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All About Skin for Cosmetologists and Estheticians

Course Hours: 8, Eligibility: Cosmetologists (C), Estheticians (E), Teachers (T)/Instructors (I)

This Course is Offered to Licensees in - Nevada, North Carolina, and West Virginia (101 & 102 - 4hr. Version)

Note: *Please take the allotted time for this 8 hr. course to read, reflect, and retain the information.  After you read through your course for the allotted 8 hrs., you can take and submit your end-of-course exam at the bottom.  Please include your name, license number and contact information at the beginning of your end-of-course exam. At the end of your exam, please press the "submit" button to submit your exam.  We will then email your exam results and course completion certificate within the same business day. If your exam is submitted after 7:00 p.m., we will email your results the next business day. Thank you and if you have any questions, please feel free to contact us at 919-672-4698, or email at SalonSpaTraining@aol.com(Note: Our online CE courses have  a timer/timing element; but it is presently being rebooted for our system, and will be up soon. Therefore, this is an alternative way you can take your online CE course.  Thank you for your patience, and we hope you enjoy your course!).

*NOTE: AFTER YOU REGISTER/PAY FOR YOUR COURSE, YOU MUST READ THIS COURSE FOR THE 8hr. REQUIREMENT. PLEASE DO NOT SUBMIT YOUR END-OF-COURSE EXAM UNTIL 8hs. AFTER YOUR COURSE PAYMENT. 
žALL ABOUT SKIN FOR COSMETOLOGISTS AND ESTHETICIANS
ž(8 Hours/480 Min.)
ž 
žThis course is designed as an 8-hour Online (Internet-based) course for Cosmetologists, Estheticians and Teachers/Instructors.  This comprehensive course addresses the many aspects of skin including: (1) the skin as the body’s largest organ and its system functions, as well as other organs of the body and their functions; (2) the composition of the skin – (a) skin anatomy and (b) physiology; (3) the facts about “problem skin” and various elements that affect the skin such as: (a) skin disorders, (b) diseases, (c) contraindications, allergies, and the like; (4) the identification of skin types; (5) the sun, various rays from sun, and how to protect the skin from the sun; and (6) current trends in skincare, and services offered; as well as (7) sanitation standards for skincare. Various objectives of how to care for and treat different skin types are included as well. Because cosmetologists in many States are able to work with esthetics-related services, this course will serve as a comprehensive guide that strives to provide advanced education regarding the skin and esthetics. There will also be an assessment of learning exercise at the end of the course – which entails a 50 question exam (with true/false answer options). There is no passing grade for this course; however, the course participants are required to read the course material, take and submit the end-of-course exam, and to answer all of the questions to the best of their ability.
 
žCourse Eligibility:Cosmetologists (C), Estheticians (E)  and Teachers/Instructors.
žTime Allotment: Course participants will have up to 30 days to complete this 8-hour Online/Internet-based course.
žMotivation Used:
žThis course strives to:
žEncourage course participants to learn more in-depth knowledge about: (1) the skin and anatomy, and (2) its body system functions and physiology – so they can be more understanding of the components of the skin and esthetics-related services.
žEncourage course participants to learn more in-depth regarding: (1) Skin disorders and skin diseases; (2) various skin types and how to treat these skin types; and (3) sanitation standards within the treatment room setting.
žTo understand the sun, various rays from the sun, and how the sun affects the skin.
žTo empower course participants, and to make them more confident in overall knowledge about the skin.
žTo serve as “refresher” for those who have studied the skin within their own cosmetology-related school curriculums.
žTo enlighten course participants about current trends in skin care services.
žTo encourage course participants to evaluate the overall benefits of offering skin care services, including career-related benefits, and financial benefits as well.
žTHE SALON SPA TRAINING INSTITUTE℠
ž“ALL ABOUT SKIN 101 
žCOURSE TIMELINE - 480 Minutes/8 Hours
ž 
žModule I: All About Skin – An Introduction   35 Min.
žCourse Introduction (10 Min.)
žSkincare and The Beauty Industry (15 Min.)
ž Knowing “All About Skin”: Empowerment &
žSkincare Knowledge (10 Min.)
ž 
žThe Skin – The Body’s Largest Organ and Its Composition    130 Min.
žThe Body, The Body’s Organs and Systems (70 Min.)
ž The Skin – The Epidermis, The Dermis, Antioxidants, 

  and Free Radicals, Vitamins, Extracts, and Acids (60 Min.)

¡The Epidermis and Dermis (35 min.)
¡Antioxidants and Free Radicals (13 min.)
¡Vitamins, Extracts, and Acids (12 min.)
ž 
žThe Sun And How It Affects The Skin  20 Min.
žThe Sun & The Skin – Introduction (5 min.)
žUVC, UVB, and UVA Rays (5 min.)
žSkin Phototype (SPT) (3 min.) & Sun Protection Factor (SPF) (7 min.)
žVarious “Skin Types”   60 Min.  
žIntroduction pH Balance of The Skin (10 Min.)
žVarious Skin Types (50 Min. Total)
¡Introduction (5 min.)
¡Normal Skin (2 min.)
¡Dry Skin (8 min.)
¡Oily Skin (10 min.)
¡Combination Skin (4min.)
¡Sensitive Skin (6 min.)
¡Acne Prone Skin (13 min.)
¡Mature Skin (2 min.)
žMODULE I: ALL ABOUT SKIN – AN INTRODUCTION  (60 Min.)
žCourse Introduction (15 Min.)
ž  The skin, our body’s largest organ, is one of the key elements of our lives and well-being. The skin is our protector from the sun, it helps our bodies to function on a daily basis, and it helps to protect us from disease and infection. The topic of skincare, is oftentimes associated within the beauty industry, and beauty professionals around the World provide various skincare and aesthetic-related services – which are directly related to the skin, such as facials, microdermabrasion, chemical peels, and the like. Additionally, the beauty profession involves other services besides skincare, in which hair services, waxing services, eyelash extensions, make up applications and other services are performed. These services also involve elements of the skin which are indirectly related.  In other words – services in the beauty industry almost always involve touching or affecting some part of the skin, whether directly or indirectly related.
ž  This course covers multiple topics about the skin, and provides a 2-hour guide for Estheticans, Cosmetologists, and Teachers (to also be identified as “beauty professionals” and “skincare professionals” throughout this course). Because the cosmetology curriculum focuses on the elements of hair, skin, and nails – this course provides a comprehensive resource for the many aspects of skin, and strives to give a more in-depth understanding of the skin and its functions.  This thee-part course (101, 102, and 103) will cover various skin-related topics including: (1) beauty industry statistics regarding skin care and employment wages of beauty industry professionals; (2) the “skin organ” and how it affects our bodies, as well as other organs and 
žsystems of the body; (3) the composition of the skin, including anatomy and physiology; (4) the subject of “problem skin” and various skin disorders, diseases, contraindications and allergies; (5) the identification of skin types and how to treat various skin types; (6) the sun and how it affects the skin; (7) current skincare trends in the beauty industry; and (8) the importance of sanitation as well. Ultimately, this course will provide a better theoretical understanding of the skin and its functions and will strive to assist beauty professionals in practical cosmetic art experiences.
žSkin Care and The Beauty Industry (30 Min.)
žThe beauty industry is a multi-billion dollar industry.  Skincare services, which are oftentimes offered at various full-service salons, day spas, medi-spas, destination spas, health and wellness spas, and skincare clinics, are part of a booming service component of the beauty industry. Whether in a therapeutic spa setting, a medical spa setting, or full-service salon setting – beauty professionals are providing services and have stable careers that are directly involved with the overall all care and treatment, and enhancement of skin.
ž  According to The National Accrediting Commission of Cosmetology Arts and Sciences (NACCAS), a statistical report prepared by John B. Lee in 2007, cited that there are over 1.6 million beauty professionals employed in the United States. These beauty professionals comprise of: cosmetologists, barbers, nail technicians, and skin care specialists.  The report also cites that there are over 370,000 beauty establishments, which include: beauty salons, “skin care salons,” nail salons and barber shops. The average number of stations within these beauty establishments was approximately 5, and the beauty establishments cited an average of 127 clients per week. Additionally, the report cited that nearly 60% of the beauty establishments were considered as “full-service salons.”  Additionally, the various 
žpercentages of employment (full-time, part-time, etc.) include: 56% of beauty professionals working full time, 31% of beauty professionals working part-time (between 20-35 hours per week), and 13 percent working under 20 hours per week or “low time.” Therefore, multiple services are being conducted in beauty establishments, and oftentimes, cosmetologists represent an overwhelming number of beauty industry professionals employed. The largest number of salons by State are in: California (48,132); Texas (28,551); and New York (23,741).  The smallest number of Salons by State are in: Wyoming (677), Vermont (805), and Alaska (810). 
* Note: This North Carolina comparrison is for statistical information relevent to the Beauty Industry. This course is still offered to licensees in Nevada, North Carolina, and West Virginia.
* According to the North Carolina State Board of Cosmetic Art Examiners, as of January 2009, there were 13,020 beauty establishments (cosmetic art shops) operating in the State. This figure marks North Carolina the seventh (7th) largest State with beauty establishments (only behind Florida, Pennsylvania, and Illinois) .Additionally, there were 59,583 Cosmetologists eligible for license renewal in North Carolina, as well as 3,647 Estheticians eligible for license renewal respectively (note – the present data/today’s date may present even more Cosmetologists and Estheticians that are up for renewal, because of new licensees; additionally, some persons may have let their licenses lapse or may have moved out-of-state).
ž  According to the U.S. Bureau of Labor and Statistics (U.S. BLS), nearly 74% of beauty industry professionals employed are Cosmetologists. There is a smaller percentage of Aestheticians (also identified as Estheticians), or skin-care specialists, however, Aesthetics is a continually growing industry with a constant increase of new Aesthetic licensees. Ultimately, Cosmetologists and Aestheticians collectively, depending upon their years of experiences, can earn [on average] between $26,000 - $50,000 per year. The U.S. Bureau of 
žLabor and Statistics also reports the estimated mean (average) wages in 2008 of Cosmetologists and Aestheticians, which include
(column 1 - beauty profession, column 2 - mean annual income, and column 3 - hourly wage):
 

eauty Profession

Mean Annual Income

Hourly Wage

Cosmetologists

   $26,660

   $12.82/hr.

Aestheticians

   $32,040

   $15.40/hr.

ž 

žThe figures above indicate that Aestheticians make on average nearly 17% more in wages per year than cosmetologists.  However, the purpose of this course introduction is not to “exploit” the wage differences, but to bring awareness of the differences in pay – and to also note that in many States, licensed Cosmetologists are able to perform the same aesthetic-related services that Aestheticians perform. 
ž 
žKnowing “All About Skin”: Empowerment & Skincare Knowledge (15 Min.)
žThis course introduction has provided information and statistics regarding skincare and the beauty industry; employment, labor and wages; various State-wide statistics; and beauty establishment statistics. Regarding employment wages, as previously mentioned, the goal is not to “exploit” the nearly 17% wage difference between Cosmetologists and Aestheticians, but to offer insight and to note that:
¡    In many States, Cosmetologists have licenses that allow them to work within the realm of hair, skin, and nails (nail technology/manicuring  will not be the focus of this course, but it is mentioned for informational purposes only);
¡Therefore, Cosmetologists can work with services directly related to skincare;
 
¡Cosmetologists traditionally make 17% less than Aestheticians; but still have the license and the ability to perform skincare services;
¡There is a difference between “theory and practice,” but there are solutions regarding more Cosmetologists offering skincare services and learning about skin overall.
¡This course strives to provide the fundamentals of skincare, and to give a foundation of skincare topics which might be advanced beyond the traditional curriculum.
žUltimately, with a more solid foundation and knowledge of skin, the skin’s anatomy,  its bodily functions, and skin types, there should be a better “comfort level” in regard to:
¢Learning more about various skincare services offered; 
¢Working directly with skincare services; as well as
¢Working indirectly with skin care services.
žLicensed Cosmetologists can continually empower themselves by growing and expanding their business – and skincare services are definitely a means to economic and professional growth in the beauty industry.
 
žModule I has offered facts and statistics that can educate and empower Cosmetologists.  Knowing your wage comparison and license operating options (i.e., offering aesthetic-related services) can empower you career-wise and financially. Within the next Modules II -VI, more in-depth information regarding the skin will be offered, including [but not limited] to: the skin as a body organ (anatomy), and the integumentary system and its functions (physiology); skin disorders; skin types; the treatment of different skin types; highly requested skincare services; client consultation; sanitation;
žand safety. Ultimately, with a more solid foundation of skincare knowledge, better preparation is on the horizon for working with your clients and expanding your skincare business! You have now read the contents of Module I (All About Skin – Course Introduction), and you will now view Module II, which will discuss the skin as an organ, and its bodily functions.

