VTCT Level 3

Provide Facial Electrical Treatments

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TABLE OF CONTENTS

➢ HEALTH AND SAFETY REVISION

➢ CLIENT CARE AND COMMUNICATION
REVISION
➢ ANATOMY OF THE SKIN REVISION
➢ FACIAL ELECTRICAL TREATMENTS

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Monitor and maintain health & safety practice in the salon
revision

Legislation Vs Regulation

Legislation is a directive placed by a government or governing body on either an

industry or a section of community which must be complied with in order to remain within
the legal boundaries of that particular organization.

In industry, legislation acts as an external driver which must be met by all involved in
order to be compliant.

Legislation is passed as laws by a parliament of a country or some other legislative arm

of a government. After legislation is passed, there will be regulators, usually government
bodies, who will examine the laws passed and work out the details that need to be
enforced so that they are followed. At times before a part of legislation becomes a law,
it may be referred to as a bill. Some countries require legislation to be validated by the
executive (usually Prime Minister) before it could be enforced as law.

A regulation refers to a specific requirement that can take on various forms, such as
industry specific regulation or regulations that are much broader in scope.

They are basically the way the legislation is enforced by regulators and they support the
requirements of the legislation. In industry, they specify the particular legal requirements
that need to be followed by organisations, workers and employers alike so as to create a
level playing field.

A policy is a statement of intent, and is implemented as a procedure or protocol. In the

salon workplace policies will be devised and set by management. The employee is
expected to be aware of and follow such policies.

Hazards & Risks

A hazard is something that has potential to cause harm. A risk is the likelihood of a
hazard happening.

A risk assessment is simply looking closely at what in your place of work or about
your work activities could cause harm to your employees and visitors to your workplace
(e.g. clients, suppliers, sales representatives etc) and determining the control measures
you can implement to minimise the risk.

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Reasons for risk assessment

• It is a legal requirement.
• It will provide a safe environment for staff, visitors and clients.
• To be identify hazards, thereby minimising the hazards and risks in the
workplace.
• So emergency procedures are put in place.
• So staff can be trained, especially new staff.
• If there are new equipment and products, so they can used safely.
• To regularly review systems to make sure they are efficient.
• To make amendments and modifications to existing risk assessments.
• To update your records.

In order to evaluate the reliability and effectiveness of a risk assessment a number of

questions should be asked such as:

• What are the significant risks in the salon?

• Which risks are high, medium and low risk?

If you cause harm or put at risk your client, yourself or your staff you are likely to be
liable for prosecution, with the possibility of being fined; likely to be sued by your client
for damages.

Risks in the clinic/ salon environment may include:

• Environmental e.g. wet floor, trailing wires

• Equipment e.g. faulty
• Security i.e. cash, people
• Hygiene e.g. cross infection
• Date protection e.g. client record cards not securely stored.

The following steps will help you assess the risks in your work place:

Step 1. Identify the hazards.

Step 2. Decide who might be harmed and how.

Step 3. Evaluate the risks and decide on precautions.

Step 4. Record your findings and implement them.

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Step 5. Review your assessment and update if necessary.

Risk assessment guidelines which include best practice procedures to follow when
carrying out a risk assessment are available and should be read, adapted and
implemented to suit your salon.

Health and Safety at Work

The Health and Safety at Work Act is the primary piece of legislation covering
occupational health and safety. It applies to all employers, employees and self-
employed people in their workplaces. The Acts set out the rights and obligations of both
employers and employees and provides for substantial fines and penalties for breaches
of the health and safety legislation.

Employer’s duties

The employer has a duty to ensure the employees’ safety, health and
welfare at work as far as is reasonably practicable. In order to
prevent workplace injuries and ill health the employer is required,
among other things, to:

• Provide and maintain a safe workplace which uses safe plant and equipment
• Display Health and safety rules in a prominent position in the workplace
• Prevent risks from use of any article or substance and from exposure to physical
agents, noise and vibration
• Prevent any improper conduct or behaviour likely to put the safety, health and
welfare of employees at risk
• Provide instruction and training to employees on health and safety
• Provide protective clothing and equipment to employees
• Appointing a competent person as the organisation’s Safety Officer
• A written health and safety policy if there are more than five employees in the
business

Employees’ duties

The duties of employees while at work include the following:

• To take reasonable care to protect the health and safety of themselves and of
other people in the workplace
• Not to engage in improper behaviour that will endanger themselves or others
• Not to be under the influence of drink or drugs in the workplace
• To undergo any reasonable medical or other assessment if requested to do so by
the employer

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 • To report any defects in the place of work or equipment which might be a
danger to health and safety

What is personal protective equipment?

Personal protective equipment, commonly referred to as "PPE", is equipment worn to

minimise exposure to serious workplace injuries and illnesses. These injuries and
illnesses may result from contact with chemical, radiological, physical, electrical,
mechanical, or other workplace hazards. Personal protective equipment may include
items such as gloves, safety glasses and aprons.

Under PPE Legislation all employers are required to provide resources where risks
cannot be controlled by another means. The employer should tell employees about any
risks that require the wearing of protective equipment and must provide protective
equipment together with training on how to use it, where necessary. An employee is
under a duty to take reasonable care for his/her own safety and to use any protective
equipment supplied. The protective equipment should be provided free of charge to
employees if it is intended for use at the workplace only.

Electricity at Work Regulations 1989

Electricity is a major hazard in the workplace. These Regulations impose health and
safety requirements with respect to electricity at work to limit the risks involved in using
electricity. Regulations requires that all electrical systems should, so far as reasonably
practicable, be of safe construction and maintained in that state.

All portable appliances must be tested and maintained on a regular basis by a suitably
qualified person to comply with the law and insurance requirements; to protect
employees/

Electrical Safety
Many of the electrical appliances used in salons are subjected to considerable wear and
tear. It is helpful to devise a system for regularly checking all portable electrical
equipment, such as facial electrical machines and for marking faulty equipment and
preventing its use until repaired. A maintenance log for electrical equipment should be
kept updated.
Accidents
RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations)
is a health and safety legislation. It applies to all ‘responsible persons’ i.e. employers

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and employees and requires them to correctly report and keep a record of certain
injuries and incidents that happen at work

RIDDOR Guidance

You must report:

• Workplace deaths (excluding suicide).

• Injuries that result in an employee being off work (or unable to complete their
normal work duties) for seven consecutive days.
• Incidents involving members of the public being injured and taken to hospital.

And include:
• The date and time of the accident
• The date of entry into the accident book
• The name of the person or people involved
• The accident details
• The injuries sustained
• The action taken
• The signature of the person making the entry

Emergency Procedures
• A first aid kit should be stored in each workplace/ classroom and be replenished
as required. Contents should include dressings, eye pads, eye bath, bandages,
safety pins, antiseptic cream, medical wipes, sterile gloves, sterile water and
cotton wool.
• A qualified first aider must be on the premises at all times.
• All accidents in the workplace should be reported to the employer, who should
record the details of the incident.

Investigating Accidents

When we look into accidents, we must look at what has happened to identify causes.

We look at

• what occurred just prior to the accident,

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 • the series of events which occurred before the accident.
• what happened this time different in some respect to what always happens?
• why the difference this time?
• are there regular risks being taken?
• is the system inherently flawed?
• are accidents and near misses happening as a result of an ineffective ‘system’?

Slips, trips and falls

Most accidents occur when staff trip over trailing leads and uneven floor surfaces, or fall
when trying to reach items e.g. by standing on chairs.
1. Fasten cables and leads securely or re-route overhead if possible.
2. Unplug all equipment when not in use.
3. Keep passageways, workstations, and stairs clear. Do not store items which may
cause obstruction.
4. Provide adequate lighting.
5. Provide proper step ladders to reach anything not accessible from the ground.
6. Clean up spillages immediately and warn everyone in the immediate vicinity. A
warning sign can be placed on the washed floor.
7. Do not overload storage items especially those which are not secured to the wall e.g.
trolley.

Fire
Obstructed exit routes, for example by stock, can prevent escape and provide fuel for
fires. Many products used in beauty treatments, particularly aerosols, are highly
flammable and potentially explosive if exposed to high temperatures.
1. Keep all escape routes and fire exits clear, and make regular checks to ensure this is
the case.
2. Store products, particularly aerosols, away from naked flames or sources of heat at
or below room temperature and in a dry atmosphere.
3. Do not use portable gas heaters as they have a naked flame.
4. Switch off and unplug all electrical appliances at night.
5. Make sure employees are aware of the action they must take in the event of a fire.

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An evacuation drill process should be put in place. The evacuation drill will help to
ensure people adopt safe behaviour in the event of fire and will test the efficiency of
the instructions to be followed in the event of an incident.

Basic principles

• Checking that evacuation routes are not obstructed. This must be done prior to
every evacuation drill.
• Checking that the alert and alarm systems are working properly.
• Setting the date and time of the evacuation drill together with the responsible
parties.
• Everyone must be notified in advance.
• The instructions must be given in advance to all persons to be evacuated.

Fire Protection

Fire extinguishers are stored around the workplace and specified staff will be trained on
their use. A fire alarm system must be installed and all fire-fighting equipment must be
regularly tested and serviced by appointed contractors; designated staff must be
trained in their use. Records on this must be filed and readily available for inspection.
All fire exits must be marked using standard symbols. New employees must be made
aware of the location of fire exits and equipment during the induction process. Fire
assembly points must be detailed under the Fire Evacuation section.

Choosing Fire Extinguishers

Identify the type of materials in the area

Class A: SOLIDS such as paper, wood, plastic etc

FLAMMABLE LIQUIDS such as paraffin,
Class B:
petrol, oil etc
FLAMMABLE GASES such as propane, butane,
Class C:
methane etc
METALS such as aluminium, magnesium,
Class D:
titanium etc
Class E: Fires involving ELECTRICAL APPARATUS
Class F: Cooking OIL & FAT etc

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Types of fire extinguisher and colour coding

Water Fire Extinguishers: RED

The cheapest and most widely used fire extinguishers for Class A fires. Not suitable for
Class B (Liquid) fires, or where electricity is involved.

Foam Fire Extinguishers: CREAM

More expensive than water, but more versatile. Used for Classes A & B fires. Foam
spray extinguishers are not recommended for fires involving electricity, but are safer
than water if inadvertently sprayed onto live electrical apparatus.

Dry Powder Fire Extinguishers: BLUE

Often termed the ‘multi-purpose’ extinguisher, as it can be used on classes A, B & C
fires. Best for running liquid fires (Class B). Will efficiently extinguish Class C gas fires,
electrical fires

CO2 Fire Extinguishers: BLACK

Carbon Dioxide is ideal for fires involving electrical apparatus, and will also exitinguish
class B liquid fires, but has NO POST FIRE SECURITY and the fire could re-ignite.

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Manual handling

Manual Handling involves any transporting or supporting of any load by one or more
employees, and includes lifting, putting down, pushing, pulling, carrying or moving a
load, which by reason of its characteristics or unfavourable ergonomic conditions,
involves risk, particularly of back injury, to employees.

The key requirements include:

• Carrying out a manual handling risk assessment of existing manual handling

tasks before making an informed decision on what manual handling tasks need
to be avoided or reduced.
• Organising tasks to allow the use of mechanical or other means to avoid or
reduce the need for the manual handling of loads by employees in the
workplace.
• Providing instruction and training to relevant staff e.g. proper lifting techniques.
Work stations in the salon should be designed to ensure staff have sufficient room to
move around when working and chairs which can be adjusted depending on the size of
the client and therapist must be provided.

Welfare

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Employers should ensure the welfare of all employees at all times. Clean and hygienic
toilet facilities and a restroom for tea and lunch breaks is essential. However it is the
responsibility of the employee to maintain these standards of hygiene.

Security

Law requires a business owner to ensure adequate security of business premises. This
is particularly important for obtaining insurance cover in the case of theft from or
damage to the property. Strict procedures are required to ensure the security of the
business premises during and outside of business hours. There are several standard
ways many businesses employ, particularly with regard to locking up

Security During Working Hours - To maximise safety and security access to the building
should be available to employers and their employees or invited guests only i.e.clients,
suppliers etc.

Money - the business should invest in an electronic till for recording and storing
payment. The till can be kept locked between uses and where only one or two
members of staff have the authority to use the till, the risk of theft becomes very small.

Stock - a good system of stock control monitors the use of consumables and retail
products and keeps supplies stored safely in a locked cupboard or stock room.

Personal Property - staff and clients also need protecting from theft. It is the
responsibility of the therapist to ensure that the client’s handbag and jewellery are kept
safe in the treatment area. The therapist themselves should keep the amount of money
and valuables they take to work to a minimum.

Violence in the workplace

The possibility of violence towards employees should be addressed in the safety

statement. For example, factors like the isolation of employees and the presence of
cash on the premises need to be taken into account. Proper safeguards should be put
into place to eliminate the risk of violence as far as possible.

Bullying

One of the employer’s duties is to prevent improper conduct or behaviour (which

includes bullying). An employer should have established procedures for dealing with
complaints of bullying in the workplace and deal with such complaints immediately.
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Ignoring complaints of bullying could leave an employer open to a possible claim for
damages by an employee. It is advisable for an employer to have an established
grievance procedure to deal with complaints of bullying..

Harassment

The Employment Equality Acts placeS an obligation on all employers to prevent

harrassment in the workplace. Under this law, you are entitled to bring a claim to the
Equality Tribunal and your employer may be obliged to pay you compensation if you are
harassed by reason of your gender, marital status, family status, sexual orientation,
age, disability, race, religious belief or membership of the Traveller community.

