Skin Health Flashcards
1
Q
What factors influence skin health and aging?
A
Heredity, sun exposure, the environment, health habits, and general lifestyles.
2
Q
Explain the immune system and skin
A
Our immune system is a complex defence mechanism that protects the body from foreign substances.
The immune system is activated when antigens (foreign invaders) are identified.
Antibodies are molecules formed to fight and neutralize bacteria.
Langerhans cells, leukocytes, and T cells are all part of the immune system
3
Q
Which cells are part of the immune system?
A
Langerhans cells and leukocyte cells & T cells
4
Q
What are t-cells responsible for?
A
T-cells identify molecules that have foreign peptides and also help regulate immune response.
Think of how drinking tea can help regulate your immune response.
5
Q
What are leukocytes & what are they responsible for?
A
Leukocytes are white blood cells that have enzymes that digest and kill bacteria and parasites. They also respond to allergies.
6
Q
Which fluids nourish the skin?
A
Blood and lymph
7
Q
What do arteries and lymphatic do?
A
They send essential materials for growth and repair throughout the body.
Networks of arteries and lymph vessels in the subcutaneous tissue send their smaller branches up to dermal papillae, follicles, and skin glands.
8
Q
What does the health of the skin depend on?
A
The cellular membrane and the water holding capacity of the stratum corneum.
9
Q
Give examples of lipids found in the stratum corneum and cell membranes.
A
Phospholipids Glycolipids Cholesterol Triglycerides Waxes
10
Q
What are ceramides?
A
Ceramides are a group of waxy lipid molecules important to barrier functioning and water-holding capacity such as glycolipids.
Topical products containing ceramides and other lipids benefit wrinkled skin and expedite healing.
11
Q
Cell recovery depends on:
A
Water
12
Q
Cell replacement:
A
Regular cell turnover is necessary to keep the skin healthy.
Organs such as the skin, heart, liver, and kidney have their cells replaced every 6 to 9 months.
Cells of the bones are replaced every 7 years.
Elastin and collagen are not easily replaced by the body and the skin does not regain its once pliable shape after being stretched or damaged by UV.
Vitamin A and alpha hydroxyl acids (AHA’s) stimulate cell turnover and reduce visible signs of aging.
13
Q
Damaged tissues can be repairs in two ways:
A
- Regeneration
2. Fibrosis
14
Q
Regeneration:
A
The replacement of dead or damaged cells by the same type of cells as before.
Most skin injuries such as cuts or burns heal by regeneration
15
Q
Fibrosis:
A
The replacement of damaged tissue with scar tissue.
Scar tissue is composed of collagen produced by fibroblasts.
Scar tissues hold an organ together but do not restore normal function.
(E.x healing of a sever cut)
16
Q
Sun damage:
A
The sun and UV have the greatest impact on how the skin ages.
80-85% of aging is caused by sun exposure.
As we age, collagen and elastin weakens but it happens at a faster rate when the skin is exposed to UV.
17
Q
UV reaches the skin in two different forms:
A
UVA and UVB radiation
18
Q
What may be the results from exposure to UV?
A
Pigment dysfunction, wrinkles, sagging, breakdown of collagen and elastin, and skin cancer.
19
Q
UVA Radiation
A
Known as aging rays
The longer wavelengths of UVA (320-400 nanometers) penetrate deep in the skin and cause genetic damage and cell death.
UVA Weakens the skins collagen and elastin fibres causing wrinkles and sagging in the tissues.
UVA is present all year and more prevalent than UVB
UVA can pass through glass windows or car windshields
20
Q
UVB Radiation
A
Known as burning rays
Cause burning of the skin, tanning, aging, and cancer.
Stronger and more damaging to the skin and eyes compared to UVA
Contributes to the body’s synthesis of vitamin D
Melanin is designed to help protect the skin from the suns UV radiation, but melanin can be altered or destroyed when UV penetrates the skin
21
Q
What is free radical damage
A
Free radicals are chemically active atoms or molecules with unpaired electrons
(They have an uneven number of electrons and unbalanced electrical charge)
They steal electrons from other molecules which leaves them damaged.
When these molecules take electrons from compounds from the body such as proteins, lipids or DNA, this destabilizes and oxidizes the once healthy molecules and creates more free radicals.
It’s a chain reaction of cellular destruction
Free radicals are generated by many factors such as exposure to UV, unhealthy foods, chemicals, smoke and trauma from medical treatments
Red and inflamed skin is a sign of free radical damage
22
Q
What does the melanin pigment do?
A
Absorbs UV to help keep cells from being damaged
23
Q
Antioxidants
A
Vital to neutralize the chain reaction by donating their electrons to stabilize the free radical electrons.
Protein, enzymes and vitamins are all antioxidants.
24
Q
What does nicotine in tobacco cause?
A
Weakening of the blood vessels and small capillaries that supply blood to the tissues, causing decreased circulation.
The tissues are deprived of essential oxygen and the skin may appear yellow, grey, or dull.
Lack of oxygen and nutrients accelerates aging
25
How does prescription or illegal drugs affect the skin?
