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1 Click Here To Take Test Now (Complete the Reading Material first then click on the Take Test Now Button to start the test. Test is at the bottom of this page) 8 hrs Maintaining Healthy Skin & Sanitation Observation Anatomy of the Skin Facts about the skin: The skin is the body's largest organ, covering the entire body. In addition to serving as a protective shield against heat, light, injury, and infection, the skin also: Regulates body temperature. Stores water and fat. Is a sensory organ. Prevents water loss. Prevents entry of bacteria. 1

2 Throughout the body, the skin's characteristics vary (i.e., thickness, color, texture). For instance, the head contains more hair follicles than anywhere else, while the soles of the feet contain none. In addition, the soles of the feet and the palms of the hands are much thicker. The skin is made up of the following layers, with each layer performing specific functions: Epidermis Dermis Subcutaneous fat layer (subcutis) Epidermis Dermis The epidermis is the thin outer layer of the skin which consists of the following three parts: Stratum corneum (horny layer): This layer consists of fully mature keratinocytes which contain fibrous proteins (keratins). The outermost layer is continuously shed. The stratum corneum prevents the entry of most foreign substances as well as the loss of fluid from the body. Keratinocytes (squamous cells): This layer, just beneath the stratum corneum, contains living keratinocytes (squamous cells), which mature and form the stratum corneum. Basal layer: The basal layer is the deepest layer of the epidermis, containing basal cells. Basal cells continually divide, forming new keratinocytes, replacing the old ones that are shed from the skin's surface. The epidermis also contains melanocytes, which are cells that produce melanin (skin pigment). The dermis is the middle layer of the skin. The dermis contains the following: Blood vessels Lymph vessels Hair follicles Sweat glands Collagen bundles 2

3 Subcutis (also known as the subcutaneous layer) Fibroblasts Nerves The dermis is held together by a protein called collagen, made by fibroblasts. This layer gives skin flexibility and strength. It also contains pain and touch receptors. The subcutis is the deepest layer of skin. The subcutis, consisting of a network of collagen and fat cells, helps conserve the body's heat and protects the body from injury by acting as a "shock absorber." What is healthy skin? Your skin is much more than an outer surface for the world to see. It protects you from bacteria, dirt and other foreign objects and the ultraviolet rays of the sun, and contains the nerve endings that let you know if something is hot or cold, soft or hard, sharp or dull. Your skin also plays an important role in regulating your body's fluids and temperature. Skin covering the average human body ranges between 1.7 and 2 square meters (~20 square feet) in length and weights about 6 pounds (2.7 kg). With so much skin to care about, lots of people ignore even the basic needs of a healthy skin. You really should pay more attention to it, knowing that the skin is actually one of the most powerful indicators of the overall health. It also eliminates toxins through perspiration via pores which is vital, not to mention the appearance and visual impact it has to people we interact with. Below the smooth, hairy outer skin, or epidermis, that we see every day is a thick, strong and elastic layer of tissue known as the dermis. The dermis is richly supplied with blood vessels, sweat and oil glands, and nerve endings. 3

4 Healthy skin is smooth, with no breaks in the surface. It is warm (not hot or red) and neither dry and flaky nor moist and wrinkled. Healthy skin is a mirror of a healthy body. Healthy skin is well hydrated skin. General Skin Care Routines Cleansing Cleansing is the first essential step to any daily skin care routine. Cleansing the face at least twice a day is suitable for normal skin. If skin is oily, a more frequent cleansing or about four to five times a day is required. However, products that are water-based and gentle are ideal so as to not over-dry the skin. For dry skin, it is best to avoid frequent washing and a suitable oilbased cosmetic cleanser instead of soap is preferred. There are several alternatives to soap and 4

5 water cleansing. Cleansers can be in the form of creams, milks, lotions, gels and liquids. All are a mixture of oil, wax and water which have been formulated to suit different skin types. A cotton -pad dipped in fresh milk available at home, is an equally effective natural cleanser. To complete the cleansing process, the skin must be rinsed with water. Some who wear long wearing foundation may find it beneficial to pre-cleanse the face with a cleansing oil to remove any silicones left over from the foundation. Masks Essentially all face masks have some sort of a cleansing action. Various ingredients are used in the masks, depending on the skin type. Clay forms an important constituent of many face masks that helps to remove dirt, sebum, and dead skin to refresh and soften the skin surface. Fullers earth is a special type of clay often used in face packs. It contains aluminum silicate and as it dries on the skin, it absorbs the superficial dead cells and blots up any excessive oil. It is therefore excellent for oily skin but should not be used on dry skin. Kaolin is also fine clay which removes grime, oils and dead cells. Again it is best for oily skin and should be avoided on dry skin. Another ingredient of some of the masks is a peeling or exfoliating agent which helps remove the top layer of dead cells from the skin, leaving behind fresh youthful skin. Oatmeal and bran are the commonly used peelers. In addition, natural ingredients such as cucumbers, curds, lemon juice and Brewer's Yeast are added to many masks to restore the acid / alkali balance of the skin. There are three general forms that masks come in: Clay, Peel, and Sheet. The clay formulation is one of the most common. It is usually composed of different clays to 5

6 draw out the impurities in the skin. Peel masks usually have a gel like consistency and are peeled off of the skin to help exfoliate. Sheet masks are becoming more common in America; they are very popular in Asia. Sheet masks can be used to treat different skin concerns, but one of the most popular concerns is skin brightening. Toning Many skin care products include skin fresheners, toners and astringents which generally contain alcohol and water. These products are used after cleansing the skin to freshen and tone up and remove any traces of dirt or impurities from the skin, as well as restore the skin s acid/ alkali balance. Non-alcoholic fresheners are for dry and sensitive skin. Those with alcohol (astringent) are for oily skin. When servicing clients with combination skin, you should use both kinds for the different areas of their face. Moisturizing Regular use of a suitable moisturizer benefits the skin as it not only replaces water lost from the skin but also prevents the loss of water. It protects the skin against the drying influences of the environment including the harsh effects of the sun, cold and heat. Tinted moisturizers can be used under foundation cosmetics. It allows make-up to remain moist. Using a moisturizer is particularly beneficial for dry skins. Oil free moisturizers are also available for oily skins. There are two types of moisturizers: Oil - in water emulsions and water -in -oil emulsions. For normal and combination skin, a water based moisturizer containing minimal oil is suitable. Sensitive and dry types of skin need moisturizers containing a high content of oil. Protecting 6