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žMODULE  II: THE SKIN – THE BODY’S LARGEST ORGANS AND ITS FUNCTIONS  (130 Min.)
žThe Body, The Body’s Organs and Systems (70 Min.)

In Milady’s Standard Fundamentals for Estheticians (2004), there is a detailed description of anatomy, physiology, and skin disorders applicable to the body. In Cosmetology and Aesthetics-related curriculums, there is a lot of content that covers chemistry, anatomy, science and the body systems as a whole. Although licensed Cosmetologists and Estheticians are not licensed medical doctors, there is a level of professionalism and judgment that has to be made in regard to not only working with a person’s skin (directly), but also in working with a person’s skin indirectly.  For instance, before a facial is performed (or even during a facial consultation), if your client appears to have “Level 4 Acne” or higher, it is wise to recommend your client to see a medical professional – such as a dermatologist (acne levels can be determined in the medical/dermatology profession as 1- 5, however, as a beauty professional, you can’t officially determine a person’s acne level).  It’s not that you would be officially licensed to diagnose your client – however, you would be properly trained within the beauty industry to visually see that the person’s skin condition needs greater assistance than what you can offer.

žUltimately, cells, tissues and organs are components of our bodies, and the following information highlights cells and cell growth and various tissues and organs as well. Therefore, a brief overview of anatomy and physiology may give you some insight upon how our bodies are made, and how they function. The beauty profession is a “touching profession” in which beauty professionals see, touch and feel clients via cosmetology, manicuring, pedicuring, and esthetics-related services. In turn, we get a first hand view of our clients’ skin and visible discoveries may be helpful to your overall client’s health.
žCells and Cell Growth
žCells are “the basic units of all living things” and the human body is made of cells which in turn produce tissues, organs, and various systems in which the body functions. Cells can grow and even reproduce and replace cells during their appropriate life cycle.  However, if the body is not functioning properly, toxins in the body can impair the overall health of cells. Therefore, cells must have “. . . an adequate supply of food, oxygen, and water . . . eliminate waste products [and be] . . . maintained at the proper temperature.”

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žTissues 
žTissues Represent groups of cells “of the same kind” that come together and they  include:

žConnective Tissues – Bind and support parts of the body such as: ligaments, cartilage, and fat tissues.
žMuscular Tissues – Helps the body movement as they allow the body to move, contract, and expand.
žNerve Tissues – Nerve tissues are important because they help to coordinate the cognitive, affective, and psychomotor functions of the brain and of the body. They most importantly carry messages to the brain, which in turn signal the body’s movement and overall function.
žEpithelial Tissue – This tissue is located all over the body as it usually represents a covering of various internal and external parts of the body such as: the skin, digestive organs, and various systems including the respiratory system.   Cells of the epithelial tissue are also packed very closely together.
žLiquid Tissue – Transportation is a key word associated with liquid tissue, which involves carrying waste products, and food by the blood and lymph and the lymphatic system.
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Cited from: www.ScienceHelpDesk.com

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žOrgans
žCells help to create tissues, and tissues help to create organs. The structure of organs, in turn, helps the body in different ways to function. The primary organs of the body include:
žThe Brain - The brain directs our sensory, motor, and learning skills and is enclosed in the skull. The brain is also a core of the central nervous system.
žThe Heart – The heart is known for circulating the blood in the body, and it receives blood from the veins and pumps blood into the arteries.  The heart is 5 inches long and 3 ½ inches wide.
žThe Lungs – The lungs are known as respiratory organs and they ultimately supply oxygen to the blood.
žThe Liver – The liver is the largest glad in the body and is known for secreting bile. The liver also aids in digestion as it removes toxic products to aid in the digestive process.
žThe Kidneys – The kidneys are known for excretion as they excrete water and waste.
žThe Stomach and Intestines – The stomach and intestines aid in the body’s digestion of food.
žThe skin, which is often referred to as “the body’s largest organ,” will be discussed further below.
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žBody Systems
ž Cells help to create tissues, tissues help to create organs, and organs help to create what is known as our body systems. In order for the body to function, the body houses ten (10) systems that are crucial for our well being. These systems include:
žThe Integumentary System – Comprised of the dermis and epidermis skin layers. This system is part of the largest organ of the body, the skin. It also has “sensory receptors” that aid us with the feeling and touching senses. Regarding our body temperature, this system regulates our body temperature – therefore, allowing us to feel hot, cold, warm, etc. (Note: There will be much further discussion regarding the skin as the body’s largest organ throughout this Module and this Course [this paragraph is for introductory purposes]).

žThe Skeletal System – This system consists of our bones, cartilages, our joints, and helps to support our overall bodies. Not only does this system serve as support to “hold up our bodies,” it also helps to produce blood cells and stores minerals in our bodies.
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žThe Muscular System – Without the muscular system, we could not move our bodies. This system covers our skeletons, and along with the joints and cartilage - allows us to have movement in our daily lives.
žThe Nervous System – When we think of our sensory motor and psychomotor skills, we oftentimes think of the nervous system. The nervous system controls our responses, feelings, and works in concert with the brain and the spine.
žCirculatory System – Blood flow is important for our everyday bodily functions.  The circulatory system is responsible for the supply of the blood. This system circulates blood and lymph, and works with blood, blood vessels, and lymphatics.
žEndocrine System – This system represents “ . . . the glands and parts of glands that produce endocrine secretions, help to integrate and control bodily metabolic activity, and include especially the pituitary, thyroid, parathyroids, adrenals, islets of Langerhans, ovaries, and testes (U.S. Department of Health and Human Services).”
žExcretory System – This system is responsible for waste elimination from the body via excretion.  Examples of excretion include urine and sweat.
žRespiratory System – It is important for the body to receive oxygen, and the respiratory system allow the body to do so by respiration. The nose, nasal passages, larynx, and trachea are key components of the respiratory system.
žThe Digestive System – Before food digests, it must ingest (be taken into the body); it then digests, and then performs absorption.  The digestive system performs the aforementioned tasks and also, the cells use digested food in different parts of the body.
žThe Reproductive System – This system allows humans to reproduce via sexual reproduction.
 
žThe Skin: A More In-Depth Perspective – The Epidermis, Dermis; Antioxidants, and Free Radicals ( 60 Min. )
žAs mentioned previously, the Integumentary System is comprised of the epidermis and the dermis skin layers. This system is part of the largest organ of the body – the skin. It is hard to imagine the skin as “an organ,” but there are so many elements of the skin that make our bodies function on a daily basis. From a more in-depth perspective, below is a description of the epidermis, the dermis, free radicals, and vitamins that at times, can aid in the betterment of the skin overall.
žThe Epidermis & Dermis (30 Min.)
ž  The skin is comprised of two layers: the epidermis and the dermis. These two layers help to protect the body from germs, toxic elements, and [again], these layers help the body to function.  Connected together, these two skin layers adjoin and connect capillaries and ducts, which produce feelings and sensation through our skin. Therefore, the dermis and epidermis are vital parts of our body.
ž  The epidermis is the layer in which beauty professionals can work with – without the direction of a physician or dermatologist. For example, regarding chemical peels, which are highly requested skincare services – If chemical peels are administered that will affect the dermis, then a medical professional such as a physician or dermatologist will have to provide supervision; and will only be able to administer the chemical peel from their respective clinics/medical practices.
 
žThe epidermis is known as the “outermost layer of the skin,” and is also a very thin layer of the skin. [Again] the epidermis has “sensory receptors” that aid us with the feeling and touching senses. Even our body temperature is regulated through the epidermis – therefore, allowing us to feel hot, cold, and warm senses. The epidermis has four layers, including the Stratum Germinativum, Stratum Granulosum, Stratum Lucidum, and the Stratum Corneum (an additional layer, the Stratum Spinosum will be mentioned as well).  The term stratum means a “layer of tissue,” and again, cells help to create tissues, tissues help to create organs, and organs help to create our bodily systems.
žThe first layer of the epidermis, the Stratum Germinativum, contains only a single layer of cells.  Melanin, which is responsible for pigmentation in the skin, is located in the stratum germinativum.
žThe next layer of the epidermis is the Stratum Granulosum, in which “cells represent granules.” Included in the stratum granulosum are keratin and intercellular lipids (which will be discussed further with the Stratum Corneum).
žThe next layer of the epidermis is the Stratum Lucidum, which represents transparency and lucidness. This unique layer is evident in the palms of the hands, as well as the soles of the feet.
žThe Stratum Corneum represents the top layer of the epidermis, and this layer is most exposed to the elements such as the sun, pollution, smoke, topical products, etc.  This layer of the epidermis is also known as “the horny layer.” Beauty professionals will work mostly with the stratum corneum, as dead skin cells will begin to shed – as well as the goal of using various products and services, such as the chemical peel; which will accelerate the shedding process and will promote cell turnover/renewal.
 
žIn the stratum corneum there are: soft keratin and keratinocytes, and these cells and proteins aid the cell renewal process. According to the National Institutes of Health Medline Dictionary (2009), keratin is a . . . “fibrous protein that forms the chemical basis of horny epidermal tissues [such as] hair and nails . . . .” Additionally, keratin is located in all the layers of the epidermis. Soft keratin produces keratinocytes, which in-turn, is a cell that produces keratin. Therefore, keratin and keratinocytes play an important role in cell renewal and the shedding of dead skin cells.  Hard keratin is a protein that is represented in the hair and nails.  
žThe Stratum Spinosum is not an “official layer” of the epidermis; however, it is located in between the Stratum Germinativum and the Stratum Granulosum. This layer has a “spine” prefix in its title, because is resembles a thorn-like or “prickly spine.”
ž 
ž  The dermis is oftentimes called the “true skin.” The dermis is beneath the epidermis, and although it does not have direct exposure to the sun, such as the stratum corneum, the dermis is still a very important part of the skin, the integumentary system, and the body as a whole.  The dermis layer is composed of connective tissues that are considered live.  These living tissue layers of the dermis are 25 times thicker than the epidermis, and the two layers of the dermis are: the Papillary Layer and the Reticular Layer (Gershon, 2004).
ž  The papillary layer provides connectivity between the dermis and the epidermis.  This layer receives its “papi” prefix from the “papillae” – a group of connective tissues that provide nourishment in the hair follicle (dermal papillae). Within the papillae, there are looped capillaries and tactile corpuscles. The looped capillaries provide nourishment from the dermis to the epidermis; and the tactile corpuscles contain nerve endings that allow us to feel sensations and temperatures (heat, cold, etc.).
 
žThe reticular layer is known as the “deeper layer of the dermis.” This layer boasts protein fibers that affect the elasticity of the skin. The reticular layer produces collagen and elastin, and both work together, to improve the overall elasticity of the skin.  Collagen contains fibroblasts, better known as fibrous proteins; and collagen also represents 70% of the dermis.  Elastin contains elastic fibers and proteins, and does not have as much mass as collagen within the dermis – but nonetheless is still an important part of the natural health of the skin.  Ultimately, within the dermis and reticular layer of the dermis; as cells, fibers and proteins began to deteriorate – the aging (or pre-aging) process begins.  Therefore, wrinkles, fine lines, and lack of elasticity start to take place - and the skin and the overall health of the skin starts changing.
ž  The papillary layer of the dermis also contains subcutaneous tissue which is also known as adipose or “fat tissue.” This tissue is located at the bottom of the papillary layer of the dermis and it assists with the skin and body’s shape. This will reveal how elastic the skin is - and the dermis has a lot to do with how the skin holds with the body (i.e., does a person’s skin sag or does it hold in its place).
ž  Below the dermis is the hypodermis, which is also called the “superficial fascia.” The hypodermis represents fatty tissue that is connective, and this tissue helps to bind or connect between the dermis and the rest of the body. This layer of connective tissue is also loose in nature. Ultimately, the explanation of the epidermis and dermis are imperative for the overall understanding of skincare and esthetics services.
 