Victimisation

Under the Safety, Health and Welfare at Work Act the employee may not be victimised
for exercising his or her rights under safety and health legislation such as making a
complaint. This means that the employer may not penalise an employee by dismissal or
in some other way, for example, by disciplinary action or by being treated less
favourably than other employees.

Trade Descriptions Act

Under the Trade Descriptions Act it is a criminal offence for a trader to make false
statements about goods or services offered for sale. Each product sold must be as
described and of satisfactory quality except for any flaws obvious or pointed out at the
point of sale. "

The description could be given iIn writing, for example in an advertisement; In an

illustration, for example on packaging; Given orally, for example by a salesperson.

It is the duty of the Trading Standards Service (TSS) and the Office of Fair Trading to
enforce this legislation. TSS have powers to enter premises and inspect goods, require
a trader to produce documents, seize and detain goods. If found guilty of an offence, a
business (Directors, managers and other employees) could face an unlimited fine and
imprisonment.

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COSHH?

COSHH is the law that requires employers to ‘control substances that are
hazardous to health’. Some of the preparations and products used in the salon
contain harmful substances which can cause both skin and respiratory problems.
Products used for cleaning can also be hazardous.

Remember that hazards and risks are not limited to substances labelled as
‘hazardous'.

Hazardous substances include:

• chemicals
• products containing chemicals
• fumes
• dusts
• vapours
• mists
• nanotechnology
• gases and asphyxiating gases and
• biological agents (germs). If the packaging has any of the hazard symbols then it
is classed as a hazardous substance.
• germs that cause diseases such as leptospirosis or legionnaires disease and
germs used in laboratories.

Steps to making a COSHH assessment:

1. Make a list of all hazardous products used in the salon and obtain hazard Material
Safety Data Sheets from the manufacturers. Safety data sheets provide information on
chemical products that help users of those chemicals to make a risk assessment. They
describe the hazards the chemical presents, and give information on handling, storage
and emergency measures in case of accident.

2. Make sure you are using the safest products available and that they comply with the
Cosmetic Products (Safety) Regulations.
3. Ensure you assess all new products before use.
4. Store and use all products in accordance safely.
5. Take care when disposing of surplus/out of date stock, following manufacturers
guidance or return to manufacturer.

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6. If signs of dermatitis or asthma are detected suitable action should be taken to
minimise the problem e.g. provide barrier creams and gloves, improve ventilation and
monitor to ensure gloves etc. are used.
7. Train staff in the safe use of chemicals under The Environment Act 2003 and the
Waste Management Act 1996. . Toxic substances such as essential oils should not be
poured down the sink as large quantities may contaminate the local water supply.

8. Provide ‘sharps’ boxes for disposal of needles, blades etc. ‘sharps’ boxes should be
disposed of by a registered waste carrier. Contaminated waste i.e. containing bodily
fluids must be regarded as a hazardous substance. Most waste of this type, depending
on its origin, will be classified as 'clinical or infectious waste' and is subject to stringent
controls and must be disposed of separately from normal waste. These can be collected
by the local authority or a private company.

Hazard Warning Symbols

Hygiene in the salon

It is the role of ALL salon staff to ensure a clean, safe and hygienic salon is maintained.

There is risk of transmission of infection when using equipment and products on

different clients. Controlling hygiene and infection within the salon will ensure that

the spread of disease and the risk of cross-infection will be reduced .

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 • Washing hands – regularly throughout the day and also before and after treating
each client to prevent the spread of germs and cross - infection in the salon
• Working surfaces - disinfect all working surfaces daily.
• Gowns and towels – freshly laundered should be provided for each client.
• Dirty Laundry – should be placed in a covered container.
• Floors – cleaned daily.
• Waste – disposed of in accordance with COSHH regulations.
• Make sure ‘hard’ re-usable equipment such as tweezers can be sterilised between
use on clients.
• Use disposable products where possible e.g. wooden spatulas to decant product.
• Use techniques which prevent cross contamination of products
• Thoroughly cleanse brushes, sponges, towels etc. between uses.
• Contact your local council to register with them if you are carrying out skin
piercing treatments such as electrolysis, micro needling.

Sterilisation and Disinfection

Sterilisation – the total destruction of all living micro - organisms on metal tools and
equipment.

Disinfection – the destruction of most living micro - organisms on non-metal tools,

equipment and work areas.

• NB. ‘Ultra-violet sterilisers DO NOT sterilise. Ultra violet light has disinfectant
properties only. The autoclave is the most effective method for sterilising objects
in the salon.

Personal health and hygiene

Beauty therapists should always reflect the desired image of the profession they work in

Personal presentation:
• Clean pressed uniform.

• Attractive subtle make-up.

• Hair tied up off the face.

• Short unpolished nails.

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 • Minimal jewellery such as a wedding ring.

• Flat comfortable shoes

Good health and personal hygiene gives a good impression to clients and allows you to
do your job properly

• A health balanced diet, regular exercise and adequate sleep.

• Correct posture enables you to work longer and prevents muscle fatigue.

• Body cleanliness from daily showers and using deodorant.

• Fresh breath – regularly freshen breath when working with clients.

What is data protection?

The Data Protection Act defines law on the processing of data on identifiable living
people.

When we take clients’ personal details in the salon environment we have a duty to keep
these details private and safe. This process is known as data protection. We refer to
organisations or individuals who control the contents and use of personal details as
'data controllers'.

Most of us give information about ourselves to groups such as Government bodies,

banks, insurance companies, medical professionals and telephone companies to use
their services or meet certain conditions. Organisations or individuals can also get
information about us from other sources.

Under data protection law, you have rights regarding the use of these personal details
and data controllers have certain responsibilities in how they handle this information.

All clients have the right to data protection when their personal details are:

• held on a computer;
• held on paper or other manual form as part of a filing system; and
• made up of photographs or video recordings of their image

Data protection rights give clients peace of mind that the information stored about
them is:

• factually correct;
• only available to those who should have it;
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 • only used for stated purposes.

Client record cards must be stored under lock and key for at least 7 years and must
only be available to the relevant employees.

Professional Indemnity Insurance

Professional liability insurance (PLI), also called professional indemnity insurance (PII) is
a form of liability insurance that helps protect professional advice- and service-providing
individuals and companies from bearing the full cost of defending against a negligence
claim made by a client, and damages awarded in such a civil lawsuit. Professional
Indemnity Insurance provides cover if you become legally liable to a member of the
public following an error or omission in the professional advice or service you have
provided your client and as a result have suffered a financial loss.
The certificate must be displayed on the premises.

Client care & communication in beauty related industries

Communication

Effective communication is all about conveying your messages to other

people clearly and unambiguously. It's also about receiving information that
others are sending to you, with as little distortion as possible.

Doing this involves effort from both the sender of the message and the
Receiver and it's a process that can be fraught with error, with messages
muddled by the sender, or misinterpreted by the recipient. When this isn't
detected, it can cause tremendous confusion, wasted effort and missed
opportunity.

In fact, communication is only successful when both the sender and the
receiver understand the same information as a result of the communication.
By successfully getting your message across, you convey your thoughts
and ideas effectively. When not successful, the thoughts and ideas that you
actually send do not necessarily reflect what you think, causing a

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communications breakdown and creating roadblocks that stand in the way
of your goals – both personally and professionally.

Methods of Communication

On a daily basis we work with people who have different opinions, values,
beliefs, and needs than our own. Our ability to exchange ideas with others,
understand others' perspectives, solve problems will depend significantly
on how effectively we are able to communicate with others

The act of communicating involves verbal, nonverbal, and para- verbal

components. The verbal component refers to the content of our message‚
the choice and arrangement of our words. The nonverbal component refers
to the message we send through our body language. The para- verbal
component refers to how we say what we say - the tone, pacing and
volume of our voices.

In order to communicate effectively, we must use all three components to

do two things:

• Send clear, concise messages.

• Hear and correctly understand messages someone is sending to us.

Verbal Communication

Our use of language has tremendous power in the type of atmosphere that
is created. Sending effective messages requires that we state our point of
view as briefly and succinctly as possible. Listening to a rambling,

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unorganized speaker is tedious and discouraging…. why continue to listen
when there is no interchange?

Lengthy explanations are confusing to the listener and the message loses
its concreteness, relevance, and impact. This is your opportunity to help the
listener understand YOUR perspective and point of view. Choose your
words with the intent of making your message as clear as possible,
avoiding jargon and unnecessary information.

Effective verbal communication:

• is brief, succinct, and organized

• is free of jargon
• does not create resistance in the listener

ADVANTAGES DISADVANTAGES
Quick No written record
Instant response No time to consider
Able to observe body language No paper trail

Verbal communication tools:

• Questioning -asking open questions to gain information, encourage

the speaker to tell her story, and gain clarification

• Paraphrasing -a brief, succinct statement reflecting the content of the

speaker’s message

• Reflecting Feeling -a statement, in a way that conveys understanding,

of the feeling that the listener has heard

• Summarizing - a statement of the main ideas and feelings to show

understanding

Non -Verbal Communication (body language)

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The power of nonverbal communication cannot be underestimated. In his
book, “Silent Messages”, Professor Albert Mehrabian says the messages
we send through our posture, gestures, facial expression, and spatial
distance account for 55% of what is perceived and understood by others. In
fact, through our body language we are always communicating, whether we
want to or not!

Nonverbal messages are the primary way that we communicate emotions:

• Facial Expression: the face is perhaps the most important conveyor

of emotional information. A face can light up with enthusiasm, energy,
and approval, express confusion or boredom, and scowl with
displeasure. The eyes are particularly expressive in telegraphing joy,
sadness, anger, or confusion.

• Postures and Gestures: our body postures can create a feeling of

warm openness or cold rejection. For example, when someone faces
us, sitting quietly with hands loosely folded in the lap, a feeling of
anticipation and interest is created. A posture of arms crossed on the
chest portrays a feeling of inflexibility. The action of gathering up
one's materials and reaching for a purse signals a desire to end the
conversation.
Para- verbal Messages

Para - verbal communication refers to the messages that we transmit

through the tone, pitch, and pacing of our voices. It is how we say
something, not what we say. Professor Mehrabian states that the para
verbal message accounts for approximately 38% of what is communicated
to someone. A sentence can convey entirely different meanings depending
on the emphasis on words and the tone of voice. For example, the
statement, "I didn't say you were stupid" has six different meanings,
depending on which word is emphasized.

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ADVANTAGES DISADVANTAGES
Able to express feelings Cannot hide feelings
Easy to identify anger, happiness or Can be a barrier
confusion

Some points to remember about our para - verbal communication:

• When we are angry or excited, our speech tends to become more

rapid and higher pitched.

• When we are bored or feeling down, our speech tends to slow and
take on a monotone quality.

• When we are feeling defensive, our speech is often abrupt.

Written communication

Written communication involves expressing yourself clearly, using

language with precision, note taking, editing and summarising written
reports.

There are three main elements to written communication:

Structure (the way the content is laid out):

• Is the layout clear and easy to follow?

• Do headings stand out (e.g. are they in a larger font size or bold)?

• Is the information arranged in a logical sequence

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Style (the way it is written):

• Does it look neat, and is it legible?

• Is it concise, simple and direct?

Content (what you are writing about):

• Have you listed the essential points you need to make?

• Have you made these points clearly?

ADVANTAGES DISADVANTAGES
Detailed record Cannot see reaction of receiver
Clear and specific Cannot change mind
Paper trail No opportunity for discussion

Listening Skills

The key to receiving messages effectively is listening. Listening is a

combination of hearing what another person says and psychological
involvement with the person who is talking. Listening requires more than
hearing words. It requires a desire to understand another human being, an
attitude of respect and acceptance, and a willingness to open one's mind to
try and see things from another's point of view.

Listening requires a high level of concentration and energy. It demands that

we set aside our own thoughts and agendas, put ourselves in another's
shoes and try to see the world through that person's eyes. True listening

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requires that we suspend judgment, evaluation, and approval in an attempt
to understand another is frame of reference, emotions, and attitudes.
Listening to understand is, indeed, a difficult task!

Key listening skills:

Nonverbal:

• giving full physical attention to the speaker

• being aware of the speaker's nonverbal messages

Verbal:

• paying attention to the words and feelings that are being expressed
• using reflective listening tools such as paraphrasing, reflecting,
summarizing, and questioning to increase understanding of the
message

Reflective listening skills

• Reflective listening or responding is the process of restating, in our

words, the feeling and/or content that is being expressed and is part
of the verbal component of sending and receiving messages. By
reflecting back to the speaker what we believe we understand, we
validate that person by giving them the experience of being heard
and acknowledged. We also provide an opportunity for the speaker to
give us feedback about the accuracy of our perceptions, thereby
increasing the effectiveness of our overall communication.

Professional Manner

• Having good manners will serve you well in a work environment.

Many of the things you do to be polite in casual settings are just as
polite in work situations, for example, using your telephone manners,
saying "please" and "excuse me", shaking hands and introducing
yourself when meeting someone new, paying attention to people
when they are talking, and appearing neat and clean.

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 • Work situations will often call for an even higher level of manners
than those you use in casual situations.

• A successful business employs committed, hard - working staff who

pulls together as a team and is motivated towards the same goals.

• Most good working relationships develop easily. Others have to be

worked at. Whatever the personal feelings of individuals towards one
another, clients must never sense a bad atmosphere in the salon
because of friction between staff. Also it will sometimes be hard to
leave personal problems at home, you must learn to always be
cheerful with your clients and colleagues.
Work place policy

• A Work Place Policy is a list of rules, regulations and procedures that

must be adhered to in the workplace to ensure the safety and well
being of individuals. Every workplace will have its own policy, which
will be determined by the nature and assessment of risks within its
industry.