7 The sun is the most damaging environmental factor to the health and appearance of skin. Ultraviolet radiation from sunlight can cause permanent damage to the skin causing it to sag, lose elasticity and form wrinkles. Severe sunburn can even cause skin cancer. Therefore, sunscreen and SPF-foundations protect the skin against these damaging effects. They also shield the skin from direct contact with dirt or pollutants in the air and help the skin retain necessary moisture. Sunscreen's come in lotions and creams. A sunscreen with the sun protection factor (SPF) of number 15 can block most of the sun's ultraviolet radiations before it can damage the skin. The SPF number indicates the length of time that the product will protect the skin, i.e. 15 hours. Sunscreens should be applied at least 10 minutes before exposure to the sun to ensure proper absorption and effective protection. Skin Types There are five basic skin types, including: Normal Skin This type of skin has a fine, even and smooth surface due to having an ideal balance between oil and moisture contents and is therefore neither greasy nor dry. People who have normal skin have small, barely-visible pores. Thus, their skin appears clear and does not develop spots and blemishes. This type of skin needs minimal and gentle treatment. Dry Skin Dry skin has a parched appearance and tends to flake easily. It is prone to wrinkles and lines due to the inability to retain moisture, as well as, the inadequate production of sebum by sebaceous glands. Dry skin often has problems in cold weather as it dries up even further. Constant protection in the form of a moisturizer by day and a moisture-rich cream by night is essential. Oily Skin As its name implies, this type of skin s surface is slightly to moderately greasy, which is caused by the over secretion of sebum. The excess oil on the surface of the skin draws dirt and dust from the environment to stick to it. Oily skin is usually prone to black heads, white heads, spots and pimples. It needs to be cleansed thoroughly every day. 7

8 Combination Skin This is the most common type of skin. As the name suggests, it is a combination of both oily and dry skin where certain areas of the face are oily and the rest dry. The oily parts are usually found on a central panel, called T Zone, consisting of the forehead, nose and chin. The dry areas consist of the cheeks and the areas around the eyes and mouth. In such cases, each part of the face should be treated accordingly where the dry areas are treated as for dry skin and the central panel is treated as for oily skin. There are also skin care products made especially for those who have combination skin. Sensitive skin Sensitive skin has a very fine texture and is excessively sensitive to changes in the climate. This skin type is easily irritated, bruised and/or scarred from bleaching, waxing, threading, perfumes, temperature extremes, soap, shaving creams, etc. People who belong to this skin type should avoid products with dyes, perfumes, or unnecessary chemical ingredients that may aggravate the skin. Common Skin Disorders Acne What is acne? Acne is a disorder of the hair follicles and sebaceous glands. With acne, the sebaceous glands are clogged, which leads to pimples and cysts. 8

9 Acne is very common - nearly 80 percent of individuals in the US between 11 and 30 years old will be affected by this condition at some point. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of sebum. How does acne develop? The sebaceous glands produce oil (sebum) which normally travels via hair follicles to the skin surface. However, skin cells can plug the follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes or P. acnes) begin to grow inside the follicles, causing inflammation. Acne progresses in the following manner: 1. Incomplete blockage of the hair follicle results in blackheads (a semisolid, black plug). 2. Complete blockage of the hair follicle results in whiteheads (a semisolid, white plug). 3. Infection and irritation cause whiteheads to form. Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedone. Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses). What causes acne? Rising hormone levels during puberty may cause acne. In addition, acne is often inherited. Other causes of acne may include the following: Hormone level changes during the menstrual cycle in women Certain drugs (such as corticosteroids, lithium, and barbiturates) Oil and grease from the scalp, mineral or cooking oil, and certain cosmetics may worsen acne Bacteria inside pimples Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard. What are the symptoms of acne? 9

10 Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following: Face Chest Upper back Shoulders Neck The following are the most common symptoms of acne. However, each child may experience symptoms differently. Symptoms may include: Blackheads Whiteheads Pus-filled lesions that may be painful Nodules (solid, raised bumps) Dry Skin What is dry skin? Dry skin is a very common skin condition, usually characterized by irritated skin and itchiness. Dry skin often worsens in the winter, when the air is cold and dry. In addition, frequent bathing can aggravate dry skin. With no treatment, dry skin may become flaky or scaly. 10

11 It is important to note, however, that dry skin symptoms may resemble other skin conditions, or result from other disorders such as an under-active thyroid or acquired immune deficiency syndrome (AIDS). Always consult your physician for a diagnosis. Treatment for dry skin: Treating dry skin may be as simple as keeping the skin moist by taking fewer baths and using ointments or creams that keep the moisture in. Treatment may also include: Avoiding harsh soaps, detergents, and perfumes, which tend to dry the skin Avoiding rubbing or scratching the skin, which can aggravate the symptoms and cause infection Applying a salicylic acid solution or cream (which removes the top layer of skin) if the skin is scaly Call your doctor if: There is itching without a visible rash. The itching and dryness are so bad you can't sleep. You have scratched so hard that you have open cuts or sores. Home remedies have not relieved the dryness and itching. Psoriasis What is psoriasis? 11

12 Psoriasis is a chronic skin condition characterized by inflamed, red, raised areas that often develop as silvery scales on the scalp, elbows, knees, and lower back. Psoriasis is estimated to affect 7.5 million people in the US. What causes psoriasis? The exact cause of psoriasis is unknown, but experts believe that the immune system, genes, and environmental factors play central roles. Normally, old skin cells are replaced with new ones every four weeks. In people with psoriasis, the immune system triggers inflammation, causing new cells to move to the surface every three or four days. The resulting buildup forms the rash. Psoriasis cannot be passed from person to person, but it does tend to run in families. What are the symptoms of psoriasis? The following are the most common symptoms of psoriasis. However, each individual may experience symptoms differently, as psoriasis comes in several forms and severity. Symptoms may include: Discoid psoriasis Also called plaque psoriasis, this type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds. Guttate psoriasis 12

13 This type of psoriasis affects mostly children. Symptoms may include many small patches of red, raised skin. A sore throat usually precedes the onset of this type of psoriasis. Pustular psoriasis Symptoms may include small pustules (pus-containing blisters) all over the body or just on the palms, soles, and other small areas. The symptoms of psoriasis may resemble other skin conditions. Always consult your physician for a diagnosis. How is psoriasis diagnosed? When the condition progresses to the development of silvery scales, the physician can usually diagnose psoriasis with a medical examination of the nails and skin. Confirmation of diagnosis may be done with a skin biopsy (taking a small skin specimen to examine under a microscope). Treatment for psoriasis Specific treatment for psoriasis will be determined by your physician based on: Your age, overall health, and medical history Severity of the condition Your tolerance of specific medications, procedures, or therapies Expectations for the course of the condition Your opinion or preference The goal of treatment is to reduce inflammation and slow down the rapid growth and shedding of skin cells. At the present time, there is no cure for psoriasis. Treatment may include: Ointments and creams (to moisturize the skin) Sunlight or ultraviolet light exposure (under a physician's supervision) Steroids (such as cortisone creams) Vitamin D cream Creams containing salicylic acid or coal tar Anthralin--a drug that treats the thicker, hard-to-treat patches of psoriasis. Methotrexate--an anti-cancer drug that interrupts the growth of skin cells. Oral or topical retinoids 13

