About Course
TOPICS OF INDEX
- SKIN CELLS & MICROANATOMY / HISTOLOGY
- SKIN PHYSIOLOGY & ANATOMY
- BACTERIAL STUDY
- INFECTION PREVENTION
- SKIN TYPING – FITZPATRICK, GLOGOU, LANCER & more.
- CLINICAL PHARMACOLOGY
- CONTRAINDICATIONS
- INJECTABLE TREATMENTS (basic knowledge)
- ACNE (types of acne)
- SKIN ANALYSIS & ASSESSMENT
- CHEMICAL VS PHYSICAL SUNSCREEN
- CLIENT CONSULTATION & DOCUMENTATION
- MICRONEEDLING (Theory)
- MEDICAL INTAKE FORM (Sample)
Course Content
SKIN CELLS & MICROANATOMY
Introduction to Cell Anatomy
Cells are the basic units of all living things. A cell is a small portion of protoplasm surrounded
by a membrane. There are different organelles within the cell membrane. A cell is the fundamental unit that makes up all living organisms, both in structure and function. Often called the "building blocks of life," cells are the smallest units capable of performing all the vital processes required for survival.
While organisms can be made up of a single cell (unicellular organisms, like bacteria), most organisms, including humans, are made up of trillions of cells working together to perform different functions.
The cell membrane has receptor sites that enable the cell to communicate with tissues, organs, and other cells. Each type of tissue in the body consists of cells with specific receptors, which allow the cells to perform their designated functions.
Human Cells
Humans have a variety of specialized cells, each with unique structures and functions. These include
Epithelial Cells: Line the body's surfaces and cavities, forming barriers and protecting underlying tissues.
Muscle Cells: Specialized for contraction and movement (e.g., skeletal, cardiac, smooth muscle cells).
Nerve Cells (Neurons): Transmit electrical signals and communicate throughout the body.
Blood Cells: Includes red blood cells (carry oxygen), white blood cells (immune defense), and platelets (involved in clotting).
Fat Cells (Adipocytes): Store energy in the form of fat and play a role in metabolic regulation.
Stem Cells: Undifferentiated cells that can develop into various specialized cell types.
Bone Cells: Include osteoblasts (bone-building cells), osteoclasts (bone-resorbing cells), and osteocytes (mature bone cells).
Each human cell performs a variety of critical functions:
Metabolism: Cells perform chemical reactions to produce energy (ATP), synthesize new molecules (like proteins), and break down waste products.
Protein Synthesis: Cells create proteins based on instructions from DNA, which are essential for structure, enzymes, signaling, and immune functions.
Reproduction: Cells divide to create new cells, either for growth (mitosis) or for reproduction (meiosis).
Communication: Cells communicate with one another through chemical signals, hormones, and neurotransmitters to coordinate body functions.
Homeostasis: Cells regulate their internal environment (e.g., pH, ion concentrations, temperature) to maintain stable conditions necessary for function.
SKIN CELLS
Skin cells are specialized cells that make up the skin, each playing a specific role in maintaining its structure, function, and health. The skin is the body's largest organ and consists of several types of cells that work together to protect, regulate, and sustain overall body functions. Here's an overview of the main types of skin cells and their functions:
1. Keratinocytes
Location: Predominantly in the epidermis, the outermost layer of skin.
Function:
Keratinocytes are the most abundant cells in the skin and are responsible for producing keratin, a tough, protective protein that strengthens the skin and makes it resistant to physical damage, water loss, and pathogens.
These cells originate in the stratum basale (the deepest layer of the epidermis) and move upward as they mature, eventually reaching the stratum corneum (the outermost layer), where they die and form a tough, protective layer of dead cells.
As they move toward the surface, they become corneocytes, which are flattened and packed with keratin, forming a water-resistant barrier.
2. Melanocytes
Location: Found in the stratum basale of the epidermis, interspersed between keratinocytes.
Function:
Melanocytes are responsible for producing melanin, the pigment that gives the skin its color.
Melanin also provides protection against the damaging effects of ultraviolet (UV) radiation by absorbing UV rays and preventing DNA damage in skin cells.
Melanin is transferred to nearby keratinocytes, where it forms a protective shield against UV light, helping to prevent sunburn and long-term skin damage.