Oxygen deprivation, dryness, allergic reaction
Some drugs can aggravate acne
26
How does alcohol effect the skin?
Alcohol dilates blood vessels and capillaries. This may cause the capillary wall to expand and burst.
This causes a constant flush appearance.
- dries out the skin by drawing essential water out of the tissue
- skin may appear dull and dry
- excess alcohol results in increased blood sugar and glycation reaction
- alcohol is metabolized by the liver into chemicals which are toxic to cells
27
Glycation
A destructive process caused by elevation in blood sugar
Glycation is the binding of a protein molecule to a glucose molecule resulting in the formation of damaged, non-functioning structures and decrease biological activity.
This results in damaged, non-functioning structures called Advanced Glycation End (AGE’s)
Glycation contributes to aging of the skin, wrinkles, and age spots
Many age related diseases are due to glycation
Anything that causes a rise in blood sugar results in inflammation
The sugar attaches to collagen making skin inflexible and saggy
28
What are the negative side effects of the hormone cortisol
Breaks down muscle tissue, thin skin, decalcify bones, elevate blood sugar
29
What are hormones
Internal messengers for most of the body’s systems and are significant internal factors in the skins appearance, strength and health.
30
Estrogen
A hormone crucial for good health and appearance of the skin.
It is a anti-inflammatory, antioxidant and a key factor in tissue repair.
Maintains coordination, balance, skin moisture, vision, bones, and nervous system.
31
Which hormone effects the skin most during puberty?
Androgen
Androgen stimulates the sebaceous glands to produce sebum which causes follicles to dilate and the scalp to become oilier.
This is when pores become more visible
32
Keratosis Pilaris
| Another problem associated with puberty
Appears as small pinpoint bumps (usually found on cheeks and the upper arms) accompanied by redness
In this condition, the androgens have affected the growth of terminal/ lanugo hairs which have started growing but aren’t strong enough to push though the follicle opening.
The hair remains trapped inside and irritate the follicle and skin.
Remedies: lotions containing AHA’s such as glycolic and lactic acid may help clear the bumpy appearance.
33
Pregnancy and hormones
An increase in blood flow and blood pressure during pregnancy may lead to the development of telangiectasia or small red enlarged capillaries on the face and body.
Pregnant women may also experience increased oiliness.
Other causes of telangiectasia on the skin are hereditary, alimentary (digestive), alcohol, smoking, sun damage, harsh cosmetics, trauma, excess localized heat, topical corticosteroids, inflammation, and heat/ cold fluctuations. These all lead to permanent dilation of capillaries.
34
Menopause
During menopause the skin thins and changes which affects the skins protective barrier, epidermis and dermis.
As skin ages, vascular and capillary walls begin to weaken, lipids are reduced, lymphatic system is less efficient, glands slow down, and there are fewer fibroblasts, this affecting cells, collagen, and elastin. 
As estrogen is depleted, skin begins to lose its tone = less moisture less melanocytes activity and cellular exchange is reduced.
Testosterone level increases as estrogen decreases which causes more oil and hair growth on the face.
35
Rashes and lesions
- may range in size from a fraction of a millimetre to many centimetres
- may be blanches (white), erythematous (reddened), purpuric (containing blood) or pigmented
36
What is Pruritus?
The sensation of itching which is a symptom to many skin disorders
37
Rashes
Rashes are temporary eruptions of the skin
Disorders that produce rashes: measles, heat, diaper rash, allergic reactions, etc
38
Lesions
Are structural changes in the tissues caused by damage or injury like an abrasion.
There are three types of lesions
Primary, secondary and tertiary (or vascular)
39
What are primary lesions
primary Lesions
- in the early stages of development
- change in colour or texture either present at birth or acquired over time such as birth mark or age spot
Examples:
Bulla, cyst, macular, nodule, papule, pustule, tubercle, tumor, vesicle, wheal
Bill can’t make noodles but, Peter Pan throws tomatoes well
40
What is a bulla
A large blister containing watery fluid
41
What is a cyst
A closed abnormally developed sac containing fluid, infection, or other matter above or below the skin.
An acne cyst is one type of cyst.
42
Macule
A flat spot or discolouration on the skin
| Ex. Freckle, or red spot left after a pimple has healed
43
Nodule
Often referred to as a tumour
Smaller bumps caused by scar tissue, fatty deposits or infection
44
Papule
A small elevation on the skin that contains no fluid, but may develop into a pustule.
Less than 1/2 an inch in diameter and may vary in colour and is either rounds, smooth or rough.
45
Pustule
An inflamed papule with a white or yellow centre containing pus
Pus( white blood cells, bacteria and debris)
46
Tubercle
Larger than a Papule
An abnormal rounded solid lump
47
Tumour
A large nodule
Abnormal cell mass resulting from excessive cell manipulation
48
Vesicle
A small blister or sac containing clear fluid
Poison ivy and poison oak produce vesicle
49
Wheal
An itchy, swollen lesion caused by an insect bite, skin allergy reaction or sting.
(Hives and mosquito bites are wheals)
50
What is another term for hives?