žFree Radicals & Antioxidants (15 Min.)
ž  As mentioned previously, there are certain internal and external causes that can enhance skin damage and promote slower cell renewal turnover rates. From an internal perspective, a person’s aging process may have begun, and elastin and collagen proteins and fibers may not be as prevalent.  From an external perspective, various environmental causes can affect the overall health and appearance of the skin, such as: the rays from the sun and sun damage; pollution; smoke; weather; and the like.  Also, a person’s diet, health, nutrition, and skin care regimen can affect the overall health of one’s skin.
ž  Ultimately, when one’s skin does begin to deteriorate, it can be associated with a term entitled “free radicals.” Free radicals represent damaged molecules that in turn damage cells.  From a more microscopic perspective, if an atom, or group of atoms have a damaged electron; then the atom(s) would be affected – this is also an example of a free radical. Free radicals cause aging, and cell damage is prevalent within free radicals. Therefore, something has to defend the skin against free radicals, and in the Esthetics Industry – there are preventative measures and corrective measures that can aid in this defense (such as facials, microdermabrasion, and chemical peels – to be explained in the later part of this course).
ž  Antioxidants can be taken orally or topically (Dermatology Times, 2006), and they represent various vitamins, extracts, acids, and natural substances.  Antioxidants are known to be good for your health and they can also help fight against chronic diseases. Some antioxidants include (but are not limited to): Vitamin C, Vitamin E, Vitamin A, Beta-Carotene, Amino Acids, Minerals, and Green Tea. There is greater discussion regarding antioxidants in the Vitamins, Extracts, and Acids section below; but first, a description of cell renewal and turnover rates needs to be examined – which in-turn gives a greater understanding of the need of antioxidants.
žCell renewal (also identified as cell turnover) can change over time, and be affected internally, as well as externally and environmentally. Babies’ cells may naturally renew every 14 days, whereas teenagers’ cell renewal may take place every 21-28 days.  As persons grow into their 20s to their 40s, the cell turnover rate may range anywhere from 21 to 42 days.  As persons age in their 50s, 60s, 70s or older, their cell renewal may range from 42 to 84 days.  What does this mean? This means that at infancy, the body’s ability to grow new cells and to shed old skin cells takes only up to two weeks – in comparison to new skin developing two-three months for older individuals.  Ultimately, the resiliency of the skin, the glow, elasticity and overall health and appearance of the skin will be affected if there is a slow cell renewal (Gershon, 2004).

 

žVitamins, Extracts, and Acids (15 Min.)
ž  There are various vitamins, extracts, and acids that are prevalent within the beauty industry.  These elements assist with the overall skincare process as a whole, and are prevalent in many skincare products, systems, and regimens.  There would be too many to mention in this 8 hr. online course, but below includes a sample (to better educate and inform). Some of the vitamins that help to fight free radicals include the following:
žVitamin C – also known as “ascorbic acid,” is found naturally in fruits (such as oranges, strawberries, and grapefruits); plants; and vegetables (such as broccoli, brussels sprouts, and collard greens).  Although Vitamin C is natural, it can also be made synthetically as well.  Traditional Vitamin C is water soluble, and helps to strengthen the immune system.
žVitamin C Esther – There are various “chemical esther bonds” that can be applied to Vitamin C, such as fatty acids that contain palm oil. This would make the Vitamin C product “oil soluble,” and would create a “chemical esther bond.”
žVitamin A – Vitamin A is fat soluble, which means that it is dissolved through the intestinal tract and it also assists the cell membrane. Vitamin A also has a strong presence in cod liver oil.
žVitamin E – is also fat soluble, and has a strong presence in wheat germ oil, dry roasted almonds, and sun flower seeds.
žThere are also various extracts that can aid in fighting free radicals - and grapeseed, licorice and willow herb extracts are well known extracts (just to name a few). Grapeseed extract is a prevalent antioxidant that is known to combat free radicals.  This extract fights against oxidation (when atoms loose electrons), and is suggested to be quite powerful in potency (in comparison to other vitamins). Willow herb extract helps to calm the skin and give it a more soothing feeling.  Licorice extract is excellent for sensitive skin and works well with melanin and pigmentation.
žAcids play a large role in the skincare process as well.  For example, Hyaluronic acid, a natural acid within the body, plays a major part in the esthetics field.  Hyaluronic acid assists with hydration, and produces fluids that are between various proteins and fibers. As mentioned previously, the prevalence of proteins and fibers are important for the overall health and function of the body. Beauty industry products can be natural or synthetic, and there are many products on the market that strive to replicate the composition and effects of hayluronic acid.
žThere are several other vitamins, extracts and acids that can be mentioned in this course, however, this is merely a sample – and the course is more designed toward the overall introduction of the skin, the skin’s components, and skincare as a whole. Nonetheless, it is important to acknowledge various vitamins, acids and extracts, and their importance from a skincare perspective.
 
žMODULE  III: THE SUN & HOW THE SUN AFFECTS THE SKIN (20 Min.)
žIntroduction (5 Min.)
žThe sun is one of the primary causes of aging prematurely, wrinkles, skin damage, and skin cancer. The sun can also affect the hydration of the skin, as it will absorb the natural hydrants from the skin and body. The sun produces rays that are very potent and powerful towards the skin, and ultraviolet light, is very important to understand. As ultraviolet light shines through the sun, there are also ultraviolet rays that give off radiation (UV radiation). Ultraviolet radiation in turn can affect the skin; and the epidermis, the outermost layer of the skin, is one of the first parts of our bodies to feel and absorb the ultraviolet radiation.    There are three (3) types of UV radiation derived from the sun which include:
žUVC radiation
žUVA radiation
žUVB radiation
žIf a person has had exposure of rays from the sun overtime, it is predicted that by age 18,the majority of sun damage has already taken place.  Therefore, if someone is exposed to the sun since childhood, and if they did not use sunscreen – then there is a greater chance that they may have more sun damage. Even the color of one’s clothing, and the coverage of a hat or clothing over one’s body can make a great difference in regard to sun protection.  It is also recommended that even in our daily routines, we are mindful of sun exposure – such as yard work, physical fitness and extra-curricular activities, and the like. Ultimately, not all sun damage is acquired through tanning out in the sun or at the beach – we can also receive sun damage through our daily activities and schedules.
žUVC, UVA, and UVB Radiation (5 Min.)
žUVC radiation is not known to affect the skin directly, as the Earth’s ozone layer protects the UVC radiation from reaching our skin. The ozone layer actually absorbs the UVC radiation, which prevents it from damaging our skin. UVA radiation is different, because it can affect our skin and may aid in damaging our skin as well.  UVA rays are known to tan the skin and to affect the epidermis and dermis, and they are also known as “shorter rays.”  UVB radiation has long been known to damage the skin, and these rays can be very potent during the daytime, especially between 10:00 a.m. – 2:00 p.m.  At this time, the sun is known to have the most exposure, and ultimately, UVB rays can cause sunburn and they greatly affect the epidermis and dermis. This can also increase the production of free radicals, which can cause the skin to age, sag, and wrinkle.
žBelow is a diagram of UVA and UVB radiation, and how it can affect the skin:
UVAUVBRays.jpg 
žSkin Phototype (SPT) (3 Min. )
žUltimately, when the skin is exposed to UVA and UVB rays, a person’s skin phototype, known as “SPT” will determine how the skin will absorb these rays. As you know, the skin is the largest organ of the body –and different people have different physical and genetic factors such as: skin types and melanin content; and lifestyle factors, such as: diet, exercise, smoking/not smoking, and skin care regimen that can affect their skin.  Collectively, these traits can help determine the overall health of the skin, and the absorbency and tolerance level the skin can take. 
žThere are six (VI) levels of SPT, which compares whether or not a person burns and/or tans from the sun, with: the lowest SPT I level representing a person that does not tan, but will burn; up to the SPT VI level representing a person that has a deep pigmentation in their skin – caused by their high level of melanin, that doesn’t burn at all. (Note: It is important that a person’s skin phototype [SPT] be determined by a physician or dermatologist.)  The first SPT levels (I & II) are the two levels in which persons will have the highest probability of sun burn and premature aging. These persons will also experience more intense effects of sun damage and increased free radicals (Brannon, 2008).
ž 
žSun Protection Factor (SPF) (7 Min.)
žProtecting the skin is important, and sunscreen has been a topical product that has aided in the protection from UVA and UVB rays that can damage the skin – and can [again] even cause skin cancer. 
Sunscreen is a topical product that has a potency level called  “SPF” – better known as the Sun Protection Factor.  The SPF can be as low as 1, to 8, 15, 25, 45, and even greater – and the greater the SPF, the more protection the skin will receive. Primarily, sunscreens can block radiation, or they can absorb radiation.
Sunscreens.Eucerin.jpg
 
žSunscreens that absorb (reflect) UVB rays include: “octyl salicylate; octyl methoxycinnamate, oxybenzone, and titanium dioxide.” (Gershon, 2004).
žSunscreens that absorb (reflect) UVA rays include: “oxybenzone, titanium dioxide, zinc oxide, butyl methoxydibenzoylmethane, and parsol 1789.” (Gershon, 2004).
žIt is also recommended that when a person does choose a sunscreen, that the sunscreen register at least an SPF15, and it should contain avobenzone, titanium dioxide, or zinc oxide (Brannon, 2008).  Gershon (2004) also cites that if a sunscreen has an SPF of 15, than it can protect the skin from up to 93% of UVB rays.  Also, if a sunscreen has an SPF of at least 30, than it can protect the skin from up to 96% of UVB rays.  Therefore, it is important to have a higher level of sunscreen, for maximum protection. Above, is an excellent SPF chart from www.Eucerin.com, which highlights various sunscreen protection strategies.
žMODULE IV: VARIOIUS “SKIN TYPES” (60 Min. Total)
žIntroduction/pH Balance of The Skin (10 Min.)
žOne of the most important elements of working with skin – as a Cosmetologist or Esthetician, is to make sure that you are familiar with various skin types. After you’ve completed Cosmetology School, you should have a wealth of knowledge regarding the skin, chemistry, and the like.  However, it is important that you receive continuing education and training beyond your formal schooling and to realize that ultimately, there is a difference between “theory and practice.” Even before skin types are interpreted, it is important to note the following: (1) as licensed Beauty Professionals, we are not medical professionals – such as a doctor, physician, or dermatologist.  Therefore, there is no formal medical diagnosis that we can determine regarding someone’s skin.  However, as Beauty Professionals, we can make our best determination regarding our client’s skin – within the realm of the beauty industry (and not the medical field); (2) understanding the pH level of one’s skin is also great to know, so you can be more familiar with one’s skin type. 
žpH Balance of the Skin
žpH stands for “potential hydrogen,” and it has a lot to do with our bodies and our skin. In Esthetics, Skin Care, and the Beauty Industry as a whole, there are several types of services conducted that can affect a person’s pH level. Therefore, it is important within the Beauty and Skincare Industry to understand the pH balance of one’s skin. Additionally, within the procedures involving the skin or hair, there are various chemicals, compounds, and derivates that can affect the skin - and again, it’s important to know about pH balance, and how one’s skin can be affected.
žpH is measured on a scale from 0 to 14 – which includes two elements: acids and alkalis (alkalinity). Acids have a pH from 0 to below 7 and alkalis have a pH from above 7 to 14. In the middle, the pH of 7 is a neutral level (this level can vary from 6.5 to 7.5). The skin’s pH is normally at 5.5, and although it is not in the “middle” of the pH scale, this is the skin’s normal pH level. An example of pH on the “acid side” of the scale is vinegar; and an example of the “alkalis side” of the pH scale is lye. Therefore, there is a great range of pH properties, and please note that either side of the pH scale can promote harm to the skin. Below is an example of a pH scale:
phScale.jpg
 
žAdditionally, within each pH number change, there is a change ten times greater in the pH level; for instance – a pH7 (neutral) to a pH6 change would be ten times greater the pH level; but from pH6 to pH5, there would be a 100 times greater pH level [10x10 = 100] (this example is in the diagram above).
žAt times, for some skincare services to be effective, the skincare solution must have a lower pH acid than the skin. The skin’s normal pH acid balance – is 5.5 However, there are certain skincare services that can alter the skin’s pH level. For instance, a chemical glycolic peel could affect the pH level of the skin from a 5.5 to a 3.5.  But in-turn, the pH level should never be taken below a 3.0, because this can have a severe effect on the skin and would promote harm to the skin.  Therefore, the pH balance should not fall under 3 on the pH scale, because this level would promote harm to the skin (Note: medically supervised chemical peels may take the skin’s pH balance below a 3.0 [such as a pH of 2.5]).
žVarious Skin Types: The Top Seven (50 Min.)
žIntroduction (5 Min.)
žKnowing what types of skin you’re working with – as well as what type of product and/or
žprocedure to use, is very important for the safety of your clientele, and your Skincare Career.  It is also important to note that there are side effects and contraindications that are key to recognize [and be aware of], and it is imperative for the overall safety for your client(s).  You want to make certain that your client’s safety is important, therefore, you have to be aware of precautions before skincare procedures, and after skincare procedures. 
žSide effects represent things that can happen to your client’s skin after a skincare procedure (such as redness, irritation, itching, burning, dryness and the like).  Contraindications represent risks and skin conditions to watch out for before  you conduct a skincare service, such as (but not limited to): psoriasis, diabetes, rosacea, a high level of active acne, and the like. Various side effects and contraindications will be discussed in further detail throughout this course.  Ultimately, this section strives to explain various skin types, and to understand skin conditions that you are able to work with – or not work with; in regard to your client’s skin type.
 