14 Outlook Immunosuppressive medications (such as Cyclosporine) There is no known way to prevent psoriasis. Although it is a life-long condition, it often can be controlled with appropriate treatment. Keeping the skin clean and moist, and avoiding personspecific psoriasis triggers (excessive stress, for example) may help decrease flare-ups. Keratosis Pilaris What is keratosis pilaris? Keratosis pilaris is a common skin disorder characterized by small, pointed pimples. The pimples usually appear on the upper arms, thighs, and buttocks. The condition worsens in the winter and usually clears up in the summer. Keratosis pilaris has no known cause, but tends to run in families. This disorder does not get worse over time. It is harmless, and often disappears as the person ages. Treatment for keratosis pilaris: Usually no treatment is necessary for keratosis pilaris, since it normally clears up by itself. Treatment may include: Using petroleum jelly with water, cold cream, or salicylic acid (which removes the top layer of skin) to flatten the pimples Using a tretinoin cream (a drug which is chemically related to vitamin A) 14

15 Contact your health care provider if the condition does not respond to over-the-counter moisturizing lotions. Since this is a common, harmless skin condition, you can also discuss it during a routine office visit. Pityriasis Rosea What is pityriasis rosea? Pityriasis rosea is a mild, but common, skin condition. Characterized by scaly, pink, inflamed skin, the condition can last from four to eight weeks and usually leaves no lasting marks. What causes pityriasis rosea? The cause of pityriasis rosea is not known, but it is commonly believed to be caused by a virus. It is usually seen in children, adolescents, and young adults. Most people with the rash are 10 to 35 years of age. The condition is more prevalent in spring and fall. What are the symptoms of pityriasis rosea? Pityriasis rosea usually starts with a pink or tan oval area (sometimes called a herald or mother patch) on the chest or back. The main patch is usually followed (after a couple of weeks) by smaller pink or tan patches elsewhere on the body--usually the back, neck, arms, and legs. The following are other common symptoms of pityriasis rosea. However, each individual may experience symptoms differently. Symptoms may include: Fatigue Aches 15

16 Itching The symptoms of pityriasis rosea may resemble other skin conditions. Always consult your physician for a diagnosis. How is pityriasis rosea diagnosed? Pityriasis rosea is usually diagnosed based on a medical history and physical examination. The rash of pityriasis rosea is unique, and the diagnosis is usually made on the basis of a physical examination. In addition, your physician may order the following tests to help aid in the diagnosis: Blood tests Skin biopsy--the removal of some of the diseased skin for laboratory analysis. The sample of skin is removed after a local anesthetic is administered. Treatment for pityriasis rosea Specific treatment for pityriasis rosea will be determined by your physician based on: Your age, overall health, and medical history Extent of the rash Your tolerance for specific medications, procedures, or therapies Expectations for the course of the rash Your opinion or preference The goal of treatment for pityriasis rosea is to relieve symptoms associated with the condition, such as itching. Treatment may include: Medicated lotions and creams (to soothe the itching) Medications by mouth (to ease the itching) Cool baths with or without oatmeal (to soothe the itching) Ultraviolet exposure (under a physician's supervision) Cool compresses (to soothe the affected skin) There is no cure for pityriasis rosea. The condition will usually resolve on its own in about six to 12 weeks. Normally, it does not return. 16

17 Rosacea What is rosacea? Rosacea is a common skin condition that usually only affects the face and eyes. Characterized by redness, pimples, and broken blood vessels, rosacea tends to begin after middle age (between the ages of 30 and 60) and is more common in fair-skinned people. The cause of rosacea is unknown. An estimated 14 million people in the US have rosacea. What are the symptoms of rosacea? Rosacea often begins with easy blushing and flushing of the facial skin. Eventually, redness will persist around the nose area, extending to the rest of the face. Rosacea has a variety of clinical symptoms and is classified into the following four types, based on these different symptoms: Type Prerosacea Vascular rosacea Inflammatory rosacea Rhinophyma Symptoms Frequent episodes of blushing and flushing of the face and neck Swelling of blood vessels under the facial skin, leading to swollen, warm skin (common in women) Formation of pimples and enlarged blood vessels on the face Enlarged oil glands in the nose and cheeks that cause an enlarged, bulbous red nose Sebaceous Cysts What are sebaceous cysts? 17

18 Sebaceous cysts are harmless, slow-growing bumps under the skin, often appearing on the scalp, face, ears, back, or groin area. The cysts usually contain dead skin and other skin particles. Treatment for sebaceous cysts: Warm moist compresses placed over the cysts may help them drain and heal. Sebaceous cysts can usually be treated by a physician by puncturing the top and removing its contents. However, large cysts may reappear and may have to be surgically removed. If a cyst becomes swollen, tender, large, or infected, treatment may include administering antibiotics and then surgically removing the cyst. Skin Disorder Awareness in the Salon While the level of knowledge needed by scientists is not necessary for cosmetologists, a thorough knowledge of the underlying structures of the skin nails and hair will benefit you in your role. Such knowledge will help you achieve the best possible results when providing hair, skin, and nail care services 18

19 while at the same time providing the utmost protection for your client. Your training will help you to become familiar with common disorders and diseases of the skin and allow you to recognize those conditions that cannot be treated or serviced by a cosmetologist. Thoroughly analyzing the functions and components of the skin is the best way to understand how the skin works. With proper care, the skin can stay young and radiantlooking for many years. This course contains extensive new terminology which will seem overwhelming at first. We will cover the material in detail and introduce several exercises and activities that can be used to help you retain the terminology and definitions. The skin is the largest and one of the most important organs of the body. A healthy skin is slightly moist, soft and flexible. It possesses a slightly acid reaction and is free from any disease or disorder. The ideal feel and appearance of skin is smooth and fine-grained. That feel and appearance is known as skin texture. Hairs, nails, sweat and oil glands, which are all very important to the cosmetologist, are considered appendages of the skin. It is important to note that the skin on the eyelids is the thinnest of the entire body while the skin on the palms of the hand and soles of the feet is the thickest. Continued pressure on any part of the skin will result in calluses. The skin on the scalp has larger and deeper follicles to accommodate the longer hair found on the head. Lesions of the Skin Skin lesions are abnormal changes in the structure of an organ or tissue. Lesions are divided into three categories: o Primary o Secondary o Tertiary Cosmetologist are only concerned with primary and secondary lesions. Primary Skin Lesions Macules: discoloration appearing on the skin's surface o Freckles are an example of macules. Lentigines: technical term for freckles 19

