In my daily practice as an esthetician, I am confronted with a myriad of questions. The vast majority of individuals who approach me generally believe that their concerns are purely cosmetic in nature. In some instances, that is true; however, in many instances, the problem appears cosmetic, but has internal causes. For example, did you know that an early sign of lupus is hair loss (When clients discuss unexplained hair loss and dismiss it as merely stress, I always refer them to a doctor because estheticians aren’t qualified to diagnose lupus)? Likewise, did you know that recurring boils may need to be surgically removed rather than being repeatedly extracted? What’s more is that the need to take these steps can often be identified through full disclosure of one’s current and past medical history.
Full disclosure is important; however, it can be hampered by clients’ perception of stigma. To this end, I am talking about cold sores. People squirm and hesitate when I ask, “Do you have herpes?” They react slightly better to “Do you get or have you ever gotten a cold sore?” I’ve even had people lie to me only to send me emails later disclosing their shame and the truth. Plain and simple, people are embarrassed about it; however, it is important know why the full truth matters.
The stigma that often accompanies the virus because many people associate it with herpes simplex 2 which affects the genitals and is a sexually transmitted disease. Let’s be crystal clear: cold sores are, in fact, a symptom of Herpes Simplex Virus 1 (HSV), which is an incurable contagious virus. Let’s be even clearer: medical professionals believe that somewhere around 50% – 80% of the US adult population has been exposed to the virus, and by age 50, 90% of the US population has been exposed. (http://www.hopkinsmedicine.org/healthlibrary/conditions/oral_health/mouth_infections_85,P00888/). While exposure doesn’t translate into automatic contraction of a disease, such a high exposure rate does translate into herpes being more common than most people probably think it is. The disease is easily transmitted from person to person and can be transmitted through non-sexual contact as well. Furthermore, the diminished stigma surrounding cold sores as opposed to HSV is irrational because the virus that causes the genital sores and lesions is the same as the virus that causes sores on the mouth. The primary purpose for distinguishing the two is so that professionals know the location of an outbreak when speaking with a client or patient.
Estheticians are concerned about HSV for three reasons. First, it is communicable and easily passed between people. While estheticians should ALWAYS take the proper steps to protect themselves and their clients, full disclosure can and should increase diligence. Second, if he or she is providing clients with certain treatments and services, clients should be made aware of the increased risk of outbreaks and steps to minimize this likelihood. HSV lives within the body’s nerve endings and has both active and dormant phases. Unfortunately, certain skincare treatments can irritate the skin and nerves; thereby triggering an active phase also referred to as an outbreak. Finally, it is important to prevent outbreaks because they can complicate recovery, increase the risk of infection, decrease quality of life and compromise the immune system as a whole. Common symptoms include lesions (which can look like infected bumps), pain, burning, tingling, swelling, crusting, and weeping (the lesions excrete a fluid as they drain and heal).
Overall, estheticians are professionals and are expected to keep your health information private and have no interest in judging you. Further, it is not worth the pain and potential health risk to hide this important information.
Blush & Brushes now uses and sells skincare products by Circadia! Circadia is a skincare line that is sold only to and by licensed skincare professionals. The company intentionally limits the ways in which customers can obtain its products because it wants to be sure that the right product type winds up
on the right skin. So, you won’t find this product line at a large box retailer nor will you find authorized sellers online. All the difference in the world is made when you work hand-in-hand with a skincare professional with quality products. Stop bumping your way through the beauty aisle.
Isn’t that what you want in a skincare company? You want them to do as much they can to make sure clients are safe! Don’t you want to be sure that your skincare professional is trained and licensed? If you experience skincare challenges, particularly on-going problems, it should make you feel better to know that you are aren’t being sold “some cream” because a salesperson could take advantage of your pain and desperation.
Blush & Brushes chooses its skincare products very carefully because we recognize that there are very few things that people use more frequently than skincare: you wash your face daily, and put “stuff” on it. Moreover, we recognize that there are few things as personal and as intimate as skincare and how your face looks. We want you to feel confident that the product you use are safe AND EFFECTIVE. We chose the Circadia brand precisely because its integrity mirrors our own: a commitment to personal service, safety, and effectiveness.
Circadia has a broad range of products and has something for every skin type, whether that skin is acneic or is affected by rosacea. Click here to see select products from Circadia. Please let us know if you have any questions.
Eczema, formally referred to atopic dermatitis, is a skin condition whose symptoms range from slightly annoying and inconvenient to intense itching and feeling raw to the touch. It can be an acute problem (one time or infrequent occurrence) or a chronic condition. The severity of the disease and the areas on the body where the condition presents itself varies from person to person; however, it does have certain common characteristics.
