The importance of carrying out a detailed skin analysis

Prior to undertaking a new skincare routine or treatment, it is vital to have a client consultation and conduct a thorough skin analysis with a professional skin therapist, so that the correct treatment plan can be personalised and tailored to the client’s skin type, concerns, and goals.

It is fundamental to assess the skin correctly; otherwise, the wrong products and pressure could be applied resulting in an ineffective treatment. To truly analyse the skin, we should be looking not only at the surface, but underneath the skin as well.

A therapist can employ the following assessment techniques to ensure a correct skin analysis:

Look. Touch. Question

  • Look- The use of a magnifying glass can help analyse and find characteristics and conditions to help guide in deciding the client’s skin type. Looking can also help to identify areas that are showing signs of ageing.
  • Touch- Using the fingers to touch the client’s skin to feel the texture of the skin, muscle tone, elasticity, skin tone, the level or amount of sebaceous secretions and also that of the subcutaneous tissue.
  • Questioning– Determine the client’s skin care routine, the type of products they are using and for what skin type. The therapist should not presume that if the client is cleansing, toning, and moisturising that the skincare routine is perfect, as they may be using the wrong product and applying them incorrectly, given that the products the client is using, and the frequency can affect the current skin condition. It is very important to get the client’s viewpoint and to ask if they have any concerns or problems with their skin. It is also important to find out the client’s expectations from the treatment.

The questions to ask can include:

  • Have you had a facial before?
  • How was your skin after your last facial?
  • How long has it been since your last facial?
  • Have you noticed any problems with your skin?
  • Have you noticed any areas of dryness or oiliness?
  • What is the main reason for you having a facial today?

This analysis and questions help determine the depth of pigmentation, hydration, skin thickness, vascularity, photodamage and the Fitzpatrick skin type.

 The importance of positioning of the therapist and the client during treatment

A good rule of thumb is for the therapist to work only on the parts of the client’s body that they can access directly, both visually and manually. The client’s body should be directly in front and facing up toward the therapist.

For the duration of the treatment, the therapist should ensure that their client remain, as much as possible, upright with their joints aligned, without bending forward, twisting or trying to reach out in front of them. The therapist should also ensure that they have the correct height for their couch and stool.

The positioning of the therapist and client during treatment is important to ensure they both always feel comfortable. If they don’t take care of their posture or positioning during treatment, they can develop Repetitive Strain Injury (RSI) as well as strain to the neck and back, foot and leg, shoulders or their hands and wrist.

Strain can occur if they bend forward when performing a treatment, when they twist their body to get closer to a client or to reach for something on a trolley or reach overhead for products or equipment. Strain can also occur if they lean backward because they have been standing for a long period or standing for a long time in high-heeled shoes.

Preparation of the client and therapist

The client should be prepared for the treatment by:

  • Asking them to remove all jewellery from the work area, eyeglasses or contact lenses

if worn.

  • Clothing to the upper part of the body should be removed (the shoulder area should be free from straps; however, underclothes should be kept on.
  • A large towel should be provided for clients to cover themselves with
  • Explain to the client to lie flat and straight on the bed, without their legs crossed. Some clients cannot lie flat and needs to be raised, so therefore the therapist will need to stand to carry out the treatment.
  • In addition, the client may prefer to have additional support behind their neck or back, so it’s up to the therapist to look out for the client’s comfort throughout the treatment.
  • Lastly, the client should be given some privacy to prepare for treatment.

Therapist’s posture during treatment:

When sitting– the therapist should sit in a chair with a back, at the correct height for the treatment. Both feet should be placed on the floor, at shoulder distance and directly under the knees. The back should be straight, and shoulders pushed back when possible.

When standing– place both feet at shoulder distance apart without pushing back on the knee joints. Weight should always be evenly distributed between both legs. The back should be straight, and shoulders pushed back slightly when possible. 

The importance of completing client records correctly

 There are a lot of important reasons for keeping and maintaining an accurate record of clients. A record card should be completed for all treatments and can contain confidential personal information about each client that is specific to them and each treatment. They can be stored in a locked metal filling or box by surname in an alphabetical order.

