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Overexposure to product (symptoms): Irritation in eyes/nose/throat, skin irritation, excessive erythema, blistering, grazing. blood spots. Examples of contra-indications that may prevent treatment: Inflamed or infected skin conditions, herpes simplex, contagious skin disease, malignant melanomas, client on medication that causes skin thinning or inflammation (e.g. steroids, acutane, retin-A), keloid scarring diagnosed scleroderma, haemophilia, insulin controlled diabetes, epilepsy, circulatory disorders, dysfunction of the nervous system, HIV, infected/pustular acne, client undergoing any medical treatment without GP's consent. Examples of contra-indications that may restrict treatment: Tattoos in treatment area, pigmented naevi, moles, recent dermabrasion or chemical peel treatment, recent scar tissue (within six months), varicose veins, cuts, abrasions, bruises, collagen, Restylane or similar filler injections, recent botox treated areas (lack) of nerve response), couperose conditions, telangiectasia/telangiectasia angioma (spider naevi) Examples of possible contra-actions: Erythema, oedema, bruising, allergic reaction, discontinuation treatment, taking remedial action Possible causes of contra-actions: Poor hygiene-Home care/aftercare, a bacterial infection caused by contamination of the treated area. Overtreatment - Excess erythema. blistering, excessive discomfort, and swelling. bruising, blood spots. Be able to provide skin treatment using microdermabrasion Skin analysis: Carried out using a magnifying lamp, protect eyes with damp cotton wool pads, check all areas of the face and neck for the skin type, skin conditions and characteristics, record results on a record card, client skin type, conditions and characteristics, treatment plan, most suitable treatment, suitable products, prevent worsening of conditions, accurate aftercare advice, future treatment needs. Skin types: Normal, city, dry Skin conditions: Mature, sensitive, dehydrated, congested. Examples of skin imperfections: Broken capillaries, pustules, papules, milia, comedones, open pores, fine lines and wrinkles. Skin characteristics: Sensitive-offen pale skins, dry, colour easily, redness, and react to products. Dehydrated-normal sebaceous secretions but still flaky, tight Mature-loss of elasticity, loose muscle tone, wrinkles Normal-fine texture, no visible pores: smooth, supple, and flexible. Oily-shiny, slightly thickening, sallow coarse texture, enlarged pores, congestion, and comedones. Combination-combination of two or more skin types, usually oily T zone, normal or dry on cheeks. Dry-lacks moisture, dry to the touch, flakiness, fine texture, thin, tight, small pores, broken capillaries, ageing. Skin sensitivity tests: Tactile test for a sharp and blunt, thermal test for hot and Tactile-Use a sharp (orange stick) and smooth (cotton pad) object, and stroke over the skin in the area to be treated, the client should be able to differentiate between the different sensations. Thermal-Fill test tube with cold water and, one with hot water, place on the skin in the area to be treated, ask the client to differentiate between the sensations Skin sensitivity test-record results Skin sensitivity test- interpret results: The client should be able to identify the difference between sharp/blunt and hot-cold, if the client can; treatment can go ahead, if the client is unresponsive to tactile and thermal tests, treatment should not be carried out, the client would not be able to feel if electrical current was too high, risks of skin damage Explain the treatment to the client: Treatment process, expected sensations, skin reaction, outcomes, and further treatments. Products and equipment: Anti-allergenic cleanser, toner, moisturiser and soothing face mask, correct-sized probe disposable head according to manufacturer's instructions to suit treatment needs, vacuum intensity between 3psi and 5psi according to treatment needs and manufacturer's instructions. Possible effects and benefits: Reduces fine lines and wrinkles, smoothes and softens skin surface, stimulates the production of natural collagen, and reduces flaccidity. enhances penetration of active products improves the appearance of stretch marks and scars, lightens hyper-pigmentation, increases blood and lymph flow, eliminates milia and blackheads, and clears spots. Mild. erythema, the skin may be taut and itchy for the first 48 hours, temporary dryness, slight skin shedding, temporary hypersensitivity, and mild sunburn sensation for the first few hours. Working position of client and therapist: Client supine, the area to be treated supported, positioned for ease of access and client comfort, avoiding awkward angles and allowing for effective treatment. Products for skin: Anti-allergenic cleanser, toner, mask, moisturiser with SPF 25 or over, large facial sponges/towelling mitts, paper tissues, and eye protection. Equipment: Couch, client