20 Papules: hardened red elevations of the skin in which no fluid is present o A large papule is known as a tubercle. o A pimple is an example of a papule. Vesicles: fluid filled elevations in the skin caused by localized accumulation of fluids or blood just below the epidermis. Macules and papules may cause vesicles. Herpes Simplex: also known as fever blister, is a contagious, chronic condition caused by a single vesicle or a group of vesicles on a red swollen base. o Appears on the lips, nostrils, or other parts of the face. o Services should not be performed when herpes simplex is present. Bulla: Lesion, and larger vesicles with a clean watery fluid o Located below the skin o Occur in second-degree burns. Pustules: Small elevations of skin; similar to vesicles, but contain pus o They are white or yellow in color and may be surrounded by a reddish inflamed border. o An example of a pustule is a pimple with pus. Wheals: Solid formation above the skin, sometimes caused by an insect bite or allergic reaction o May be accompanied with itching or tingling o An example of a wheal is hives or an insect bite. Tumors: Solid masses in the skin, which may be soft or hard Secondary Lesions o An example of a small tumor is a nodule. A secondary skin lesion is the progressed stage of a disease. Needs to be treated by a dermatologist or a physician Scales: Dead cells of the uppermost layer of the epidermis that shed. o Psoriasis and dandruff are examples of scales Psoriasis: Round, dry patches of skin, covered with rough silvery scales. 20

21 o It is chronic, but not contagious. Crust: Dried masses that come from the remains of an oozing sore. o An example:scab on a sore Excoriations: mechanical abrasions or injury to the epidermis o Occur when an insect bites or scab is scratched o An example of an excoriation is a scratch Fissure: Cracks in the skin o Cracks or lines that go deep into the underlying dermis o Occur when skin is exposed to wind, cold, or water and loses its flexibility o An example of a fissure is a chapped lip Scars: Forms from a lesion when injury extends deep into the dermis Keloids: Thick scars Ulcers: Open lesions that are visible on the surface of the skin o Services should not be performed when ulcers are present. Pigmentation Abnormalities Pigmentation Abnormalities are conditions with little or too much color in certain areas of the skin. Melanoderma: Hyper-pigmentation caused by over activity of the melanocytes in the epidermis o Examples of melanoderma are chloasma and lentigines. Chloasma: Group of brownish macules usually on the hands and face o Also known as liver spots Moles: Small, brown pigmented spots that may be elevated. o Some contain hair, but should not be removed o A physician should be seen if there are any changes in the appearance of a mole. o Moles are the cause of some skin cancers. Naevus: Birth mark or a congenital mole 21

22 Leukoderma: Hypo-pigmentation (lack of pigmentation) of the skin caused by a decrease in melanocytes. Albinism: Congenital failure of the skin to produce melanin pigment o A person with albinism has very fair skin, white hair, and pink eyes. o They are sensitive to light and sun. Vitiligo: Oval or odd shaped patches of white skin that do not have normal pigmentation. o Usually appear on the face, hands, and neck Disorders of the Sebaceous Glands Comedones: Also known as blackheads; masses of sebum (oil) locked inside the hair follicle Milia: Also known as whiteheads; caused by accumulation of hardened sebum beneath the skin Acne: Chronic inflammatory disorder of the sebaceous glands o Acne occurs in two stages: acne simplex and acne vulgaris. o A person with acne vulgaris should seek a physician Rosacea: Also known as acne rosacea; a chronic inflammatory congestion of the cheeks and nose; papules and pustules are sometimes present. o Services should not be performed when rosacea is present. Asteatosis: dry, scaly skin caused by low sebum production Seborrhea: Excessive secretion of the sebaceous glands. Steatoma: Also known as a sebaceous cyst or wen; subcutaneous tumor of the sebaceous glands, filled with sebum Furuncles: Also known as boil; appears in the dermis and the epidermis and are caused by acute staphylococcal infection. o Usually are hair follicle infections Carbuncles: Larger than furuncles; located above and below the skin are caused by acute staphylococcal infection of several adjoining hair follicles. Disorders of the Sudoriferous Glands Bromidrosis: Foul-smelling perspiration 22

23 Anhidrosis: Lack of perspiration; caused by fever or disease Hyperhidrosis: Over-production of perspiration; caused by excessive heat or body weakness Miliaria Rubra: Acute eruption of small red vesicles; caused by excessive heat Services should not be performed when Miliaria Rubra is present. Keep the following facts in mind before performing a service on any client who may have a skin disorder: Cosmetologists and estheticians are not dermatologist or physicians who diagnose and treat skin diseases and disorders. It is very important that you are able to recognize different skin conditions in-order to protect yourself and your client. However, coming in contact with skin every day should encourage you to be cautious when you find cases of severe skin disorders. THE SUN AND YOUR SKIN Skin Damage Overexposure to ultraviolet (UV) radiation from the sun can cause significant damage to your skin. Wrinkles UVA rays from the sun can penetrate deep into your skin and damage collagen, which is the protein that holds your skin together in a firm and smooth way. Collagen and elastin fibers weaken faster when skin is frequently exposed to ultraviolet (UV) rays without proper protection. UVA breaks down the collagen structure which results in wrinkles. UVB rays, also called burning rays; cause sunburn and tanning of the skin by affecting the melanocytes (cells of the epidermis that produce melanin). These rays are not as deep as UVA but are equally damaging to the skin and eyes. They do, however, contribute to the body s synthesis of vitamin D. Once collagen is damaged, it cannot re-build itself. Up to 80% of skin aging is caused by the sun. 23

24 Freckles/Sun Spots Sun Tan Sunburn Freckles and sun spots are signs of skin damage and develop as a result of too much sun exposure. Freckles and sun spots are frequently found on face, legs and back of hands. Individuals who sunbathe regularly may develop freckles and sun spots all over their skin. Contrary to popular belief, a tan is not healthy. A tan is a sign that damage has been done to your skin. When exposed to the sun s UV rays, your skin s melanocytes produce melanin, the dark pigment that creates a tan. A tan is your skin s attempt to prevent UV rays from doing any further damage to the sensitive skin cells in your epidermis. A tan does not help protect your skin from getting sunburn in the future. A tan is equivalent to merely an SPF 4! Overexposure to the sun s UV rays results in a painful sunburn. UV rays penetrate deep into the layers of your skin and kill living skin cells. In response to this trauma, your body s immune system increases blood flow into the damaged area so white blood cells can remove the dead skin cells. This blood flow is what causes your sunburned skin to become warm and red. There is substantial evidence that sunburns can lead to DNA damage. Repeated sunburns dramatically increase your risk of developing skin cancer because of this damage to your DNA. SUN EXPOSURE PRECAUTIONS Wear protective lotion. Sunscreen with SPF (sun protection factor) of 15 is recommended. Avoid prolonged exposure. (Especially during peak hours of 10:00 a.m. and 3:00 p.m.) Apply sunscreen liberally after swimming. (Apply periodically throughout day as a precaution) 24