• As a therapist it is vital that you are aware and compliant with the
workplace policies that exist within your training establishment or
salon, to ensure the safety and well-being of yourself, colleagues and
clients.

Positive Image

• The effort you put in to getting ready for work reflects your pride in the
job. Clients will initially judge your professionalism on how you
present yourself. You are working in an industry where image and
appearance are important, so represent yourself and the industry well
and win the confidence of the client upon meeting them for the first
time.

Reasons for a Consultation

25
A consultation should be performed on all clients before treatment
commences in order to:

• obtain personal details about the client (address, telephone number,

etc)

• gather information about needs and expectations

• assess client’s suitability for treatment

• establish a rapport with the client

• explain the treatment procedure and other related information

(expected sensations, skin reactions, contra- actions and outcomes)
to give the client the opportunity to discuss the treatment plan and to
ask questions

• create the opportunity to devise a treatment plan for the client taking
into account suitability for treatment, frequency of treatments, future
client and therapist availability, future cost implications and any
additional services which may be of benefit to them

• obtain client consent and a signature

Consultation Techniques

• Smile, introduce yourself and shake hands with the client

• Accompany your client to a quiet, private area
• Offer the client a seat and sit yourself alongside and facing her with
no barrier between you
• Lean forward slightly when talking to your client
• Use appropriate body language such as nodding and smiling
• Make and keep eye contact
• Ask open ended questions to encourage client to elaborate

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Contra Indications

These are conditions or factors that will prevent or restrict a certain

treatment due to the harm that it would cause the patient.

• Each individual therapy will have a list of contra - indications that may
prevent the treatment being carried out.
• It is important to establish if a contra-indication exists before
proceeding with treatment.

Contra - Actions

• These are reactions that may naturally occur following a treatment.

They do not necessarily mean the treatment has been performed
incorrectly, but are a way in which the skin / client may react to a
treatment e.g. erythema.
• It is important to advise the client of what these may be and that this
is not abnormal and how they can deal with this.

After care

• Each therapy will have a suggested after - care routine that aims to
maintain the effects of the treatment for longer and enables the client
to even improve the results. This can also include lifestyle changes
such as diet and exercise as well as changes to their daily routine.

• One aspect of after care is recommending retail products for the

client to use at home. As well as the benefit of the clients being able
to continue using the professional products at home, this can
generate profit for the therapist / salon.

Personal space

Your personal space is like an invisible bubble that surrounds you. If people
move inside this bubble when they are talking to you, it may make you feel
uncomfortable. Everyone's personal space is different. How close you
normally stand to someone else when you are talking to him or she will

27
depend on who it is you are talking to, and under what circumstances. Here
are some facts about personal space bubbles:

• The bubble is larger if you are talking to a stranger.

• The better you know the person you're talking to, the smaller the
bubble may be.

• The bubble is usually larger for two men than for two women.

• The bubble may be very small for a man and a woman if they are in a
relationship.

• The bubble may be larger than normal for a man and a woman who
are strangers to each other.

• The bubble size may differ for different cultures.

We all have boundaries for our personal space but there is a great deal of
variation in the distance of these boundaries from person to person and
from culture to culture. How is it then that we communicate the size of our
own personal space so that others are aware and can take steps to avoid
infringing upon it?

You know where the boundaries of your personal space are located, even if
you have never put any conscious thought into defining them. It is an innate
sense inside of you, developed throughout your lifetime in response to your
personality, environment, and life experiences. You also have ways of
communicating the location of those boundaries so that others can clearly
know where they begin. Nearly all of the communication methods you use
to send messages about personal space are non - verbal. They are a
combination of body language and other actions you take, consciously or
unconsciously, to preserve your personal space.

28
Client Confidentiality

The Data Protection Act (DPA) is a law designed to protect personal data
stored on computers or in an organised paper filing system to control the
way information is handled and to give legal rights to people who have
information stored about them. The basic way it works is by setting up rules
that people have to follow.
It does not stop companies storing information about people. It just makes
them follow rules.

The roles of those involved:

• The Information Commissioner is the person who has powers to

enforce the Act.
• A data controller is a person or company that collects and keeps data
about people.
• A data subject is someone who has data about them stored
somewhere, outside of their direct control. e.g. a beauty salon stores
its customers' names, addresses and phone numbers. This makes us
all data subjects, as there can be few people in the UK who do not
feature in records somewhere. People whose personal data is stored
are called data subjects. A data subject has a right to be supplied by
a data controller with the personal data held about him or her.

Dealing with Clients Complaints

Within any business you have most likely run across a dissatisfied
customer at least once or twice. While these encounters are not pleasant,
the worst thing to do is to ignore the person or hope they just go away.
Instead, it is best to face the situation head on and do some damage
control. Take a look at these pointers for turning an unhappy customer into
one who will return.

Environment: Move the client away to a quiet area. This will give you the
privacy to discuss the matter without it being overheard by other staff or
customers.

Listen: Most people express their displeasure for one main purpose and
that is to be heard. After all, it takes time for someone to complain. It is far
easier to never say a word and simply spread the word to others that you
29
had a really bad experience. In this sense, you should thank those who let
you know of a problem. They are giving you an opportunity to rectify the
situation instead of simply spreading bad publicity.

The first rule of thumb is to listen. This holds for any type of communication
you receive, whether it is in the form of an email message, a phone call, or
a written letter. Take the time to read, or listen to it with an open mind.
Don’t take it as personal criticism, but use the information as a way to make
your business better.

Acknowledge: after you have heard the customer’s complaint,

acknowledge it. Don’t try to make excuses. Let the customer know that you
have heard them correctly by repeating back their complaint. Express
empathy and understanding of how the problem impacted their life. In this
way you are acknowledging their feelings. For some people, just having
been heard and having their complaint acknowledged is enough to calm
them down.

Apologise for the client’s inconvenience or misunderstanding but do not

pass the blame. Say, “I am sorry that the service did not meet your
expectations”, not “I am sorry Jo is not very good at that treatment, she is
new”.

Management: manage your emotions; speak slowly, clearly and calmly.

This will help to calm the customer down.

Offer: the next step is to offer the customer something in exchange for
their trouble. Even if they say they want nothing, it is good business to offer
them something, however small. Remember that you are showing your
appreciation for the fact that they brought a problem to your attention.

What you offer largely depends on the situation and the person. Some
dissatisfied customers will make outrageous demands. In this instance, tell
them you can’t do what they are asking, but you are willing to offer
whatever it is you can.

Remember that each dissatisfied customer presents an opportunity. Listen,

acknowledge, offer, and then follow through on your promises. You might
just find that you gain a customer for life.
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Importance of customer feedback
Customer feedback is vital to making a business work. Your customers are
the heart of your operation without them, it would be impossible to have
any of the success that you do. Customer feedback can be an excellent
way to keep your business going in a positive direction.

Get Honest Opinions

Customer feedback is a vital way to get honest opinions on your services or
products from people who are familiar with them.

Improve Relations
When customers feel that a business truly cares about them and what they
think, they may be more likely to be loyal customers. When a business
makes changes according to feedback, it shows that they truly listen and
respect those opinions.

Inexpensive Business Advice

Customer feedback is essentially inexpensive business advice directly from
the source.

More Customers
When a business is willing to receive feedback and listen to it, word
spreads and more customers could give you a try based on your
commitment to excellent customer service.

Positive Changes
A business does not like to brag about the negative aspects of
their operation; they want to have mostly positive things to say. Customer
feedback can mean positive changes according to their comments, which
could mean a better reputation and more business.

Retail opportunities
Retail sales are of importance to the beauty salon as they are a simple way
of greatly increasing the income and profit without too much extra time
being spent.

When selling products, first you must find out about your customer’s needs.
Consider the following:

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 – Are they allergic to any particular ingredient?

– What products does she usually use?

– How much is she used to spending on products?

– How long do they usually last?

– Are they finding the products they are using beneficial?

This information should help you to guide the customer to the most suitable
products. This is where the therapists’ expertise in product knowledge is
important: you should be able to fully describe the key features, functions
and benefits of the products you retail.

The products should be presented in such a way that they seem both
attractive and desirable to the customer, presentation should encourage a
sale. Testers should be available wherever possible so that the client can
try the product before purchasing it.

Once a product is purchased by the customer, always check they

understand how to properly use the product, therefore gaining the best
benefits and effects.

It is not just products that need to be promoted and sold within a salon,
attention needs to be given to future treatments. This is not just a case of
recommending how often they come back for a repeat of a treatment just
provided, but also other treatments which they may be interested in. For
example, a client having regular manicures may also like regular pedicures.

Any recommendations or purchases should always be recorded on the

client’s record card. This will enable the therapist to check progress during
subsequent treatments to ensure the client is happy with your suggestions
and their purchases.

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Sales Techniques

Sales professionals use body language and personal space quite

deliberately. With a potential or new client, the salesperson is likely to be
quite respectful of personal space, avoiding even the appearance of
encroachment. As trust develops between client and salesperson,
however, those boundaries tend to shrink.
The salesperson will move in closer to the client, assuming a more familiar
body position as a way to influence the client’s buying decision.

The first rule of selling is: Know your product. This applies to retail
products as well as salon services. Product companies will often train staff
in their products so that they can successfully be used within treatments as
well as recommended for purchase.

Salons should ensure that all staff are trained in retail products as well as
ensuring they all have a thorough understanding of the treatments on offer
and can confidently talk to clients about these.

Improving Working Practices

In order to develop personally and to improve your skills professional, it is

important to have personal targets which you can measure your
achievements. Targets should follow the SMART principle:

• Specific – clearly defined

• Measurable – quantifiable in some way

• Agreed – between both parties

• Realistic – achievable

• Timed – for a duration of a fixed period

Salons will often set employees targets to achieve. This could be related to
the income you generate for the salon (a certain amount each week or
month), or based on productivity (how much of the time you are being

33
paid you spend actually working on a client and generating income
often based as a percentage %).

Whether it is one or the other, or both jointly, there is often a reward or

incentive to help you achieve this (a pay bonus of a set amount, or a
percentage of the income generated)

SWOT analysis

This is a strategic planning method used to evaluate the Strengths,

Weaknesses, Opportunities, and Threats involved in a project or in a
business venture. It involves specifying the objective of the business
venture or project and identifying the internal and external factors that are
favourable and unfavourable to achieve that objective.

Strengths: characteristics of the business or team that give it an

advantage over others in the industry

Weaknesses: are characteristics that place the firm at a disadvantage

relative to others

Opportunities: external chances to make greater sales or profits in the

environment

Threats: external elements in the environment that could cause trouble for
the business

Appraisals
Also known as a progress review, this is an important method of
communication, where one member of the staff looks at the way another
member of the staff is performing in their job role, usually from a superior or
supervisor. Each member of a team will have their own strengths and
weaknesses and it is important to utilise the strength and action plan the
weaknesses with appropriate personal goals.

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Performance appraisals will look at:

• Results achieved against agreed targets set

• Additional accomplishments and contributions

This can be a daunting process, but it is useful and can be used to your
advantage:

• Identify training needs that can provide you with a greater range of
skills and expertise
• Identify obstructions that are affecting you progress
• Identify and amend any changes to your job role
• Identify additional responsibilities which you would like
• Update your action plan, which will help you achieve your targets

Your appraisal may not always be positive, but it is important to be positive

about improvements and any recommendations to improve your
performance and to work towards achieving these.

35
The Anatomy of the Skin revision
Although you may not typically think of the skin as an organ, it is in fact made of
tissues that work together as a single structure to perform unique and critical functions.

The skin and its accessory structures make up the integumentary system, which
provides the body with overall protection.

The skin is made of multiple layers of cells and tissues, which are held to underlying
structures by connective tissue. The deeper layer of skin is well vascularised (has
numerous blood vessels). It also has numerous sensory, autonomic and sympathetic
nerve fibers ensuring communication to and from the brain.

The skin is broken down to 3 separate layers - the epidermis our outmost layer which is
made up of up to 95% skin cells , the dermis which is made up to 90% collagen and
elastin and the hypodermis where our fat cells nerve endings ‘ and blood vessels reside.

Diagram of the Skin

36
Let’s first explore the epidermis in depth. The epidermis is composed of keratinized,
stratified squamous epithelium. It is made up of 5 major layers ranging from the
stratum basale up to the stratum corneum. It does not have any blood vessels within it
(i.e., it is avascular).

The cells in all the layers except the stratum basale are called keratinocytes. A
keratinocyte is a cell that manufactures and stores the protein keratin. Keratin is a
protein that gives hair, nails and skin their toughness and water-resistant properties.
The keratinocytes in the stratum corneum (now corneocytes) are dead and regularly
slough away, being replaced by cells from the deeper layers.

The epidermis consists of 90% keratinocyte cells and 8% melanocyte cells.

The basal layer consists of cuboidal cells, whereas the outer layers are squamous,
keratinized cells, so the whole epithelium is often described as being keratinized
stratified squamous epithelium.

37
Layers of the epidermis

Stratum Germinativum (basale layer)

The stratum germinativum is the deepest layer of the epidermis and attaches the
epidermis to the basal lamina (basement membrane), below which lies the dermis.

