells together.
This will give a much better result as during a Microdermabrasion treatment to
remove a greater amount of skin cells, therefore giving a better resurfacing
treatment.
do not expose the area to be treated to the sun or any other form of tanning
use a sun block SPF 30+ every day
prepare (condition) your skin with the skin care products recommended
use these for at least two weeks before commencing the treatment
Prepare service area
Before beginning any service, ensure that the service area is organised, arranged
and equipped to that you can perform the treatment efficiently and according to
health regulations and workplace procedures.
Ideally, equipment, furniture, fittings and walls should be purpose built or purchased
specifically for the task to be performed. They should be durable, safe and suitable
for cleaning and maintenance, and constructed of sealed non porous material.
There should be adequate lighting and ventilation throughout the premises and
sufficient bench space for good working practices. After the client characteristics
have been assessed and a beauty treatment plan agreed upon, you will be able to
identify the products and any extra equipment that are required to perform the
treatment. Products and consumables will differ according to the brand of machine
used. Always refer to manufacturer’s instructions.
Prepare yourself
Your personal presentation is important because you are in the profession where you
are expected to act as a role model. Clients will expect a beauty operator’s
grooming and presentation to be of a high standard. As beauty operators work in
close proximity with clients, personal hygiene is a very important issue. Clients are
able to detect smells or body odour easily.
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Most salons have a policy on uniforms. Some supply uniforms and others simply
expect the beauty therapist to be dressed in a specific way. The health regulations
in most States and Territories say that the operator (that is you) should wear clean
washable garments. These garments will protect you from contamination with blood
or body fluids and substances. Watches, wrist and finger jewellery should not be
worn when attending to clients because these items are a potential source of
infection. Hand jewellery should not be worn during skin penetration (this term
includes temporary hair removal) procedures as it may tear the gloves.
After recommending and discussing a treatment with the client, there are some final
preparation steps before the treatment begins.
Place the completed client record card in a safe place during treatment.
Ensure that the treatment bed is at the correct height for you to work at
comfortably.
The client will already be gowned and on the treatment bed. Position the
client comfortably.
All protective garments should be in place. Place a towel across the parts of
the body where treatment will not be performed for modesty, warmth and
protection from spillage.
Ensure that there is enough light in the cubicle and a magnifying light
available. When the light is turned on it should not cause discomfort by
shining directly into the client’s eyes.
Check again that the client is comfortable before beginning the treatment. A
pregnant client may need a pillow to place under the knees or lower back.
Make sure that the client is as comfortable as possible throughout the
treatment. Continually check the client’s comfort level and make
adjustments to suit the client’s needs where appropriate.
Wash your hands with an antibacterial hand wash.
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Treatment bed set up:
1 bed roll on top of
towel
1 bed roll underneath
blanket
Hair net on pillow
Maggi lamp plugged
in
1 hot towel in cabinet
to remove mask
Before client arrives:
Microdermabrasion
plugged in with filter
Tissues
Cotton balls
Jewellery bowl
Water bowl
Fibrella
Skin O2 & ASAP
prescription pads
Pen and Consult
Card
After client consultation
(whilst they are getting
onto bed) add:
Cleanser
Eye cleanser
Exfoliator (optional)
Mask
Mask brush
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SECTION 4 PERFORM PATCH TEST
In rare and unusual cases it may be necessary to perform a test patch pre-
treatment. This is the only way to accurately assess how the skin will react. Choose
an inconspicuous area in the general region, test patches can be given where the
client’s hairstyle covers the test area if it is not appropriate to test in the actual
treatment site. Initially when we perform a test patch we want to assess the skin’s
reaction to the treatment. This will give us a safe starting point for the first treatment.
Most of the time we can also observe a clinical endpoint, which indicates that the
treatment should be effective as well (it is not always possible)
Why do we perform a test patch?
To assess the skins suitability for treatment – right skin type or skin condition
Determine suitable parameters – increased safety
Determine the clinical end point – for the most effective treatment
Prepare the client for treatment
To prevent any unwanted side effects – test on a small area only
Skin type 4 - 6
Hypersensitive skin
Clients who have medical conditions
Post Accutane
Any other concerns (emotional)
A 24hr period is sufficient to ensure the treatment is not contraindicated. A mild
microdermabrasion may be performed as a first treatment. Darker skins (4 and
above) require at least 4 weeks before treatments may commence.
Prior to performing a full treatment and small, skin sensitivity test is done to allow the
client to experience the sensation on their inner arm before the procedure begins.