Urticaria
Which can also be caused by exposure to allergens in products
51
Secondary lesions
Develop in later stages of disease and change the structure of tissue and organs
Examples:
Crust, Excoriation, fissures, keloids, scales, scar, ulcers
Crust: Dead cells formed over a wound while it is healing resulting in an accumulation of pus and sebum
Excoriation: A skin sore or abrasion produced by scratching or scraping
Fissure: A crack in the skin that penetrates the dermis example chapped lips
Keloids: abnormal formation of scar tissue resulting from excessive growth of fibrous tissues and collagen
Scales: flaky skin cells for example excessive dandruff
Scars: light coloured slightly raised marks on the skin formed after injury of the skin
Ulcers: an open lesion on the skin or mucous membrane of the body filled with pus

52
Abnormal pigmentation is called
| And what causes it?
Dyschromia
This is caused by many internal and external factors, sun exposure being the biggest external cause
Drugs may be another cause
53
What is Hypopigmentation?
A lack of pigment
54
Vitiligo
- white patches on the skin which vary in size
- vitiligo is an acquired condition
- the spots are caused from a lack of pigment cells
- common on the face, axillae, neck, hands and feet
- these areas burn easily and enlarge over time
- an autoimmune disorder causing an absence of melanocytes
- no pain or other symptoms
- appears at any age but commonly in 20’s or 30’s
55
Albinism
- lack of pigmentation in the skin, hair, and iris of the eye
- a congenital disorder in which there a normal number of melanocytes but they lack the enzyme tyrosinase needed to produce melanin
- the individual may have pale or pink skin, white or yellow hair, and light coloured or pink eyes
- ocular problems such as sensitivity to light and other vision problems are common
- treatments are aimed to reduce risk of cancer through protection from the sun
56
Hyperpigmentation
An overproduction of pigment
Increased melanin causes excess pigment
Sun exposure, acne, medications, and post inflammatory hyperpigmentation from skin damage can cause darkened pigmentation
57
Melasma(chloasma)
- darkened macules on the face
- triggered by hormonal changes
- most prominent in darker skins
- more common in women, especially during pregnancy, while using oral contraceptives or menopause
- may or may not resolve after giving birth or discontinuing birth control
- worsened by sun exposure
- treatment involves sun protection and bleaching agents
58
What is a tan or sunburn and what are the symptoms?
A change in pigmentation due to melanin production as a defence against UV rays
```
Mild = redness
Severe = vesicle eruption, weakness, chills, fever, fatigue and pain
```
Black skin may also burn and may appear more greyish
Essentially a tan is visible skin and cell damage
59
Lentigines (lentigo)
Brown or black spots that are flat and found in sun-exposed areas
A cosmetic concern only
If they change, grow or develop a darker centre, it may become malignant
Lentigines that result from sunlight exposure are also called actinic or solar Lentigines.
Also referred to as age spots or liver spots
60
Stain
Brown or wine coloured skin discolouration with a circular or irregular shape.
Usually round or oval, tan, brown or black
Often develops on sun exposed areas
61
What are Birthmarks
Congenital pigmented blemish or spot on the skin
Visible at birth or shortly after
Usually benign but may become cancerous
62
What are the different types of birthmarks
NCPHF
Nevi (Nevus) - abnormal pigmentation or dilated capillaries
Cafe au lait - flat, light brown
Port wine spots - flat, pink, red or purply/ red. They are formed by a collection of superficial capillaries
Haemangioma - raised, small and bright red. They are a group of superficial blood vessels with three stages
1. Proliferation 2. Rest 3. Involution (diminishes)
50% diminish by age 5, 90% diminish by age 10
Freckles - benign, small tan to brown spots occurring on sun exposed skin
- tend to fade in adult life
- The tendency to develop freckles is inherited & seen more in red haired people
63
Moles or nevi
Common congenital or acquired tumours of the skin that are benign almost all adults have moles.
Mole is a pigmented nevus; A brownish spot ranging in colour from tan to blueish black. Some are flat, others raised and darker.
Most are benign but changes in colour or shape should be checked by physicians. 
moles are common and should not be removed unless by physicians because it may irritate or cause structural changes to the mole 
64
Nevocellur nevi (mole)
Most moles are tan to deep brown, uniformly pigmented, small papules with well defined and rounded borders
These are not usually removed except for cosmetic reasons or if they are in an area which they become irritated
65
Dysplatic nevi (mole)
Larger than common moles with flat slightly raised Pebbly surface
Darker in the centre and an irregular border
Have the capacity to transform to malignant melanomas and tend to appear in families who are prone to them
These occur in sun exposed and covered areas of the body

66
What are hypertrophies of the skin
```
Abnormal growths Example:
Skin tags
Keratosis
keratosis pilaris
Actinic keratosis
Verruca
Hyper keratosis
```
67
Skin tag (hypertrophy)
Soft, brown or flesh coloured papules
They occur on any skin surface but most commonly the neck, axilla and face
Range in size from a pinhead to a pea
Normal texture of skin
Benign
More common as people age
68
Keratosis
Is a abnormally thick buildup of skin cells
Horny growth, wart-like lesions that have a stuck on appearance
Vary in size
69
Keratosis pilaris
Redness and bumps in the cheeks or upper arms
Caused by blocked follicles
Exfoliation can help unblock follicles and alleviate the roughness
70
Actinic keratosis
Pink or flesh coloured pre-cancerous lesions that feel sharp or rough
These result from sun damage and should be seen by a dermatologist
71
Verruca
Also known as a wart
A hypertrophy of the papillae of epidermis caused by a virus
Infectious and contagious and they can spread
Some have a black dot in the middle
72
Hyperkeratosis
Thickening of the skin caused by a mass of keratinocytes
73
Fungi
Plant-like organisms
Certain strains are considered part of the normal skin flora
Superficial infections invade only the superficial tissue (skin, hair, nails)
Deep infections invade the epidermis, dermis, and subcutaneous
74
What are some superficial fungal infections?