25 Use full or broad spectrum sunscreen. (These filter out UVA and UVB rays of the sun) Check expiration dates on products. Avoid exposing children under 6 months. Wear hat and protective clothing outdoors. Since repeated sunburns can increase your risk of developing skin cancer, lets now consider the ABCDE Cancer Checklist. Melanoma Checklist Even if you have carefully practiced sun safety all summer, it's important to continue being vigilant about your skin in fall, winter, and beyond. Throughout the year, you should examine your skin head-to-toe once a month, looking for any suspicious lesions. Self-exams can help you identify potential skin cancers early, when they can almost always be completely cured. First, for a successful self-exam, you obviously need to know what you're looking for. As a general rule, to spot either melanomas or non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma), take note of any new moles or growths, and any existing growths that begin to grow or change significantly in any other way. Lesions that change, itch, bleed, or don't heal are also alarm signals. It is so vital to catch melanoma, the deadliest form of skin cancer, early that physicians have developed a specific strategy for early recognition of the disease: the ABCDEs. The ABCDEs of Melanoma 25

26 A-Asymmetry Asymmetry means one half of a mole does not match the other half. Normal moles are symmetrical. When checking your moles or freckles, draw an imaginary line through the middle and compare the two halves. If they do not look the same on both sides, have it checked by a dermatologist. B-Border If the border or edges of the mole are ragged, blurred, or irregular, have it checked by a dermatologist. Melanoma lesions often have uneven borders. 26

27 C-Color A mole that does not have the same color throughout or that has shades of tan, brown, black, blue, white, or red is suspicious. Normal moles are usually a single shade of color. A mole of many shades or that has lightened or darkened should be checked by a doctor. D-Diameter A mole is suspicious if the diameter is larger than the eraser of a pencil. Benign moles are usually less than 6 millimeters in diameter. 27

28 E-Elevation If a portion of the mole appears elevated, or raised from the skin, have it looked at by a doctor. Melanoma lesions often grow in size or change in height rapidly. A mole that is evolving shrinking, growing larger, changing color, begins to itch or bleed should also be checked. CHECK YOUR BODY ONCE A MONTH Examine your skin after a shower while skin is wet. A common location for melanoma in men is on the back, and in women, the lower leg. But check your entire body for moles or suspicious spots once a month. Start at your head and work your way down. Check the "hidden" areas: between fingers and toes, the groin, soles of the feet, the backs of the knees. Check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Be especially suspicious of a new mole. Take a photo of moles and date it to help you monitor them for change. Pay special attention to moles if you're a teen, pregnant, or going through menopause, times when your hormones may be surging. It is very important that cosmetologist and estheticians know what products can penetrate the skin and what effects they will have on clients. By learning to identify the various diseases and disorders of the skin, you will be able to provide more effective and safe services for your clients. Flash Facts: Histology of the Skin 28

29 ACNE Skin disorder characterized by chronic inflammation of the sebaceous glands from retained secretions ALBINISM ANHIDROSIS Congenital leukoderma or absence of melanin pigment of the body, including the skin, hair, and eyes Deficiency in perspiration, often result of fever or certain skin diseases ASTEATOSIS Condition of dry, scaly skin due to deficiency or absence of sebum; caused by old age and by exposure to cold 29

30 BASAL CELL CARCINOMA Most common and least severe type of skin cancer; often characterized by light or pearly nodules BROMHIDROSIS Foul-smelling perspiration, usually noticeable in the armpits or on the feet BULLA Large blister containing a watery fluid; similar to a vesicle but larger CHLOASMA Condition characterized by increased pigmentation on the skin, in spots that are not elevated 30

31 COLLAGEN Fibrous protein that gives the skin form and strength COMEDONES Blackheads CRUST Dead cells that form over a wound or blemish while it is healing; an accumulation of sebum and pus, sometimes mixed with epidermal 31

32 CYST Abnormal sac containing fluid above and below the skin ECZEMA ELASTIN Inflammatory, painful itching disease of the skin, acute or chronic in nature, presenting many forms of dry or moist lesions Protein base similar to collagen that forms elastic tissue 32

33 EXCORIATION Skin sore or abrasion produced by scratching or scraping FISSURE Crack in the skin that penetrates the dermis, such as chapped hands or lips HERPES SIMPLEX Fever blister or cold sore 33

34 HYPERHIDROSIS Excessive sweating, caused by heat or general body weakness HYPERTROPHY Abnormal growth of the skin KELOID Thick scar resulting from excessive growth of fibrous tissue 34

35 KERATOMA LENTIGINES Acquired, superficial, thickened patch of epidermis commonly known as callus, caused by pressure or friction on hands and feet Freckles LEUKODERMA MACULA Skin disorder characterized by light abnormal patches; caused by burn or congenital disease that destroys the pigmentproducing cells Small, discolored patch; freckle 35

36 MALIGNANT MELANOMA MELANIN Most serious form of skin cancer; often characterized by black or dark brown patches on the skin that may appear uneven in texture, jagged, or raised Tiny grains of pigment deposited in the stratum germinativum of the epidermis and the papillary layers of the dermis MILIA Prickly heat; acute inflammatory disorder of the sweat glands 36

37 MOLE Small, brownish spot or blemish on the skin NEVUS Small or large malformation of the skin due to abnormal pigmentation or dilated capillaries PAPULE Pimple 37

38 PSORIASIS PUSTULE Skin disease characterized by red patches; covered with white silver scales usually found on scalp, elbows, knees, chest, and lower back An inflamed pimple containing pus ROSACEA Chronic congestion appearing primarily on the cheeks and nose, characterized by redness, dilation of the blood vessels, and the formation of papules and pustules 38

39 SCALE Any thin plate of epidermal flakes, dry or oily, such as abnormal or excessive dandruff SCAR Light-colored, slightly raised mark on the skin formed after an injury or lesion SEBORRHEA Skin condition caused by an abnormal increase of secretion from the sebaceous glands 39

40 SKIN TAG Cutaneous outgrowth of the skin SQUAMOUS CELL CARCINOMA Type of skin cancer more serious than basal cell carcinoma; often characterized by scaly red papules or nodules STAIN Abnormal brown or winecolored skin discoloration with a circular and irregular shape 40

41 STEATOMA Sebaceous cyst or fatty tumor TAN Change in pigmentation of skin caused by exposure to the sun or ultraviolet rays TUBERCLE Abnormal rounded, solid lump above, within, or under the skin TUMOR Abnormal cell mass, varying in size, shape, and color 41

42 ULCER Open lesion on the skin or mucous membrane of the body, accompanied by pus and loss of skin depth VESICLE Small blister or sac containing clear fluid, lying within or just beneath the epidermis VITILIGO WHEAL Milky-white spots (leukoderma) of the skin; acquired condition Itchy, swollen lesion that lasts only a few hours; caused by a blow, insect bite, urticaria, or sting of the nettle 42