Consider your client:
At all times keep explaining to your client what you are about to do. If this is the first
experience with microdermabrasion for the client, they can feel quite anxious and
need reassurance.
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SECTION 5 PROVIDE MICRO-DERMABRASION
Once you have conducted a thorough consultation, designed a treatment plan
and received consent you are ready to begin treatments.
Cleanse treatment area
In preparing the client for a micro-dermabrasion treatment, it is necessary to clean
the area. There are two (2) manual processes involved in a cleansing routine.
1. First cleanse, or superficial cleanse
2. Second cleanse, or deep cleanse
The first cleanse uses a lotion or milk product to emulsify and remove make-up,
pollutants and excess oil on the surface of the skin. For the eyes an eye make-up
remover may also be used. This prepares the skin for a skin analysis. The second
cleanse uses a product to suit the skin type of the client. This cleanse cleans the
‘true’ skin, prior to the remaining steps of a treatment to begin.
Each cleansing routine requires the application and removal of the cleansing
product, in a certain order.
Generic procedure for cleansing the eyes includes:
1. Wash your hands, apply disposable
gloves and secure the clients hair with a
disposable hair net and headband.
2. Dampen two (2) cotton round in warm
water, then apply an oil-free eye make-
up remover
3. Gently press each cotton round into the
eye area for a few seconds, focusing on
the lash line and eyelashes to infuse the
remover.
4. Working on one eye at a time, support the eyebrow and eye tissue with your
non-dominant hand. With the dominant hand, sweep the cotton round down
and out. First along the eyelid, second along the lash line and thirdly
underneath the eye.
1. Eye area & eyelashes
2. Lips
3. Decolletage, neck, cheeks & forehead
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5. Continue this process until all make-up has been removed and area is clean
from any pollutants.
6. Throw the cotton round into the bin straight away.
7. Repeat this process on the second eye, until all make-up has been removed
and area is clean from any pollutants.
8. Blot dry with a tissue. Throw the tissue into the bin straight away.
Generic procedure for cleansing the lips includes:
1. Dampen the fingertips of your dominant hand
2. Using a cleansing lotion or milk, apply a small amount to the middle and ring
finger of your dominant hand.
3. Supporting the skin around the mouth with the non-dominant hand, apply the
cleansing product in a figure eight motion. Ensure the full lip line is covered
4. Continue this process until all make-up has been removed and area is clean
from any pollutants
5. Dampen a cotton round in warm water and wrap around the middle and
ring finger of your dominant hand.
6. Still supporting the skin, use the cotton round to remove the cleanser in a
figure eight motion. Some sweeping movements from corner to corner can
be made to ensure all the cleanser has been removed from the lips.
7. Throw the cotton round into the bin straight away
8. Blot dry with a tissue. Throw the tissue into the bin straight away.
Generic procedure for cleansing the décolletage, neck, cheeks and forehead
includes:
1. Dampen both hands in warm water
2. Apply the cleansing product to both hands, pressing between both to slightly
warm the product. (do not rub, the product is for the client’s skin, not the
therapist’s hands)
3. In sweeping motions, apply the cleanser to the décolletage, neck, cheeks
and forehead. Follow through on the last motion, slide your hands down,
returning to the décolletage.
4. Massage the surface of the décolletage using circular motions
5. Sliding up to the neck, perform sweeping movements from one side to the
other, from the collar bone to jaw line
6. On the last motion, slide your hands to the cheeks and perform large circular
motions
7. Sliding up each side of the nose, perform small circular motions using your ring
finger on each nostril. Focus on the nasolabial folds.
8. Finally, slide your hands onto the forehead. Perform sweeping movements
from one side to the other, from the eyebrow to the hair line. Then small
circular movements.
9. On the last motion, slide your hand down returning to the décolletage to
repeat this routine.
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10. Once the routine has been performed twice, pressure off at the temples of
the client.
11. Dampen two (2) fibrella squares in hot water and wrap around the index,
middle and ring finger.
12. Starting from the décolletage, use sweeping movements from the centre
outward, to remove the cleansing product. Turn fibrella to a clean section as
you work.
13. Sliding up to the neck, perform sweeping movements from one side to the
other, from the collar bone to jaw line. Turn your fibrella to a clean section as
you work.
14. One the last motion, slide your hands to the cheeks and sweep from the
centre of the face outward. This will include the jaw, upper lip, nose and
cheeks.