The term “eczema” simply describes, in a general sense, “irritated skin” although there are five different types of eczema (atopic, contact, seborrheic, nummular, and dishydrotic), all of which cause itching and redness and some will blister, weep or peel. Additionally, because eczema causes both itching and cracks in the skin, individuals with the condition are more prone to infection. Finally, eczema can be episodic and will flare regularly, i.e., when the weather seasons change and when the person who has it endures significant stress.
The Five Different Types of Eczema
Atopic Dermatitis is the most severe and chronic kind of eczema, causes itchy, inflamed skin. It almost always begins in childhood, usually during infancy. It typically affects the insides of the elbows, backs of the knees, and the face but can cover most of the body.
Contact Dermatitis is a reaction that can occur when the skin comes in contact with certain substances, which can cause skin inflammation and is most often seen around the hands or parts of the body that touched the irritant/allergen.
Dyshidrotic Dermatitis is a blistering type of eczema, which is twice as common in women. It is limited to the fingers, palms and soles of the feet.
Nummular Dermatitis (Discoid) presents as dry skin in the winter months and causes dry non-itchy round patches. It can affect any part of the body particularly the lower leg. One or many patches appear, and may persist for weeks or months.
Seborrheic Dermatitis consists of red, scaly, itchy rash in various locations on the body. The scalp, sides of the nose, eyebrows, eyelids, and the skin behind the ears and middle of the chest are the most common areas affected.
Generally, individuals with eczema often find that the skin looks as if it has a rash and is simultaneously characterized as dry, sensitive, and easily irritated by anything that touches it. Although the exact cause of eczema is not clear, it is thought to be an auto-immune issue whereby the body’s immune system does not function properly and therefore attacks itself. Although more definitive research is needed, it is also thought that people who have eczema are likely to also have asthma. Research in lab mice has shown that a substance secreted by damaged skin circulates through the body and triggers asthmatic symptoms in allergen-exposed laboratory mice. The body is highly effective at secreting this substance, TSLP (thymic stromal lymphopoietin), which triggers hypersensitivity characteristic of asthma when it reaches the lungs. Moreover, fifty percent to 70 percent of children with severe atopic dermatitis go on to develop asthma.
Treatment options depend on the severity of the condition. The simplest forms include temporary changes to one’s lifestyle and skincare routines like the following:
- Minimizing contact with water on the skin, including taking shorter showers and baths;
- Using cool to tepid bathing water;
- More consistent use of heavy moisturizers like Aquaphor, Vaselline, Eucerin;
- Using sensitive body washes and cleansers like Eucerin Shower Oil and Aveeno Bath Therapy;
- Minimizing the use of perfumes, colognes, and products with fragrance;
- A commitment to reapplying moisturizers throughout the day during times of flare ups;
- Wearing soft and non-abrasive fabrics;
- Minimizing sweating and removing wet or damp clothing quickly; and
- Temporary use (no more than 14 days) of other-the-counter hydrocortisones.
Eczema persisting longer than two weeks should be treated by a dermatologist to prevent worsening and infection. Further, when eczema appears on the palms of the hands, soles of the feet and genitals, a physician should always be consulted. Most commonly, people are prescribed topical steroids for short-term use when lifestyle changes are ineffective or the condition last for more than two weeks and the itching becomes increasingly intolerable. In some cases, topical steroids are coupled with anti-histamines to calm the body. Finally, in serious cases, steroid injections may be necessary to relieve the inflammation and irritation.
1) http://www.nationaleczema.org/living-with-eczema/eczema-quick-fact sheet gclid=CIP30qWB2boCFc9QOgodzA0Avg
Risk Management for Special Circumstances
by Morag Currin
As estheticians, our compassion, skill, and training all have the potential to greatly affect someone’s outlook and sense of well-being. On any given day, our service might mean everything to that person. When the client has a serious medical condition, the impact of our work can be even greater, but it also requires a new world of knowledge and a lot of caution.
The client’s safety always comes first, and working with medically challenged clients brings an increased level of risk. Managing that risk requires a good understanding of many different factors–including your own abilities and motivation. It is essential to be truthful with yourself and answer this question honestly: “Do I want to serve these clients because it is a noble thing to do, or is it really because I want to appear noble to others?”
This article does not aim to teach you how to work with a medically challenged client, but to give an overview of all the areas in which you will need to seek appropriate training or advice before deciding to take on this challenge.