The basal layer is the point where new skin cells are made. This layer is comprised of a
single layer of cells primarily made of basal cells. A basal cell is a cuboidal-shaped
stem cell. The stem cells’ job is to duplicate themselves creating daughter cells. These
daughter cells will then differentiate into keratinocytes or skin cells. These skin cells will
make up the first layer of the epidermis. The basal cells are constantly going through
mitosis to produce new cells which then force the existing cells towards the next layer
of the epidermis and beyond. This is called keratinocyte maturation. As these skin cells
progress through these 4 layers they will compact, they will start to lose some of their
intercellular fluid, and so become dehydrated and they will begin to keratinise or
harden.

Two other cell types are found dispersed among the basal cells in the stratum basale.
The first is a Merkel cell, which functions as a receptor and is responsible for
stimulating sensory nerves that the brain perceives as touch. These cells are especially
plentiful on the surfaces of the hands and feet.

38
The second is a melanocyte, a dendritic cell that produces the pigment melanin.
Melanin gives hair and skin its colour and also helps protect the living cells of the
epidermis from ultraviolet (UV) radiation damage.

Stratum Spinosum (also called prickle cell layer)

This layer is composed of eight to 10 layers of keratinocytes, formed as a result of

mitosis in the stratum germinativum. In this layer cells interlock with each other by
spiney like structures called desmosomes, bridge like structures. These desmosomes
are very strong in the lower layers of the epidermis where there’s up to 85% hydration.
However as the skin dehydrates towards the surface where there’s as little as 15%
hydration these desmosome bonds can become weak and eventually snap. This is what
allows desquamation.

Found amongst the keratinocytes is a type of dendritic cell called the Langerhans cell,
which functions as a ‘macrophage’ by engulfing bacteria, foreign particles and damaged
cells.

The keratinisation process i.e. the hardening of the cell, begins in this layer and as the
cell starts to die it releases a water-repelling glycolipid that helps prevent water loss
from the body. As mitosis continues in the layer below, the keratinocytes of the stratum
spinosum are pushed up into the stratum granulosum.

39
Stratum Granulosum (also called granular layer)

As the keratinocytes start to differentiate and are pushed from the stratum spinosum
they take on a ‘grainy’ appearance due to the accumulation of large amounts of the
protein keratin and keratohyalin. The cells (three to five layers deep) become flatter
and their cell membranes thicken. The nuclei and other cell organelles disintegrate as
the cells die, the contents of which is then broken down by lamellar bodies to form
lipids. Lipids pass through the membrane along with the lamellar bodies to form part of
the ‘Natural Moisturising Factor’.

Stratum Lucidum (also called clear layer)

The stratum lucidum is a smooth, seemingly translucent layer of the epidermis

located just above the stratum granulosum. This thin layer of cells is found only in the
thick skin of the palms of the hands, soles of the feet and fingers and toes. The
keratinocytes are now dead and flattened and are densely packed with eleiden, a clear
protein rich in lipids, derived from keratohyalin formed in the layer below. This gives
these cells their lucid appearance and provides a barrier to water. At this stage all the
cells are filled with keratin and therefore look clear as opposed to ‘grainy’. No nucleus is
found here in any of the flattened cells.

Stratum Corneum

The stratum corneum is the most superficial layer of the epidermis and is the layer
exposed to the outside environment. The increased keratinization (also called
cornification) of the cells in this layer gives it its name. There are usually 15 to 30 layers
of cells in the stratum corneum, packed tightly together and scale like. Keratin has
made them tough, dry, no nucleus and horny. Cells in this layer are shed periodically, a
process known as desquamation and are replaced by cells pushed up from the
stratum granulosum. This is called cellular turnover or a keratinocyte maturation cycle.
In a young healthy skin this cellular turnover will take roughly 28 days meaning it takes
only 4 weeks for the body to make a brand new differentiated keratinocyte for it to
mature through the skin layers before becoming a corneocyte on the surface of the skin
and sloughing off.

Corneocytes are simply keratinocytes without nuclei. They are found in the lower part
of the stratum corneum and are adhered together by corneodesmosomes. These
‘bridges’ break down as the corneocytes journey towards the surface of the skin and
this is why desquamation occurs. At the same time, as these detached bridges
encounter more hydration, they will expand and stick together, forming potential entry
pores for microorganisms across the stratum corneum. This may indirectly reduce
enzyme action in the most superficial layers leading to the formation of visible flakes on
the skin surface (excess keratinization).

40
Ultimately the stratum corneum is the outcome of the change that happens when new,
live cells are produced in the basal layer and are pushed upward by the newer cells
until they’ve reached the surface, dry out and are sloughed off.

This layer acts as the principle defence of the body against injury, invasion of bacteria,
and acts as a waterproof covering for the skin. Water gets pushed outside the cell
which makes up the barrier function.

The acid mantle

The acid mantle which rests on the stratum corneum, contributes to skin protection and
is the first line of the skin barrier defence, sometimes referred to as the hydrolipidic
layer (which means a layer of oil and water) that covers the skin surface. The acid
mantle is a complex fluid entirely formed by the following substances and is an end
result of the skin’s own metabolism:

➢ Sweat from the sudoriferous glands

➢ Sebum from the sebaceous glands, (sebum is made up of ceramides and fatty
acids)
➢ Epidermic lipids
➢ Hydration from our GAGs (see below)

This water/ oil mixture lies between the corneocytes and keeps intercellular fluids inside
the skin. This prevents/slows trans-epidermal water loss (TEWL) as oil being denser,
will sit on top of the water layer preventing its loss.

The acid mantle has a pH of between 4 and 6.2 (ideally 5.5) and therefore is a slightly
acidic environment in which micro flora/bacteria resides. These micro flora and bacteria
digest all the nutrients on the outer layer of the skin, therefore preventing the entry of
any harmful bacteria as they have nothing to feed on and will be repelled.

41
The Dermis
Structure of the Dermis

Underneath the epidermis we have the dermis. This is where our collagen and elastin is
made.

The dermis is composed of three major types of cells:

➢ fibroblasts
➢ macrophages
➢ mast cells

Apart from these cells, the dermis is also composed of matrix components such as
collagen and elastin and the extrafibrillar matrix, an extracellular gel-like substance
primarily composed of glycosaminoglycans/GAGS (most notably hyaluronan),
proteoglycans, and glycoproteins.

42
Collagen is a protein fibre forming the main part of the connective tissue. It is strong
and resistant and found in abundance, much more so than elastin. It is non-elastic but
flexible and found within many organs and structures. Collagen fibres lie parallel to
each other in bundles. It is vital to the skin’s support and strength. Age and exposure to
environmental factors causes it to breaks down, resulting in lines and wrinkles. It is
responsible for maintaining the growth and repair of the skin.

Elastin is a protein fibre made up of elastin forming a small part of the connective
tissue. These are thinner than collagen fibres and are very elastic, they give the skin its
elasticity. They are strong but can be stretched up to 150% of their relaxed length
without breaking and can return to their original shape = ‘elasticity’. Elastin is vital for
the skin’s youthful appearance. Age and exposure to environmental factors make these
fibres less effective. The degradation of elastic fibres is very much associated with UV
exposure.

Fibroblasts – large, flat cells producing collagen and elastin fibres to help repair tissue.
Fibrobaslts also produce gycosaminosglycans (GAGS) i.e. Hyaluronic acid, Heparan
sulfate, Heparin and Dermatan sulfate. Skin cells use these GAGs for support, water
storage, binding, and they form a medium for intercellular exchange (especially
between blood cells and other types of cells). The GAG’s attract and retain water and
form a sort of gel substance through which ions, hormones and nutrients can freely
move and will from part of the acid mantle.

43
Macrophages – irregular shaped cells that ‘eat’ or ‘mop’ up bacteria and other
unwanted substances in the tissue. Protects the body.

The Macrophage

Mast cells – these produce heparin to thin the blood and histamine that is released
during an allergic response. These cells are found very close to blood vessels.

44
Plasma cells – also found in the dermis, these are small white blood cells which
produce anti-bodies to foreign particles or bacteria that may damage tissues of the
body, so help to fight infection in the skin and protect the body.

The dermis
The dermis makes up to 90% of the skin’s weight. It is split into two layers: Papillary
and Reticular

45
Papillary dermis
Lying directly beneath the basal layer of the epidermis and the dermal/epidermal
junction, the papillary region is composed of loose areolar connective tissue. It is
named for its finger like projections called papillae (see picture above) which greatly
increase the surface area between the dermis and epidermis. Because the main
function of the dermis is to support the epidermis, this greatly increases the exchange
of oxygen, nutrients, and waste products between these two layers. Additionally, the
increase in surface area prevents the dermal and epidermal layers from separating from
each other by strengthening the junction between them. As we age these structures
become irregular and are retracted and lost, leading to a flattening of the dermal-
epidermal junction.

Reticular dermis
The reticular dermis is the lower layer of the dermis, found under the papillary dermis,
composed of dense, irregular connective tissue featuring densely packed collagen
fibers. The reticular region is usually much thicker than the overlying papillary dermis. It
receives its name from the dense concentration of collagen, elastic, and reticular fibers
that weave throughout it. These protein fibers give the dermis its properties of
strength, extensibility and elasticity. Within the reticular layer we find the root of the
hair, sebaceous glands, sweat glands, receptors and blood vessels.
The extracellular matrix (ECM) is the environment found around the cells of the dermis
like the fibroblast, mast cells, etc. It is also sometimes referred to as “ground
substance”.

In both the papillary and the reticular layers of dermis, fibroblasts and fibrocytes
(immature fibroblasts) are the cells responsible for laying down and maintaining the
extracellular matrix, and hence the structure of the dermis.

Appendages of the dermis

➢ Sebaceous glands are connected to the hair follicle and secrete an oily substance
known as sebum into the neck of the hair follicle. It coats the surface of the hair
and prevents it from drying or becoming brittle. Sebum lubricates the skin and
hair and exits onto skin via a pore. As previously mentioned sebum will form art
of the acid mantle and NMF.

46
 ➢ Arrector Pilli Muscle is connected to the epidermis and hair follicles. When these
muscles contract they pull the skin to form ‘goose bumps’. As they contract
individual hairs are pulled upwards helping to trap warm air between the skin
and hair.

➢ Sweat glands. Technically classified as sudoriferous glands, there are two types.
Eccrine glands are found all over the body especially on the palms of the hands
and the soles of the feet. They are active from birth; they produce sweat with a
high salt and water content that helps to regulate body temperature. Apocrine
glands are found on the hairy parts of the body e.g. underarms, groin and are
larger than eccrine glands. These glands become active during puberty and they
produce sweat that has a higher fat content than that produced by eccrine
glands. Due to their location (warm moist areas) bacteria will feed on the fat
content of the sweat, break down and so produce body odour.

➢ Hair follicle

The subcutaneous layer (The Hypodermis)

The hypodermis is the borderline between the deepest layer and the reticular above
and is often indistinct. It is made up of adipose tissue (fat), (energy reserve, support
and protection)) and loose connective tissue that house larger blood vessels and
nerves. This is an area where fats are made and stored. The hypodermis helps to
insulate the body by preventing loss of heat through the skin.

47
Functions of the Skin (remember SHAPESV)
The skin plays many important functions:

➢ Secretion – of sebum from the sebaceous glands. A sebaceous gland is a

microscopic exocrine gland in the skin that opens into a hair follicle to secrete an
oily substance called sebum, which lubricates the hair and skin.

➢ Heat regulation – the skin allows the body to either lose heat or retain it. It does
this through the blood that is flowing in the blood vessels. Vasoconstriction is
when the blood capillaries tighten up to stop blood from reaching the skin
surface. It happens if the body is cold. If no blood is getting to the skin surface,
then no heat will be lost. Vasodilation is when the blood capillaries relax and
allow a lot of blood to reach the skin surface. This causes the skin to flush and
heat is lost. The body is also able to promote shivering to increase body
temperature. The eccrine sweat gland, which is controlled by the sympathetic
nervous system, regulates body temperature. When internal temperature rises,
the eccrine glands secrete water to the skin surface, where heat is removed by
evaporation.

➢ Absorption – the skin cannot absorb a lot of substances as it is a waterproof

layer. Essential oils, drugs and some cosmeceutical products can be absorbed via
pores in the epidermis, depending on molecular size.

➢ Protection – the skin is a natural layered barrier against entry of bacteria etc. It
also has the protective acid mantle to stop microbes growing on the skin surface.
UV rays from sunlight causes an increase in natural skin pigment melanin to be
released. This pigment absorbs the damaging rays of sunlight and protects us
from burning and damage. Langerhans cells protect us from infection and boost
the immune system. Nerve endings give us warning signs of extremes or danger.
The skin’s waterproof layer prevents the loss of essential body fluids.

➢ Excretion (elimination) – toxins such as salts, urea and waste are lost through
sweat glands of the skin.

➢ Sensation – the nerve endings and other receptors of the skin can detect pain,
cold, heat, pressure and touch. Different receptors lie at different levels in the
skin.

➢ Vitamin D production – sunlight converts a substance called ergosterol found in

sebum into vitamin D. Vitamin D is essential for calcium and phosphorus
absorption for healthy teeth and bones. A lack of vitamin D leads to rickets in
children.

48
Disorders of the Skin
Congenital disorders

Eczema: The skin in any area of the body can become dry, itchy and flakey and cause
great discomfort. Bleeding and oozing will occur due to itching. Common areas for
eczema are elbows, behind knees, face, hands and scalp. Causes may be endogenous
or exogenous. It is not contagious. Eczema is likely related to conditions that adversely
affect the skin's barrier function (including genetic factors, nutrient deficiencies,
bacterial infection, and dry, irritated skin). Certain foods such as nuts and dairy can
trigger symptoms. Eczema can also be triggered by environmental factors such as
smoke and pollen. Treatment focuses on healing damaged skin and alleviating the
symptoms. For some, their eczema will eventually disappear completely, but for others,
it remains a lifelong condition.