15. Sliding up each side of the nose to the forehead, sweep from the centre of
the forehead outward. Pressure off at the temples of the client
16. Rinse the fibrella in hot water and repeat this routine.
17. Once the routine has been performed twice, blot dry with a tissue.
18. Throw the tissue into the bin straight away
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APPY MICRO-DERMABRASION
It is important to identify how to perform a micro-dermabrasion treatment in a
professional and organised sequence. This ensures you keep track of the areas
covered, number of passes and technique of the hand piece.
1. start on one half of the face and complete the other half the same way
2. divide the face into five zones and work in sequential order:
zone 1 = forehead from above eyebrows to hairline
zone 2 = mid face, cheeks, nose to upper lip
zone 3 = eye area treat last
zone 4 = lower lip to lower jaw
zone 5 = neck and décolletage
3. Start on zone 1, and then continue on one side to 2, 3, and 4. Then repeat
on the other side.
4. Zone 5 can be done last.
5. Zone 5 is treated with vertical strokes only
6. Pay attention to problem areas, treating more frequently and aggressively
7. movements can be made vertically and followed up horizontally or with
circles
8. To loosen up comedones make small twisting movements
9. Throughout the treatment move your supporting hand around so that the
skin is stretched and supported at all times
10. When treating the eye area, turning the vacuum down & using light
feathery movements away from the eye.
This procedure can also be applied to the body. Follow the principles of zoning,
direction, passes and pressure to the chosen treatment area, and always work in
sequential order.
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DIAMOND TIP MICRO-DERMABRASION
Application technique:
1. Perform thorough consultation with your client’s
Identify the objective and client characteristics, gain consent and design and
record these details in a treatment plan.
2. Prepare the treatment area, therapist, then the client
3. Cleanse the skin
This is the first cleanse, including the eye area, lip, face, neck and
décolletage.
4. Skin analysis
Identify the client’s skin type, Fitzpatrick skin type and skin condition/s.
5. Cleanse the skin
This is the second cleanse to clean the ‘true’ skin.
6. Exfoliate (optional)
Warm the chosen product in damp hands and effleurage onto the skin.
Perform small and large circles over the treatment area, with long flowing
movements to finish. Remove.
7. Ensure the therapist has put on PPE
Disposable gloves, disposable facial mask and protective glasses. Protective
glasses are optional for diamond technique.
8. Start micro-dermabrasion:
turn the machine on
select suction to suit skin type and condition
perform a skin sensitivity test on the clients inner wrist or arm
hold wand in dominant hand
hold handpiece at a 90 degree angle to the skin
place the wand onto the skin creating suction
support the skin while moving the wand away from the support
gently “lift” the skin and drag the wand across
*do NOT press down
*do NOT stop or pause the wand whilst it is on the skin as pressure can
create a blood blister
* keep the wand parallel to the skin at all times, following the curves and
shape of the treatment area.
to finish a pass, flick the wand off the skin by gently tilting to the side to
break the vacuum
make the passes slightly overlap to prevent striping
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make 2 – 3 passes – move vertically and horizontally (except for the neck
area)
The end point:
The skin should turn pink
The colour should be even all over
No striping should be visible The skin feels smoother (almost slippery)
9. Apply mask
Apply mask in long sweeping movements and according to manufactures
instructions.
Remove mask after appropriate amount of time using a hot towel. Ensure the
towel is ‘luke-warm’ so it does not aggravate the abraded skin. Alternatively
you can remove with fibrella.
10. Apply treatment products
Serum – press the selected serum directly onto the treatment area
Eye cream – mix between the ring fingers and dot along the ocular
bones, smooth from inner corner of the eye, outwards.
Moisturiser - Warm the chosen product in your hands, starting at the
chin, spread the moisturiser over the chin, cheeks, nose and forehead,
smooth over, and then finish by sliding down the neck onto the
décolletage.
SPF - Warm the chosen product in your hands and press onto the skin,
starting at the chin, cheeks, nose and forehead, smooth over entire
face and neck.
11. Once finished, provide aftercare and homecare advice.
This is done once the client has changed, and is sitting down in a relaxing
environment. Advise on:
What they can and cannot do 12 – 24 hours after a treatment
Realistic expectations
Recommend retail products
Correct use of homecare products
Additional advice on complimentary services, nutrition or health care
Recommendation of complimentary therapies
Rebooking sequence
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CRYSTAL TIP MICRO-DERMABRASION
Application technique:
1. Perform thorough consultation with your client’s
Identify the objective and client characteristics, gain consent and design and
record these details in a treatment plan.
