Issue link: https://www.ascpskindeepdigital.com/i/70637
Both viral and bacterial infections may appear as pustules, or tender lesions. They can sometimes look like acne, but may also be bigger or more isolated than a pimple, Weinstein says. Esthetic treatments shouldn't be performed on a client who has signs of an infection, because of the danger of worsening the outbreak or spreading the virus to yourself and other clients. 3. Patchy Hair Estheticians should be alert for round, patchy areas of hair loss, which can be a sign of an autoimmune disease called alopecia areata, Jorizzo says. "Alopecia is associated with thyroid disease, but it can also be upsetting to the patient in and of itself," Jorizzo explains. "Prognosis is very good if there is just one little circle, but if they lose their eyebrows or eyelashes, or if it goes around the bottom of the scalp, the condition is likely to be more chronic." 4. Symptoms on the Nails A client's nails may also offer evidence of a medical condition to the alert esthetician. "Signs on the nails include a condition called clubbing, where there's body under the cuticle that changes the angle of the nail, so that it's like an upside down V," Jorizzo says. Clubbing is sometimes accompanied by edema, and the cuticle area may feel wet. It can be a symptom of several lung conditions, ranging from chronic bronchitis to lung cancer. Pits in the nails can be a sign of arthritis or psoriasis. Pits resemble a mere dent, perhaps 1 millimeter across. Jorizzo explains, "In psoriasis, the outer layers of skin turn over very quickly, and when they come from under the cuticle, little patches fall off, so you get a pit." Finally, a single dark black streak in the nail that comes up on to the cuticle can be a sign of melanoma. Get connected to your peers @ www.skincareprofessionals.com 19 What Do I Say? When you see something suspicious on a client's skin, how do you bring it up? "I usually phrase it like, 'I see this mole has an irregular shape. Have you noticed that?'" says Kirsten Kayser, a licensed esthetician and webinar coordinator for Associated Skin Care Professionals (ASCP). "They may say yes or no. Then I say, 'Do you have a dermatologist that you like to see?' If not, then I say, 'Because I'm not a physician, I can't make a diagnosis, so I'm going to give you the name of a dermatologist who can check this for you, just to be safe.' I've had clients who were diagnosed with skin cancer after I referred them to a dermatologist. If I hadn't referred them, it could have been life-threatening." It's natural for a client to ask what you think the problem is, but avoid answering that question. "I tell them, 'Usually it's nothing to worry about, but it's better to have it checked out,'" Kayser says. "Dermatologists can be booked months in advance, so I let the client know that they should call within the next couple of days to set up an appointment. It's also important to make a note in their file about what you found, and who you referred them to." What about those delicate situations where you need to refuse service because the client has an obvious medical condition? Susanne Schmaling, ASCP's director of education, says, "I never get specific about the disease, but describe the characteristics of what I see. If I have to refuse service due to open lesions, irritation, infection, or other unusual appearance of the skin, my statement is 'I am concerned that I will cause this infection (or rash, or whatever) to get worse if we do the treatment today.' You can also suggest an alternative service if possible, such as a hand treatment or scalp massage."