```
Tinea of the body of face
Athletes foot (tinea pedis)
Ringworm (tinea corporis)
Tinea of the scalp (tinea capitis)
Tinea versicolor (Pityriasis versicolor)
```
75
What is Tinea?
A fungal infection
This fungi feeds on proteins, carbs and lipids in the skin
Tinea of the body and face is most common in children
Spread by animals and children
Oval or circular patches
76
Athletes foot (Tinea Pedis)
A fungus that affects the feet
Ranges from mild to severe
Unpleasant odour
77
Ringworm (tinea corporis)
Highly contagious
Ringed red pattern with elevated edges
Affects the body or face
Most common in children
Transmission is commonly from kittens, puppies and children
78
Tinea of the scalp (Tinea capitis)
Superficial fungal infection of the scalp
Associated with white patches on the back of the head
Lesions may vary from greyish, round hairless patches to balding spots or black dots on the head
Mild redness, crust or scale may be present
Selenium sulphide shampoo can treat the condition
79
Tinea versicolor (pityriasis versicolor)
A fungal infection that Inhibits melanin production
Caused by yeast, not contagious
Characterized by white, brown or salmon coloured flaky patches from the yeast on the skin
Can be treated with anti fungal cream or medication
80
Impetigo (bacterial infection)
Common superficial bacterial infection
Most common in the summer or in warm, moist, climates
Appears as a small vesicle or large bulla on the body or face
As the lesion ruptures it leaves a denuded (stripped or bare) area that discharges a honey coloured liquid that hardens on the skin and dries as a crust with a “stuck on” appearance
New spores appear within hours
Extremely contagious
81
Viral infections
Warts/ verruca
Herpes simplex - type 1&2
Herpes zoster (shingles)
82
Warts or verruca
Common benign papillomas
A wart is an exaggeration of the normal skin structure with an irregular thickening
There are more than 50 types of HPV (
Human papilloma viruses) including skin warts and genital warts
Majority are found on hands & feet
83
Herpes simplex (viral infection)
Cold sore or fever blister
There are two type of herpes viruses that infect humans
Type 1: usually confined to the Oropharynx and is spread by respiratory droplets or contact with infected saliva. It is contagious
Type 2: is spread to other body parts and can cause genital herpes
Never work on a client with a current herpes lesion
Recurrences may be brought on by stress, sunlight, or injury
Individuals who are immune suppressed may have severe attacks
A recurrence usually begins with a Burning or tingling sensation
Vesicles and redness follow and progress to pastilles, ulcers and crusts.
The lesion is most common on the lips, mouth and face
84
Herpes zoster (shingles)
This is an acute local eruption distributed over a dermatome area of the skin (an area with nerves)
Chickenpox is a childhood disease caused by the virus
It is believed that a person who had chickenpox as a child carries the dominant virus in the nerve roots. When the adult is again exposed to the disease it reactivates the virus which appears as shingles
Onset is burning pain, tingling sensation, extreme sensitivity of the skin, and itching - this may be present for 1-3 days before a rash appears
The pain may be mistaken for heart disease (if on the chest) or stomach disorders
When the vesicles appear they are red, dry, form crusts and eventually fall off
Eye involvement can result in permanent blindness
After the rash has subsided, it can reoccur if the individual is stressed or fatigued
Can spread to people who are not immune
85
Name 5 Sebaceous gland disorders
```
Acne
Sebaceous cysts or Steatoma
Acne vulgaris
Acne conglobata
Acne rosacea (papulopustular)
```
86
What is acne?
Acne is a chronic inflammatory skin disorder of the sebaceous glands characterized by comedones and blemishes
In men, testicular androgens are the main stimulus for sebaceous activity
In women, adrenal and ovarian androgens maintain sebaceous activity
There are many types of acne, acne vulgaris being the most common
Inflammation of the sebaceous glands results from retained oil secretions, cells, and excessive Propionibacterium acne bacteria (p. Acne)
P. acnes is the scientific name of the bacterium that causes acne vulgaris
These bacteria are anaerobic, which means they cannot survive in the presence of oxygen
When the follicle is blocked from oxygen circulation, these bacteria multiply in great numbers, feeding off the sebum produced by overactive sebaceous glands
Acne ranges from mild breakouts to disfiguring cysts and scarring
Acne can be controlled with medication but they have side effects and treatments may be a long battle 
87
How many grades is acne broken down into? And explain.