žBelow is a listing of seven (7) primary skin types, in which you will work with, as a Beauty and Skincare Professional. These skin types include but are not limited to:

žNormal Skin
žOily Skin
žDry Skin
žCombination Skin
žSensitive Skin
žAcne Prone Skin
žMature/Aging Skin
ž 
žNormal Skin (2 Min.)
ž  “Normal Skin” is a skin type that may not be as common as anticipated.  Usually, when a person has Normal Skin, you can take note of the following characteristics:
žNormal skin usually represents a person not experiencing as many acne break outs;
žS/he may not have oily blotches and complications due to oily skin;
žItching and redness may not be as common as well.
žDryness is usually not an issue with normal skin, as well as itching and irritation due to dryness.
žAdditionally, one should take care of the normal skin type by cleansing, toning, and moisturizing their skin at least twice a day.
žThere is no distinct population of would have normal skin, but there are some additional factors that may attribute to normal skin types such as: diet, exercise, internal influences (such as health and hereditary traits), external influences (such as pollution, climate, temperature, and pollution). A person’s daily skin-care regimen may also have an impact upon the normal skin type as well.
 
žDry Skin (8 Min.)
ž  Dry skin warrants different conditions and contraindications, and there are several elements of understanding dry skin.  For persons who have dry skin, they oftentimes may be older or mature aged, and they may have experienced photoaging (over exposure to the sun over time) as well.  Their climate and living environment – such as sun exposure, and other outdoor influences may also contribute to their dry skin condition. Persons may also be on certain medications that have side effects that attribute to their dry skin.  Also, there are various diseases that affect the skin and the body, and these diseases could contribute to dry skin complications as well. Usually, when a person has dry skin, please take note of the following characteristics:
žPersons often need to hydrate their skin, because the dryness presents a lack of hydration in the skin. Water is one of the most common means of hydrating the skin – and the body as well.
žPersons with dry skin usually need more exfoliation in regard to skin rejuvenation.  However, over-exfoliation could aid in harming the skin – therefore, it is important to know whether or not your client has seen a doctor, physician, or dermatologist in regard to their dry skin condition. You as a skin care professional also need to know whether or not your client is taking medications, that could also attribute to dry skin.
žMoisturizing the skin is very important for persons with dry skin. Since the skin is often deprived of having moisture – due to natural reasons (heredity, hormonal composition, etc.) and/or environmental reasons (such as smoking, pollution, workplace, climate, etc.), moisturizing the skin [again] is very important.
 
žAnother important note is that the temperature of water could greatly affect the condition of the skin.  The warmer the water temperature is – the more dry the skin can become.  Therefore, if a person is prone to dry skin conditions, s/he can use lukewarm water, instead of hot water. Lukewarm water is known to have less potential of stripping the skin of its natural oil balance – in comparison to hot water, which is more prone to stripping the skin of its natural oil balance.
žYour clients should also know that soaps play a large role in the dryness of one’s skin. Usually, if a person wants to improve her or his dry skin condition, they should use soaps with glycerin or petrolatum.
¡Glycerin is a component of glycerol, and it is known to aid the skin in holding moisture, combating dryness, and is a known lubricant and emollient of the skin.
¡ Petrolatum is also a component of petroleum jelly, and is often used as a “base” in cosmetics and skin care products.  Petrolatum is also known to lubricate the skin, and to protect the skin from dryness as well.
ž 
žOily Skin (10 Min.)
žOily skin is one of the most common conditions of clients in the skin care industry. It is often misunderstood that oily skin only occurs in teenagers, and that persons have oily skin at only one time or phase in their lives.  However, oily skin can affect people’s skin at various times in their lives – whether younger or more mature-aged. There are so many different components regarding the causes of oily skin, but skincare specialists need to know the basic foundation of the causes of oily skin:
 
žOil within our bodies comes from sebum, which derives from the sebaceous glands. The sebaceous glands produce oil that lubricates within our bodies – primarily on the facial portion of the skin, and the scalp and hair. However, sebaceous glands are not known to lubricate the palms of the hands, nor the soles of the feet. Below is a diagram of the sebaceous gland, the hair follicle, and the skin’s surface.  The diagram also reveals where the sebum is produced, and how sebum follows along the lines of the hair follicle; which in-turn is produced under the outermost layer of the skin, and seeps above the skin’s surface.
HairFolicleSebumOil.jpg
 
žOily skin may contribute to several types of skin conditions, in which the skin may develop acne. The latter portion of this course will discuss in more detail various types of skin conditions in which oily skin is a contributor.

 
žOftentimes, persons with oily skin refrain from using a moisturizer, because they do not want to “appear” to make the skin “more oily.” However, there are now oil-free moisturizers that aid in the proper moisturization of the skin.
žAlso, your clients should not “over cleanse” and exfoliate the skin – in order to “wash the oil away.” It is recommended that cleansing and moisturizing should only take place twice a day, because you can strip the skin of the natural oil barrier that is imperative for holding in a certain amount of moisture – in order to protect the skin. The skin needs a “natural barrier” that contains fatty acids, and lipids that protect the skin from the sun, sun damage, and environmental influences as well.
Acne can also have a reddish color and may produce pus – or may not produce pus. At times, colonies of red bumps can produce massive amounts of acne – and at other times, acne can be represented by a single red bump. The “red bumps” on the skin are often referred to as “pimples,” which are also identified as “papules.” Papules represent an acne lesion which is inflamed; as this causes the reddish color of the papule. Pustules are also a form of acne, in which they are pimples with a white head.
žThere are several types of skin care procedures and products that aid in controlling oily skin, and usually, the lower the pH balance of skin cleansers – the better they can aid in oil reduction. Amino fruit acids are also known to combat oil, as well as various masks, such as clay-based masks, which help to draw out impurities from the skin and reduce oil production.
žThe T-Zone is also a common term used in acne, which identifies oil production on the face.  The T-Zone is similar to placing the letter “T” on one’s face and includes: the forehead, nose, and chin as key areas where oil can produce on the face.
ž 
žCombination Skin (4 Min.)
žCombination skin occurs in millions of people, as they experience different types of skin balance combinations. For example, some skin type combinations on the face could include (but would not be limited to):
žnormal-to-oily skin;
ždry and oily skin (in different locations on the face);
žacne-prone and sensitive skin;
žmature skin and excessive dry skin;
žand even sensitive/oily/dry skin at the same time.
 
žThe most important components to know about combination skin is that there are different parts of the face that can experience different needs – especially pertaining to skin care, and skin care procedures.  For example, during a facial, a client may have sensitive skin such as rosacea on her or his cheeks; however, the rest of your client’s face may be oily.  Therefore, the mask that you select for your client’s skin during the facial may have to reflect two types of masks – one mask may have to be a calming gel mask for sensitive skin; and the other mask can be a clay mask that is recommended for oily skin. 
ž  Ultimately, this section of the course addresses seven (7) primary skin types, which [again] includes – normal, oily, dry, combination, acne prone, sensitive, and mature/aging skin. Combination skin can include two or more of the aforementioned skin types, and it’s important to note that if your client has combination skin, be mindful of how you treat your client’s skin with product and skincare procedures.  It is also important to note that hormonal, hereditary, and various environmental influences can attribute to combination skin, and all the different skin types as well.
ž  Sensitive Skin (6 Min.)
ž  Sensitive skin is a skin condition that the skincare professional needs to be aware of, before any skincare services are initiated.  Traditionally, the skin is very sensitive, and when various products are used on sensitive skin – side effects can occur such as:
žredness
žirritation
žburning
 
žSensitive skin can also have several contraindications – and your client needs to be forthcoming in regard to how her or his skin feels.  Skincare products also have ingredients that may make the skin even more sensitive, and you want to make sure that you let your clients know that they could receive an even greater sensitive skin reaction – depending upon which type of product or procedure was used. 
ž  Usually with sensitive skin, clients should use mild-based products on their skin, including: sensitive skin cleansers, moisturizers, masks, and the like.  Additionally, steam - which is used often in skincare services, may be too harsh for certain sensitive skin care types. Therefore, for certain procedures, you may not use steam (such as during a facial, you may have to use a cold or lukewarm cloth instead of steam).
ž  It is recommended that if your clients have sensitive skin (or any other skin conditions), that they see a dermatologist – so a correct diagnosis can be determined.  Again, it is important for the skincare professional and skincare client to monitor skin sensitivity during esthetic and skincare procedures. It is also important to monitor the sensitive skin and how it reacts with “home care” products as well. There are professional skin care lines that have products especially tailored for sensitive skin needs. This is a great plus for cosmetologists and estheticians - because they can offer retail products; that can help to protect clients’ skin from irritation and various side effects.  It is also important to receive continuing education and to be knowledgeable regarding various product lines, and their products for different types of skin.
ž  
žAcne-Prone Skin (13 Min.)
ž  Acne-prone skin has many components – including internal, hereditary and hormonal components; as well as a client’s diet, nutrition, and skin care regimen. Acne-prone skin may also be caused by a certain stage in a person’s life – such as puberty, or even during menopause.
žAs mentioned previously in the oily skin segment – sebum is a part of the sebaceous glands and is the primary cause of oily skin.  The hair follicle also carries sebum, which seeps out above the outermost layer of the skin – the stratum corneum. The opening of the skin in which sebum exerts itself is called a “pore.”  Pores of the skin are an important part of the overall health and wellness of the skin. The pore contains the hair shaft, and as oil comes to the skin’s surface – this creates the pore.  Some pores can be smaller pores and other pores can be enlarged pores. It is usually the goal of all who practice good skincare, to have smaller pores.  The larger the pores – the more you can see them under a magnifying lamp, and even without a magnifying lamp.
žWhen sebum/oil comes to the surface of the skin, along with dead skin cell debris – it can create blackheads and whiteheads, which are traditionally known as comedones. When pores are larger, the exposure of air to the comedone can produce oxidation – in which the open pore clogged with sebum and dead skin cells can appear as a black color.  This is known as “blackheads” or an open comedone. Whiteheads, which are oftentimes referred to as “milia,” are similar in the composition of a blackhead, however, the primary difference is that whiteheads are comprised of a smaller pore, in which the sebum/oil has not had full exposure and is not as oxidized as blackheads.  Whiteheads and milia are oftentimes referred to as: “closed comedones.” This causes the whitehead to keep a whitish color and therefore, it may not have turned black.  Regarding comedones, below is a picture of open comedones, or blackheads; and how their appearance may also appear in small colonies.
AcneSalonSpaTraining.jpg
(Acne)
ComedonesPicNIHAdamCitation.jpg
 (Comedones)
 
žThere are several means to treating acne-prone skin which includes [but is not limited to]:
ž Cleansing, toning and moisturizing the skin twice daily;
žThe toning of the skin can also be utilized with an astringent, which has a higher potency of bactericidal properties (but be mindful that an astringent can dry out the skin if used too frequently).
žBenzoyl peroxide is also very useful in combating acne-prone skin.  Benzoyl peroxide has oxidizing agents, which include hydrogen peroxide and benzoyl chloride. Benzoyl peroxide is widely used in skincare products that are used for acne-prone skin.
žFacial scrubs may also be used with acne-prone skin. However, make certain that your client’s skin is not too sensitive for a facial scrub.
žSkincare procedures such as facials, microdermabrasion, and chemical peels are also be able to combat acne as well.
žUltimately, if your client’s skin is too acne-prone and to your visual eye you see a high level of acne activity – consider recommending your client to a dermatologist.
ž 
žMature Skin (2 Min.)
žMature skin is mostly associated with aging skin that may be experiencing free radical damage.  Some mature skin can reflect “pre-mature aging” of the skin as well, in which over exposure to the sun has caused photo-aging. Some traits of mature skin include [but are not limited to]:
žAge Spots
žWrinkles
žSagging Skin
žSun Damage & Photo aging
žLack of elasticity in the Skin
 
žAs mentioned in this course previously, when one’s skin does begin to deteriorate, it can be associated with a term entitled “free radicals.” Free radicals represent damaged molecules that in turn damage cells.   A good professional skincare regimen and home care regimen can aid in “fighting” free radicals; as well as reducing the appearance of wrinkles, age spots, and the like. This professional regimen may include [but is not limited to]: monthly facials, chemical peels, enzyme peels & masks, microdermabrasion, and the use of serums, ampoules, and special conditioning treatments for the skin – such as specialized masks for mature or aging skin, which have emollients that condition the skin.
 