2. Prepare the treatment area, therapist, then the client
3. Cleanse the skin
This is the first cleanse, including the eye area, lip, face, neck and
décolletage.
4. Skin analysis
Identify the client’s skin type, Fitzpatrick skin type and skin condition/s.
5. Cleanse the skin
This is the second cleanse to clean the ‘true’ skin.
6. Exfoliate (optional)
Warm the chosen product in damp hands and effleurage onto the skin.
Perform small and large circles over the treatment area, with long flowing
movements to finish. Remove.
7. Ensure the therapist has put on PPE
Disposable gloves, disposable facial mask and protective glasses must be
worn for crystal technique.
8. Prepare the client with PPE
Client goggles must be put on. An optional extra is to place cotton in the
client’s ears, then cover with the hair net. This prevents crystals entering the
ears.
9. Start micro-dermabrasion:
turn the machine on
select suction to suit skin type and condition
select crystal flow to suit skin type and condition
*Check manufactuers instructions
hold wand in dominant hand
hold handpiece at a 90 degree angle to the skin
place the treatment head onto the skin support the skin while moving the
wand away from the support. This will create a vacuum seal required to
create a continuous flow to deliver and retrieve the crystals
*do NOT press down
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*do NOT stop or pause the wand whilst it is on the skin as pressure can
create a blood blister
* keep the wand parallel to the skin at all times, following the curves and
shape of the treatment area.
to finish a pass, flick the wand off the skin by gently tilting to the side to
break the vacuum
make the passes slightly overlap to prevent striping
make 2 – 3 passes – move vertically and horizontally (except for the neck
area)
The end point:
The skin should turn pink
The colour should be even all over
No striping should be visible The skin feels smoother (almost slippery)
10. Brush away any crystals left on the clients skin
12. Apply mask
Apply mask in long sweeping movements and according to manufactures
instructions.
Remove mask after appropriate amount of time using a hot towel. Ensure the
towel is ‘luke-warm’ so it does not aggravate the abraded skin. Alternatively
you can remove with fibrella.
13. Apply treatment products
Serum – press the selected serum directly onto the treatment area
Eye cream – mix between the ring fingers and dot along the ocular
bones, smooth from inner corner of the eye, outwards.
Moisturiser - Warm the chosen product in your hands, starting at the
chin, spread the moisturiser over the chin, cheeks, nose and forehead,
smooth over, and then finish by sliding down the neck onto the
décolletage.
SPF - Warm the chosen product in your hands and press onto the skin,
starting at the chin, cheeks, nose and forehead, smooth over entire
face and neck.
14. Once finished, provide aftercare and homecare advice.
This is done once the client has changed, and is sitting down in a relaxing
environment. Advise on:
What they can and cannot do 12 – 24 hours after a treatment
Realistic expectations
Recommend retail products
Correct use of homecare products
Additional advice on complimentary services, nutrition or health care
Recommendation of complimentary therapies
Rebooking sequence
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The neck:
get client to tilt the neck back (this places neck skin under tension)
ask client to support skin on base of neck
support the skin at chin level
use vertical strokes up and down the neck only
finish treatment as above
The chest:
to stimulate the skin you may use vacuum only for the first pass
second pass vertically with crystal / diamond head
another pass in a horizontal movement, similar to the face
finish treatment as above
The hands:
ask client to make a loose fist,
support the hand with one hand
treat with short strokes parallel to long axis of the arm
brown spots require higher power and additional strokes
finish treatment as above
When using crystal microdermabrasion we advise not to treat the feet, ears, eyelids.
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SECTION 6 REVIEW TREATMENT AND PROVIDE POST TREATMENT
ADVICE
Following a Microdermabrasion treatment the client may feel tightness or the
sensation of mild sunburn for 1-2 days. In the early stages of treatment the client may
have mild exfoliation for a few days; this will improve as the skin improves. Erythema
is minimal and resolves within hours. It is possible for breakouts to occur post
treatment. Some skins may peel, flake slightly or feel dry; this is normal and should
heal within 1 – 2 days.
Appearance, causes and management of adverse effects of micro-
dermabrasion treatments
Erythema of the skin is an expected effect of the treatment and should subside in a
matter of hours. Clients must ensure that their skin is protected from sun by using a
sun block and wearing a hat if going outdoors. Increased skin sensitivity can result
but this should resolve within a matter of hours. Petechiae or small blood spots can
occur with aggressive treatment. Treatment parameters should be adjusted.