43 Sanitation Observation and Alabama Health and Sanitation Regulations Contaminated tools used in the salon can spread infections from client to client if the proper disinfection steps are not taken after servicing clients. Your professional and legal obligation to protect clients from harm by using proper sanitation observation procedures is very important. To help professionals in the beauty industry avoid being found legally responsible for a client s injuries or infections, this course will highlight the importance of the following: Types of infections encountered in the salon Basic cleaning and disinfecting Federal and state rules governing sanitation procedures Chemistry of cleaning and disinfecting products used in the salon DISEASES THAT CAN BE SPREAD BY NOT FOLLOWING SANITATION PROCEDURES Staphylococci Staphylococci are among the most common human bacteria and are carried by about a third of the population. Staph can be picked up on doorknobs, counter tops, and other surfaces, but is more frequently transferred through skin to skin contact, such as shaking hands or using unclean implements. Antibiotics once controlled these bacteria, but certain strains of staph are now resistant to the drugs. There is now a greater need than ever for proper use of infection control measures in the cosmetology industry because of these resistance bacteria. Tuberculosis TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected. When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they move through the blood to other parts of the body, such as the kidney, spine, and brain. TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious. 43

44 HERPES Inflammatory diseases of the skin caused by one of several herpes viruses and characterized by clusters of blisters. HEPATITIS Hepatitis is a disease marked by inflammation of the liver, is caused by a blood borne virus similar to HIV in transmission. It is more easily contracted than HIV; however, it is present in all body fluids. The three types of hepatitis that are of concern to a cosmetologist. Hepatitis A The illness usually lasts about three weeks. Symptoms are similar to those of the flu. Adults often have yellowing of the skin or the eyes. The disease is spread through close household contact, such as common bathroom use; poor sanitation; poor personal hygiene, contaminated food, milk, water, shellfish, infected food handlers; and sexual contact. A vaccine is available. Hepatitis B This illness can cause long-term hepatitis, cirrhosis, and or liver cancer. About half the people with the disease do not have symptoms, although the disease can mirror the flu. The disease is primarily transferred through sexual contact or parenteral exposure (piercing mucous membranes or skin barrier) to blood products. A vaccine is available. Hepatitis C The illness can progress slowly, and about one-third of those with the illness do not have symptoms, though symptoms can include fatigue and stomach pain. The disease is transferred through parental contact and sexual activity with infected partners. No vaccine is available. RINGWORM Ringworm is a contagious fungus infection that can affect the scalp, the body (particularly the groin), the feet, and the nails. Despite its name, it has nothing to do with 44

45 worms. The name comes from the characteristic red ring that can appear on an infected person's skin. Ringworm is also called Tinea. What are the signs and symptoms of Ringworm? Ringworm of the scalp usually begins as a small pimple that becomes larger, leaving scaly patches of temporary baldness. Infected hairs become brittle and break off easily. Yellowish crusty areas sometimes develop. Ringworm of the Body Ringworm of the body shows up as a flat, round patch anywhere on the skin except for the scalp and feet. Ringworm of the Groin The groin is a common area of infection (groin Ringworm). As the rash gradually expands, its center clears to produce a ring. More than one patch might appear, and the patches can overlap. The area is sometimes itchy. Ringworm of the Foot Ringworm of the foot is also called athlete's foot. It appears as a scaling or cracking of the skin, especially between the toes. Ringworm of the Nails 45

46 Ringworm of the nails causes the affected nails to become thicker, discolored, and brittle, or to become chalky and disintegrate. How soon after exposure do symptoms appear? Scalp Ringworm usually appears 10 to 14 days after contact and Ringworm of the skin 4 to 10 days after contact. The time between exposure and symptoms is not known for the other types of ringworm. Scabies Scabies is an itchy skin condition caused by teeny, tiny mites that dig tunnels underneath the skin surface. These mites are part of the arachnid family, the same family that includes spiders and ticks. Scabies mites have eight legs and a round body and are hard to see. When they are fully grown, each mite is no bigger than the size of the point of a pin. How Scabies Live on Humans When you get scabies mites, the female mites dig under the top layer of your skin. There they lay eggs and die after about a month. The eggs hatch, and the new mites grow up and come to the skin's surface. The females mate with the males, then the males die and the females dig back under the skin to lay new eggs. This life cycle takes only 2 to 3 weeks. Anyone can get scabies - little babies, adults, the mites are not picky. They do not care if you are clean, dirty, rich, or poor. All they want is to live on or in the skin of a human being, and any human being will do. Where can you get scabies? When people get close enough, mites move from skin to skin. That is how you can get scabies from someone who already has them. Sometimes the mites may move onto a person from a towel, clothing, or sheets recently used by someone who has scabies, 46

47 but this is not common. (Doctors believe mites can only live 2 to 3 days when they are not on a human body.) What Are the Symptoms? Mites are nothing to be scared of, but these little creatures certainly can be irritating. After they make your skin their home, your body may react to them with a dry, itchy, reddish rash of bumps. You may also see thin, slightly raised light lines on your skin where the mites have been digging. These signs of scabies usually appear in places where there are skin folds, such as between your fingers and toes, on your wrists, behind your knees, under your arms, or around your groin or rear end. When you have scabies you may have lots of itching at night and sores from scratching, too. It takes about 4 to 6 weeks for the rash to show up. If you've had scabies before, your body will recognize the mites more quickly and you'll probably see the bumpy rash in just a few days. Head Lice Head lice are tiny six-legged insects that cling to the scalp and neck and feed on human blood. Each louse is about the size of a sesame seed and can be hard to spot. Lice 47

48 eggs, called nits, are glued onto hairs near the scalp and can be even more difficult to see. When a large number of lice live in a person's hair, it is called an infestation. How to spot lice: Although lice and their nits are small, they are visible to the naked eye. Head lice can be white, brown, or dark gray. They are most often found in the hair at the back of the neck or behind the ears. The nits are round or oval specks that are tightly glued to hairs near the scalp. If you try to slide the nits off, they won't budge. Recent research suggests combing through wet hair is the best way to spot an active infestation. Symptoms of Head Lice Spotting a louse or nit is often the only sign of an infestation. In many children, head lice don't cause any discomfort. When symptoms do occur, the most common problem is itching that may start weeks or even months after the lice move in. 48

49 Allergies to Head Lice The itching associated with lice is caused by an allergic reaction to the bug bites. Frequent scratching may lead to sores or raw skin on the scalp. Call a doctor promptly if: the skin becomes red, swollen, or painful; the lymph nodes in the neck become tender; or if there is a fever of 100 degrees Fahrenheit or higher. These are signs of a skin infection. IF YOU SUSPECT A CLIENT HAS HEAD LICE SEND THEM OUT OF THE SALON IMMEDIATELY! Decontamination Decontamination is the removal of pathogens and other substances from tools and surfaces. Decontamination involves the use of physical or chemical means to remove, inactivate, or destroy pathogens. Sterilization Sterilization is the highest level of decontamination. It completely destroys every organism on a surface, whether beneficial or harmful. Sterilization even kills bacterial spores, the most resistant form of life on Earth. Methods of sterilization include the steam autoclave and dry heat (a form of extreme heat). Sterilization is a process used by dentists and surgeons, whose tools are designed to break and penetrate the skin barrier. Estheticians also use needles and probes that lance the skin, so they must follow the same sterilization procedures. Pre-sterilized disposable lancets or needles are a simpler solution to the issue of sterilization. 49