Psoriasis: A chronic inflammatory disorder of the skin. Psoriasis affects the life cycle of
skin cells, causing an accelerated rate of turnover of the top layer of the skin. The
whole cycle - skin cell production to skin death and flaking off - takes between 21 and
28 days. In patients with psoriasis, the cycle takes only between 2 to 6 days; resulting
in a rapid buildup of cells on the skin’s surface, causing red, flaky, scaly, crusty patches
covered with silvery scales, which are then shed. Bleeding, oozing, irritation and itching
occurs. It can be found anywhere on the body. There is no ‘cure’ and it is not
contagious.

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Bacterial disorders

Acne Vulgaris: See below

Folliculitis: This is a bacterial infection of the pilo-sebaceous duct (sebaceous gland +

hair follicle). It causes redness and inflammation. It is connected with acne vulgaris and
hormonal imbalances.

Boils (furuncles): This is a bacterial infection of the skin, causing an infection locally
around a hair follicle. Can be contagious – mostly not.

Carbuncle: a severe abscess or multiple boisl in the skin, typically infected with
staphylococcus bacteria.

Impetigo: a skin infection caused by bacteria. It is usually caused by staphylococcal

(staph) bacteria, but it can also be caused by streptococcal (strep) bacteria. It is most
common in children between the ages of two and six. It usually starts when bacteria
get into a break in the skin, such as a cut, scratch, or insect bite.
Results in sores and blisters. It is highly contagious.

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Conjunctivitis: Viral conjunctivitis and bacterial conjunctivitis may affect one or both
eyes. Viral conjunctivitis usually produces a watery discharge. Bacterial conjunctivitis
often produces a thicker, yellow-green discharge. Both types can be associated with
colds or symptoms of a respiratory infection, such as a sore throat. Both viral and
bacterial types are very contagious. They are spread through direct or indirect contact
with the eye secretions of someone who's infected.

Stye: an inflamed swelling on the edge of an eyelid, caused by bacterial infection of

the gland at the base of an eyelash.

Viral disorders

Warts: Small horny tumours on the skin caused by a viral infection. Highly contagious.

Verruca: ‘Plantar warts’. These are warts found only on the feet. They appear more
spread out and ‘see through’ with a small black dot in the center. They are highly
contagious.

Herpes Simplex (HSV): This is an infection known as the ‘common cold sore’. They
can be found on the mouth, cheeks, chin, and other body parts. Red area with small
fluid filled blisters that break open and leave scabs. Highly contagious.

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Herpes zoster: A viral infection known as ‘shingles’. This is the adult form of chicken
pox. It affects the spinal nerves and is extremely painful. Can take up to 2 years to
recover. Highly contagious. It appears as redness and blisters that form crusts along
the nerve pathways leaving purplish pigmentation marks.

Fungal disorders

Tinea pedis: ‘Athletes Foot’. This is an infection caused by the presence of fungus,
found on the feet and between the toes. Fungal infections thrive in warm, moist and
dark conditions. They attach themselves onto and live off the keratinised skin cells.
Causes redness, itching, bleeding, white peeling skin. Highly contagious and can be
moved from the feet to other parts of the body.

Tinea corporis: Fungal infection of the skin on the body. It is the ‘common ringworm’
that appears as a red circle on the skin and spreads out. Highly contagious.

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Tinea ungium: Fungal infection of the nail. Highly contagious.

Infestations

Scabies: an animal parasite that burrows beneath the skin and invades the hair
follicles. Tiny papules and grey lines appear. Secondary bacterial infections can occur.
Highly contagious.

Pediculosis: Pediculosis capitas (headlice); Pediculosis pubis (pubic lice). These are
animal parasites that infect the hair. They bite onto the skin and draw blood to survive.
They lay eggs. When the eggs have hatched, the empty shell oxidises and looks white –
these are the lice. Highly contagious.

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General conditions/ disorders (not contagious)

NB: It is important that you are capable of recognizing and understanding

these conditions:

Dermatosis Papulosa Nigra: a common papular disorder, which develops in

adolescence & only in black skin. The lesions are histologically identical to seborrhoeic
keratosis. They are smooth, dome shaped, brown to black papules seen mainly on the
cheeks, neck.

Naevae: Birthmarks are areas of pigmentation (light to dark) found in different parts of
the body. Some are associated with strong hair growth. Strawberry naevae are found
on babies and are a pink color.

Port wine stains: a collection of abnormally formed blood vessels. (capillaries) in the
skin, which results in a red mark that may have the colour of port wine however they
can vary from pink to dark red. They are commonly found on the face and are present
from birth.

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Broken capillaries: (telangiectasia) tiny blood vessels that become visible near the
surface of the skin when the walls of the blood vessel break down due to persistant
contraction and dilation. Also caused by trauma to the skin including overzealous
cleansing and exfoliating and UV exposure.

Skin tag: a small tag of skin which may have a peduncle (stalk) - they look like a small
piece of soft, hanging skin. They are usually found on the neck, chest, back, armpits,
under the breasts, or in the groin area. Thought to be caused by friction and an over-
abundance of cells.

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Papilloma: Moles. Pigmented areas of skin found in varying parts of the body. Sessile
moles are flat. Pedunculated moles are raised.

Keloid scar: an enlarged, raised scar that can be pink, red, skin-coloured or darker
than the surrounding skin, an overgrowth of dense fibrous tissue that usually develops
after tissue damage and extends beyond the borders of the original wound. It does not
normally regress spontaneously.

Keloid Scar

Xanthoma: a xanthelasma is a sharply demarcated yellowish collection of cholesterol

underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a
distinct condition, being called a xanthoma only when becoming larger and nodular,
assuming tumorous proportions.

Xanthoma

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Crows feet: Fine expression lines around the eyes – ‘laughter lines’.

Urticaria: Hives, nettle rash. An allergic reaction to some stimulant. Characterised by

weals/welts of pink colour. Very itchy and can lead to secondary bacterial infection.

Comedones: can be closed or open. Closed – blackheads. Open – whiteheads. Due to

build-up of sebum and dirt on the skin and pores. The sebum is oxidised and gives the
colour (blackhead). Common with acne vulgaris.

Milia: small white/ pearly coloured lumps when keratin becomes trapped in a duct with
no opening/ below the epidermis. Common on the orbicularis oculi areas around the
eyes.

Dermatitis: allergic reaction to being in contact with some irritant like shampoos or
detergents (contact dermatitis).

Seborrhoea: Excessive oiliness due to hyperactivity of the sebaceous glands. Caused

by hormonal imbalances.

Papule: a small nodule or swelling on the skin common in acne

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Pustule: a small nodule on the skin containing pus. Frequently form in sweat glands or
hair follicles. Pus is a mixture of inflammatory cells and liquid.

Open pores: Stretched hair follicles due to excess oil.

Skin Cancer
Non-melanoma cancers: refers to all the types of cancer that occur in the skin that
are not melanoma. Several types of skin cancer fall within the broader category of non-
melanoma skin cancer, with the most common types being basal cell carcinoma and
squamous cell carcinoma.
Basal cell carcinoma: tumours arise in the cell of the stratum germinativum of the
epidermis. They rarely metastasize (spread). Usually on face, nose, eyelids, cheeks.
Squamous cell carcinoma: tumours arise in the squamous cells of the epidermis.
Most arise from pre-existing lesions or damage due to chemicals, sun-exposure, etc.
Some metastasize others don’t.
Malignant melanomas: arise from melanocytes in the epidermis. Can develop from a
previously benign mole. They metastasise rapidly.

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Key to early detection of melanomas:

A- ASYMMETRY
B- BORDER
C- COLOUR
D- DIAMETER

Skin Conditions
Ageing Skin
As previously mentioned skin function and structural stability diminishes with age as the
dermal-epidermal junction flattens and reduces exchange between epidermis and dermis.
Cellular turnover slows down and the stratum corneum becomes thicker whilst other layers
thin out due to lack of nourishment. Fibroblasts within the dermis deform and their numbers
decrease and their activity level slows resulting in a decrease in glycosaminoglycans (GAGS e.g.
hyaluronic acid). Collagen fibres become rigid and break forming fine lines and wrinkles. Elastin
fibres lose structure resulting in poor skin elasticity and fat is lost, thinning the skin. Pigment
changes also often become more apparent.
Ageing is due to both intrinsic and extrinsic factors. Intrinsic ageing is an inevitable, genetically
determined process that occurs naturally and is affected by the degenerative effects of free radicals,
hormonal shifts and the body's inability to perfectly repair skin damage. Extrinsic ageing is a result of
lifestyle and environmental factors.

Free radicals
Oxidative stress occurs when you combine free radicals with oxygen and the free radicals are
greater than the body's ability to detoxify them.
To be more scientific …. oxidative stress occurs when an oxygen molecule splits into single
atoms with unpaired electrons, which are called free radicals. Electrons like to be in pairs, so
these atoms, called free radicals, scavenge the body to seek out other electrons so they can
become a pair. This causes damage to cells, proteins and DNA which, over time, results in
visible signs of aging including fine lines, wrinkles, discoloration, reduced firmness, and skin
cancer.

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Free radicals are generated by the sun’s UV and infrared rays, pollution, stress, alcohol, and
smoking.
Antioxidants, sometimes referred to as “free radical scavengers” are molecules that prevent
oxidative reactions by donating an electron to a free radical without becoming destabilized.
Different antioxidants work via different mechanisms to neutralize damage. There are five
antioxidants naturally found in the body: ascorbic acid (vitamin C), tocopherol (vitamin E),
alpha-lipoic acid, glutathione, and ubiquinone. Antioxidants are the skin’s natural way to
protect itself from free radicals. Topical antioxidants have been shown to protect skin from
damaging free radicals caused by UV rays.

Hormones
The hormone estrogen has a profound effect on female skin and as levels fall pre and post
menopause premature ageing occurs, much more so compared with similarly aged men.

Smoking
Regular smoking accelerates the ageing process of skin because of the reduced blood supply
and subsequent lack of nutrients to the tissue. It also causes the release of proteolytic enzymes,
which in turn degrade collagen and elastin fibers.
Alcohol
Alcohol dehydrates the skin causing premature ageing and also widens the blood vessels
causing broken capillaries.

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Pollution
Although we might not be able to see pollution it is all around us. The molecules of pollution
are so small they penetrate the skin causing oxidative stress i.e. ageing of the cells.
UV exposure
Chronic exposure to UV radiation causes a number of weakening changes in the cells, fibrous
tissue and blood vessels of the skin. UV light exposure often upsets the melanocyte response,
producing freckles, age spots and other pigmentation issues.
When the skin is exposed to excessive sun, the stratum corneum responds by becoming thicker
in order to protect the underlying layers. When the quality of the stratum corneum is altered
the epidermis can dry out as water reserves evaporate. Dehydration can result in rough skin
that is hypersensitive which flakes, scales and creates wrinkles.
The Glogau classification system was developed to objectively measure the severity of
wrinkles and photoageing.

Rosacea
Rosacea is a chronic skin condition affecting mainly the 30-50 age group. It affects both males and
females but tends to be more aggressive in males. The signs and symptoms of rosacea are detailed
below.

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Nobody really knows what causes rosacea but there are many theories.

The first is vulnerabilised blood vessels, the second is a linking to the helicobacter bacteria in the gut.

The third is a sensitivity to the demodex mite that lives normally in healthy levels in the skin. It has been
suggested that rosacea sufferers have a sensitivity to the demodex mite and the bacteria that’s
associated with it. The demodex mite thrives in the warmer facial temperature that rosacea sufferers
tend to present.

We do know that rosacea is the only progressive skin condition which means that it will never normalise
itself. Unless there is intervention rosacea will only get worse. We also know that there are certain
triggers that make rosacea more aggravated. These include things that are known vaso-dilators such as
alcohol and spicy foods, excessive exercise, sunlight.

There’s often an associated compromised hydro lipidic barrier with rosacea skins. This means the
epidermis is vulnerable to external invasion and environmental damage especially from free radicals,
when this sensitivity occurs the body can respond by sending bloods to the area because blood brings
with it red platelets, oxygen and nutrients and white platelets for immunity. The blood vessels that
consistently carry this blood that leads to a flushing of the skin can become weakened and burst. So now
we have visible red, hot skin with visible veins and broken capillaries. When these broken veins and
capillaries appear in clusters, it presents as telangiectasia. There’s also in some cases inflammation of
the pilo-sebaceous unit that leads to papules and pustules on the surface of the skin. This can lead to
redness and inflammation and persistent flushing and whiteheads on top of this sensitised skin.

There are 4 subtypes of rosacea. Mild early onset of rosacea exhibits telangiectasia and redness
while severe cases can result in papules and pustules.

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1. Erythematotelangiectatic Rosacea
Characterized by persistent redness on the face. Small blood vessels beneath the skin surface
may become enlarged and visible; these symptoms often flare up and then disappear. Without
treatment, the redness can get more persistent, cover more skin, and even become permanent.
2. Papulopustular Rosacea
Associated with “whitehead” pustules, which are pus-filled blemishes, and red, swollen bumps.
These typically appear on the cheeks, chin, and forehead and are frequently misidentified as
acne. Facial redness and flushing may appear, as well. Severe papulopustular rosacea can cause
upwards of 40 blemishes that can take a long time to go away. Blemishes may also appear on
the scalp, neck, or chest.
3. Phymatous Rosacea
Causes skin to thicken and scar, making it bumpy, swollen, and sometimes discoloured. This
rare but treatable type most often affects the nose—resulting in what is sometimes called a
bulbous nose, or rhinophyma, and appears more frequently in men than in women.
4. Ocular Rosacea
Symptoms affect the eyes, causing them to look watery or bloodshot. There may be an
associated feeling of burning or irritation in your eyes. Ocular rosacea can cause persistently
dry, sensitive eyes, and cysts may form on the eyelids.