žMODULE V: SKIN CONDITIONS AT-A-GLANCE: DISORDERS, DISEASES, & ALLERGIES (70 Min.)
žThere are skin conditions that persons have, in which a dermatologist, physician, or
žmedical professional may have to work with in regard to – diagnosis, treatment, and care. There are also persons who may have certain skin conditions or disorders – but their conditions may go undiagnosed or untreated.  However, as a Skincare Professional, there are various conditions that you need to be aware of, because you will make selections regarding the type of product and procedure you will utilize for your client.
žAgain, not that we are licensed medical professionals; however, it is wise to become as knowledgeable as possible regarding various skin conditions – because visually, your judgment may be very important regarding the overall health, betterment, and safety of your client’s skin. Below is a listing of several skin conditions that you should be familiar with.  These listings are “at-a-glance” and the goal of this course section is to make the course participant more familiar with skin conditions.  Dermatology.com (2010) has a listing of skin conditions, and the list represents some of the conditions documented by Dermatology.com, as well as other skin conditions compiled by the Salon Spa Training Institute (2010).  These selected conditions include:
žAbscess - An abscess is a mass of pus that is formed on many different parts of the body, such as under the arm/armpits, or within the inner thighs. At times, abscesses are drained, because of sanitary and medical reasons.
žAcne – As mentioned previously, when sebum/oil comes to the surface of the skin, along with dead skin cell debris – it can create blackheads and whiteheads, which are traditionally known as comedones. When pores are larger, the exposure of air to the comedone can produce oxidation – in which the open pore clogged with sebum and dead skin cells can appear a black color.  This is known as “blackheads” or an “open comedone.” Whiteheads, which are oftentimes referred to as “milia,” are similar in the composition of a blackhead, however, the primary difference is that whiteheads are comprised of a smaller pore, in which the sebum/oil has not had full exposure and is not as oxidized as blackheads.  Whiteheads and milia are oftentimes referred to as: “closed comedones.” The blackheads, whiteheads, and milia represent forms of acne, but there are other forms of acne as well.  Acne can also have a reddish color and may produce pus – or may not produce pus. At times, colonies of red bumps can produce massive amounts of acne – and at other times, acne can be represented by a single red bump. The “red bumps” on the skin are often referred to as “pimples,” which are also identified as “papules.” Papules represent an acne lesion which is inflamed; as this causes the reddish color of the papule. Pustules are also a form of acne, in which they are pimples with a white head.
žAcne Scaring – Acne conditions can also cause acne scaring, where marks can remain on the skin. Usually, the acne lesion and skin have to heal after the acne breakout/condition; and it may take weeks or months for this healing process. Additionally, some persons may have a more permanent acne scar as well.  From a beauty industry perspective, there are means of reducing the appearance of acne scaring with treatments such as chemical peels and microdermabrasion.
žAllergic Contact Dermatitis – When “allergens” come in contact with the skin – this can cause an allergic reaction, such as the Allergic Contact Dermatitis reaction. According to Medline Plus Dictionary (2010), certain allergens include but are not limited to:
žBacteria, viruses, and animal parasites
žVarious Chemicals
žDust Particles
žTopical Medications (that you put on your skin)
žVarious Foods (such as milk, chocolate, strawberries, wheat)
žPerfumes and Fragrances
žPlants
žPollen
žSmoke
 
žAtopic Dermatitis/Eczema -  This is a very common form of “Eczema,” and it represents a hypersensitive reaction toward the skin – in which the skin may be inflamed and/or have a rash. (Eczema will be described in more detail in the latter part of the Skin Conditions section.) The cause of Atopic Dermatitis is associated with the immune system, and there are more than 15 million people in the United States that encounter Atopic Dermatitis.
žBasal Cell Carcinoma – This is a form of skin cancer, and very common among skin cancer types. Over one million people are diagnosed with skin cancer every year, and some of the causes of skin cancer include [but are not limited to]: over exposure to UVB rays and the sun; over exposure to rays from tanning beds; and hereditary reasons as well. The appearance of Basal Cell Carcinoma may seem like a small blister or pustule, that may have a “fleshy” appearance.
žBlisters – Blisters represent skin that becomes raised, with a liquid consistency. Usually, various rubbing or pressure on the skin can cause a blister, such as when wearing tight shoes. If a person experiences a burn on their skin, they can also blister as well.
žCellulitis – Is caused by bacteria that has infected the skin through an opening of the skin (such as a cut, scrape, incision, and the like). This infection is a deeper skin-related infection, which occurs within the dermis, which is also known as the “true skin.”
žChicken Pox – The formal name for Chicken Pox is the Varicella Virus, and mostly occurs with children under the age of 15. It is not common among adults - but adults can still experience Chicken Pox as well. During Chicken Pox, a rash occurs on the skin and a person can experience headache and fever as well.  The Chicken Pox usually lasts between 5-10 days. A person can get the Varicella Virus throughout the calendar year, but the spring months are the most common months Chicken Pox occurs. Chicken Pox physically occurs mostly on the scalp and the face.
žAthlete’s Foot – Athlete’s foot is an infection that occurs on the feet and there may be an increase of dead skin and scaling present on the foot.  This infection derives from the “tinea fungus.” A person may experience increased itching and burning, and the feet may also appear cracked. Working with the feet would traditionally not be associated with this course, however, it is mentioned to increase the general knowledge of skin disorders. Athlete’s foot is also more common with males, and damp surfaces/environments for the feet often cause the Athlete’s Foot infection.
 
žAtopic Dermatitis/Eczema -  This is a very common form of “Eczema,” and it represents a hypersensitive reaction toward the skin – in which the skin may be inflamed and/or have a rash. (Eczema will be described in more detail in the latter part of the Skin Conditions section.) The cause of Atopic Dermatitis is associated with the immune system, and there are more than 15 million people in the United States that encounter Atopic Dermatitis.
žBasal Cell Carcinoma – This is a form of skin cancer, and very common among skin cancer types. Over one million people are diagnosed with skin cancer every year, and some of the causes of skin cancer include [but are not limited to]: over exposure to UVB rays and the sun; over exposure to rays from tanning beds; and hereditary reasons as well. The appearance of Basal Cell Carcinoma may seem like a small blister or pustule, that may have a “fleshy” appearance.
žBlisters – Blisters represent skin that becomes raised, with a liquid consistency. Usually, various rubbing or pressure on the skin can cause a blister, such as when wearing tight shoes. If a person experiences a burn on their skin, they can also blister as well.
žCellulitis – Is caused by bacteria that has infected the skin through an opening of the skin (such as a cut, scrape, incision, and the like). This infection is a deeper skin-related infection, which occurs within the dermis, which is also known as the “true skin.”
žChicken Pox – The formal name for Chicken Pox is the Varicella Virus, and mostly occurs with children under the age of 15. It is not common among adults - but adults can still experience Chicken Pox as well. During Chicken Pox, a rash occurs on the skin and a person can experience headache and fever as well.  The Chicken Pox usually lasts between 5-10 days. A person can get the Varicella Virus throughout the calendar year, but the spring months are the most common months Chicken Pox occurs. Chicken Pox physically occurs mostly on the scalp and the face.
 
žCholinergic Urticaria This is also known as “hives.” Cholinergic Urticaria can occur when a person’s body temperature rises or when there is a hormonal in-balance from stressful activities. These hives can occur on the body within minutes and may take anywhere from 30 minutes to hours to go away.
žCold Sores  Cold Sores represent “ . . . a vesicular lesion that typically occurs in or around the mouth, that initially causes pain, burning, or itching before bursting and crusting over, and that is caused by a herpes simplex virus which remains dormant in the body and may be reactivated by a variety of factors (as stress, fever, or sunburn)— called also fever blister . . .” (Medline Plus, 2010).  
žComodones – As mentioned previously in this online course . . .  When sebum/oil comes to the surface of the skin, along with dead skin cell debris – it can create blackheads and whiteheads, which are traditionally known as comedones. When pores are larger, the exposure of air to the comedone can produce oxidation – in which the open pore clogged with sebum and dead skin cells can appear as a black color.  This is known as “blackheads” or an “open comedone.” Whiteheads, which are oftentimes referred to as “milia,” are similar in the composition of a blackhead, however, the primary difference is that whiteheads comprise of a smaller pore, in which the sebum/oil has not had full exposure and is not as oxidized as blackheads.  Whiteheads and milia are oftentimes referred to as: “closed comedones.” This causes the whitehead to keep a whitish color and therefore, it may not have turned black. 
 
žEczema – As mentioned previously, Eczema represents a hypersensitive reaction toward the skin – in which the skin may be inflamed and/or have a rash. Eczema is also known as “Atopic Dermatitis,” and the skin is affected by the immune system and the outer surface of the skin may also experience inflammation as well. Eczema often occurs with children, and occurs less often with adults.
žEpidermoid Cyst  This cyst is very common among skin conditions. It consists of skin cells and keratin and has a “cyst wall” that barriers it. This cyst also resembles a sac-like appearance and favors a bump that is raised over the skin. Epidermoid cysts are also called epidermal and keratin cysts.
žHerpes Simplex 1 – Herpes Simplex 1 includes lesions, blisters, and sores that can be around the mouth, eyes, and in the inner mouth as well.  It is caused by the Herpes Simplex Type 1 Virus, and is an infection as well.
žHead Lice  The technical term for Head Lice is Pediculus Humanus Capitis, and it occurs in more than six million people per year.  The Head Lice are parasites (small insects) that multiply mostly in children and not adults. This condition usually lasts no longer than one month.  
žHirsutism – This occurs when women have an overabundance of hair growth, caused to testosterone (also known as androgens) in their bodies.  This additional hair growth oftentimes can occur on the body where typically, men will experience hair growth as well, such as – on the face and on the neck.
 
žHyperpigmentation -  Hyperpigmentation represents portions of the skin appearing darker in comparison to rest of the skin. This may be due to acne scaring, sun and age spots, and the like.
žHypopigmentation – Hypopigmentation is the opposite from Hyperpigmentation, as portions of the skin appear lighter then the rest of the skin. This can occur due to hereditary issues; skin diseases – such as Vitiligo; the use of skin care products that are too harsh for the skin and remove pigment from the skin; and even from burns toward the skin.   
žImpetigo  Impetigo is a bacterial infection that is known to be contagious. This common infection has symptoms of rash, blisters, and skin lesions. This bacterial infection is caused by streptococcus  or the staphylococcus bacteria.
žIntertrigo – “Candida Albicans” is the cause of Intertrigo, which is known also as a type of yeast infection. Intertrigo occurs in layers and folds of the skin.  If a person is in a warm climate, or even if they wear tight clothing, they could acquire Intertrigo.
žIrritant Contact Dermatitis – Irritants, such as soaps can make contact with the skin and cause irritation and reaction towards the skin.
žJock Itch – The Jock Itch, is also known as “Tinea Cruris.” Men are more affected by Jock Itch in comparison to women, and it serves as a fungal infection – which is usually located in the groin area. Moisture and warmth are the growth areas for Tinea Cruris, and wet/damp clothing can cause Jock Itch as well.
 
žLichen Simplex Chronicus (LSC) – This occurs when someone continues to scratch in a specific area over time. This causes the skin to change as it may become darker and thicker as well. LSC often occurs with persons that have Eczema as well.
žMelanoma – Melanoma, a Skin Cancer, causes the most common deaths attributed to skin disease. Melanoma originates from Melanocytes, which are cells that in-turn produce Melanin. Melanin is responsible for the pigment that produces the color of our skin, as well as the color of our hair.   Below is a picture of Melanoma:

Cited from Adam.com

melanoma.jpg

žMelasma – Melasma, is also referred to as the “Pregnancy Mask.” However, women and men can have melasma. This is known as a rash that may occur primarily on the face, neck. Melasma is also common among persons with darker pigmented skin as well, such as persons from African American, Hispanic, and Indian descent. 
 
žMoles – Moles are very common among persons, and different people may have different types and appearances of moles.  Moles represent small tumors that derive from melanocytes, which are the cells that produce melanin – which determines the pigment of our skin. Moles can also be different shapes, sizes, and colors, and textures.
žPoison Ivy - Poison Ivy, also known as “Rhus Dermatitis,” is caused by the skin touching an irritant including [but not limited to] – poison ivy, poison oak, and another plant entitled poison sumac.  The irritant in these plants is known as “Urushiol” and when someone catches Poison Ivy, there are known to acquire a rash that may also itch.
žPsoriasis – According to the National Psoriasis Foundation (2010) , . . “Psoriasis is a chronic, autoimmune disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. There are five types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.”
žPyogenic Granuloma – This skin disorder represents a lesion that bleeds, and that can bleed quite easily. When the skin is traumatized, the blood vessels can grow at a more rapid pace, and this is known to attribute to the “easy bleeding.” Pyogenic Granuloma can occur oftentimes within acne cysts. A scale-like appearance and reddish color are also traits of Pyogenic Granuloma.
žRingworm – Ringworm is also known as “Tinea Corporis,” and although its title contains the word “worm,” there are no worms involved with Ringworm. Ringworm represents a fungus, in which Tinea Corporis is a fungal infection. Ringworm appears as an infection that may simulate a round shape and is located on the top layer of the skin, or the epidermis.
 