Adverse reactions can include:
Excess erythema
Blistering
Excessive discomfort
Swelling
Over treatment
Reactions leading to bruising
Hyper-pigmentation
Scarring
Pin point bleeding
Cross contamination &
infections
Abrasions or tears
All these adverse reactions are the result of treatment parameters or techniques
that are too aggressive. As well as observing the skin’s reaction to the treatment you
should ask the client during the treatment for feedback on the discomfort level.
Some clients, however, are reluctant to give you accurate feedback as they think
that if the treatment is uncomfortable that is proof that it is working extra well. Use
subtle body language signs, your observations of the skin’s reaction and the client
feedback to determine, intra-treatment, if your settings are correct and if the
number of passes, speed and pressure is achieving the appropriate outcome.
Adverse effects should be managed and supported by the salon but not treated.
Advise the client to receive medical advice on treatment and care, should they
have a prolonged effect. In addition to this, any immediate or post-treatment
effects should be recorded on the client’s treatment plan for follow-up and
prevention for their next appointment.
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Post treatment care and advice for specific treatment areas
This advice supports the treatment they receive in salon and aid achieving their
results. This means that you will need to provide them with information about suitable
products to use at home and how to apply them. Remind the client of how to use
the products and confirm the application techniques to be used at home.
Encourage the client to ask questions and provide visual demonstrations to clarify
any information. You can put this information on a card so that the client can take
the instructions home.
For seven days post treatment client should not have:
scrubs or exfoliants (other than the mild exfoliant supplied in the post
treatment pack) • electrolysis, tweezing or waxing
injections such as collagen or Botox
Laser or IPL treatments
Chemical peels.
They should not use products that contain AHAs, Salicylic Acid, retinoids.
For the next 24 hours they should not:
Perform any activity that causes excessive perspiration such as exercise, as
excessive perspiration will be irritating to the skin
Additional information could include:
do not expose the treated area to the sun or any other form of tanning for the
duration of the treatment plan
use a sun block SPF 30+ - 50+ every day
soothe your skin by using the post care products as recommended
use these until your skin has settled completely
avoid waxing for a week after
Use a mineral makeup if desired
dietary advice
Therapists
advice
Aftercare
What the client can and cannot do 12 – 24 hours
after their treatment
Homecare
What the client can do at home, in-between their
appointments
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stress management
exercise
water intake
caffeine, alcohol and cigarette reduction
adequate rest and relaxation
fresh air intake
Clients suffering from non-contagious skin conditions and disorders can also be
provided further advice for homecare treatment:
Use of hypo-allergenic skin care products
Avoidance of possible irritants
Avoidance of soap, and products containing lanolin and perfumed products
Gently patting skin dry after bathing, not rubbing
Treating dry skin with emollients
Avoiding specific foods that may trigger or aggravate a skin condition
Changing towels and linen regularly to maintain hygiene
Receive protected sun exposure before 10:00am and 3:00pm to maintain
Vitamin D intake
To achieve the best possible results from your Microdermabrasion treatment, it is
important that you follow the pre and post care instructions thoroughly.
Lifestyle factors and benefits of lifestyle changes on skin There are countless factors that can impact on the provision and outcomes of
beauty therapy treatments; they are that of the lifestyle habits of the client. An
insight into their lifestyle will assist in the planning of treatments by establishing how
much time will be available for salon treatments and how much time the client has
available for home care to supplement the salon treatments. Lifestyle knowledge
also informs after-care and home care and gives you an idea of where to put the
emphasis when advising clients.
Alcohol consumption deprives the body of its vitamin reserves, especially Vitamins B
and C, which are important in maintaining a healthy skin. Alcohol can also
dehydrate the body and therefore the skin.
Climate can affect sebum production and protection. It is the skin’s own natural oil
and helps to reduce evaporation of water from the tissues. However, if skin is
unprotected and over-exposed, evaporation from the epidermis will occur, causing
dry, dehydrated skin.
Exercise routine and physical activity not only helps to maintain weight and muscle
tone it can also improve sleeping patterns and general feelings of wellbeing.
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Hobbies a client who engages in leisure activities, more those that are outdoors such
as bush walking or sailing may require more intensive skin treatments to prevent and
protect from any external threats to the skin (UV). Additionally leisure activities can
bring on psychological benefit of relaxation, de-stressing and inner peace.
Nutrition, The skin is a canvas for what the body intakes. The foods we eat and the
water we drink are the basic building blocks of life and for cells to rebuild
continually.
Sleeping patterns a lack of sleep can cause the skin to look dull and puffy. This
especially occurs in the skin beneath the eyes, where dark circles can appear. Too
much sleep can have the same effect due to slow circulation.