chair, therapy chair, magnifying lamp, microdermabrasion machine, disposable headed for probe, aluminium oxide crystals (corundum), spatulas, bowls, mask brush, couch roll, towels, covers. Treatment technique (machine and probe techniques): Probe with an opening flat to the surface of the skin with, a firm grip. no pressure, rate, depth, direction, Vacuum pressure between 3psi and 5psi according to sensitivity, condition, and depth. of peel and manufacturer's instructions (sensitive, mature, thin epidermal clients. quick, light strokes, vacuum pressure low 3psi/manufacturer's instructions to aid regeneration and elasticity of skin), skin type (sun damaged, acne, oily, seborrhoea, sluggish, combination, normal-medium. rate movements, horizontally and vertically. problem areas, wrinkles, character lines) spots (vacuum pressure between 3psi and Spsilaccording to manufacturer's instructions), client comfort, regularity of treatments, aftercare. Treatment technique (scar tissue, post-injury and post-acne): Medium dermabrasion rate movements from outside edge to centre of scar, 3psi to 5psi/according to manufacturer's instructions, regularity of treatments, and aftercare. Treatment technique (stretch marks): Low pressure-max 3psi, according to manufacturer's instructions and client comfort, light quick strokes, from centre to outside edge, regularity of treatments aftercare. Treatment technique (hyperpigmentation): Chloasma, lentigo, sunspots, medium rate, max 5psi/ manufacturer's instructions, client comfort. regularity of treatments, aftercare. Treatment technique (cellulite): Largest disposable probe head, circular movements, medium rate movements, 3psi to 5psi according to client comfort and manufacturer's instructions, regularity of treatments, and aftercare. Response to contra-actions: Excessive erythema, blistering, swelling, excessive discomfort, bruising, blood spots (over-treatment, allergic reaction), remove product, cool compress, refer to GP exposure to UV, pigmentation, soreness excessive erythema, swelling, home care, cool compress, medical referral, avoid facial treatments, make-up, cosmetic products, use anti-allergenic products, avoid sunlight, sun beds, use protection SPF 25 plus in normal daylight, SPF 30 in sunlight. Client satisfaction: Objectives. client expectations, no contra-actions, questioning, listening, visual observation, non-verbal communication, eye contact. body language, future treatment needs. Aftercare and home care advice: No make-up or perfumed products for 24hrs. apply healing products (such as aloe vera gel at night), use moisturiser (with sun block factor 15-30 during the day), avoid sunlight/sun beds (for at least two weeks after the course of treatment), avoid touching the area (always wash hands before applying products), avoid over-stimulating the area (no heat treatments/exercise/hot showers for 24hrs, no swimming or other facial treatments for 24hrs). Skin (epidermis): Stratum germinativum, stratum spinosum, stratum granulosum. stratum lucidum, stratum comeum), the process of keratinisation.. Skin (dermis): Structure, blood/ lymph supply, papillary layer, reticular layer, collagen, elastin, macrophages, adipocytes, mast cells, fibroblasts, and hair. dermal papilla, sebaceous glands and sebum, arrector pili muscle, sweat glands (eccrine and apocrine), and sensory nerve endings. Skin (hypodermis): Structure (subcutaneous layer, adipose tissue, adipocytes) Functions of the skin: Secretion heat regulation, absorption, protection, elimination, sensation, vitamin D formation, melanin production. Examples of skin diseases and disorders: Congenital eczema, psoriasis. Bacterial - acne vulgaris, acne rosacea. folliculitis, boils (furuncles), impetigo. Viral - warts, verruca, herpes simplex (HSV), herpes zoster. Fungal-tinea (pedis, corporis, ungium). Infestations-scabies, pediculosis (capital, pubis). Pigmentation - vitiligo, albinism, chloasma, ephelides, lentigo, papilloma. naevae, part wine stains. Others: Basal cell carcinoma, squamous; cell carcinoma, malignant melanomas. Growth cycle and repair of skin; From germination to corneum, the process of keratinisation. Ageing process: Loss of elasticity, dryness of skin, cell regeneration slows, thinning of the skin, broken capillaries, slack muscle tone, poor circulation, waste product removal slows, less fatty tissue, and irregular pigmentation. Lifestyle factors that affect skin: Occupation, diet and fluid intake, sleep patterns, smoking, exercise, hobbies, home situation, stress levels, medication, illness, premature ageing, poor skin condition, loss of muscle tone, dehydration, poor circulation, excess fatty tissue, increased cellulite, slow metabolism, cell regeneration and growth. Environmental factors that affect skin: UV light, weather, central heating, drugs. alcohol, serious illness, medication, occupation, dryness, dehydration, premature ageing, wrinkles and loss of elasticity, and a slower metabolism.