4 grades
Grade 1. Minor breakout, mostly open comedones, some closed comedones, few papules
Grade 2. Many closed comedones, more open comedones, occasional papules and pustules
Grade 3. Red and inflamed, many comedones, papules and pustules
Grade 4. Cystic acne, cysts with comedones, papules, pustules, inflammation present. Scar formation from tissue damage is common
Physicians may prescribe medications to treat grade 3&4
88
Sebaceous cysts (steatoma)
Benign swelling beneath the skin and filled with material composed of sebum and epithelial debris
These cysts are mobile but attach to the skin by the remains of a sebaceous gland duct
Often become infected and need to be surgically removed
Cysts are found on the face, scalp, back and anywhere there are sebaceous ducts 
The client should see a doctor to ensure they are not tumours and if they are not infected or a concern they do not have to be removed 
89
Acne vulgaris
Most common during adolescence
There is a genetic predisposition to acne, and stress may be a factor
Many females experience a break out in the week before menstruation
Acne vulgaris is most common on the face and neck and to a lesser extent on the back, chest and shoulders.
Good hygiene is important
Contact with other surfaces such as hands, hats, sweatbands can lead to worsening of lesions
A balanced diet is recommended
90
Acne conglobata
Acne Conglobata is a chronic form of acne and occurs later in life
Comedones have multiple openings
Most commonly on the back, buttocks, and chest
Their discharge is odoriferous (unpleasant odour)
Healing leaves deep keloid scars
Affected people have anaemia with increased white blood count
91
Acne rosacea (papulopustular)
Rosacea is a vascular disorder, meaning it is related to blood vessels and circulation of the blood
Chronic congestion primarily on the cheeks and nose
Characterized by redness, comedones, papules, elevated areas, nodules, and in severe cases cysts
Often resembles acne but often there are no clogged pores or comedones present
92
Types & stages of rosacea
```
Non-permanent
Permanent
Acne rosacea
Rhinophyma
Ocular rosacea
Comedo (plural comedones)
```
RAPCON 
93
Non/ permanent rosacea
In the early stages of development there are repeated episodes of blushing
(Occurs before the age of 20)
This eventually becomes a permanent dark erythema (capillary congestion) on the nose and cheeks and sometimes extends to the forehead and the chin
2- permanent
94
Acne rosacea
Often resembles acne but these larger than normal pimples occur on the nose and upper cheeks
Redness in the skin around papules and pustules
There may be a dehydrated, crinkled appearance to the skin
Symptoms of burning and stinging may also be present
95
Rhinophyma (type of rosacea)
Rosacea may develop into an irregular bulbous thickening of the nose
Colour changes to purple red
Mistaken for signs of alcoholism
96
Ocular rosacea
Occurs in the eye and eyelids resulting in eye redness, swollen eyelids
They should avoid: heat, cold, sunlight, hot liquids, alcohol and highly seasoned foods
97
Comedo (plural comedones)
A comedone is a mass of hardened sebum and skin cells in a hair follicle
When the follicle fills with excess oil a blackhead is formed
Open comedones occur when the follicle is large enough to hold debris retained by the follicle
The ostium (opening) in these follicles is dilated by the mass of impaction, allowing the Comedo to push toward the surface opening - it is dark because it is exposed to oxygen and oxidation occurs
Closed comedones form  when the opening of the follicle is blocked with debris and white cells (whitehead)
98
Milia
Similar to whiteheads but they are hardened and closed over.
pale, slightly elevated papules, with no visible opening found under the surface of the skin (not in a pore)
These epidermal cysts are small, firm, white papules with sebum and dead cells
Milia are more common in dry skin types and may form after skin trauma, such as exposure to UV
Usually found are the eyes, cheeks, and forehead
Also caused by blocked follicular openings from thick moisturizers
99
Papules
A pimple
Small elevation that contains no fluid but may develop pus
When enough white blood cells arrive they may form a clump and rise to the surface, creating a pustule
Papule may hurt more than pustules because they are deeper in the skin - explains the soreness
100
Pustules
Raised, inflamed Papule with a white or yellow centre
Contains pus, fluid and bacteria produced by an infection (head of a pimple)
101
Nodules
Nodules are small bumps caused by scar tissue, fatty deposits, or infection
102
Sebaceous hyperplasia
Benign lesion frequently seen in oilier areas of the face
An overgrowth of sebaceous gland
Donut shape with sebaceous material in the centre
103
Causes of acne:
```
Genetics
Clogged follicles
Bacteria
Heat
Over cleansing
Self trauma excoriation
Nutrition and diet
Triggers include: hormones, stress, cosmetics, skin care products
```
104
Medication and treatments for acne
Antibiotics (tetracycline, erythromycin, tretinoin (retin A)
Actutane:
- Vitamin a derivative
- Dosage is according to weight, usually a five month treatment
- Skin and mucous membranes will be very dry
- avoid sun exposure 
- no waxing on the face
- only for resistant acne or acne rosacea
105
Which disorders cause inflammation of the skin?