Tobacco consumption and smoking interferes with cell respiration and slows down
circulation. This makes it harder for nutrients to reach the skin and for waste to be
removed. Cigarettes also have chemicals that destroy Vitamin C. This in turn
interferes with the production of collagen, and therefore plays a major part in
premature wrinkles occurring.
Type of employment the client has a commitment to can have varying environment.
Those situated in an office are faced under air-conditioning and fluorescent lighting,
and those outside or in the car are under the UVA and UVB rays, pollution and dust.
Each of these environments can trigger and worsen presenting skin conditions and
should be talked about when prescribing a treatment plan.
The client work commitments generally determine their available time. Salon
bookings should be made to suit the client schedule with the appropriate amount of
time between.
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SECTION 7 CLEAN TREATMENT AREA
Infectious disease transmission routes and prevention of infection transmission
As a practicing beauty therapist or beauty worker, you are continually confronted
with the possibility that you may be responsible for the transmission of diseases, or
you may come into contact with them from your clients or fellow workers. Knowing
what the disease is and how to control the problem is an essential part of being a
professional.
Clients with blood borne diseases
When a client currently presents with HIV/AIDS, Hepatitis B or Hepatitis C and as per
the Australian National Guidelines and Department of Health NSW, workers are
expected to protect the health and safety of their clients. This obligation includes
preventing transmission of blood borne viruses (BBVs) from themselves to clients, and
clients to themselves.
Prevention of blood to blood contact
Prevention is better than cure. In this case all protective measures must be followed
in preparation, during and post-treatment.
Contingency procedures for blood and body fluid contact
Should the therapist come into contact with blood or form of bodily fluid it must be
controlled and contained to protect the client, therapist and environment.
If exposure occurs:
1. Inform the client
2. Cease treatment
3. Use saline solution and cotton to cleanse away the fluid or blood
4. Dispose of the cotton immediately into a flip-top bin
5. Therapist must now change their gloves
6. Therapist must also change the hand piece (diamond tip or crystal cap)
7. Do not pass over the same area
8. Check client comfort level
9. Check selected setting on machine
Post treatment dispose of all waste immediately and follow procedures to correctly
disinfect and sterilize all tools, equipment and linens.
Definitions and methods of cleaning, disinfection and sterilization
Difference between cleaning, disinfection and sterilisation
Cleaning is the process of removing dirt and other types of soil from a surface, such
as a dish, glass, or hard surface. Cleaning is accomplished using a cleaning agent
that removes these deposits and utilizes a cleaning agent such as ‘spray and wipe’.
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Disinfection and Sanitisation is the process of
reducing the number of microorganisms that
are on a properly cleaned surface to a safe
level. A safe level is defined as a 99.999%
reduction of the number of disease
microorganisms that are of public health
importance. Sanitizing is accomplished by
using heat, radiation, or chemicals. Some
disinfectants may be harmful to human
health. Always check the manufacture’s
(MSDS) prior to using a chemical disinfectant.
Contact time (how long the equipment is in contact with the chemical) may
become ineffective if left for long time periods. Always read manufacturer’s
instructions.
Chemical concentration (manufacture will recommend an optimal strength).
Always read manufacturer’s instructions.
Sterilisation defines the complete destruction of all microorganisms including spores.
This can require the use of a ‘hot-air oven’ or ‘glass-bead steriliser’, but more
commonly used is an Autoclave. This unit sterilises using boiling water; because of
the increased pressure the temperature reaches approximately 121-134◦c
Benefits of chemical and physical disinfection
Chemical disinfectants should be used only for items for which thermal disinfection
and sterilisation are not suitable – for example items unable to be immersed in water
(thermal) or unable to withstand high pressure (sterilisation). It is appropriate to use
chemical disinfectant when equipment or the environment is contaminated with
blood or other body substances and cannot be thermally disinfected. (Detergent is
sufficient for cleaning off perspiration, for example.)
Due to the over use and misuse of chemical disinfectant, many micro-organisms
have become or are becoming resistant to them. For this reason, the routine use of
disinfectants is not recommended. Disinfectants can easily become contaminated
and are a potential source of infection. Detergent or disinfectant solutions should
not be mixed because they may react with each other and in doing so reduce their
effectiveness or cause harm. Some disinfectants such as those producing chlorine
must be freshly prepared. Operators should only use disinfectants specified by the
Australian Register of Therapeutic Goods (ARTG) and for the approved purpose and
for the time specified by the manufacturer.