Understand the Law
Above all else, estheticians must have a valid esthetics license in their state and know and follow their state’s scope of practice. No state officially certifies or sets standards specifically for oncology esthetics, and although there are reputable organizations offering advanced education in this specialty, with exams and certification, these certifications do not imply official state licensing. In addition, organizations such as the Comite International D’Esthetique et de Cosmetologie (CIDESCO), the International Therapy Examination Council (ITEC),and the National Coalition of Estheticians, Manufacturers/Distributors and Associations (NCEA) have standards that can assist esthetician’s in achieving a high level of training and professionalism, and the International Society of Oncology Estheticians endorses organizations that adhere to high standards for evidence-based therapies.
Know the Risks
In any skin care work, there is a risk of harm. An esthetician’s most important obligation is to use his or her best efforts to avoid reasonably forseeable accidents or adverse reactions. In legal terms, negligence is the failure to meet this expected obligation.
Studies within the medical professional have found that 10-20 percent of all medical diagnoses are incorrect. These diagnostic errors typically result from flawed ways of thinking, sometimes coupled with negligence. Could there be a similar rate of error among estheticians? How many estheticians are not performing a proper skin analysis or not getting all the necessary facts during the client-intake process and, as a result, are not providing appropriate treatments?
With a medically challenged client, there are even more risks and clinical considerations to take into account. Estheticians must know how to work safely with a client who has medical implants, compromised lymph nodes and blood cell counts, and multiple side effects from medication, radiation, and/or surgery. As just one example, a client who has low blood-cell counts has an increased risk of unpleasant and sometimes life-threatening side effects, including bleeding and infection. This client needs a physician’s release to get a spa treatment of any kind.
Many of these risks also apply to clients who had cancer treatment in the past, not just those who are currently going through it.
The increased risks of the medically challenged client go hand in hand with sanitation and infection control in the spa. Most state boards have infection-control and safety standards, and may even name the disinfectants that must be used. Correct procedures must be followed for every surface in the spa: bed and chairs, countertops, instruments, machines, and trolleys. The cleaning, disposal, storage and use of supplies–everything from sponges to linens–must also be taken into consideration.
Seek Appropriate TrainingSimply taking a health history is not enough to give you the information you need with these clients. Specialized training and the subsequent dedication to keep that training current are imperative.
You must understand the condition, its medical treatment, and the side effects of that treatment. You must also know how these things can affect, or be affected by, your skin treatments, products, and ingredients, as well as the client’s home-care regimen.
“It’s more than just knowing what to do to minimize risk,” says Paul Griffin, executive director of the International Association of Oncology Estheticians. “It’s understanding why.”
Advanced training for estheticians who want to work with oncology clients should include:• How cancer starts and spreads.
• Primary clinical considerations and contraindications.
• Cancer treatments and their side effects.
• Edema and lymphedema.
• Product considerations, including ingredient knowledge.
• Hands-on, supervised experience working with oncology clients.
Have Liability Coverage
If you harm a client and that client holds you responsible, the financial cost can be tremendous–even if there is no lawsuit. No matter what type of clients they serve, all estheticians should have their own liability insurance. Never assume you are fully covered by your employer’s or landlord’s insurance.
The same caution applies if you work at a medical facility. Do not assume you are covered by the supervising physician’s medical malpractice insurance. Even if you are, it may only apply when you are working under that physician’s direct supervision. Ask to review the policy to make sure. Estheticians who work in a medical setting are often required, as hiring condition, to sign a contract that waives any liability for their employer.
Always verify that the insurance covers you personally (not just the business) if you are named in a lawsuit and that it covers every treatment that you provide.
If you are working outside your scope of practice, or are in the violation of any local, city, state, or federal law, your policy will be null and void. Bottom line: if you’re not legally allowed to do something, your insurance won’t cover if something goes wrong.
Do the Paperwork
Your client’s safety requires completion of detailed paperwork: a thorough intake form, informed consent, a physician’s release if necessary, and any other form that will help ensure safe treatment.
Update the client’s file at every appointment to note any changes in health, medical treatment or medication. This can be as simple as adding a brief note to the file to describe any changes or confirm that there have been no changes, then having the client sign it. Maintain detailed,orderly notes that are easy to read and understand.
Record keeping is a requirement of most liability insurance policies,and even if it isn’t required by your policy, having good records can make all the difference if you ever need to file a claim. Client records should be kept at least seven years, or the length of the time required by your state laws.
Article taken from the September/October 2013 issue of Skin Deep, a publication of the Associated Skin Care Professionals.
Understanding the Stress Response
Why does skin react the way it does?
by Susanne Schmaling
Susan Schmaling, director of education for Associated skincare Professionals, is a licensed esthetician, experienced educator, former spa owner, founder of the Pacific Institute of Esthetics, and author of A Comprehensive Guide to Equipment (Milady, 2009). Contact her at email@example.com.