People with darker skin have melanocytes that produce more melanin, while those with lighter skin have melanocytes that produce less melanin.
3. Langerhans Cells
Location: Found in the stratum spinosum (The stratum spinosum is a layer of the epidermis, or skin, that's also known as the prickle cell layer) of the epidermis.
Function:
Langerhans cells are specialized dendritic cells (a type of immune cell) that function as part of the body's immune system.
They act as antigen-presenting cells, which means they detect and process harmful invaders such as bacteria, viruses, and allergens.
After detecting harmful substances, Langerhans cells migrate to the lymph nodes to activate the immune response.
These cells play a key role in defending the skin from infections and diseases.
4.Merkel Cells
Location: Found in the stratum basale of the epidermis, especially in areas of high tactile sensitivity (such as fingertips).
Function:
Merkel cells are specialized mechanoreceptors that are involved in touch sensation.
They are responsible for detecting light touch and pressure and relay this sensory information to the nervous system.
Merkel cells form complexes with nerve endings called Merkel disks, which help in the perception of pressure and texture.
5. Fibroblasts
Location: Found in the dermis, beneath the epidermis.
Function:
Fibroblasts are the primary cells responsible for producing the extracellular matrix of the skin, including collagen, elastin, and hyaluronic acid.
Collagen provides skin with strength and structure, while elastin gives the skin its flexibility and ability to return to its original shape after stretching.
Hyaluronic acid helps to maintain moisture in the skin, contributing to hydration and skin plumpness.
Fibroblasts also play a key role in wound healing and tissue repair by generating new tissue and blood vessels after injury.
6. Endothelial Cells
Location: Found in the blood vessels within the dermis and hypodermis (subcutaneous layer).
Function:
Endothelial cells line the blood vessels and help regulate the flow of blood to the skin.
They are involved in the formation of new blood vessels (angiogenesis) during the healing process and in the regulation of inflammation and vascular permeability.
7. Adipocytes (Fat Cells)
Location: Found in the hypodermis (subcutaneous layer) beneath the dermis.
Function:
Adipocytes store fat in the form of triglycerides, which serve as an energy reservoir and provide insulation and cushioning to protect the body.
The fat stored in the hypodermis also acts as a thermal insulator, helping to maintain body temperature.
Adipocytes play a role in regulating hormones and immune function through the secretion of adipokines.
8. Mast Cells
Location: Found in the dermis and surrounding blood vessels.
Function:
Mast cells are involved in immune responses, particularly in allergic reactions.
They release histamine and other inflammatory chemicals when the skin is exposed to allergens or injury, which causes blood vessels to dilate and leads to inflammation.
Mast cells play a crucial role in wound healing and in protecting the skin from infections by initiating inflammatory responses.
9. Sweat Gland Cells
Location: Located in the dermis with ducts leading to the surface of the skin.
Function:
Sweat gland cells produce and secrete sweat, which is composed of water, electrolytes, and waste products like urea.
Sweat helps to regulate body temperature through evaporation and plays a role in detoxification.
Eccrine sweat glands are found all over the body, while apocrine sweat glands are mainly located in areas like the armpits and groin.
10. Sebaceous Gland Cells
Location: Found in the dermis, connected to hair follicles.
Function:
Sebaceous gland cells produce and secrete sebum, an oily substance that lubricates and protects the skin.
Sebum helps to keep the skin and hair moisturized and prevents drying out.
These glands are often associated with hair follicles, and their secretion is regulated by hormones, particularly androgens (male hormones that are also present in females).
Skin Cell Life Cycle
Keratinocytes originate in the deepest layer of the epidermis, the stratum basale, where they continuously divide.
As they mature, they move upward through the epidermis, eventually reaching the stratum corneum, the outermost layer, where they become dead, flattened cells filled with keratin.