Dermatitis
Eczema
Psoriasis
Urticaria
Inflammation m: UPED
106
What is dermatitis?
An inflammatory condition of the skin
| Various forms include lesions such as eczema, vesicles, or papules
107
What are the three main categories of dermatitis?
Atopic, contact, and seborrheic
108
Contact dermatitis
Inflammatory skin condition
Caused by an allergic reaction from contact with a substance or chemical/ irritant
Makeup, skin care products, detergents, dyes, fabrics, jewelry, plants can all cause red itchy skin
Allergies to red dyes and nickel are common
109
atopic dermatitis
Is a chronic, relapsing form of dermatitis
Irritants and allergens trigger reactions that include dry, cracking skin
The redness, itching, and dehydration of the dermatitis makes the condition worse
110
Seborrheic dermatitis
Recurring patches of white or yellowish inflammation often on the head, face, chest & back
Sometimes a chronic inflammation of the skin associated with oily skin and oily areas
One cause is an inflammation of sebaceous glands
This condition is sometimes treated with cortisone creams
Seborrheic dermatitis is also a common form of eczema
111
Eczema
Eczema is a common skin disorder that occurs into clinical forms, infantile and adult
Hypersensitivity reaction
Eczema is an inflammatory, painful, itching disease of the skin
Acute or chronic in nature with moist or dry lesions
Avoid contact and skin care treatment if a client has eczema
Usually family history of hay fever or asthma is associated with eczema
Eczema causes intense itching.
the infantile form shows vesicle formation, oozing and crusting.
Usually begins in the cheeks and made progress to scalp, arms, trunk and legs.
In adults it is often found on the hands, feet, elbows and knees
Care involves allergin control, moisturizing to control dryness, avoidance of soap, and topical medication 
112
Psoriasis
Psoriasis is a common popular squamous disease characterized by red, thickened plaques with an overlying silvery white scale
Caused by overproliferation of skin cells that replicate too fast
There is a hereditary factor and this is a chronic disease - thought to be an autoimmune disease
There are several types of psoriasis
May occur anywhere on the body but most often at the elbows, knees and scalp
Psoriasis is treated with topical medication such as corticosteroids and oral medication

113
Urticaria (hives)
Hives are characterized by red plaques called “wheals” that are accompanied by intense itching
Appears raised pink or red areas surrounded by a paler halo and blanch with pressure
Can occur on any skin surface and often involve the larynx, causing hoarseness or sore throat
Hives are caused by histamine release which causes hyper permeability of the vessels of the skin allowing fluid to leak into the tissues
Hives can be acute or chronic
Causes are: food, drinks, medication, or exposure to pollen or chemicals
114
Treatments for rashes and eczema:
Cortisone, topical creams
115
Skin cancer
Skin cancer risk increases with accumulative ultraviolet sun exposure and is found in three distinct forms that vary in severity
Each is named for the type of cells that are affected
Arises from keratinocytes of the stratum Spinosum
Chance of recovery is good with early detection and surgical removal but if it goes undetected it can spread to lymph nodes and be lethal
Skin cancer has been linked to exposure to the sun
Fair skinned, freckle people are highest risk for sun related cancers
Most developed from pre-existing moles
They are slightly raised, black or brown, and borders are irregular
Skin cancers caused by damage to DNA
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What are the three main types of skin cancer?
Malignant melanomas
Squamous cell carcinomas
Basale cell carcinomas
* Most severe to least severe *
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Malignant melanoma
| Think of malicious melanocytes mole
The most deadly skin cancer
Accounts for 5% of all cases
 often arises from melanocytes of a pre-existing mole
Spreads rapidly and is fatal if not treated immediately
It is more deadly because it can spread throughout the body to internal organs via the lymphatics and bloodstream
Melanoma may have surface crust or bleed
Caucasian’s Who have a tendency to burn are more susceptible to skin cancer

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Basale cell carcinomas
The most common skin cancer and least severe
Rises from the cells of the stratum basale and eventually invades the dermis
Appears as light, pearly nodules
Characteristics include sores, red patches, or a smooth growth with an elevated border

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Squamous cell carcinomas
| Second worse
More serious than basal cell carcinoma
Characterized by red or pink scaly papules or nodules
Sometimes are characterized by open sores are crusty areas that do not heal in bleedy easily
3rd type of skin cancer
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What does pH stand for? And what is the scale used to measure?
PH is the scale used to measure acidity and alkalinity
P stands for the potential of the hydrogen ion
H is the hydrogen ion concentration of a solution
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What is an ion?
An ion is an atom or molecule that carries an electrical charge
Ionization causes an atom to split in two, creating a pair of ions with opposite electrical charges
An ion with a negative electrical charge: anion
An ion with a positive electrical charge is: cation
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What should the pH of healthy skin be between?
5.5 and 6
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When a solution is neither alkaline or acidic it is called..