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General method of cleaning, disinfection and sterilisation
Any instrument or part of an instrument used on a client should be cleaned with
detergent and warm water, dried and either thermally or chemically disinfected
before being used on another client. Below is a step-by-step procedure:
1. Wash implement with anti-bacterial soap in warm water.
2. Rinse under fresh water
3. Dry with disposable towelling
4. Treat with chemical disinfecting / sanitising agent (cover and leave for
appropriate amount of time)
5. Rinse under fresh water
6. Dry with disposable towelling
7. Store in a clean, air-tight container
Process for cleaning and sterilising diamond tips, stainless steel wands and safety
polycarbonate caps and tubing
1. Rinse soiled instruments under running water (between 15°C - 35°C)
2. Fill sink or container with tepid water (30°C – 35°C) and add CliniZyme (as per
instructions) or use made up solution
3. Immerse instruments in the CliniZyme solution and soak for 10 minutes
4. Clean instruments with a small brush (e.g. brush supplied or toothbrush)
5. Rinse instruments well with warm to hot clean water
6. Ensure instruments are clean and dry
7. Sterilize in Autoclave at 121°C for 15 minutes or 134°C for 3.5 min then store
when cool in a clean, dust free container or pack
Where an Autoclave is not available:
1. Soak in Clinidet for ten minutes, rinse in cold water
2. Tubing: rinse and clean as above, hang up tubing to dry overnight.
3. Remove implements from Clinidet and place on paper towel, spray with
Clinicol and cover.
4. Place in sterilised container with lid to store until required for use.
5. Polycarbonate caps may suffer deformation during autoclaving and are
better soaked as above.
Micro-organisms
Micro-organisms are everywhere! On all the surfaces you can see, on you and your
clothes, on the tools and equipment you use. Most of these micro-organisms are
harmless; some are even needed to maintain our health. However, there are some
micro-organisms that are harmful to us and cause illness and disease. The goal of
infection control procedures is to kill these harmful micro-organisms and to stop the
movement of them between people (cross-infection). The micro-organisms of
interest in infection control are bacteria, fungi and viruses.
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Bacteria
There is a whole classification system that puts
bacteria into categories. For example, you may
have heard of ‘golden staph’. This is a bacterium
that has caused problems in hospitals. Its real
name is Staphylococcus aureus. It is conical in
shape, grows in grape like clusters and it has a
gold colour. About 20% of the population carries
golden staph; they often do not know it and it may cause them no problems. The
shape of ‘golden staph’, the way it grows and its colour help scientists to classify it
and give it a name. However, some bacteria are useful. An example would be some
of the bacteria in your digestive system that help to keep the system healthy.
Fungi
Are next on our list and are also useful micro-organisms to humans. For example they
are used as yeast in bread-baking and in making soy sauce. A few are harmful to
humans. Fungi that are harmful in a facial treatment context are usually rare, and
predominantly found on fingernails, toenails and feet. They like the warm, moist and
dark environment provided by feet which are in socks and shoes. Fungi like the
keratin (a protein) in the nail plate and also the skin. An example of the type of fungi
that can cause problems for you is those that cause tinea pedis or ‘athletes foot’.
Viruses
The third micro-organisms that we are interested in are viruses. They are sub-
microscopic infectious agents that are unable to exist outside a cell. These are
spread by blood-to-blood contact. Examples of viruses that you should be
concerned in a facial treatment are HIV
and Hepatitis. Clients are not obliged to tell
you that they have blood borne diseases
like HIV and Hepatitis; you are safe to do
treatments on them provided you follow the
guidelines. If the client tells you they have a
blood borne disease you must not reveal
that information to other people. As a result
of the privacy considerations the industry works as if everyone has a blood borne
disease and everyone strictly follows the correct procedures to prevent cross
infection/contamination, that way you are automatically protected whether your
client has a blood borne disease or not.
Immunisation against Hepatitis B is
recommended. You need to consult your
personal doctor about this option.
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Infection control procedures and application of standard precautions
Infection control procedures
Infections can be spread between the client and operator, and from client to client,
from you to other employees of the salon and even from you to your family and
friends. This gives you some idea of the importance of following the health
guidelines. Most people that visit your salon will be free of diseases, some will
unknowingly have come into contact with a contagious condition and in rare cases
they may know that they have a contagious condition but hope that you will
proceed with the service anyway. If you follow the recommended procedures in
your States or Territories guidelines you and your clients will be protected from cross
infection.