The link between skin health and a person’s stress level has been substantiated by many studies. Whether you address clients’ stress through your own treatments (see page 12) or by guiding them to another professional in your referral network (see page 9), it’s helpful to understand the physical reasons why stress affects the skin.
A Response to Danger
Stress occurs as an automatic response to anything the brain identifies as a threat. To our primitive ancestors, this usually meant a physical danger, so the body winds itself up to a fever pitch, ready to fight or run away fast (the fight-or-flight response). Clearly, these are not very useful solutions to typical modern problems! However, it is still the way our bodies work, and so the stressed person lives in a state of constant high alert, physically reacting to a danger that may not even exist.
It is important not to make judgment about a client’s stress based on how you think you would react in the same situation. Any given situation may be intensely stressful for one person, while another person might find it only a little stressful, and a third person may even find it motivating.
From the Brain to the Skin
The brain’s identification of an environmental, physical, or psychological stressor will start a chain reaction within the body, eventually impacting the skin’s barrier function. The stress reaction in the skin is very complicated, but researchers have identified many aspects of what happens. Here is a simplified outline of the process.
1. A stressor is recognized by the brain.
2. The hypothalamus, adrenal glands, and pituitary gland are activated, releasing hormones and enzymes to stimulate the fight-or-flight response.
3. Inflammation increases in the body due to the surge of hormones and enzymes.
4. The immune system is activated in response to the inflammation. Some of the resulting enzymes and peptides have the effect of reducing the skin’s protective barrier.
5. Skin health is impacted.
More Risks, Fewer Results
The weakening of the skin’s protective barrier brings a higher risk of the following problems:
• Hyperpimentation or hypopigmentation• Infections
• Signs of aging–wrinkles, loss of elasticity
• Sensitivity, often leading to redness and/or flakiness.
It also brings reduced effectiveness of professional treatments and home care for any of the above problems. Hyperpigmentation is a good example of the condition that is very difficult to treat when a client is under chronic stress, because melanin-stimulating hormone (MSH) is one of the hormones activated when the brain recognizes a stressor. When you are dealing with skin that has a weakened protective barrier, and a brain that subconsciously believes the body is under attack, no topical product or piece of equipment will be able to quickly improve the skin’s condition.
In your treatments and home-care recommendations, focus on repairing and supporting the skin’s barrier function. The four most important factors in restoring the barrier are consistent home care, proper nutrition, daily sun protection, and regular exercise. Remind your client about the need for sufficient water intake, and refer him or her to an appropriate professional if detailed advice on exercise or nutrition is needed.
Professional treatments should focus on increasing the skin’s hydration. In addition, increase the amount of touch in your services; the effectiveness of massage for reducing stress is well documented. An increase in the hormone oxytocin is an important benefit of touch and can improve your treatment outcome. For some clients, a skincare appointment is the only time they are ever touched by another person.
Chronic stress is a challenge for everyone. Being aware of its effects on the body will help you manage your clients’ expectations and results from their skincare regimen.
Article taken from the September/October 2013 issue of Skin Deep, a publication of the Associated Skin Care Professionals
I have a win-win that I believe you’re going to like!
I want to do a series of before and after pictures using two of the chemical peel treatments that I provide. Yes, there is a catch. Actually, there are three catches and a deal! I’m hoping that if this doesn’t work for you that it’ll work for one of your friends. Please feel free to share this post!
Catch one: You have to come to Jersey three times!
Catch two: You have to be comfortable with your skin peeling visibly for several days.
Catch three: You have to pay for the service first; however, after making your third visit to Jersey, you’ll get all of your money back. The purpose of this fee is to make sure you show up! If I don’t get what I need, there is no value in offering the service for free. However, if you decide after one or two treatments that you don’t want to come back, you don’t get you your money back. Hey, this must be a win-win!
You probably want to know what I’m doing: I’m creating a series of before and after pictures. These pictures will be used on my website, placed in my portfolio, and used where ever Blush & Brushes decides to work. Clients generally want to know what to expect in terms of the peel, and this is my way to give my people what they want.
I’m taking up to six people for this option, and I need people of varying ethnic backgrounds.
Here’s the deal:
For the people participating in the free deal, you can continuing saving on peels if you actually get them consistently every 4 – 5 weeks! No exceptions! If you receive a treatment every 4 – 5 weeks, I’ll knock off 50% because I want to continue photographing changes to your skin. This time, however, you can choose whether you want to come to me or if you want me to come to you (as long as you’re within 15 miles of Haddonfield, NJ.