learner guide - files.transtutors.com fileshop 2, 161 new south head road, edgecliff, nsw 2027...

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

http://www.sbdi.com.au/

mailto:[email protected]

2 S:\SHB Training package\SHB Training tools\SHBBSKS005 Provide micro-dermabrasion treatments v1.00

8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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:


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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:


8/06/2017

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):


8/06/2017

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,


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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).


8/06/2017

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:


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


Select #3 medium or #4 fine

Moderate crystal flow

Stretch marks


Select #1 extra coarse or #2 coarse

Strong crystal flow

Acne


Select #2 coarse or #3 medium

Moderate crystal flow

Acne scars


Select #2 coarse or #3 medium

Strong crystal flow

Scar tissue or cracked skin


Select #1 extra coarse or #2 coarse

Strong crystal flow

Skin texture


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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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


8/06/2017

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


8/06/2017

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


8/06/2017

*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


8/06/2017

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


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


When using crystal microdermabrasion we advise not to treat the feet, ears, eyelids.


8/06/2017

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.


8/06/2017

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


8/06/2017

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.


8/06/2017

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.


8/06/2017

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’.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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.


8/06/2017

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


8/06/2017

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:


8/06/2017

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


8/06/2017

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

learner guide - files.transtutors.com fileshop 2, 161 new south head road, edgecliff, nsw 2027...

Documents