Acne
Non inflammatory acne can affect 90% of us at some times in our lives. Inflammatory acne is
more commonly related to hormones. Acne occurs in and around the sebaceous glands of the

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face, neck, chest, back and shoulders brought on by a combination of over active sebaceous
glands, hormonal activity and blocked pores.

Acne is characterised by acne lesions which include blackheads, whiteheads, papules and pustules.

Sebum is made in the sebaceous gland which is attached to the hair follicle. In a normal and healthy skin
the sebum is allowed to escape through into the epidermis and contribute to the hydro-lipidic barrier.
There is also skin cells inside the hair follicle which would normally desquamate onto the surface of the
follicle to be exfoliated naturally. In an acneic skin the sebum and dead skin can collect inside the hair
follicle creating inflammation.

When the backlog of sebum has been produced the bacteria (p acne bacteria) that lives on our skin
usually in health levels as part of our flora will feed on this sebum and cellular debris meaning that they
can grow divide and multiply rapidly. That is when bacteria becomes a problem and can trigger
inflammatory acne.

The severity of acne can be classified into four grades.

• Grade 1 (mild): mostly confined to whiteheads and blackheads, with a few papules and
pustules

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 • Grade 2 (moderate, or pustular acne): multiple papules and pustules, mostly confined to
the face

• Grade 3 (moderately severe; nodulocystic acne): numerous papules and pustules; the
occasional inflamed nodule; the back and the chest may also be affected

• Grade 4 (severe nodulocystic acne): numerous large, painful pustules and nodules;
inflammation.

Acne and Food Connection

Alcohol
Studies suggest that alcohol can lead to hormonal imbalances therefore making acne worse
because our sebaceous glands are overly stimulated, which leads to an overproduction of
sebum
Sugars and Refined Carbohydrates
One study found that people who frequently consumed added sugars had a 30% greater risk of
developing acne. This increased risk may be explained by the effects refined carbohydrates
have on blood sugar and insulin levels. Refined carbohydrates are absorbed quickly into the
bloodstream, which rapidly raises blood sugar levels. When blood sugars rise, insulin levels also
rise to help shuttle the blood sugars out of the bloodstream and into your cells. Insulin makes
androgen hormones more active and increases insulin-like growth factor 1 (IGF-1). This
contributes to acne development by making skin cells grow more quickly and by boosting
sebum production. On the other hand, low-glycemic diets, which do not dramatically raise
blood sugars or insulin levels, are associated with reduced acne severity
Dairy Products
Many studies have found a link between milk products and acne severity. Milk is known to
increase insulin levels, independent of its effects on blood sugar, which may worsen acne
severity. Cow’s milk also contains amino acids that stimulate the liver to produce more IGF-1,
which has been linked to the development of acne.

Fast Food
Acne is strongly associated with eating a Western-style diet rich in calories, fat and refined
carbohydrates. It is unclear why eating fast food may increase the risk of developing acne, but
some researchers propose that it may affect gene expression and alter hormone levels in a way
that promotes acne development.

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Foods Rich in Omega-6 Fats
Diets containing large amounts of omega-6 fatty acids, like the typical Western diet, have been
linked to increased levels of inflammation and acne. This may be because Western diets contain
large amounts of corn and soy oils, which are rich in omega-6 fats, and few foods that contain
omega-3 fats, like fish and walnuts. This imbalance of omega-6 and omega-3 fatty acids pushes
the body into an inflammatory state, which may worsen acne severity. Conversely,
supplementing with omega-3 fatty acids may reduce levels of inflammation and has been found
to reduce acne severity.
While the links between omega-6 fatty acids and acne are promising, there have been no
controlled studies on this topic, and more research is needed.

Foods You’re Sensitive To

It has been proposed that acne is, at its root, an inflammatory disease. This is supported by the
fact that anti-inflammatory drugs, like corticosteroids, are effective treatments for severe acne
and that people with acne have elevated levels of inflammatory molecules in their blood. One
way that food may contribute to inflammation is through food sensitivities, also known as
delayed hypersensitivity reactions. Food sensitivities occur when your immune system
mistakenly identifies food as a threat and launches an immune attack against it. This results in
high levels of pro-inflammatory molecules circulating throughout the body, which may
aggravate acne.
While there appears to be a link between inflammation and acne, no studies have directly
investigated the specific role of food sensitivities in its development.

Pigmentation

Pigment is vital in our skin for photo defence. This means that the pigment that resides
in our skin cells protects the DNA that resides in our keratinocytes from DNA damage
from both UVA and UVB radiation.
The pigment in our skin is made by melanocyte cells that sit in the basal layer of the
epidermis. The melanocyte cell will produce melanosomes. This melanosome will then
travel up through dendritic fingers of the melanocyte cell and will transfer its pigment to
roughly 35 keratinocytes in its near vicinity. When the melanocytes are making healthy
levels of pigment and dispersing the pigment horizontally throughout the skin we have
an even skin tone. When a cluster of melanocytes make too much pigment or start to
disperse the pigment vertically we can see patches of pigment on the skin leading to an
unclear, mottled skin condition.

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Hyperpigmentation is categorised by darker areas of the skin, some small areas like
freckles, some larger areas as with hormonal related melasma. Chloasma/ Melasma is a
condition in which areas of the skin become darker than the surrounding skin. It
typically occurs symmetrically on the face, particularly the forehead, cheeks and above
the upper lip. ... Sometimes it is called the "mask of pregnancy". It is due to hormonal
changes or imbalances – birth control pills, pregnancy, and hormone therapy can all
trigger melasma. It’s often made worse or permanent by further UV exposure. When
trying to assess whether the clients pigmentation is hormone related have a look at the
symmetry of it on the skin. It might appear worse or more mottled on one side. Before
you try to address treatment suggest to the client that she might want to explore the
idea of endocrine disruption. It might be that she may want to change her
contraception, wait for the completion of her pregnancy or address endocrine disruption
with her medical professional.

Whether pigmentation is caused by hormone disruption, trauma to the skin or exposure

to UV radiation, the physiology of pigment is the same.
Post inflammatory hyper-pigmentation (PIH) is also hyper production of melanin by the
melanocyte and trauma to the area of the skin. It’s common in Fitzpatrick skin types 4-
6 whose skin is very accustomed to making pigment anyway. PIH will be the direct
result of inflammation in the skin caused by eg an acne lesion, a burn or an ill
performed aesthetic treatment.

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When trying to address PIH it’s vital that you also address the skin concern that’s
causing the PIH - we want to reduce inflammation in the skin and control acne lesions
so that we can prevent further PIH.
PIH can occur in darker skin types if they undergo a medical peel without pre-treating
the skin first. It’s vital that we use melanin suppressing peptides and products for 2
weeks before a peel to suppress these melanocyte cells so that they don’t respond to a
peel with PIH.
You will also see hyper- pigmentation related to ageing. This is also called photo
damage or sun damage. Photo damage is hyper- pigmentation as a direct result of UV
exposure.

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Whether the hyperpigmentation is melasma, PIH or photo damage the melanocyte
pathway is the same. This pathway is known as melanogenesis. Tyrosinase is
responsible for the first step in melanin production. It converts a protein building block
(amino acid) called tyrosine (an amino acid that resides in the factory of the melanocyte
cell) to another compound called dopa (Dihydroxyphenylalanine) which is converted
into dopaquinone which goes on to form melanin
To target hyper-pigmentation we need to supress the melanogenesis pathway. By
controlling the enzyme tyrosinase we can target how much tyrosine is converted into
dopa and dopa quinone reducing the amount of pigment that is made by the
melanocyte cell.

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Pigmentation disorders continued (not contagious)

Vitiligo: a complete loss of colour in well-defined areas of the body. It is a form of

leucoderma. The melanocytes stop producing melanin. It is more obvious in darker
skins. White patches may start small but develop and merge.

Albinism: this is a genetic / inherited disorder where there is a complete lack of

melanocytes, therefore, the pigment melanin cannot be produced. Sufferers are very
photosensitive.

Ephelides: Freckles. Small pigmented areas that become darker on exposure to

sunlight.

Lentigo: an individual sun spot known as a solar lentigo can look like a large freckle on
the skin. Lentigos in collection are known as solar lentigines. This is what leads to that
mottled ageing skin complexion.

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FACIAL ELECTRICAL TREATMENTS

Electrical treatments are a large source of revenue for salons, and are very popular with
clients. While therapists may argue that nothing is more relaxing than manual massage,
electrical treatments are more effective for treating skin problems and for deeper
penetration of products into the skin. Any treatment using an electrical current, adapted
to any of the machinery used with beauty therapy, will be more effective than manual
treatments alone. As with standard facials a course of treatments is always
recommended for your client.

The benefits and effects of electrical treatments

NVQ 3 BEAUTY THERAPY: Facial treatments
• Stimulates the circulation, lymphatic flow and glandular activity
• Deep cleanses the skin
• Helps products penetrate into the skin effectively
• Stimulates the muscles
• Heats the skin through the increase in circulation
• Massages the face
• Visible results in the skin’s condition
• More penetrating than manual treatments
• More effective than manual treatments
• Better results on specific areas and conditions
• Long-term benefits with a long term programme of treatments
• Instant results can often be felt by the client e.g. relaxation

A complete circuit is needed for the current to flow. If the circuit is broken, there will be
no current flow and no transfer of energy. This is important during electrical treatments
when you think your machine is not working properly. Often you have not completed
the circuit by giving the client the saturator, or passive electrode, to hold, so completing
a circuit.

However, not all treatments are suitable for all clients. Choice of equipment will depend
on:

• the client’s needs and any contra-indications present

• the client’s likes and dislikes
• the cost of a treatment or course of treatments
• the time constraints for a course to be fitted into a client’s lifestyle
• the skin type

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Keys to good practice
Make sure you are well-informed regarding all the options so that you can offer the
client several alternatives. Always ask the client if he or she has any particular likes or
dislikes. For example, it could be that the client’s wishes are for relaxation, so the noise
of a high frequency machine might not appeal. Instead, offer the slow rhythm of a
pulsation vacuum suction treatment to the face, which would be suitable. Be informed
about all the latest reports in the media about new electrical treatments within the
beauty industry. You could be missing an opportunity to expand your business and offer
clients something new and innovative. Talk to the clients about the benefits of the new
treatments, and be specific about the benefits for the client’s skin. Take extra training
to learn new equipment usage and increase your client base by having the latest
treatments available.

Using Equipment Safely

Using Equipment safely and with confidence is essential and it is very important that
you follow the manufacturer’s instructions for the machine you are using, since these
will vary. Products used, treatments times and the dials showing strength of current will
differ from one make of machine to another. The only way to be totally safe and
confident for your assessments is to understand each machine thoroughly and know its
capabilities. This will provide you with the confidence to treat clients in a professional
manner which in turn will give the client confidence in your abilities.

Points to remember - Always:

• Complete a full consultation.

• Complete a contra-indication checklist.
• Carry out thermal and sensitivity tests after the skin analysis.
• Follow the manufacturer’s instructions.
• Test the equipment on yourself before using it on the client.
• Ensure all jewellery is removed from client and therapist and also any metal
conducting material e.g. belt.
• Always start on zero intensity
• Make electrode contact with client and start to move electrode slowly before
increasing intensity
• Check how client is feeling throughout the treatment
• Constantly monitor for any developing contra-actions
• Always clean and sterilise electrodes and equipment after each use
• Follow manufacturer’s instructions for safe and effective treatment
• Remember any electrical current is attracted to the moisture content in the hair
shaft therefore the hair needs to be well covered with a headband. This should
encase all of the hair to ensure the current stays concentrated on the skin.

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Note: always carry out a risk assessment in terms of health and safety before
proceeding with any treatment.

Note:
Electrical therapies

Electrical therapies use a range of different currents and frequencies. To understand

the differences in equipment, you will need to know:

• the type of current used and how it behaves

• how each piece of equipment works
• its benefits to the client
• its risk assessment and hazard potential
• how to use it most effectively for the client’s needs.

To appreciate these topics, you first need to understand the properties of electricity:

What is electricity?
Electricity is a type of energy that can build up in one place or flow from one place to
another. When electricity gathers in one place it is known as static electricity (the word
static means something that does not move); electricity that moves from one place to
another is called current electricity.

For an electric current to happen, there must be a circuit. A circuit is a closed path or
loop around which an electric current flows. A circuit is usually made by linking
electrical components together with pieces of wire cable. Thus, in a flashlight, there is a
simple circuit with a switch, a lamp, and a battery linked together by a few short pieces
of copper wire. When you turn the switch on electricity flows around the circuit. If there
is a break anywhere in the circuit electricity cannot flow. If one of the wires is broken,
for example, the lamp will not light. Similarly, if the switch is turned off, no electricity
can flow. This is why a switch is sometimes called a circuit breaker.

Materials such as copper metal that conduct electricity (allow it to flow freely) are called
conductors. Materials that don't allow electricity to pass through them so readily, such
as rubber and plastic are called insulators.

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A current of electricity is a steady flow of electrons. When electrons move from one
place to another, round a circuit, they carry electrical energy from place to place like
marching ants carrying leaves. Instead of carrying leaves, electrons carry a tiny amount
of electric charge.