The cycle from birth to shedding of keratinocytes takes about 28-30 days in healthy skin
SKIN PHYSIOLOGY & ANATOMY
Layers of the Skin
The skin is primarily composed of three layers:
Epidermis (Outer Layer)
Dermis (Middle Layer)
Hypodermis (Subcutaneous Layer)
The Epidermis: is controlled by hormones called epidermal growth factor (EGF) and fibroblast growth factor (FGF). This layer of the skin consists of five sublayers:
1. Stratum Corneum (Horny Layer)
2. Stratum Lucidum (Clear Layer)
3. Stratum Granulosum (Grainy Layer)
4. Stratum Spinosum (Spiny Layer)
5. Stratum Germinativum (Basal Layer)
Stratum Corneum (Horny Layer)
The outermost layer, composed of dead, flattened skin cells called corneocytes (keratinized cells). These cells are filled with keratin, a protective protein that helps keep the skin waterproof and resilient. The stratum corneum forms a barrier that prevents water loss and protects against pathogens and physical damage.
Stratum Lucidum (Clear Layer)
This is a thin, translucent layer found only in thick skin (such as the palms of the hands and soles of the feet). It provides an additional barrier and is composed of dead skin cells that are transitioning into the stratum corneum.
Stratum Granulosum (Granular Layer)
This layer consists of flattened cells that contain keratohyalin granules, which help in the formation of keratin. Cells in this layer are beginning to lose their nuclei and other organelles, preparing to become part of the outermost protective layer.
Stratum Spinosum (Prickle Cell Layer)
The stratum spinosum contains keratinocytes (skin cells), which are interconnected by desmosomes (cell structures that provide mechanical strength). This layer also contains Langerhans cells, which are part of the immune system and help protect the skin from infections.
Stratum Basale (Stratum Germinativum or Basal Layer)
This is the deepest layer of the epidermis, where new skin cells are generated through mitosis. These newly formed cells gradually move upwards toward the surface as they mature and become keratinized.
The basal layer also contains melanocytes, which produce melanin (the pigment responsible for skin color). Melanocytes transfer melanin to nearby keratinocytes to protect the skin from UV radiation.
THE DERMIS
The dermis is the middle layer of the skin and is made up of two sublayers. The papillary dermis lies just beneath the epidermis and contains small projections called papillae, which house the blood vessels that supply the epidermis. This layer also contains free sensory nerve endings and Meissner’s corpuscles, which are particularly concentrated in sensitive areas of the skin.
The capillary networks in the papillary dermis serve two main functions. First, they provide essential nutrients to the epidermis, which lacks its own blood supply, relying instead on the capillaries in the dermis for nourishment. Second, the papillary dermis plays a role in thermoregulation. The vascular system in this layer adjusts blood flow, helping to conserve heat or dissipate it, depending on the body's temperature needs.
HYPODERMIS (SUBCUTANEOUS TISSUE)
The subcutaneous layer, also known as the hypodermis, is the deepest layer of skin located beneath the dermis. It consists of adipose tissue (fat) and collagen fibers, which provide insulation, cushioning, and support for the skin. Rich in blood vessels and nerves, this layer also contains sweat glands, hair follicles, and sebaceous glands.
One of the primary roles of the subcutaneous layer is to help regulate body temperature. The fat beneath the skin acts as insulation, trapping heat to help maintain a stable body temperature. The blood vessels within the subcutaneous layer also contribute to temperature regulation by expanding or contracting in response to environmental changes.
Additionally, the subcutaneous layer offers protection by cushioning internal organs and tissues. The fat serves as a shock absorber, safeguarding underlying structures from impact and injury.
BACTERIOLOGY
Bacteriology in the context of medical esthetics refers to the study of bacteria and their role in skin health, infections, and various skin conditions that estheticians might encounter during treatments. Understanding bacteriology is crucial for estheticians, as the skin is constantly exposed to various bacteria, and improper hygiene during treatments can introduce harmful bacteria into the skin, leading to infections or complications.
Importance of Bacteriology in Medical Esthetics
Prevention of Infections: A solid understanding of bacteriology helps estheticians prevent the introduction of harmful bacteria into the skin during procedures like facials, chemical peels, microneedling, or extractions.
Skin Health: Bacteria, both harmful and beneficial, are always present on the skin's surface. A balance of skin-friendly bacteria helps maintain healthy skin, while an overgrowth of pathogenic bacteria can lead to conditions like acne, folliculitis, and cellulitis.