Neutral
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If The pH of a solution is less than 7 it is: 
Acidic
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If the pH of a solution is greater than 7 it is
Alkaline
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Acids
Substances that have a pH below seven
Taste sour and turn litmus paper from blue to red
The lower the pH number the greater the degree of acidity
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Alkalis
Also known as bases have a pH above seven
Taste bitter and turn litmus paper from red to blue
The higher the pH number the greater the degree of alkalinity
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In Pure (distilled) water each molecule produces…
One hydrogen ion
One hydroxide ion
Pure water has a neutral pH because it contains the same number of hydrogen ions as hydroxide ions

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Chemical solutions that resist changes in pH are called
Buffers
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PH SCALE
1 ACIDIC 7 ALKALINE 14
_________________________________________
NEUTRAL
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PH Is influenced by external agents such as
Sunlight, cleansing preparations, cosmetics, digestion, diet and other factors 
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PH scale is a logarithmic scale which means:
In a pH scale, a change of one whole number represents a tenfold change in pH
(The change is 10x greater)
A pH of eight is 10 times more alkaline than a pH of seven 
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What can result if a product is incorrect for a given skin type
Dryness, dehydration, inflammation and even bacteria can grow if the product is incorrect
Extreme variations in pH can damage the skins barrier function and cause irritation
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Buffering agents
Buffering agents are added to skin care products to maintain the pH at the correct level to produce desired effect well keeping the product safe and non-irritating to the skin
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During the primary analysis which concerns are being assessed?
Allergies, dehydration, breakout and oiliness
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Which Things should we be mindful to explain to the client during treatment?
Our Steps, the sensation they may experience, performing extractions & the discomfort they may cause, the benefits and results of the treatment
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Questions that should be frequently asked by an aesthetician
How often do you cleanse your skin?
What type of skin are your products for?
What is your cleansing and moisturizing routine?
Does your skin feel tight?
Does your make up last and does it change color?
Does your skin get covered with an oily film?
Do you break out often?
How often do you see a spa therapist and when was your last visit?
Are you pleased with the condition of your skin?
Do you smoke? How much water do you drink? Do you have any allergies?
What are your concerns with your skin?

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What is the purpose of a skin analysis form? 
Skin analysis forms allow the aesthetician to thoroughly examine their clients skin type and conditions they may be experiencing due to internal or external agents in order to recommend the appropriate products and treatments

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Analysis of the skin with assistance of the magnifying lamp
The magnifying lamp magnifies the face to help the therapist analyze and treat the skin
The lamp uses a cool fluorescent lightbulb
eye pads should always be used to protect the eyes from the bright light
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What are skin types?
People are born with their skin types
Skin types are determined by genetics and ethnicity
An individual skin type is based on:
A) how much oil is produced in the follicles from the sebaceous glands
B) on the amount of lipids found in between the cells
The size of pores in T-Zones and throughout the face can help determine skin type
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What are the 6 skin types?
1. NORMAL
2. OILY
3. DRY
4. COMBINATION
5. SENSITIVE
6. ACNE
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Skin analysis procedure
Cleanse the skin
Look at clients skin through magnifying lamp
Cleanse
Cover eyes
Look, listen, ask & touch
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What is normal skin and what are external and internal symptoms of Normal skin?
Normal skin looks clear and even
Good oil- water balance 
External:
Pores are normal/ small-medium
Oil can fluctuate (sometimes more dry/ oily)
Good elasticity
Few blackheads
Perfect tone
Medium in thickness
Skin can become shiny if not cleaned often
Internal:
Perfect balance of sebaceous and sweat glands
blood circulation is good so the skin gets enough oxygen and nutrients
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Treatment recommendations for normal skin
Facial once a month to maintain the skin and observe for changes
Products:
All products should be for normal skin
Cleansing milk, toner, moisturizing cream, eye cream, mask two times per week
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What is oily skin and what are external and internal symptoms?
Oily skin gives a shiny complexion, it has a thick epidermis and open pores
Has the tendency to develop whiteheads and blackheads (comedones and blemishes)
Has an abundance of oil secretions
Commonly affects young teens due to change in hormone levels, diet and stress
Adults can have oily skin which is Hereditary
Oily skin requires more cleansing and exfoliating than other types
the excess oil and buildup on the surface of the skin make it appear thicker and sallow
Internal: overactive sebaceous glands
External: Lipidic skin = excess sebum
External symptoms:
Enlarged pores, thick texture, large amount of blackheads, sometimes pimples and whiteheads, good elasticity, oily film, colour of makeup changes, superfluous hair 
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Treatment for oily skin:
Balancing the skins oil production is important but over cleansing can make it worse by stripping the skins acid mantle and irritating it
The goal is to balance the barrier function
Basic facial to begin and more specific treatments to follow.
people with the skin type need professional treatments more than those with normal skin
All products should be marked for oily skin
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What is dry skin (alipidic) and what are external and internal symptoms of Dry skin?