žRosacea – Rosacea appears as a rash on the body, oftentimes on the face and cheeks, that has a very reddish, flushed color. There is presently no well documented cause of Rosacea, or even a cure – however, Rosacea occurs in over 16 million persons per year. Some of the visible traits of Rosacea include but are not limited to: redness- primarily on the “cheeks, nose, chin, or forehead;” blood vessels that are small but visible; and acne in the form of bumps and or pimples.  A person’s eyes being watered can also be a symptom of Rosacea. 
žScabies – Sarcoptes Scabiei, is known as a microscopic “mite” that causes a rash that also itches. Scabies occur in everyone representing gender, ages, and ethnic backgrounds. According to Dermatology.com (2010),  . . . “ at least 300 million cases of scabies occur worldwide every year.” Ironically, Scabies occur when the female mite delivers eggs that hatch just under the skin. 
žShingles – Shingles occur as a viral infection, that is caused by the same virus that causes Chicken Pox – Varicella Zoster. Shingles presents a rash that is also known to be painful. This rash usually originates on the back - and even toward the breastbone. However, it can occur on other parts of the body as well. Up to 600,000 cases of Shingles are reported each year in the U.S., and Shingles oftentimes occur in mature adults. In the United States, approximately 300,000 to 600,000 cases are reported yearly.
žVitiligoVitiligo occurs when parts of the skin appear lighter than other portions of a person’s skin – due to loss of pigmentation.
 
žMODULE VI: VARIOUS SKINCARE TRENDS, CLIENT CONSULTATION, AND SANITATION (160 Min.)
žIntroduction (3 Min.)
žThere are several skincare-related services that offered in the beauty industry, and as mentioned at the beginning of this online course, Cosmetologists licensed in the State of North Carolina are offered the opportunity to work in the esthetics industry as well.  This section seeks to offer an introduction to some of the most requested and effective skincare services within the beauty industry.  This in-turn helps to solidify “All About Skin,” and why these serves are requested.  It is recommended that you as a beauty professional continue to be educated and exposed to skincare –and with your background in the overall Cosmetology Area, it is a plus to be knowledgeable about skincare, and to enhance your skincare services. The following services will be introduced, which include Chemical Peels, Microdermabrasion, and Facials.
žChemical Peels (22 Min.)
žChemical Peels At-a-Glance
žKnown as a non-invasive treatment, chemical peels – also known as “epidermal exfoliation,” “chemexfoliation,” or “derma-peeling” have elevated advanced esthetics to a new level, with cost effective means of improving the overall appearance of the skin. Primarily, Chemical peels can be identified as: light, medium, or deep chemical peels.  Light chemical peels are known as either AHA (Alpha Hydroxy Acid) peels, or BHA (Beta Hydroxy Acid) peels. Medium Chemical Peels can be associated with TCA peels (Trichloroacetic Acid Peels, Obaji Blue Peels, and Jessner’s Peels). Deep Chemical Peels can be associated with Phenol or Carbolic Acid Peels.
 
žIt is important to note [again] that licensed Cosmetologists and Estheticians should work only with light (AHA and BHA Chemical Peels), if they are solely administering a chemical peel service – and it should also be noted that beauty and skincare professionals should work with light Chemical Peels that have no greater than 30% acidity (this percentage my fluctuate, depending upon State regulations).  Licensed beauty professionals may work under the direction of a dermatologist or physician in regard to administering medium or deep chemical peels; as well as performing pre- and post- operative care for medium and deep chemical peels clients. However, if a beauty professional is solely performing a chemical peel – then only a light chemical peel should be administered. 
žChemical peels are comprised of a chemical solution, oftentimes an acid solution; that is applied to the outer layer of the skin, better known as the “epidermis.” There are also chemical peels that are administered that penetrate past the epidermis and into the initial layers of the “dermis” or the true skin. Ultimately, the anticipated results of the chemical peel, are to improve the overall appearance of the skin by working against “free radicals,” in which overtime, promote cell damage and skin deterioration. Upon application of the chemical peel acid solution, various results occur – depending upon the type of chemical peel and the skin type of the client.
ž  There are various types of chemical peels that help with a multitude of skin conditions and skin imperfections (to be identified as acne scars, uneven pigmentation, and the like). Some of the visible improvements that chemical peels have been able to improve include (but are not limited to): (a) helping to reduce the appearance of facial blemishes, freckles, fine lines, wrinkles, age spots, and dark marks from pregnancy (a condition known as melasma); (b) improving uneven pigmentation, particularly with hyperpigmentation (darkening of the skin) and dyspigmentation; (c) aiding in the appearance of clients with skin conditions including acne, rosacea, and pilaris; and (d) to improve the overall skin texture and vibrancy by enhancing the appearance of dull skin.
 
žChemical peels also help to increase cell renewal, as they promote a “new skin”, which has shed dead skin cells, and has begun a fresh “cell turnover.”
ž  Ultimately, chemical peels have produced results which have led to a large client following of advanced esthetics services.  Depending upon the type of chemical peel administered, there are regulations and restrictions upon who can perform a chemical peel, whether it be a physician and or board-certified dermatologist; a medical professional such as a nurse; an esthetician, who in some states may solely administer chemical peels in the esthetics and cosmetology industries, or may work directly under a physician or dermatologist; or cosmetologists, whom in many U.S. States, have licenses that allow them to work in esthetics-related capacities as well.
ž  Contraindications of Chemical Peels
žThe term “contraindication” [again] means that there is a symptom or condition that a person may have before a skincare service. Therefore, a risk that might be taken – in which a particular service will have an adverse effect.  Contraindications are widely identified in the beauty industry as a whole, and for esthetic services and chemical peels – they are important to note. Cosmetic Surgery Times recommends various “risks” that are involved with chemical peels (light, medium and deep) which include (but are not limited to): scarring, infections, changes in skin tone, cold sore breakouts, heart disease, and swelling.  Additional contraindications include erythema (redness), and skin sensitivity from the sun.
 
žScarring - Chemical peels can have such a potency, that they can cause scarring on the skin. Particularly in medium (TCA) and deep (phenol/carbolic acid) peels, scarring does have the potential to occur. There is less potential of scarring in light (AHA and BHA peels).
žInfections –Infections can occur because the epidermis (AHAs & BHAs) or the dermis (TCA & Phenol/carbolic) is being exposed.  The skin is a part of the Integumentary system, and it is the largest organ of the body. Therefore, when various chemical compounds (whether natural or synthetic) are being applied to the body, there is a change in the chemical balance of the skin, as well as exposure to the skin.  This leaves the skin to potential infection. 
žChanges in Skin Tone – Depending upon the type of chemical peel, there could be a change in skin tone that could be temporary or permanent. This is more prevalent in medium and deep chemical peels, and not as prevalent in light chemical peels.  Nonetheless, there may be a temporary hypopigmentation (lightening of the skin) that can occur with light chemical peels; and usually, it will take a few days for the skin to resume its natural skin tone. However, it is better to improve hyperpigmentation (darkening of the skin) as opposed to hyperpigmentation.
žCold Sore Breakouts – If clients have a history of cold sores, than cold sore breakouts could occur.  Also, if clients have recurring herpetic sores, they can experience a breakout as well.
žHeart Disease – Particularly in deep chemical peels, heart disease may be a contraindication. With deep peels, the client/patient will have to go into sedation, and this can be of harm to the client.
žSwelling – Depending upon the client’s physical and genetic makeup, swelling can occur.
žErythema – As mentioned previously, light, medium, and deep peels can cause erythema – in which redness, burning, stinging, or itching could occur.  There are different recovery times with erythema, which may be from 24-48 hours and beyond.
žSkin sensitivity is important to note as well for light, medium and deep peels. It is one of the most important contraindications that can occur with all chemical peel clients.
 
žMicrodermabrasion (20 Min.)
žIn the advanced esthetics arena, the Microdermabrasion service has been a highly requested service, in which clients receive a “mechanical peel,” “dermabrasion,” or “skin resurfacing.” Overall, exfoliation is the most important component of this service, as layers from the stratum corneum, the skin’s outermost layer are removed. This service overall, which is known to aid in the reduction of wrinkles, fine lines, age spots, acne scars, enlarged pores, and the like – is one of the top five most sought after esthetics services.
žAccording to Dr. Heather Brannon, in 2005, nearly “150,000 microdermabrasion procedures were performed” at dermatology and physician’s offices in the United States. Ironically, within just two (2) years; since 2003, this was a nearly 26% increase. However, it is very difficult to include all statistics of microdermabrasion procedures performed within spas, full-service salons, and skin care clinics – but if these statistics were included, there were probably tens-of-thousands of additional microdermabrasion procedures performed as well.  
žUltimately, microdermabrasion helps within the skin cell renewal process, also known as “cell renewal,” or “cell turnover.” As the skin is mechanically exfoliated, the newer skin cells regenerate – which offer the skin a more rejuvenated look and feel- and it can also improve the overall health of the skin. Within the skin renewal process, microdermabrasion can also help with the improvement of photoaging, which is associated with sun damage from the rays of the sun.
 
žWhen you breakdown the term “microdermabrasion”, and the usage of a microdermabrasion machine, it can be interpreted in two different ways.  The prefix mirco-, traditionally represents very small granules of crystals that are used with a wand to blow onto the skin.  In turn, these small crystals are then suctioned with the wand, and dead skin from the stratum corneum suctions with the disposed crystals. Therefore, the microdermabrasion machine should serve as a blower of the crystals onto the skin, and a suction of crystals and dead skin away from the skin. The suffix –dermabrasion,  represents the exfoliation and “abrasion” of the skin. Dermabrasion aids in the skin resurfacing and this overall process of microdermabrasion is done mechanically. Therefore, micro crystals are utilized to exfoliate and practically “sand” the skin.
žUltimately, as the microdermabrasion procedure is being performed, the crystals are aiding in the loosening of dead skin cells, which in-turn, initiates the cell renewal process.
žHowever, there are also microdermabrasion machines that don’t have a “crystal flow,” and they may be called “crystal free machines.” Instead they may have a diamond-tipped wand that serves as an abrasive to the skin, and the dead skin is still suctioned from the stratum corneum.
žThere are also new microdermabrasion machines that use highly pressurized water as an exfoliating agent – in which water is blown onto the face; which initiates exfoliation as well.
 
žMicrodermabrasion is also known to be “non-invasive,” which means that it is not considered as a surgical or operative procedure (no anesthesia required).  There is hardly any downtime, and the microdermabrasion procedure can be performed during a client’s lunch hour – and then the client can go about her or his daily schedule. Within 1-2 days, their skin should feel more normal, but there are contraindications to be cautious of (such as over sun exposure, active acne/redness, and sensitive skin); and side effects (erythema) that can occur. Microdermabrasion is considered to not be as “discomforting” as other advanced esthetics and dermatological procedures, and the results are oftentimes long lasting. 
žClients may have a series of microdermabrasion treatments, in which they may have 6-8 procedures every 10-14 days. This treatment cycle may be more or less (4-6 treatments or 8-10 treatments) – depending upon the client’s skin and skin care needs.
žFacials (45 Min.)
žThe Facial is one of the most common skincare service offered around the World.  There are several different means upon how to offer a facial, and there are several different skincare lines that offer facial products.  In the Cosmetology field, there are widespread opportunities to offer facials as add-on services within the salon and/or spa settings. Therefore, below is an overview of the facial procedure, and how the set-up of a skincare treatment room is initiated.  There are also other means of gaining experience with facials and how to broaden the knowledge of skincare. As mentioned throughout this course – continuing education courses and product manufacturer demonstrations are excellent means of further education in the skincare industry.
 
žAdditionally, Cosmetologists can obtain on-the-job training for their skincare careers by working at various spas, full-service salons, medical spas; and receiving hands-on training from other skincare specialists - such as experienced estheticians and cosmetologists who are advanced in skin care knowledge and professional experiences. Below is a step-by-step analysis of the facial skincare services:
žTHE FACIAL

*   The facial is an excellent cleansing, exfoliation, and moisturizing technique that can be applied in several ways.  Facials can help to improve the overall health and appearance of the skin, and can also rejuvenate the skin. There are basic facials and there are more elaborate facials which include add-on services such as: aromatherapy, oxygen steam, serums, eye and lip treatments, and an atmosphere with music, candle lights, and other additives. Various masks can be used as well, depending upon your client’s skin type. 

ž SalonSpaFacialSteam.jpg

Universal facial steps include:

žSanitation – the area and implements utilized must be sanitary and must comply with the NC State Board of Cosmetic Art Examiners Rules. This link includes the most updated Sanitation Standards (Dec. 2008), published by the NC State Board of Cosmetic Art Examiners: http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2014%20-%20cosmetic%20art%20examiners/subchapter%20h/subchapter%20h%20rules.html

 
žSet up -
ž MySalonSpaPic.1.jpg
žAccording to Gerson (2004), recommended materials for set up include:
¢Supplies/equipment – hand towels, paper towels, steam machine, distilled water, magnifying lamps, extractor (if applicable to state rule), UV sanitizer, hand sanitizer, astringent, mask brushes, bowls, spatulas, head band, client gown or wrap, clean linens (or disposable linens), blanket, tweezers, bolster.
¢Disposables – cotton pads, cotton rounds, tissues, cotton swabs, gloves, extraction supplies. 
¢Products – cleanser, toner, exfoliant, mask(s) applicable to skin type, massage lotion, sunscreen; and serums, eye creams, and aromatherapy oils if applicable.
žBasic step-by-step procedure:
žClient Consultation – Discuss with your client past skin care history, allergies, medical conditions (on medication, pregnant, dermatology issues, smoking habits)
žRemove Eye and Lip Make Up – gently remove eye and lip make up with make up remover (you can use cotton pads to aid in make up removal).
žCleansing – In a sweeping movement, cleanse with both hands - upward and outward among the face, chin and décolleté. Remove cleansing debris with a soft cloth or enlarged, dampened cotton pads. Use facial water bowl as an accessory for cleansing removal.
žAnalyze the Skin – Use a magnifying lamp to assess the skin and evaluate – wrinkles, fine lines, oil, dryness, combination skin, acne, enlarged pores, blemishes, and age spots. If you have a digital camera (with your client’s permission), you can take pictures and keep a record of skin improvement for future facials and skin care treatments.
 