A record card should contain the following information:

  • A client’s name and address and telephone number
  • Client’s medical details, doctor’s name, and telephone number
  • List to check for contra-indications
  • Treatment aims and desired outcomes, also treatment plan for future treatments
  • Services rendered, specific products used and products sales
  • Client’s signature

For a facial treatment, current skincare routine, results of skin analysis and all the products that’s used should also be accurately recorded. After each treatment the record card should be updated, and this can be particularly useful in the following instances:

  • When there is the need to contact a client urgently due to a cancellation or double booking
  • If there is need to make enquiries from the client about details of a particular treatment
  • Or, if the client wants to purchase a product that has been used in a previous treatment.

The client’s information should be easily accessible to the therapist, when ready to perform a treatment. This information could also be updated onto a computer system and the therapist must be aware of their responsibility under the Data Protection Act.

People’s lives can be affected by incorrect data, for example they can be refused job or credit because of this, thereby under the Data Protection Act of 1984 and when processing a data on the computer, the information should be:

  • Fairly and lawfully processed
  • Processed for limited purposes
  • Adequate, relevant, and not excessive
  • Accurate and not kept longer than is necessary
  • Secure and processed in line with the subject data’s rights
  • Only transferred to countries outside the EU with adequate protection

The importance of completing the treatment to the satisfaction of the client.

One of the most important parts of the treatment is the consultation. This is done to discuss the client needs and to know what can be done to meet those needs. For a customer to be satisfied with the treatment, a therapist needs to fully understand what the client needs are.

Therefore, a therapist must be good with the following consultation techniques:

  1. Good communication skills- both verbal (talking) and non-verbal (body language). Smiling at customers, good posture, eye contact and encouraging head nods are examples of good body language.
  2. Good questioning techniques- asking the right question is the heart of effective communication and information exchange. It is very important for the therapist to ask the right questions to gain vital information that is required to carry out treatment.
  3. Open questions- this type of question starts with How? What? Where? When? Why? An open question asks the respondent for their knowledge, opinion, or feelings. “Tell me” or “describe” can also be used to gain vital information from a client.
  4. Closed questions- this type of questions usually receives a single “Yes” or “No” answer which can lead to a one-sided conversation.
  5. Good observation skills- being able to read a client’s body language can help determine if the client is feeling good about the treatment they are receiving.
  6. At all times, a therapist should speak clearly and accurately when carrying out treatment; sometimes a client may not fully grasp what is being said, in this instance the therapist should try a different approach and if in doubt, they should ask for help.

The beauty therapy industry is a service industry and therefore relies on customers to keep business operating. A therapist must have a good working relationship to encourage return customers and future recommendation. Basic techniques that can enhance working relationships with customers is by greeting the clients by name, asking after their family and interests, offering a choice of refreshments, offering a choice of reading material and being polite. The therapist can then complete the record card, discuss the client’s requirement, explain the treatment procedure by discussing the cost, time, frequency, and possible courses of treatment.

Therapists should remember that most customers like to be kept up to date with salon offers as it makes them feel valued. The client should also be advised on aftercare and homecare procedures and in some instance the therapist can advise on the products that will need to be purchased to achieve the desired result.

Contra-indications which could prevent or restrict a facial skincare treatment.

Contra-indication is something that prevents or restricts the way in which a treatment is carried out. It is very important for a therapist to recognise a contra-indication, so further cross or secondary infection can be prevented either to the client or the therapist themselves.

The therapist should make a note on the record card, reassure the client, or offer an alternative treatment that is not contra-indicated and if the client wishes for the treatment to be carried out, they must provide a doctor’s note.

The contra-indications to a facial treatment that require medical referral are:

Fungal infection: caused by fungus and called tinea corporis or commonly known as ringworm, it is a condition of the body that is highly infectious and spreads easily.

Firstly, small red pimples appear, a flat scaly ring-like lesions forms and it heals from the centre outwards.