Electricity can travel through something when its structure allows electrons to move
through it easily. Metals like copper have "free" electrons that are not bound tightly to
their parent atoms. These electrons flow freely throughout the structure of copper and
this is what enables an electric current to flow. In rubber, the electrons are more tightly
bound. There are no "free" electrons and, as a result, electricity does not really flow
through rubber at all.

Conductors are materials which are good transmitters of electricity that is they are
substances that allow electricity to flow through them quite easily. Metal, the human
body, water, saline solution (salts in water), silver and gold are all good conductors of
electricity. Materials that let electricity flow freely are said to have a high conductance
and a low resistance

Insulators are materials which are not good transmitters of electricity that is they do not
allow electricity to flow through them easily. They are used as protection from an
electrical current. Examples include glass, oil, plastic, rubber and wood, and they either
inhibit or prevent the flow. These have a low conductance and a high resistance.

For electricity to flow, there has to be something to push the electrons along. This is
called an electromotive force (EMF). A battery or power outlet creates the electromotive
force that makes a current of electrons flow. An electromotive force is better known as
a voltage.

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Types of electrical current

Electricity can move around a circuit in two different ways. In the diagram above you
can see electrons racing around a loop always going in the same direction. This type of
electricity is called direct current (DC). An alternating current is an electric current in
which the flow of electric charge periodically reverses direction,

The atom
All matter, whether a solid, gas or liquid, is composed of units called atoms. Every atom
has a nucleus and an external or outer layer.
• The nucleus contains positively charged particles, or protons.
• The nucleus also contains neutrons, which have no charge.
• The outer layer contains negatively charged particles called electrons

Each electron rotates continuously around the nucleus, always in the same orbit. When
electrons move, they carry electrical energy from one place to another. This is called
current electricity or an electric current. A lightning bolt is one example of an electric
current, although it does not last very long.

An atom has one of the following three characteristics:

1 Atom without electrical charge – when the number of electrons and protons is equal
and therefore the atom has no charge.

2 Negative ions or anions – if the atom gains an electron, the number of electrons will
be greater than the protons, so the atom takes on a negative charge. The atom
becomes a negative ion or anion.

3 Positive ion or cation – if the atom loses an electron, the number of protons is higher,
and the atom becomes a positive ion or cation.

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An atom

All ions relate to each other according to the physical laws of electricity: the same
charged ions repel each other, while opposite charged ions are attracted to each other.
Therefore, two negatives repel one another, so do two positives. A positive is only
attracted to a negative, and vice versa. This theory of opposites attracting is very
important in galvanic work, when the active ingredients in the gels and solutions used
have active ions, and they are used to aid skin penetration.

Electricity and electrical circuits

An electric current is a flow of electrons passing through a fixed point in an electrical

circuit per second, measured in amps. Electrons flow from negative to positive as they
are negatively charged. The pressure required to drive the electric current around a
circuit in measured in volts. The bigger the voltage, the more current will tend to flow.

Together, voltage and current give you electrical power. The bigger the voltage and the
bigger the current, the more electrical power you have. We measure electric power
(power rating) in units called watts. Something that uses 1 watt uses 1 joule of energy
each second.

Resistance is anything in the circuit which slows down the flow of electricity. There is a
balance – the voltage is trying to push the current around the circuit and the resistance
is opposing it. The relative sizes of voltage and resistance decide how big the current
will be:

• If you increase the voltage, more current will flow.

• If you increase the resistance, less current will flow.

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Resistance is measured in units called Ohms, but they cannot be measured directly.
They need to be calculated from the volts and amps.

Series or parallel circuits

Circuits are classified as either: series or parallel.

A series circuit is all or nothing – the components are connected in a line, end to end,
and they all share the electrical current going through them, so once one part is broken
the whole series breaks down. Think about the lights on a Christmas tree. If one bulb
blows, the whole line of bulbs goes out, and it is a process of elimination to find out
which one has gone. This is not very practical and, generally, few things are connected
in series.

In a parallel circuit each component is separately connected to the supply. This type of
circuit is sensible to work with, as removing or disconnecting one component of the
circuit will not disrupt the whole circuit. Household electrics are run this way, so you
can switch everything on or off separately.

Where does electricity come from?

Electricity is generated in power stations throughout the country and is distributed

through the National Grid to local electricity substations, where the electricity is
converted to a lower voltage for use in factories, businesses and homes. Factories
require very high voltages (33,000 volts), whereas small businesses such as your salon
will receive a 240-volt supply. In urban areas, the 240-volt supply comes into individual
premises through underground cables beneath the street. The supply cable enters the
building underground and arrives at the meter, fuse board, or circuit breaker, where
usage is measured, and once the meter is read, electricity bills can be calculated.

Most electrical equipment in a beauty salon runs from the 240 volts coming through the
wall sockets (mains electricity), and the machine will convert it into the type of current
it is built to provide, e.g. faradic, high frequency or galvanic. The exceptions to this are
the bigger electrical units, which require a higher voltage, such as saunas and steam
cabinets. They require a greater supply than 240 volts and have to be connected using
a special consumer unit, by the installation company. The local electricity supplier will
have to be informed and special rates of payment will be required – a sauna, shower
unit and spa may need more than double the amps/volts normally available

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Summary of Electricity Terms

Electric current:
• a flow of electrical charges called electrons
• measured in amps
• symbol used A

Pressure needed to drive current (driving force):

• measured in Volts, using a voltmeter
• Symbol used V

Power used to run equipment:

• measured in Watts and kilowatts (1000 watts = 1 kilowatt)
• symbol used W and kW

Resistance which slows the current down:

• measured in Ohms
• symbol used Ω

Alternating current (AC) flows in one direction, then in the reverse direction
in the circuit. One complete back and forth is called a cycle:

• measured in Hertz (one Hertz = one alternation per cycle)

• symbol used Hz

Effects of an electrical current

An electrical current is able to produce:
• chemical change
• heat
• sound waves
• magnetic fields
• light rays
• mechanical movements (kinetic effects)
• changes of matter from one state to another, e.g. water to steam through heating.

All of this is put to good use within the beauty salon equipment for the benefit of the
client. An electrical current adapted for use on or through the face/ body is able to:
• help improve skin function and appearance
• stimulate glandular and cellular activity in the region being worked upon
• improve the tone, functioning and appearance of the muscles
• provide relaxation to the tissues through heating them• stimulate the systems of the
body to encourage better functioning, that is the lymphatic system, circulation, cell
reproduction and growth and repair.

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Types of electrical current

Galvanic
Constant and direct (DC) – has no break in the flow of electrons. Low voltage. An
electric current produced by a chemical action.

Used for:
• iontophoresis – to penetrate beneficial creams into the skin
• desincrustation – deep cleansing. Usually to prepare the skin for iontophoresis
but can be used on its own.
• epilation

Both methods have two fundamental principles for correct use:

The polarity of the product used on the skin and the polarity setting of the machine
Penetration of products into the skin is only successful because of the action of the ions
when forced into action by the current. According to the basic laws of polarity the same
poles repel each other but opposite poles are attracted to each other.

Faradic
Surged and interrupted – alternating and low frequency. The current and wave
formations can be adjusted on the machine to suit the client’s needs
Used for:
• muscle toning
• passive exercise

High frequency
Alternating, oscillating, high in frequency, higher in voltage with lower amps. Alternates
rapidly at more than 50 times per second.
Used for:
• direct application
• indirect application

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Microcurrent
Modified direct currents (DC) – a galvanic current which can be altered on the machine
for the client’s needs and differing stages of treatment
Used for:
• uplifting facial/ body contours

Types of electrical facial treatments

Steamer
A heating element is used to boil the water, creating moist heat i.e. a jet of steam from
a nozzle.
Used to:
• Warm the tissues of the face, upper chest treatment
• Helps open the pores, and cleanses the skin.
• Warms the facial muscle fibres and relaxes them, making other treatments after
steaming very effective.
• Very good prior to comedone extraction, but be careful to time the treatment, as
if an erythema occurs too strongly, it may contra-indicate other treatments

Can be used on most skin types except extremely sensitive/ vascular. Timing of
treatment can be adjusted to suit skin type.

Brush Cleansing
A brush-cleansing machine has a motor, which rotates a held head that can have a
variety of brushes inserted into it. The speed of the rotations is adjustable to suit the
client’s needs and preference, as is the direction of the revolution – clockwise or
anticlockwise. Brushes of various thickness and stiffness will alter the treatment effect,
as will the accompanying products used with the machine. Most water-based products
are suitable, from basic foaming facial wash used to cleanse the face to cleansing grains
and specialist creams for particular skin problems.
The effect of the treatment is one of exfoliation and stimulation to the skin and
circulation. Can also be a useful tool in the removal of peels or masks from the face.

Can be used on most skin types except sensitive/ vascular. Product use will be
determined by skin type or problem. Most well known one on the market is the
“Clarisonic”.

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Vacuum suction

In the US this technique is referred to as non invasive sub dermal therapy (NIST)!
This machine uses a pump to create a vacuum within an attached cup (ventouse),
which picks up the tissue. Each ventouse (except the comedone extractor) has an air
hole at the side which when covered creates the vacuum. It is a mechanical treatment
performed with the aid of a compressor (pump) as there is no electrical current flowing
through the body.

Can be used either:

• to glide to the lymphatic nodes, in a single movement,
• to create a pulse within the vacuum, for extra stimulation.

Effects
• Encourages lymphatic drainage thus helping the removal of toxins from the area.
• Increases cellular activity
• Reduces areas of fluid retention
• Increases blood circulation to the area therefore bring fresh oxygen/ nutrients to
the tissue
• Aids desquamation
• Stimulates glandular activity in a dry skin
• Improves the general skin texture.
• Reinforces cleansing effect and aids removal of blockages

Note: Always work towards the lymph nodes to reinforce the natural draining ability of
the lymphatic system.

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Precautions
• Always change ventouse over the trolley top and not near the client
• Avoid pressure on the skin. Use a gliding action to avoid bruising
• Use a lubricating product eg oil to avoid dragging the skin
• Be careful not to have too great a vacuum within the ventouse as this
compresses the tissues and capillaries may burst causing bruising
• Suction should not exceed 20%
• Always remove the ventouse from the skin by breaking the vacuum i.e. releasing
the finger from the hole.

Can be used on all skin types

After each treatment ventouses should be placed in warm soapy water and cleaned
thoroughly and left to dry. Must be wrapped up and stored safely as they are easily
broken.

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Contra-indications in addition to standard facials
• Delicate sensitive skins
• Broken capillaries
• Couperose conditions
• Loose older skin with little underlying tissue
• Acneic skin
• Thin, boney areas
• Undiagnosed swelling
• Fine texture skin eg diabetics
• Any glandular swelling
• Very hairy areas (uncomfortable for client)

After care advice

• Same as standard facials

High Frequency

Indirect
Often called a ‘Viennese massage’ involves creating a circuit of current, flowing through
the client via a hand-held glass rod, called a saturator, connected to the machine. The
therapist’s hands make contact with the client and the current is discharged through
her fingertips, as she is massaging, creating warmth in the area. This deep massage will
improve a dry skin, relax the tissues and help increase a poor or sluggish circulation to
the area. Can be used in place of the facial massage routine, although if clients become
too relaxed, they will lose contact with the saturator which they should be holding.
Avoid losing contact with the skin, as this breaks the circuit so avoid all tapotement type
movements. Most frequently used on a dry skin.

Most commonly used on dry or fine skins as the medium used is oil which will help the
glide of the treatment and lubricate the skin.

Effects:
• Warms and relaxes the tissues
• Increases circulation to the area
• Improves moisture balance in the skin
• Calms the sensory nerve endings in the skin
• Increases cellular activity

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Precautions
• Care should be taken around the hairline as sensation will be increased because
hair is a good conductor
• Contact must not be broken
• The intensity of the current in the tissues will be increased when lifting one hand
off
• No alcohol based toner used beforehand as there is a small risk that f sparking
occurs they could ignite and cause burns

Direct

The current is transmitted into a glass electrode, which is in direct contact with the skin.
Light small circular motions then disperse the current. This is a drying germicidal
treatment, ideal for a seborrheic skin, one that is congested or has blemishes.
Uses an alternating current of around 250,000Hz to heat the superficial tissues

The client will feel a slight warmth and tingling sensation.

Most commonly used on oily, congested or acne skin types.

Effects
• Helps dry out an oily skin
• Increases cellular activity
• Helps improve oxygen levels by way of oxygenating cream
• Improves skin texture
• Helps healing after comedone extraction
• Ant-bacterial germicidal effect (and promotes healing of blemishes) due to
ozone production
• Sparking effect produces ultra-violet emissions which also destroys bacteria. The
germicidal effect is created by the ionization of the oxygen in the air which

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 creates ozone. Controlled quantities of ozone help to promote the healing
process. This effect is produced when the electrode is moved away from the skin
slightly causing the current to jump across the air gap to the skin.
• Calms the sensory nerve endings in the skin

Precautions
• Always use eye pads
• Gauze is used to hold oxygenating cream in place. Cut nose hole for client to
prevent the client from feeling claustrophobic.
• When sparking ensure the distance between skin and electrode is only a few
millimetres or tissue destruction may occur. Only to be used for individual
papules.
• No alcohol based toner used beforehand as there is a small risk that if sparking
occurs it could ignite and cause burns

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Electrode – a conductor through which electricity enters or leaves a vacuum tube.

Clean electrodes with warm, soapy water and dry thoroughly or wipe with surgical
spirit. The heads are made of glass so be careful when handling them and store them
correctly.