50 Disinfection Disinfection is a higher level of decontamination; it is second only to sterilization. Disinfection controls microorganisms on hard, nonporous surfaces such as cuticle nippers and other salon implements. Disinfectant provides the level of protection required by the salon to kill most organisms, with one exception. Disinfection does not kill bacterial spores, but this is not necessary in the salon environment. It is important only in hospitals and other health-care facilities where instruments are used to penetrate or cut the skin. Lancets and other metal implements used in advanced facial treatments should be sterilized, or disposable implements should be used. Sanitation The third, or lowest, level of decontamination is called sanitation or sanitizing. These words are often frequently misused and misunderstood. To sanitize means, To significantly reduce the number of pathogens of disease producing organisms found on a surface. Cleaning with soaps or detergents will sanitize salon tools and other surfaces. Sanitized surfaces may still harbor pathogens or other organisms. Removing hair from a brush and washing the brush with detergent is considered sanitation. Putting antiseptics designed for hands or feet on your skin or washing your hands is another example of sanitation. Your hands may appear very clean when you are finished but will still harbor pathogens found in the tap water and on the towel. Types of Disinfectants Quats Quaternary ammonium compounds, commonly called quats, are a type of disinfectant considered non-toxic, odorless, and fast acting. Most quat solutions disinfect implements in 10 to 15 minutes. Leaving some tools in the solution for too long may damage them. Phenols Like quats, phenolic disinfectants, or phenols, have been used reliably over the years to disinfect implements. Phenol is a caustic poison, but it can be safe and extremely effective if used according to instructions. One disadvantage is that most rubber and 50

51 plastic materials may be softened or discolored by phenols. Phenols in 5 percent solution are used mostly for metal implements. Choosing a Disinfectant All disinfectants must be approved by the Environmental Protection Agency (EPA) and each individual state. The disinfectant s label must also have an EPA registration number. To meet salon and state requirements, a disinfectant must have the correct effectiveness to be used against bacteria, fungi, and viruses. Cleaning Implements All implements should be thoroughly cleaned before soaking to avoid contaminating the disinfecting solution. Implements must be completely submerged for proper disinfection. Disinfectant Safety Disinfectants are powerful, professional-strength tools that can be hazardous if used incorrectly. Disinfectants can be poisonous if ingested and can cause serious skin and eye damage, especially in a concentrated form. A good rule to remember is use caution. More on disinfectant safety: } Always wear gloves and safety glasses when mixing chemicals with water } Always add disinfectants away from children } Never pour quats, phenols, formalin, alcohol, or any other disinfectants over your hands. This hazardous practice can cause skin irritation and increase the chance of infection. Wash your hands with soap and warm water and dry them thoroughly. } Carefully weigh and measure all products to ensure that they perform at their peak efficiency. } Never place any disinfectant or other product in an unmarked container. Disinfectants come in different forms such as ready-to-use sprays (for surface cleaning), liquid concentrate, and powders. Some disinfectants appear clear while others are a little cloudy. 51

52 } Always follow manufacturer s recommendations for mixing and using, and check the efficiency to make sure you are using the right disinfectant } Avoid overexposure. Disinfectants are chemicals, and overuse is detrimental to the environment. SANITATION AND OBSERVATION Every year, the cosmetology industry serves hundreds of thousands of clients. That means billions and billions of germs, viruses, and bacteria are coming along for the ride. To combat this army of invaders, regulatory agencies and governmental departments of health require that any business that serves the public, such as a salon, must follow certain prescribed sanitary precautions. As a practitioner, it is your duty to ensure that your clients receive their service in the safest possible environment. This section will help you understand the need for preventing infection and will introduce you to practices that will allow to perform your work in a safe manner that protects individual and public health. In this section, we will learn the nature of various organisms, how they relate to disease, and how their spread can be prevented in the salon and at school. Let us begin with bacteria. Bacteria Bacteria are one-celled microorganisms with both plant and animal characteristics. Also known as germs or microbes, bacteria can exist almost anywhere; on the skin, in water, air, decayed matter, secretions of body openings, on clothing, and beneath the nails. 52

53 Bacteria can only be seen with the aid of a microscope. Fifteen hundred rod-shaped bacteria will fit comfortably on the head of a pin. Types of Bacteria There are hundreds of different kinds of bacteria. Bacteria are classified into two main types, depending on whether they are beneficial or harmful. Most bacteria are non-pathogenic organisms (helpful or harmless; not diseaseproducing), which perform many useful functions, such as decomposing garbage and improving soil fertility. In the human body, non-pathogenic bacteria help metabolize food, protect against infectious microorganisms, and stimulate immune response. Some bacteria cultures are used to produce penicillin, acidophilus yogurt, and a special type of mile used for gastrointestinal disorders. Saprophytes, a type of non-pathogenic bacteria, lives on dead matter. Pathogenic bacteria (microbes or germs) are harmful and, although in the minority, cause disease when they invade plant or animal tissue. To this group belong the parasites, which require living matter for their growth. It is because of pathogenic bacteria that salons and cosmetology schools must maintain certain sanitary standards. Classifications of Pathogenic Bacteria Bacteria have distinct shapes that help to identify them. Pathogenic bacteria are classified as follows: Cocci are round-shaped bacteria that appear singly (alone) or in the following groups. Staphylococci- Pus-forming bacteria that grow in clusters like a bunch of grapes. They cause abscesses, pustules, and boils. Streptococci- Pus-forming bacteria arranged in curved lines resembling a string of beads. They cause infections such as strep throat and blood poisoning. Diplococcic- Spherical bacteria that grow in pairs and cause disease such as pneumonia. 53

54 Bacilli are short, rod-shaped bacteria. They are the most common bacteria and produce diseases such as tetanus (lockjaw), typhoid fever, tuberculosis, and diphtheria. Spirilla are spiral or corkscrew-shaped bacteria. They are subdivided into subgroups, such as Treponema pallida, which causes syphilis, a sexually transmitted disease (STD) or Borrelia burgdorferi, which causes Lyme disease. 54