Bacterial infection- If an infection has pus, then bacteria is present. Two examples of a bacterial infections are impetigo and a boil.

Boil, also called furuncles are reddish or purplish, painful lump that can appear around a hair follicle before forming a pus, it will then extend deeply into the skin and will cause scarring once the boil has healed.

Impetigo on the other hand is caused by staphylococci organisms and is a highly contagious infection which initially appears as red, itchy patches or spots, honey-coloured crusts then develop, that leaks serum and spreads, causing the skin to break and small blisters appear. It affects mostly exposed skin areas such as those around the nose, mouth, the arms, or legs.

Viral infection- Three common viral infections are: –

Herpes Simplex (Cold sore)– A highly contagious infection that often occur at times of illness, stress or under excessive exposure to wind or sun. A red itchy patch will occur followed by swelling and the formation of blisters around, the nose and mouth area.

If scratched this causes the release of serum, which forms a crust.

Herpes Zoster (Shingles) – It is a painful condition caused by the reactivation of the varicella zoster virus (VZV), the same virus that causes chickenpox in children and is thought to lay dormant in the body. Anyone can get it, but it’s common in older people.

It begins with itching, erythema (reddening of the skin) and inflammation followed by blisters that develop along the sensory nerve pathway. It is very painful and often affects the abdomen, chest and one side of the body.

Verruca Vulgaris (Warts)- is the common wart caused by a certain strain of human papillomaviruses (HPV). A papule/round lump with a rough surface that can vary in size; they can develop individually or in clusters and can spread to other areas.

The wart will often be a yellow/ greyish colour, spreads through direct contact and while they may develop on any skin surface, most occur on extremities like hands, fingers, feet, or toes. They may disappear on their own but can also be removed with a medical procedure.

Severe skin infections that would restrict a facial treatment: –

Acne Vulgaris- is the formation of comedones, pustules, papules, nodules and/or cysts and can also be recognised by seborrhoea (greasy shine) or inflammation of the pilosebaceous units (hair follicles and their accompanying sebaceous gland). Acne develops on the face and upper trunk; the condition is most common in teenage years and is linked to the influence of the androgen hormone and can be treated once diagnosed by a doctor.

Acne rosacea- This condition is a long-term skin condition that mainly affects the face, it’s more common in women and people of lighter skin tone, however symptoms can be worse in men.

This condition is most common in later life and is recognised by:

  • Red flush to the skin due to dilated capillaries
  • Sebaceous glands are over stimulated resulting in papules, pustules, open pores and a greasy shine
  • A burning or stinging feeling when using skincare products
  • Inflamed skin that often appears in a butterfly shaped panel over the forehead, nose, cheeks, and chin.

Eye infection that would prevent a facial treatment: –

Conjunctivitis – Quite often this condition contagious and is due to a bacterial infection occurring, it is caused by the inflammation of the mucous membrane that covers the eye and lid and causes the eye to become red, sore, and bloodshot. A pussy discharge is often produced which causes the eyelids to stick together which feels gritty to the person.

It can also be caused by a chemical burn or mechanical injury or may happen due to an allergic reaction. Often, both the conjunctiva and the cornea are involved, a condition called keratoconjunctivitis. The symptoms also vary, but they can include light sensitivity, redness, itching, a sensation of sand in the eye.

Typically, a person is contagious for at least a week following onset of symptoms and treatment is on strict hygiene to minimize the spread of the virus.

Blepharitis – is where the edges of the eyelids become red and swollen. Symptoms include sore eyelids, itchy and a gritty feeling around the eyes, the skin around the eye is often dry.

The condition is often chronic, uncomfortable and can be difficult to treat. It usually doesn’t cause permanent damage to the eyesight and it’s not contagious.

Blepharitis can be caused by a type of bacteria living in the skin, or a skin condition like dermatitis.

Ten contra-indications that would restrict a facial treatment.

  1. Hyperkeratosis- is a chronic thickening of the stratum corneum (outer layer of the skin). This outer layer contains a though, protective protein called keratin, which is found in fingernails, hair and skin.