 
žCleanse the face and neck area again and remove cleanser and debris.
žExfoliation – Exfoliation may not be for all skin types, especially for clients with rosacea. However, it is useful for lifting debris and sebum from the outermost layer of the skin – the epidermis. Exfoliation can be conducted manually (with the hands) or mechanically (with an electric or battery operated facial brush).
ž 
žOther Important Skin Care Facts: Exfoliation, Accutane, and Retin A (35 Min.)
ž  In the skincare industry, there are some other important facts that beauty professionals and skincare specialists should be aware of. Exfoliation and skin cell turnover are important to understand “in theory” and “in practice.” Accutane and Retin A are also important to be aware of, because they could pose extreme contraindications towards your client’s skin. Below is a description of Exfoliation, Accutane, and Retin A.
ž  Exfoliation (20 Min.)
žWhen the skin exfoliates, various layers of the skin are removed.  Primarily, the stratum corneum, the outermost layer of the epidermis, is removed during exfoliation.  There are other layers of the skin that can be removed during exfoliation as well, but this removal may require a chemical peel within a physician’s or dermatologist’s office. Ultimately, with exfoliation, cell turn over and cell renewal are occurring, and it helps your client to have a more resilient, glowing, and newer skin.
žExfoliation is generally administered in three ways, which include:
¡Manual exfoliation
¡Mechanical exfoliation
¢Electric/mechanical brush
¢Microdermabrasion
¡Peels – chemical and enzyme peels (primarily).
ž 
žSteaming – Use distilled water for steaming if using a steam machine.  Make certain the steamer is not too hot and too close to your client’s face. You can also steam with hot steamed towels (make sure you check the temperature before applying to client’s face).   Don’t steam longer than 10 minutes.
ž FacialSteamer.jpg

ž 
žExtractions – Gerson (2004) describes the extraction process as “manually removing impurities and comedones . . . [which] helps unblock clogged areas and refines pores.” Exfoliation and/or steaming are imperative for an extraction to be carried out because it loosens debris from under the skin and makes the process more user-friendly.  You can use your fingers (gloves on), accompanied with dampened pads or you can use a State Board-approved extractor or lancet.
žMassage – Facial manipulations are applied with a massage cream (oil content or oil free, depending upon facial type) and are utilized with a technique similar to cleansing – upward and outward along the face, chin, and neck.
ž  
žThe Mask – The facial mask is important, because the type of mask is vital to your client’s skin type – which in-turn will provide the outcome of appropriate skincare choices by the cosmetologist or esthetician. Some general skin types to consider are:
žNormal
žOily
žDry
žCombination
žSensitive
žAcne-prone
žMature
žToner or Astringent – This process is good for protection from bacteria, and it helps to cleanse and tighten the skin before moisturizing.
žMoisturize  – A moisturizer with a sun screen will protect the skin from the elements and the sun rays when your client leaves. Serums and eye creams can be applied before the moisturizer as well.
ž  Post-facial consultation – After the facial is over, you can talk with your clients about their skin-type and preventative measures that may help their skin (sunscreen, monthly facials, eye cream, etc.).
žRetail Recommendation – You can suggest various skin care items that you used on your client; and they may purchase or order products from you or your salon.
žMake An Appointment – If your client is pleased, s/he may make another appointment. And/or they may want additional business cards to pass out to friends and family regarding your services.
 
žManual exfoliation involves the beauty professional (esthetician or cosmetologist) using her or his hands to exfoliate the skin.  A manual exfoliant can be a “scrub”, in which usually small granules are used for the face, and larger granules are used for the body. An example of facial scrubs used in manual exfoliation include: pumice (small granules from the pumice stone), oatmeal, almonds, sugar (very small granules), enzyme scrubs, and other types of exfoliating agents. An example of scrub products utilized for the body include sugar and sea salt scrubs.
žMechanical exfoliation represents the usage of either an electric scrub brush, or it can be as sophisticated as microdermabrasion.  Oftentimes, a professional mechanical scrub brush is attached to 9-in-1 and 13-in-1 facial machines; and traditionally, they are used for exfoliation during a facial. Microdermabrasion is another form of mechanical exfoliation, in which the top layer of the epidermis is exfoliated, and skin cell renewal takes place. Microdermabrasion is usually administered with a crystal flow machine, a diamond tip machine, or even pressurized water microdermabrasion machines.
žThere are also techniques of manual microdermabrasion as well. Some commercial skin care lines (that sell their products to the general public) produce microdermabrasion kits with a small electric wand that enhances the treatment.  However, this course section concentrates on mechanical microdermabrasion. Additionally, there are professional skincare companies within the beauty industry, that have “micro crystals” that can be applied manually to the face as well. 
ž  
žPeels can also be utilized during the exfoliation process, in which chemical and enzyme peels can be used to exfoliate the skin. Chemical peels are exfoliating agents that can exfoliate the stratum corneum within the epidermis, the outermost layer of the skin. Chemical peels can also loosen skin cells within the dermis, the “true skin layer.” Chemical peels are usually classified as either light, medium, or deep peels, and the light peels can usually be administered by a beauty professional. Light chemical peels include AHAs – Alpha Hydroxy Acids, or BHAs – Beta Hydroxy Acids. Examples of AHA peels include: glycolic, lactic, tartaric, fruit, and malic acid peels. Salicylic acid is used with BHA peels, and is the lone acid for BHAs. Trichloroacetic acid peels, or TCAs are considered medium peels; and Phenol or Carbolic acid is used for deep peels. Medium and deep peels should be administered only by a physician or dermatologist and make certain that you are aware of your State compliance rules for administering chemical peels.
žRetinoids: Accutane & Retin A (15 Min.)
žAccutane and Retin A, both also known as “Retinoids,” are widely used among skincare clients who may have a prescription from a dermatologist or physician. It is important to note that if your client is using Accutane or Retin A, then you should refrain from certain skincare services – such as the aforementioned chemical peels, microdermabrasion, and facials.  The reason refraining may be the best alternative, is because there may be too much abrasion and harm to the skin – and you don’t want to endanger your client’s skin. Hence, we as beauty professionals and skincare specialists are not medical professionals; but asking your clients during client consultation whether or not they are using Accutane or Retin A is a must.
 
žTraditionally, if your client has received a prescription from a dermatologist, physician, or medical professional that contains Accutane or Retin A, you should suggest that your client obtains a permission letter from the medical professional, regarding when s/he can receive skincare treatments.
ž  Accutane
ž  Accutane is also known as Isotretinoin, and it is an oral medication utilized for acne treatment. Accutane is also a part of the Retinoid family, which is a derivative of Vitamin A. Accutane has properties that allow the reduction of the sebaceous glands – which produce sebum, or the natural oils of our skin. Accutane also aids in the dead skin cells not being as “sticky,” which helps with the reduction of comedones – also known as blackheads and whiteheads. Those who take accutane may take it for several months (4-5 months for example), and the length of the treatment is determined by a dermatologist.
ž  Retin A/Retinol
ž  Retin A, or Retinol is a topical prescribed medication that is also a derivative of Vitamin A. Retin A/Retinol also treats comedones (blackheads and whiteheads), and aids in the cell turnover rate, but allows the dead skin cells, sebum, and other particles in the hair follicles to exit the surface of the skin. Because Retin A/Retinol increases the skin cell turnover rate, the skin may experience flaking and dryness. Therefore, it can be a deterrent to using, because of the side effects. However, it does take time for Retin A/Retinol to show results (such as 6-9 weeks), and persons may be prescribed to take Retin A for several months.
ž Client Consultation (15 Min.)
žClient consultation is one of the more important components of the beauty industry as a whole.  It is important to talk with your client to understand various medical, lifestyle, and environmental aspects of her or his everyday life. Although licensed beauty professionals are not medical professionals; [in comparison] in the medical profession, your doctor or nurse would ask you questions about your health. And in the beauty profession, as you use different chemicals and compounds, and you too should ask your clients about their health as well. This is for the betterment of your client’s experience, and it also helps you to be a responsible beauty industry professional in using your best judgment regarding a particular client.
ž  From a medical perspective, various questions should include (but are not limited to):
žAre there any present medical conditions that your client may have – such as diabetes, high blood pressure, seizures, etc.?
žAre there any past medical conditions that your client would like to make you aware of – such as skin cancer, previous surgeries, shingles, etc.?
žAre there any medications that your client is taking – such as skin care medications including accutane or retinol products; heart medication, birth control, and other medications?
žIs your client pregnant?
žDoes your client have any allergies?
žHas your client had any previous skincare services (such as chemical peels, facials, or microdermabrasion)? – If so, what type of skincare service have they had and how many sessions?
žWhat type of skincare products does your client use and what type of regimen do they have (such as daily use of cleansers, moisturizers, and toners; weekly use of masks; bi-weekly use of exfoliants, etc.)?
 
žFrom a lifestyle perspective, you may want to ask some of the following questions:
žDoes your client smoke?
žWhat type of diet does your client have (beverages, foods, and dietary supplements)?
žDoes your client exercise?
žDoes your client experience fatigue?
žVarious environmental questions can include:
žDoes your client’s work environment affect her or his skin? – Such as in a manufacturing plant, where there may be dust particles in the air;
žDoes your client live where there may be a high density of smog?
žIs your client exposed to second-hand smoke at home or on the job?
žIt is also important to ask your client: “What are your client’s overall goals for the health and betterment of her or his skin?”  - It’s always good to know what your client’s needs and goals are, regarding the overall appearance of her or his skin.  Communicating these goals are key during the client consultation process.
žSome of the aforementioned questions may affect the skincare service directly or
žin-directly; and some of these questions might not affect the skincare service process at all.  However, it is important to know as many factors as you can, that might better your knowledge of your clients, and their overall health and lifestyle. It could also help your client as well – because you will have to make choices upon what type of skincare service to use, as well as the selections of skincare products and ultimately – you want the best results possible.
 
žSanitation (20 Min.)
žPre-Service Set Up
ž  The pre-service set up for skincare services is important, and traditionally, the skincare service room is often referred to as the “treatment room.” The skincare treatment room will need either a spa chair or spa table for the client to lie down or to sit while leaned back. There are also supplies, equipment, product, and disposable items that will be needed, and sanitation is also very important for your treatment room setting. Preparation before your skincare service is key, and if your product, supplies and equipment are in place – then it makes a more user-friendly transition for your skincare service. You as the Skincare Professional will feel more comfortable, as well as your client.  Ultimately, if your treatment room is well sanitized, you will also aid in protecting the overall health and safety of your client.
ž  Sanitation
žSanitation is very important in a salon setting.  State Boards and regulatory agencies are very stringent on making certain that professionals in the beauty industry use precaution in regard to cleanliness and sanitary salon and spa environments. It is an overall goal of making sure that there is control of contamination upon all levels in the salon setting.  Ultimately, if something is soiled, tainted, or infected – it can be considered contaminated. Therefore, decontamination is imperative for a safe, healthy salon environment.
žPathogens are disease-causing microorganisms that cause contamination.  In order to control pathogens, surfaces (living or non-living) and implements must be decontaminated.
žThere are three (3) types of decontamination which include sterilization, disinfection, and sanitation.
 
žSterilization – This is the very highest level of decontamination, and it is mostly associated with hospital-grade decontamination.  The sterilization process destroys all living organisms related to a surface or an object. However, the chemicals, products, and processes utilized in sterilization are not appropriate for salon settings.  They are not appropriate because there are dangers involved and the chemicals could damage skin and cause harm to your eyes, and the like. Therefore, sterilization is [again] not appropriate for the salon and spa settings.
žDisinfection – This process is the second highest level of decontamination, because it controls microorganisms that grow on various implements used in the salon setting such as metal extractors – which are known as “non-living surfaces.” The chemical products used in disinfection often have strong chemical properties and need to be used safely. Therefore, you must follow safety rules documented by the manufacturer of the disinfectant product. Safety rules are published on the Material Safety Data Sheet, or the – “MSDS.”
žIn the salon setting, the disinfection: of bacteria, viruses, and fungus are crucial.  Therefore, EPA-registered, hospital-level disinfectants must be bactericidal, virucidal, tuberculocidal, and fungicidal. The EPA stands for the United States Environmental Protection Agency, and their primary mission is to: “. . . protect human health and the environment . . .” and to “. . . lead the nation's environmental science, research, education and assessment efforts.” Concerning skincare procedures - disinfection is key for the overall health and safety of client; the esthetician or cosmetologist; the salon equipment and tools; and the salon and spa environment overall.
 