Prevention
The above information should not make you uncertain and unconfident in providing
beauty services, you should not be concerned because there are guidelines,
procedures, tools, chemicals and equipment all designed to make it safe for you to
work in the beauty industry.
The first thing you should know is how cross infections can occur. There are many
routes of infection. Intact skin is the body’s first defense against infection. You should
make sure that you have no cuts or abrasions on your skin, if you have cuts and
abrasions you should cover them with a waterproof dressing and gloves, and you
should keep the skin of your hands moisturized and supple.
The first route of infection to consider is through the penetration of the skin. In beauty
services and treatments, it might be through hair removal. Sometimes the treated
area can bleed. Any instrument that comes into contact with the blood is then
infected and you must follow the right sterilisation process before using the
instrument again.
Wash your hands before and after working on a client, before working on the
next client and if you are interrupted during a service, when you resume the
service.
Follow the workplace procedure for the cleaning and disinfection of tools
and equipment and never mix clean and unclean instruments.
Use clean single use gloves for hair removal procedures
The second route of infection is through open wounds or cuts. If you accidentally cut
the skin on the client and if you also have an uncovered cut on your finger, the
client’s blood can enter your body through the wound.
Ensure any wounds on you or the client with a waterproof dressing that
completely covers the affected area. You can also use clean disposable
gloves if you have a cut on your hand.
Third, contamination of instruments is another way that infection travels from one
person to another. You need to follow a particular procedure to make sure that all
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instruments you use are cleaned and disinfected properly and then stored correctly
until they are used on the next client. For example if you use tweezers on a client
and there is an infection that is not visible you will transfer this to the next client if you
reuse the tweezers without following the correct disinfection processes.
Use disposable or single use equipment where possible.
Use equipment that has been properly cleaned and disinfected or if
necessary, sterilised.
Next you should consider what the client comes into contact with and what needs
to be changed after a service. For example, if a client has an eyebrow wax and you
use a hand band to protect and draw back their hair then that headband must not
be used on another client until it has been laundered correctly.
Linen that has come into contact with the client’s skin should be changed
after each client and laundered according to the State or Territory guidelines.
Finally, contaminated waste is another source of infection. This can happen when,
for example, you put a cotton round you have used on the client, onto the trolley.
The table top then becomes a potential source of cross contamination during the
service. All waste should go directly into a rubbish bin with a lid.
Waste should be disposed of in accordance with your State or Territory guidelines.
Make sure you dispose of waste directly into the proper bin; never leave used
disposables, soiled lined or other waste lying around.
Sustainable operating procedures for the conservation of product, water and
power Sustainability is about doing more with less. All salons use resources. A resource is a
supply or source that can be used to your benefit. It can be a chemical, a product,
material, equipment or a staff member that helps you to perform your job. A natural
resource is something that has come from the environment that we can use for our
wants and needs.
Environmental sustainable work practices not only satisfy sustainability goals, but also
promote these ideas to the wider community. Sustainability can be grouped into
three categories:
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Resource efficiency looks at energy, water and material use and waste generation.
Energy –
Turning off lights and equipment when not in use
Using power saving functions on office equipment
Using efficient lights
Replacing incandescent tubes with fluorescent tubes
Installing skylights
Keeping heating at 20 degrees Celsius
Insulating rooms
Fitting self-closing doors
Minimising the use of hot water
Using alternative energy sources where possible
Water
Comparing your water usage to others and make adjustments where needed
Fixing dripping taps
Fixing leaking pipes
Avoiding using water wherever possible
Investigating ways to use or treat wastewater
Material
The way packaging is used
Using materials that produce less waste
The environmental standards of your suppliers
Using recycled materials
Using products designed for long life
Avoiding buying products or services that have a high risk
Only storing materials that you need
Storing all materials in designated areas
Keeping stored materials labelled
Economic
efficiency and profitability of the
business
Social
-Image of the salon in the community
- human rights
- staff conditions and oppertunities
Environmental
Impact on the natural
environment
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Keeping storage areas clean
Ensuring storage containers are sealed
Keeping spill kits in chemical storage areas
Waste
In regards to waste generation, it is important to remember the 3 R’s:
1. Reduce
2. Reuse
3. Recycle
You can reduce waste by:
Quantifying the waste you produce
Accounting for the difference between raw materials and products
produced
Examining work activities to identify ways to reduce waste
Keeping a running tally for waste production
You can reuse by:
Reusing drums and other containers
Reusing materials within work activities
Selling waste to other production processes
You can recycle by:
Segregating waste where possible
Composting organic waste
Separating recyclable waste