Chapter 3: consultation Flashcards
How to prepare for a consultation:
Block a 30 min time slot for the client
Forms: health history, consent, skin typing chart
Have the client fill out these forms to determine their candidacy and to prepare them for a comfortable experience
What is the purpose of the consultation?
To discuss why the patient is seeking treatment
to understand clients expectations
To discuss treatment conditions, indications and contraindications, side effects and realistic expectations
Absolute contraindications
Pacemaker
Metal plates or implants in tx area
Skin cancer (past/present)
Precancerous lesions
Heart disease
Pregnancy/breast feeding
Topical use of acids, bleaching agents, retin A, etc.
Immune depressants
Photosensitive medications
HIV
Immunosuppressive conditions
White hair
Light induced diseases (epilepsy, etc)
Herpes
Skin diseases (psoriasis, eczema, etc)
Rosacea/ acne
Keloid scar
Dry/ sensitive skin
Retinoids (topical & oral)
Steroids
Bleeding/ hemorrhages
Tanned skin
Tattoo
Fertility treatments
Relative contraindications
Non skin cancer (past) Hormonal changes or imbalances  Blood pressure problems Coagulation problems Liver and kidney disease Arthritis Herpes Endocrine diseases Menstrual cycle Antibiotics during 3 previous weeks Antidepressants Anemia Fractures Respiratory problems Epilepsy connective and muscular tissue diseases Surgical tx within 2 months Deep to moderate chemic peel within 3 months
3 things when a physicians reference is needed
- The patients specific medical condition
- The specific intended treatment
- The physicians permission to perform the treatment related to be patients medical condition
How should you take before/ after photographs?
Should always be taken before this first session, and after the last one
Important things to communicate with client about IPL/ LHR
Patients with a history of herpes simplex should get preventative medication by a physician prior to the treatment
Texture of skin may change (improve) @ pigmentation of the skin may become more universal
Transient erythema (redness) and edema (swelling) may appear after treatment
The tx may be discomforting and painful
The therapy series is consisted of several treatments over a period of time (usually several months)
If there is hair in Tx area; it must be shaved

What do we use to determine skintype?
Fitzpatrick skin type chart
If a client has pigmentation or hair follicles that are very dense and dark in colour it may be wise to treat the skin according to damage as the light energy may be absorbed rapidly.. wdyd?
Treat the client as a skin type darker
How do you perform a skin test
Select Fitzpatrick I-V classification, hair melanin concentration, and body area
Choose low visibility area with similar sun exposure
Shave the area to avoid burns
Clean tx area (not with alcohol)
Select parameters for test
Accommodate wavelength, hair type, skin type, pulse duration(msec), Fluence (j/cm2)
How many joules should you increase at a time
Only by 1 j/cm2
Skin test: SR immediate responses
Textural: stinging sensation while pulse is emitted
Pigmented lesion: immediate darkening
Slight erythema, warm sensation
Skin test HR immediate responses
Smell of burnt hair
Stinging sensation
Redness skin types 1-3
Mild erythema
Mild peri follicular edema
Skin test VP
Immediate response
Vascular lesion: darkening/ brightening
Pigmented lesion: darkening
What are other side effects we should be mindful of
Discomfort; stinging; burning up to 1 hour post tx
Change of colour (pigmentation)
- most cases of hypo/hyperpigmentation occurs on darker skin
Fragile skin
Purpura (purple bruise) - may appear 5-15days
Scarring (rare)