Pressure- related hyperkeratosis occurs because of excessive pressure, inflammation, or irritation to the skin. When this happens, the skin responds by producing extra layers of keratin to protect the damaged areas of the skin.

  1. Skin allergies– also called contact dermatitis is a reaction that appears on the skin when it comes in contact with an irritant or an allergen. Symptoms can include a rash, redness, swelling or itching and in severe cases, blisters may develop.

Soap, laundry detergents, fabric softeners, shampoos or excessive exposure to water can irritate the skin.

Other items that can cause skin allergies are metals such as nickel and other alloys used in the production of costume jewellery. Adhesives, nail polish, topical medications, plants, and latex gloves can also cause irritation on the skin. Sometimes an allergen won’t cause a skin reaction, unless the skin has been exposed to sunlight. This condition is called photo-allergic contact dermatitis, it can occur with products such as perfumes, shaving lotion and sunscreen.

  1. Bruising- It is caused by damage to the underlying blood vessels that bursts when pressure is applied making the blood to stay under the skin’s surface. At this point, the skin would appear a shade of purple to yellow. The beauty therapist should avoid any facial treatment on the client as further pressure on the skin would cause discomfort and could worsen the bruise.
  2. Watery Eyes – It’s normal for our eyes to water in smoky surroundings, in cold or windy weather conditions. An eye injury or something in the eye, such as an eyelash or a piece of grit, can also make the eye water.

Sometimes watering eyes can be caused by allergies or infection to the eyes such as conjunctivitis or over activity, blockage of the tear duct can as well cause the eye to water frequently. Dry-eye syndrome can also cause eyes to produce too many tears. Watery eyes can be uncomfortable for the client and the facial may aggravate the condition, so the therapist should ensure they avoid the area.

  1. Styes – This is caused by a blockage of the sebaceous gland or the eyelash hair follicle. This allows bacteria to grow inside the blocked gland, pus may also be present. It appears as a red, inflamed lump on or inside the eyelid or around the eye.

The redness may be harder to see on brown and black skin. A stye usually affects only one eye at a time, but it’s possible to have more than one at a time. A therapist should totally avoid carrying out beauty treatment in this situation.

  1. 6. Cuts or abrasions – If a client has cuts or abrasions, apparently the skin would be damaged, and dry blood would be present. If the area seems unavoidable, then gloves should be worn and it should be covered with a sterile dressing, caution should be practised as secondary or cross infection could occur.ty
  2. Recent scar tissue – Scar tissue is classed as recent, if it is less than 6 months old. It would appear as an area of shiny red skin that could be raise or indented. Treatment on this area should be avoided as secondary infection could occur or the scar could re-open.
  3. Pediculosis- is a parasitic infestation commonly known as lice. This could be in the form of body lice or more commonly head lice. Lice are small parasites that puncture the skin and suck out blood and this makes the skin itch. The lice then lay eggs on the hairs close to the skin. The un-hatched eggs are known as nits and are recognised as shiny, pearl-coloured oval bodies that cling to the hair shaft.
  4. Malignant melanoma – is a type of skin cancer which is often caused by too much sun exposure and skin cells that begin to develop abnormally. The first sign of melanoma is often a new mole or a change in appearance of an existing one. Exposure to sunlight is thought to cause most melanomas, and some through sunbed exposure.

Malignant melanomas tend to vary in size and shades of colour, it is likely to be irregular in shape with a jagged edge. Therapist should avoid treatment on the client.

  1. 10. Eczema of a mild form- Common triggers include irritants- such as soaps and detergents, including shampoo, washing-up liquid and bubble bath. Environmental factors or allergens -like cold and dry weather, dampness, also, specific things such as house dust mites, pet fur, pollen, and moulds. If a client suffers from a mild form of eczema; it would appear as a small red patch of itchy skin which can easily be avoided during the treatment.

It is important not to diagnose any condition, as it is unprofessional and may worry or unnecessarily upset the client. If a contra-indication is suspected, the therapist should inform the client that a treatment cannot proceed as it may cause harm to the client.

 

    References

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