Within each electrode a small quantity of inert gas is sealed, usually argon. As the
current flows through the gas a coloured glow is produced. The electrodes glow either
blue/ violet if they contain argon and red/ orange if they contain neon.

Contra-indications in addition to standard facials

• Vascular conditions
• Migraine
• Acne rosacea
• Sensitive skin
• Highly nervous clients
• Excessive metal in the area i.e. fillings
• Swelling in the area
• Very hairy areas
• Sinus blockages
• Circulatory problems*
• Asthmatics*
*Only to be carried out with medical approval

Aftercare Advice in addition to standard facials

• No other skin care i.e. cleansing, toning, moisturizing for 24 hours after
treatment because of germicidal finish

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Galvanic

A galvanic machine uses a smooth direct constant current to produce the chemical
effects of galvanic therapy. If the current was not smooth muscle contraction would
occur.

Electrically charged water based solutions known as electrolytes are applied to the skin
to increase it’s electrical conductivity. When dissolved in water an electrolyte partly
splits and forms ions which carry either a positive charge (cation) or a negative charge
(anion). When the galvanic current is applied the ions within the solution start to move
– they are attracted towards either the positive pole (anode) or negative pole
(cathode). As discussed previously this is because like charges repel and opposite
charges attract. The results depend upon the method of use and the gels and products
used.

The current can pass through the body because the body’s tissue fluids contain ions. In
order for the treatment to work both positive and negative connections are required.
The electrode that creates the chemical effect is known as the active electrode and this
is applied to the face (rollers). The other electrode is known as the indifferent electrode
and this is placed in the client’s hand in order to complete the circuit.

If the polarity of the rollers is the same as the product then they will not attract one
another and the ions in the product will be attracted to the electrode in the hand
therefore going through the skin to get there. If the polarity is set wrongly and the
product is negative and the rollers are positive or vice versa then the cream is attracted
to the rollers and the client’s skin receives no benefit at all.

Desincrustation is usually performed using the negative polarity but always check as
manufacturers may differ. If the polarity is not stated on the gel look for the ph value of
the product: if acidic use the positive polarity and if alkaline use the negative polarity.

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For use on all skin types:
• desincrustation – removes the incrustation, i.e. the excess sebum. For oily skins
or skins in need of a deep cleanse.
• iontophoresis – used to penetrate beneficial substances into the skin. For a dry
skin or to rebalance the skin or just to improve the skin texture

Effects of Desincrustation
• Breaks down the acid mantle
• Stimulates secretions of the sebaceous and sweat glands
• Deep cleanses the skin and relaxes the pores making extractions easier
• Saponification – emulsifying the sebum so aiding removal (the effect at the
cathode)

Effects of iontophoresis
• Active ingredients in products will aid in detoxifying and decongesting skin.
Results vary according to ingredients and client’s needs
• Drives active products used into the skin by ionization
• Creates warmth in the tissues
• Rebuilds the acid mantle
• Soothes and sedates nerve endings
• Calms redness
• Improves skin texture

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Precautions
• Ensure client has removed rings
• Check product polarity required
• Ensure there is sufficient product applied to the skin. Do not allow the client’s
skin to become dry.
• Always keep rollers moving to prevent galvanic burns
• Contact lenses should be removed
• Avoid the rollers clashing together

Contra-indications in addition to standard facials

• Vascular conditions
• Very sensitive skin
• Highly nervous clients
• Excessive metal in the area i.e. fillings/ metal plates (turn down intensity to suit
clients tolerance)
• Swelling in the area
• Headache/ migraine sufferer
• Sinus blockages
• Heart conditions/ pacemaker

Aftercare advice - Same as standard facials

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Microcurrent

A modified direct, low-frequency current which is used on its own for lifting of the facial
contours and in conjunction with a galvanic current for skin improvement. Can help with
fine line reduction. Microcurrent has been around for about 25 years in medicine. Good
results have been achieved in the treatment of Bell’s Palsy, facial paralysis, strokes. The
current mimics the body’s own natural bio-electrical impulses. Our brain is continuously
sending out impulses through the spinal column to muscles and soft tissues. As we get
older the body slows down, the muscles start to age and the skin begins to deteriorate.
Microcurrent has the ability to speed up the whole metabolism of the tissue and cellular
activity. It works in two ways – preventative and corrective. The skin will tighten and
lines and wrinkles will be softened because of the cellular activity being stimulated. In
addition because the muscle and tissue is then in a better state of repair to receive the
body’s own bio electrical impulses there is preventative care as well. The ageing
process is being delayed and a healing effect is produced.

The current can be applied at any point along the length of the muscle fibre; however
the current intensity is insufficient to stimulate the motor nerve, though depending on
the duration it can stimulate the fibres of the muscle directly, causing them to contract.
This contraction will be barely visible as it is far weaker than a contraction produced by
stimulating the motor nerve directly. The current will improve the tone, function and
condition of the muscle but not it’s strength.

The treatment is applied in a certain routine to ensure that both halves of the face are
treated equally. If you did not perform the treatment correctly an uneven result may
occur. The direction of the muscle fibres are also considered during the application
sequence to ensure a beneficial result.

For use on all skin types.

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Effects
• Reduces the appearance of fine lines
• Gives a youthful appearance to the skin
• Improves overall muscle tone and lifts sagging muscles
• Reduces oedema – puffiness under the eyes is reduced as are dark circles
• Improves colour and texture of skin

Contra-indications in addition to standard facials

• Anti-depressants – add two more treatments to course as they can act as a
barrier to microcurrent
• Dermal fillers – wait 6 to 8 weeks
• Botox injections –avoid area totally as microcurrent will stimulate the area
• Chemotherapy/ radiology – must be totally clear of cancer for five years
• Excessive metal in the area i.e. fillings/ metal plates in the face or neck
• Swelling in the area
• Diabetes* be aware of any skin reaction during treatment
• Circulatory problems/ high or low blood pressure*
• Migraines
• Asthmatics* *Only to be carried out with medical approval
*Smokers – due to premature ageing add six treatments to the course.

Aftercare Advice in addition to standard facials

• At home facial exercises several times per week
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Faradic (EMS – electro muscle stimulation)

Named after Michael Faraday who studied the nature of electricity

Using a surged and interrupted direct current, a faradic machine can stimulate muscular
contractions on the face through stimulation of the motor nerves within the belly of the
muscle. It is often referred to as passive exercise, and you can actually see the muscles
contracting under the pads, with no effort on behalf of the client. It is possible to target
specific muscle groups for improvement in tone and suppleness. Treatment is ideal for
double chins, dropped jaw line and cheekbone definition. Each muscle should be
contracted 10-15 times before moving on to the next muscle and up to 20 contractions
on a mature client with poor muscle tone.

How does it work?

Muscles comprise of bundles of muscle fibres and there are many nerves that supply
each muscle fibre. These nerves create the movement in the muscle
When the nerves are stimulated they cause the muscle fibres to shorten therefore the
muscle contracts and causes movement to occur. The nerves that create this movement
are called motor nerves.

Normally a muscle would contract in response to an impulse from the brain received via
a sensory nerve, a message would then be sent to the motor nerve which would cause
the muscle to contract. Stimulation by a faradic current activates the motor nerve
directly to produce a contraction; basically it takes a short cut.

Can be used on all skin types.

Effects
• Increases muscle tone
• Creates and improves face shape and contours
• Stimulation of motor nerves and sensory nerves
• Increases blood and lymphatic flow
• Strengthens muscle fibres

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Pulse sequence
Bi-phasic – the electrical impulses pass in both directions between the pads giving a
good firming and toning treatment. Used for body treatments.
Mono-phasic – for facial work - the electrical impulses pass in only one direction
helping to lift the muscles. The black (negative) pad should always be placed in the
insertion of the muscle and the red block (positive) on to the origin. Remember BIRO –
black insertion red origin.

Sensation experienced
When the current is initially applied the client will feel a tingling sensation as the
sensory nerves are stimulated. As the current intensity is increased the motor nerves
will be stimulated and the client will feel the muscle contracting.

Application techniques
It is best to treat the same muscle groups on the opposite side of the face one after the
other. This will ensure that you apply a similar current intensity to similar muscle groups
which should result in a more precise treatment. Once you have treated all areas you
should then return to the first area and repeat the procedure again a further two times.
When applying the treatment it is difficult to isolate individual muscles as many of the
muscles insert into each other therefore appropriate facial nerves are stimulated to
produce a contraction.

The current intensity will need to be varied depending on :

Client’s needs
Client’s tolerance
Muscle tone
Area being stimulated
Remember that as you move to a new area you will have to re-evaluate the intensity
required. You should use the minimum intensity to produce a smooth and comfortable
contraction.

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Precautions
• Just like normal exercising the muscles work better after some kind of warm up –
for a facial treatment this could be steaming
• After treatment lymphatic drainage should be carried out for a few minutes as
lactic acid will have accumulated in the muscles as a byproduct of oxygen and
nutrient exchange
• Ensure surge speed is not too slow as this would make the muscle contraction
too long and will be uncomfortable for the client
• Never exercise a muscle to the point of no reaction as that is muscle fatigue.
Always reduce the current around the eye area, bony areas or where there are
fillings or dentures
• Never give treatment over areas where metal has replaced tissue or around a
mouth with extensive fillings
• Always re-adjust the placement point if the client experiences discomfort
• Only turn up the contraction intensity when the block is in contact with the skin
and the contraction light is on. This will ensure that you do not exceed the
client’s tolerance. If turned up in a relaxation phase the client may have too
strong a sensation – it will be uncomfortable and may hurt.

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Contra-indications
• Muscle disease, paralysed muscles
• History of strokes, facial paralysis, Bell’s Palsy
• Old scars in the treatment area
• Highly nervous clients
• Excessive metal in the area i.e. fillings/ metal plates
• Swelling in the area
• Heart conditions/ pacemaker
• Asthmatics*

*Only to be carried out with doctor’s approval

Reasons for poor muscle contraction

• Grease or makeup on the client’s skin
• Intensity too low
• Insufficient solution on the electrodes
• Electrode pads are dirty
• Incorrect positioning of the electrodes i.e. not over the motor points
• Loose leads in the terminals
• Poor contact between the electrode pads and the skin.

Aftercare advice in addition to standard facials

• At home facial exercises several times per week

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Skin analysis
Once the client is comfortably positioned on the couch, and you have washed your
hands, you will be ready to begin. Perform the initial cleanse and then carry out the
skin analysis. Cover the clients’ eyes with cotton wool pads to protect against the light
from the mag lamp. Look closely when doing a skin analysis. Use the mag lamp to
illuminate the face, and study the facial contours, jaw line, chin, nose, cheeks and
forehead. Touch the skin to assess texture and signs of laxity. Once the skin analysis
has been performed note down any findings on the consultation form and then perform
thermal and touch sensitivity tests. The thermal test can be hot or cold water and the
touch test can be something sharp or soft e.g. cotton bud or orange stick.

You are looking for:

• the skin’s general condition
• pore size
• any area of shininess
• dry flaky patches
• comedones or blocked pores or papules
• skin problems, e.g. acne rosacea or acne vulgaris
• the contours of the face – any loss of elasticity or dropped contours
• dilated capillaries
• the colour and texture of the skin
• areas of pigmentation.

What you see is very important, and you need to use your consultation skills to confirm
verbally with the client exactly what you have seen and how this may affect the client
and the treatment plan. Questions such as ‘How long have you had a broken capillary
on your nose?’ will lead into a discussion as to whether the client regards it as a
problem, if she is conscious of it, and would like to have it treated, or if she is happy
because it is covered with make-up and does not bother her. When looking at the skin,
you can also talk about the client’s current skin care range, and how happy the client
she is with the results.

For example:
• Is she using a regular exfoliant to help slough off the dead skin cells?
• Does the colour look a little flat and dull?
• Would the skin benefit from having the circulation stimulated, bringing
oxygen and nutrients to the cells?
• Are the current products drying out the top layers of the skin?
• Does the skin look plump and full of moisture, or dehydrated and dry,
with lines?
• How firm is the jaw line?
• Is the client developing a double chin?
• How much water is the client drinking every day to keep the skin clear
and healthy?

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Manual examination of the face

Most of the information gathered on the record card is from questioning the client and
observation of the facial skin condition, but you will also need to feel the skin’s texture,
warmth and contours. This will be done when carrying out the superficial and deep
cleansing routine – your fingertips will alert you to rough patches of skin, moles and
raised areas of skin, which may not be visible but can be felt. A cold face will often
indicate poor circulation, or a hot face may be a sign of the client’s age, and the onset
of the menopause, which often affects body temperature regulation. In fact, hormones
are one of the key factors in the skin’s behaviour, along with diet, water intake and
environmental aspects and product use. Be aware that the client may be very adept at
applying make-up, so the skin might look flawless and there may be no visible
problems. However, with make-up removed, your light massage technique during
cleansing, may tell a different story. Feel for cysts, raised moles and indentations. You
are also feeling the firmness of the tissue, whether there is good muscular support, if
the skin feels firm to the touch and springs back easily when manipulated. Older skins
are less springy because the supporting collagen fibres begin to weaken, resulting in
the skin and underlying tissue feeling a little slack. Another factor affecting the contours
of the face is if the client has had extensive dental work done, or has recently had
dentures fitted – this affects the gums, cheek muscles and jaw line, especially if the
client is not yet comfortable with new teeth. If this is the case, avoid any heavy
pressure along the lower face, as it will be uncomfortable for the client. Once you have
completed the facial examination, you are ready to discuss and then carry out facial
treatments with the client’s permission.

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