Characteristics: alpidic (lacks oil), small pores, rough texture and flaky, premature aging, easily irritated, may feel itchy, thin texture, elasticity is weak rarely suffers from acne
Watch out for Couperose (dilated blood vessels) , blotchiness and sensitivities to products
Internal symptoms: dry skin has few or underactive sebaceous and sweat glands
Not enough secretions to protect and lubricate the skin therefore exposing it to dehydration
External symptoms: Small pores, thin skin texture, no blackheads, premature lines, elasticities is weak, tight feeling, flakiness
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Drying of the skin can be caused by: 
Sun exposure, illness, smoking, medication‘s and hormone changes
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Treatment and product recommendation for dry skin:
A basic facial to start, more advanced treatments to follow
All products should be for normal to dry skin
Occlusive products are thick and lay on top of the skin to reduce transepidermal water loss
these products help to hold a moisture and protect the skins top barrier layer which combat dryness
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What is sensitive skin and what are external and internal symptoms of Sensitive skin?
Sensitive skin is a condition
Can be genetically predisposed the skin
can appear on all types
Avoid causing extra stimulation
Characterized by redness
symptoms:
Erythrosis: abnormal redness resulting from dilation of blood vessels generally occurring on cheeks, nose and forehead
Erythema: redness caused by inflammation
Couperose - broken or dilated capillaries
Treatment:
Goal is to sooth irritation
Use gentle cleanser
Less steam and heat
Enzyme peel for sensitive skin
Lipids protect the skin
Serum and moisturizer with lipids is essential for sensitive and dry skin
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Acne skin
Appears commonly on oily skin
Usually in adolescence
Estheticians only treat acne vulgaris
Internal symptoms:
Inflammation of sebaceous glands and hair follicles
External symptoms:
ACNE PUNCTATA : superficial red pimples usually around the blackhead
ACNE ROSACEA : often resembles acne, but often there are no clogged pores or comedones present
Larger than normal pimples that occur on the nose and upper cheek
Lots of redness in skin around papules and pustules
Dehydrated appearance and burning and stinging may be present
ACNE VULGARIS: Can be treated by draining pustules
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Common causes of acne
Hormones, heredity, stress, birth control pills, pregnancy and menopause
Also environmental factors such as heat and humidity, sun exposure, greasy workplace, over cleaning, nutrition/ diet
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Acne care tips:
Eliminate comedogenic products (pore clogging)
Avoid harsh products
Exfoliate follicles to keep sebum from building up
Avoid environmental aggravated such as dirt, grease, sun, humidity and pollution
Benzoyle peroxide or alpha hydroxyl acids are beneficial
Practice stress reduction and good nutrition
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Asphyxiated skin
Coarse to the touch and delicate
Requires the same treatment as dehydrated skin with addition of secretion extraction and frequent exfoliation
Smokers have asphyxiated skin from lack of oxygen characterized by the following:
- shallow or grey complexion
- pores filled with blackheads
- clogged pores and wrinkles
- exterior layer covered with a film similar to varnish 
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Actinic keratosis
Rough areas resulting from sun exposure
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Open Comedones
Open comedones are blackheads and clogged pores caused by a buildup of debris, oil and dead skin cells in the follicles
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Closed comedones
Closed comedons are not open to the air for oxygen. They are trapped by dead skin cells and need to be exfoliated and extracted
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Hyperkeratinisation
Excessive buildup of cells, a rough texture
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Hyper pigmentation
Brown or dark pigmentation, discolouration from melanin production due to sun or other factors
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Hypopigmentation
White colourless areas from lack of melanin production
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Milia
Hardened, pearl like masses of oil and dead cells trapped beneath the surface of the skin. Millia are not exposed to oxygen and have to be lanced to open and remove them
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Seborrhea
Common skin problem
Causes red, itchy rash and white scales
When it affects the scalp, it is called dandruff
May be on parts of the face including folds around the nose and behind the ears the forehead, eyebrows and eyelids
Occurs more frequently in people with oily skin
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Wrinkles/ aging
Lines and damage from internal or external causes
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Internal effects on the skin:
Genetics and ethnicity
Stress, lifestyle, negative attitude
Free radicals
Dehydration
Vitamin deficiency
Alcohol, caffeine, aging, glycation , hormones
Menopause
Lack of exercise or sleep
Smoking, medication, drugs
Improper Nutrition 
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External effects on the skin
UV exposure and sun damage
Sun lamps and tanning booths
Environmental exposure, pollutants and air quality, climate and humidity
Poor maintenance and skin care
Misuse of products or treatments, over exfoliation or harsh products
Allergies and reactions to environmental factors or products
Photo sensitivity to the sun from medications or products

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Combination skin
Can be both oily and dry at the same time
T-zone is oilier
Outer areas are dry and flaky
Needs to be balanced
Use cleanser appropriate for most problematic area
Use different lotion for the different skin types
External symptoms:
- Medium to large pores
- Outer areas of the skin can be dry and flaky from dehydration or build up of dead skin cells
Treatment: basic facial to start and more advanced treatments to follow
Recommended products: Products can be mixed and matched to accommodate the changes in the skin
water base products work best for these clients
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What are skin transition types?
Menopause
Puberty
Pregnancy