žSanitation is the lowest level of decontamination in the salon setting, however, it is still very important. Sanitation can help to reduce pathogens on living and non-living surfaces: such as your hands (living) and your salon floor (non-living). If you are using an antiseptic on your hands - that is an example of sanitation. If you are washing your towels and linens - that is a form of sanitation (as long as the water temperature is appropriate according to State Board regulatory standards). If you are sweeping the floor - that is a form of sanitation.  Therefore, sanitation is important as well; and can oftentimes be associated with the daily cleaning routine of a salon. Please make sure that you follow sanitation rules and guidelines, according to your State Board rules, regulations, and standards.
žMODULE  VII: COURSE CONCLUSION (5 Min.)
ž  In conclusion, the overall goal of “All About Skin: A n 8-Hour Guide For Cosmetologists,” is to: (1) broaden the scope of knowledge regarding the skincare and the beauty industry; (2) to offer strategies upon how Cosmetologists can enhance their careers and finances by offering skincare services; (3) to enhance the learning of the skin’s anatomy and its functions; (4) to educate regarding the sun, the rays of the sun, and how to protect the skin; (5) to address various skin types, and how to familiarize yourself with your clients’ various skincare needs; (6) to identify different skin disorders and diseases; (7) to discuss various skincare services that are highly requested in the beauty industry; (8) to highlight client consultation needs and offer an example of different client consultation questions; (9) to discuss the importance of sanitation and skincare; and (10) to overall empower Cosmetologists regarding the skincare industry, and ultimately – to promote continued education and best practices within the skincare field.
 
žThis course contained detailed information about the sun and how it affects the skin; as well as UVA and UVB rays; and how the skin’s SPF – or sun protection factor has vital importance in the skincare industry. This course also discussed in detail various skin types –and ultimately, as a skincare professional, you have to be aware of various skin types, and how to analyze your client’s skin to the best of your ability.  This course also discussed side effects and contraindications of the skin, and how to make certain that your client consultation includes questions regarding the health, skincare practices, and the lifestyle (such as diet, exercise, nutrition) of your client.
ž  Upon your successful completion of this 8 hr. online course, please be encouraged to broaden your skincare knowledge base within theoretical and practical means.  From a theoretical perspective – reading and researching within the esthetics and skincare field is very empowering and informative.  Additionally, participating in various face-to-face and online continuing education courses can assist you as well.  Hands-on courses are also key, because they offer you more visual advantages and provide a more humanistic approach to skincare within the beauty industry. There are also several international, national, and regional product lines that offer esthetics education as well.
ž  Ultimately, with the Cosmetology license – “the sky is the limit” within the beauty and skincare industry! Continue to embrace your knowledge, skills, and abilities – and continue to grow and expand your talents in the beauty, cosmetology, and skin care industries. 
ž 
žCitations/Bibliography
žBrannon, M.D., Heather. Preventing Wrinkles With Sunscreen. About.com: Dermatology. July 26, 2008.
žBrannon, M.D., Heather. UVB Radiation. About.com: Dermatology. August 27, 2006.
žBrannon, M.D., Heather. Alpha Hydroxy Acids/Beta Hydroxy Acids. About.com: Dermatology. March 23, 2007.
žDermatology Times. Dermatologic Cosmetic Laboratories. P. 146. March 2006.
žFacial Plastic Surgery.net. Chemical Peels. 2009.
žFacial Skin Rejuvenation. The American Academy of Dermatology. 2006.
žFoltz-Gray, Dorothy. A Beginner’s Guide to Facial Peels. Health (Time Inc.). Vol. 11, Issue 7, p. 42. October 1997.
žGalan, Nicole. Hirsutism in Women. About.Com/Dermatology. May 2009.
žGalan, Nicole. Skin Disorders. About.Com/Dermatology. 2009.
žGershon, J. Milady’s Standard Fundamentals for Estheticians. Thompson-Delmar Learning. 2004.
žGuttman, C. Citric Acid Formations Enhance Glycolic Peels. Cosmetic Dermatology/ Dermatology Times. June 1, 2005.
žGuttman, C. Choice of Peeling Agent Depends on Patient Characteristics. Cosmetic Surgery Times. March 2003.
žLaing, J. The Peel Deal. Women’s Wear Daily/Beauty Biz. Vol. 189, Issue 51, p. 14. 2005.
žKotter, M.D., Robert. Peels, Lasers and Microdermabrasion? Which is Best? WebMD. March 25, 2008.
žLee, John B. National Accrediting Commission of Cosmetology Arts and Sciences (NACCAS). 2007.
žModern Medicine/Cosmetic Surgery Times. Chemical Peel. November 12, 2008.
žNorth Carolina State Board of Cosmetic Art Examiners (2009, 2010). Raleigh , NC.
žOliveri, C. Nutraceuticals, Phytochemicals, and Antioxidants – What are They All About?. Ohio State University Extension. 2000.
žPearl, Nicole. Amazing Skin in Your 30s, 40s and 50s: Who Needs Extreme Measures? Health.com. June 2007.
žRowland, Terri. The Salon Spa Training Institute. Durham, NC. 2009-2010.
žSavardekar, Preeti. Microdermabrasion. The Indian Journal of Dermatology. December 2007.
žSharquie, K. et al. Latic Acid as a New Therapeutic Peeling Agent in Melasma. Dermatologic Surgery. Vol. 31., Issue 2. February 2005.
žUnited States Bureau of Labor Statistics, Washington, D.C. (2005-2010).
žWeb Citations
ž 
THE END OF COURSE EXAM IS BELOW
 
žYou have up to 2 hours to complete your exam. If you finish within 2 hours, you will not be penalized.
žPlease answer each question to the best of your ability.
žAfter you complete your exam, you will be emailed a course completion certificate within one business day.
žUpon receipt of your exam and course payment - your course completion certificate and test results will be emailed to you the same business day (if your test is submitted after 7:00 p.m. EST, you should receive your results no later than the next business day.
žWe hope you enjoyed your online course!
           

END OF COURSE EXAM - Please answer each question below, and submit your contact information as well (contact information must be included for exam submittal). Thank you.

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1. The skin is the largest ordan of the body. 

  2. There are over 1.6 million beauty professionals that work in the United States.
3. Nearly 74% of beauty professionals are Cosmetologists.  
4. In many States, including Nevada and North Carolina, Cosmetology licenses allow the Cosmetologists to administer esthetics-related skincare services.
5. Cells create tissues, but tissues to not join together to create organs.
6. Nerve tissues bind and support parts of the body such as: ligaments, cartilage, and fat tissues.
7. The lung is the largest gland in the body and is known for secreting bile.
8. The circulatory system is responsible for the supply of the blood. This system circulates blood and lymph, and works with blood, blood vessels, and lymphatics.
 
9. The Excretory system is responsible for waste elimination from the body via excretion. Examples of excretion include urine and sweat.
10. The dermis is the layer of the skin, in which beauty professionals can work with - without the direction of a physician.
11. The epidermis is known as the "outermost layer of the skin," and is also a very thin layer of the skin.
12. The first layer of the epidermis, the Stratum Germinativum, contains only a single layer of cells. Melanin, which is responsible for pigmentation in the skin, is located in the stratum germinativum.
13. The Stratum Corneum represents the top layer of the dermis, and this layer is most exposed to the elements such as the sun, pollution, smoke, topical products, etc.
14. The Dermis is often referred to as the "true skin."
15. The papillary layer provides connectivity between the dermis and the epidermis. This layer receives its "papi" prefix from the "papillae" - a group of connective tissues that provide nourishment in the hair follicle (dermal papillae).
16. Collagen only represents 25% of the dermis.
17. Ultimately, when one's skin does begin to deteriorate, it can be associated with a term entitled "free radicals." Free radicals represent damaged molecules that in turn damage cells.

18. From an external perspective, various environmental causes can affect the overall health and appearance of the skin, such as: the rays from the Sun and sun damage; pollution; smoke; weather; and the like.
19. A person's diet, health, nutrition, and skin care regimen does not have any effect upon the overall health of one's skin.
20. The glow, elasticity and overall health and appearance of the skin will not be affected if there is a slow cell renewal.
21. Hyaluronic acid, a natural acid within the body, plays a major part in the esthetics field. Hyaluronic acid assists with hydration, and produces fluids that are between various proteins and fibers.
22. The sun is one of the primary causes of aging prematurely, wrinkles, skin damage, and skin cancer. The sun can also affect the hydration of the skin, as it will absorb the natural hydrants from the skin and body.
23. If a person has had exposure of rays from the sun overtime, it is predicted that by age 9, the majority of sun damage has already taken place.
24. Even the color of one's clothing, and the coverage of a hat or clothing over their bodies can make a great difference in regard to sun protection.
25. UVA rays are known to tan the skin and to affect the epidermis, and they are also known as "shorter rays."
26. UVB radiation has long been known to damage the skin, and these rays can be very potent during the daytime, especially between 10:00 a.m. - 2:00 p.m. At this time, the sun is known to have the most exposure.
27. Sunscreen is a topical product that has a potency level called "SPF" - better known as the Sun Protection Factor.  The SPF can be as low as 1, to 8, 15, 25, 45, and even greater - and the greater the SPF, the more protection the skin will receive.
28. pH balance stands for "potential harm," towards the skin.
29.  The skin's normal pH acid balance - is 5.5 However, there are certain skincare services that can alter the skin's pH level.
30.  Side effects represent things that can happen to your client's skin after a skincare procedure (such as redness, irritation, itching, burning, dryness and the like).
31. Combination Skin represents . . . usually a person not experiencing as many acne break outs; s/he may not have oily blotches and complication due to oily skin; and itching and redness may not be as common as well.
32. Moisturizing a person with dry skin in not a good idea, because you want to continue to deprive the person's skin of moisture, so their skin will not become too oily.
33. Oil within our bodies comes from sebum, which derives from the sebaceous glands. The sebaceous glands produce oil that lubricates within our bodies - primarily on the facial portion of the skin and the scalp and hair.


34. Side effects of having sensitive skin can include: redness, irritation, and burning.

35. When sebum/oil comes to the surface of the skin, along with dead skin cell debris - it can create blackheads and whiteheads, which are traditionally known as comedones.

36. Whiteheads and milia are oftentimes referred to as open comedones.

37. When "allergens" come in contact with the skin - this can cause an allergic reaction, such as the Allergic Contact Dermatitis reaction.
38. Eczema represents a hypersensitive reaction toward the skin - in which the skin may be inflamed and/or have a rash. Eczema is also known as "Atopic Dermatitis," and the skin is affected by the immune system and the outer surface of the skin may also experience inflammation as well.
39. Hypopigmentation represents portions of the skin appearing darker in comparison to rest of the skin.
40. Melasma, is also referred to as the "Pregnancy Mask" and only women can have melasma.

41. Chemical peels are known as a non-invasive treatment, and they are also referred to as "derma-peeling."

42. Licensed Cosmetologists and Estheticians should only work with Light Chemical Peels, which include AHA and BHA peels.

43. Microdermabrasion should only be performed manually, in which there is no formal machine that is used for the microdermabrasion procedure.
44. Clients may have a series of Microdermabrasion treatments, which may include 8-12 treatments every 4-5 days.

45. When performing a facial, it should be noted that your client may have combination skin, in which you may have to use different products to accomodate different types of skin your client may have.
46. Before performing a skincare procedure, client consultation is important - so the beauty professional can be aware of the client's skincare needs, as well as issues regarding side effects, and contraindications.
47. Exfoliation is not an important process of cell renewal and cell turnover.

48. Accutane is also known as Isotretinoin, and it is an oral medication utilized for acne treatment.

49. Retin A/Retinol also treats comedones (blackheads and whiteheads), and aids in the cell turnover rate - by allowing the dead skin cells, sebum, and other particles in the hair follicles to exit the surface of the skin.

50. In the salon setting, the disinfection of bacteria, viruses, and fungus are crucial. Therefore, EPA registered, hospital-level disinfection is used to disinfect by killing bactericides, viricides, and fungicides. 

END OF EXAM.

You may now submit your exam by clicking the "Submit Exam" button (below left). Your test results and course completion certificate will be emailed to you the same business day. If your test is submitted after 7:00 p.m. EST, your results and completion certificate will be emailed to you the next business day. Please make sure you have included your name, license type, State where licensed, license number, email address, and phone number with the submittal of your exam. Thank you for choosing The Salon Spa Training Institute as your Continuing Education Course Provider! 

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