55 Movement of Bacteria Different bacteria move in different ways. Cocci rarely show active motility (self-movement). They are transmitted in the air, in dust, or within the substance in which they settle. Bacilli and Spirilla are both motile and use slender, hair like extensions, known as flagella or cilia, for locomotion (moving about). A whip like motion of these hairs moves the bacteria in liquid. Bacterial Growth and Reproduction Bacteria generally consist of an outer cell wall and internal protoplasm. They manufacture their own food from the surrounding environment, give off waste products, grow and reproduce. The life cycle of bacteria is made up of two distinct phases: the active or vegetative stage, and the inactive or spore-forming stage. Active or Vegetative Stage During the active stage, bacteria grow and reproduce. These microorganisms multiply best in warm, dark, damp, or dirty places where sufficient food is available. When conditions are favorable, bacteria grow and reproduce. When they reach their largest size, they divide into two new cells. This division is called mitosis. The cells that are formed are called daughter cells. When conditions are unfavorable, bacteria die or become inactive. Inactive or Spore-Forming Stage Certain bacteria, such as the anthrax and tetanus bacilli, form spherical spores with tough outer coverings during their inactive stage. The purpose is to be able to withstand periods or famine, dryness, and unsuitable temperatures. In this stage, spores can be blown about and are not harmed by disinfectants, heat or cold. When favorable conditions are restored, the spores change into the active or vegetative form, 55

56 then grow and reproduce. Bacterial Infections An infection occurs when body tissue are invaded by disease-causing or pathogenic bacteria. There can be no bacterial infection without the presence of pathogenic bacteria. The presence of pus is a sign of infection. Pus is a fluid product of inflammation and contains white blood cells and the debris of dead cells, tissue elements, and bacteria. Staphylococci are among the most common human bacteria and are carried by about a third of the population. Staph can be picked up on doorknobs, counter tops, and other surfaces, but is more frequently transferred through skin to skin contact, such as shaking hands or using unclean implements. Antibiotics once controlled these bacteria, but certain strains of staph are now resistant to the drugs. There is now a greater need than ever for proper use of infection control measures in the cosmetology industry because of these resistance bacteria. A local infection, such as a pimple or abscess, is one that is confined to a particular part of the body and in indicated by a lesion containing pus. A general infection results when the bloodstream carries the bacteria or virus and their toxins (poisons) to all parts of the body. 56

57 Syphilis is an example. When a disease spreads from one person to another by contact, it is said to be contagious or communicable. Some of the more common contagious diseases that will prevent a cosmetologist from servicing a client are tuberculosis, common cold, ringworm, scabies, and viral infections. The chief sources of contagion are unclean hands and implements, open sores, pus, mouth and nose discharge, shared drinking cups and towels. Uncovered coughing or sneezing and spitting in public also spread germs. Viruses A virus is a submicroscopic structure capable of infesting almost all plants and animals, including bacteria. They are so small they can even pass through the pores of a porcelain filter. They are common colds, and other respiratory and gastrointestinal (digestive tract) infections. Other viruses that plague humans are: 57

58 CHICKEN POX RABIES 58

59 SMALL POX INFLUENZA 59

60 One difference between viruses and bacteria is that a virus lives only by penetrating cells and becoming part of them, while bacteria are organisms that can live on their own. It is for this reason that bacterial infections can usually be treated with specific antibiotics, while viruses are hard to kill without harming the body in the process. Generally, viruses are resistant to antibiotics. Vaccination prevents viruses from penetrating cells. vaccinations are not available for all viruses. Hepatitis Hepatitis, a disease marked by inflammation of the liver, is caused by a bloodborne virus similar to HIV in transmission. It is more easily contracted than HIV, however, as it is present in all body fluids. Three types of hepatitis are of concern to a cosmetologist. 1. Hepatitis A. The illness usually lasts about three weeks. Symptoms are similar to those of the flu. Adults often have yellowing of the skin or the eyes. The disease is spread through close household contact, such as common bathroom use; poor sanitation; poor personal hygiene, contaminated food, milk, water, and shellfish; infected food handlers; and sexual contact. A vaccine is available. 2. Hepatitis B. This illness can cause long-term hepatitis, cirrhosis, and or liver cancer. About half the people with the disease do not have symptoms, although the disease can mirror the flu. The disease is primarily transferred through sexual contact or parenteral exposure (piercing mucous membranes or skin barrier) to blood or blood products. A vaccine is available. 3. Hepatitis C. The illness can progress slowly, and about one-third of those with the illness do not have symptoms, though symptoms can include fatigue and stomach pain. The disease is transferred through parenteral contact and sexual activity with infected partners. No vaccine is available. HIV AIDS HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (acquired Immune Deficiency Syndrome). AIDS, the disease, breaks down the body s immune system. HIV is passed from person to person through blood and other body fluids, such as semen and vaginal secretions. A person can be infected with HIV for up to 11 years without having symptoms. Sometimes, people who are HIV-positive have never been tested and do not know they are infecting other people. The HIV virus is transmitted through unprotected sexual contact, the sharing of needles by intravenous (IV) drug users, and accidents with needles in health-care settings. It can enter the bloodstream through cuts and sores and can be transmitted in the salon by a sharp implement. It 60

61 is not transmitted by holding hands, hugging, kissing, sharing food or household items like the telephone, or even toilet seats. There are not documented cases of the virus being transmitted by food handlers, insects, or casual contact. How Pathogens enter the Body Pathogenic bacteria or viruses can enter the body through: A break in the skin, such as a cut, pimple, or scratch The mouth (contaminated water or food) The nose (air) The eyes or ears Unprotected sex The body fights infection by mean of: Unbroken skin, which is the body s first line of defense Body secretions, such as perspiration and digestive juices White cells within the blood that destroy bacteria Antitoxins that counteract the toxins produced by bacteria and viruses Bloodborne Pathogens Disease-causing bacteria or viruses that are carried through blood and body fluids, such as hepatitis and HIV, are called bloodborne pathogens. If you accidentally cut a client who is HIV-positive or is infected with hepatitis and you continue to use the implement without cleaning and disinfecting it, you risk puncturing your skin or cutting another client with a contaminated tool. Similarly, if you are shaving a client s face or neck with a razor or clipper blades and pick up body fluid from a blemish or open sore, transmission is possible. Risks are also present when waxing and tweezing. 61

62 Parasites Parasites are vegetable or animal organisms that live in or on another living organism and draw their nourishment from that organism (referred to as a host). They are not capable of sustaining their own life without a host. Vegetable parasites or fungi, which include molds, mildews, and yeasts, can produce contagious diseases, such as ringworm and favus, both skin diseases. Nail fungus can be contracted through implements that have not been disinfected properly or by moisture trapped under nail enhancements. Nail fungus is chronic and usually localized, but can spread to other nails and from client to client if implements are not disinfected before and after each client. Treatment is generally applied directly to the affected area. In serious cases, however, a physician s care is required. Animal parasites, such as head lice, are responsible for contagious diseases and conditions. A skin disease caused by an infestation of head lice is called pediculosis capitis. Scabies is another contagious skin disease and is caused by the itch mite, which burrows under the skin. Contagious diseases and conditions caused by parasites should never be treated in a cosmetology school or salon. Clients should be referred to a physician. Contaminated 62