Proper Sanitation and Sterilization: Knowledge of bacteriology informs the proper cleaning, sterilizing, and disinfecting of tools, equipment, and treatment areas, minimizing the risk of bacterial contamination.
Key Concepts of Bacteriology
1. Types of Bacteria on the Skin
Commensal Bacteria: These are harmless bacteria that live on the skin and are often part of the skin's natural microbiome, contributing to a healthy barrier and preventing harmful microorganisms from flourishing. Examples include Staphylococcus epidermidis.(is a bacteria & can cause wound infections, boils, sinus infections, endocarditis and other inflammations)
Pathogenic Bacteria: These are harmful bacteria that can cause infections. Pathogens like Staphylococcus aureus (which can cause folliculitis or boils) and Propionibacterium acnes (linked to acne) are common examples in the esthetic field.
2. Common Bacterial Skin Conditions
Acne Vulgaris: Caused by an overgrowth of Propionibacterium acnes (P. acnes), leading to inflammation in clogged hair follicles.
Folliculitis: A bacterial infection of the hair follicles, often caused by Staphylococcus aureus.
Impetigo: A highly contagious skin infection, often caused by Staphylococcus aureus or Streptococcus pyogenes, leading to crusty, yellowish sores.
Cellulitis: A deep skin infection caused by bacteria like Streptococcus or Staphylococcus, leading to redness, swelling, and pain in the affected area.
3. Bacterial Infections Related to Esthetic Procedures
Microdermabrasion and Chemical Peels: These treatments exfoliate the skin, which can leave the skin vulnerable to bacterial infections if not performed in a sterile environment.
Extractions: Improper extraction techniques can force bacteria deeper into the skin, potentially causing infection or scarring.
Microneedling: The use of needles creates microchannels in the skin, which can allow bacteria to enter the dermis if not done with proper sanitation.
Waxing: Waxing can cause small tears in the skin, increasing the risk of bacterial entry and infection if the area is not properly cleaned and disinfected.
4. Transmission of Bacteria
Cross-Contamination: Bacteria can spread between clients or from tools to clients if estheticians do not follow proper hygiene and infection control practices.
Contact with Non-sterile Surfaces: Bacteria can be transferred from surfaces (e.g., treatment beds, towels, and equipment) to the skin, especially if the esthetician’s hands or tools are not sanitized between treatments.
Aerosols and Droplets: Procedures that involve water, steam, or other aerosol-generating techniques can cause bacteria to spread through the air or on surfaces.
5. Infection Control Measures for Estheticians
Sanitization and Sterilization: All equipment, tools, and surfaces that come in contact with the skin must be disinfected or sterilized. This includes using autoclaves for tools that can be sterilized and hospital-grade disinfectants for surfaces and non-sterilizable items.
Personal Protective Equipment (PPE): Estheticians should wear gloves, face masks, and protective clothing to minimize the risk of bacterial transfer from themselves to the client or the environment.
Hand Hygiene: Regular handwashing and the use of alcohol-based hand sanitizers are essential to prevent bacterial contamination.
Avoiding Treatments on Infected Skin: Estheticians should avoid performing treatments on clients with active bacterial infections like acne, folliculitis, or impetigo until the condition is cleared by a medical professional.
6. Antiseptic Use
Pre-Treatment Skin Preparation: Before performing any treatment that breaks the skin barrier (e.g., extractions, microneedling), estheticians should apply an antiseptic solution (e.g., alcohol or chlorhexidine) to disinfect the skin and reduce the risk of infection.
Post-Treatment Care: After treatments, using a gentle, antibacterial or soothing product on the skin helps prevent post-procedure infections.
BLOODBORNE PATHOGENS
Bloodborne pathogens are harmful microorganisms found in human blood that can cause serious diseases. These pathogens are spread through contact with blood or other potentially infectious body fluids, leading to severe health conditions. For estheticians and medical aestheticians, it is essential to understand bloodborne pathogens and how to prevent exposure. Certain treatments, such as microneedling, waxing, and extractions, can create small breaks in the skin, providing a potential entry point for these pathogens.
Avoiding Exposure to Blood or Body Fluids
If blood is accidentally drawn during a procedure, stop the treatment immediately, clean the area, and apply first aid if needed.
Any blood or body fluids must be cleaned up with proper disinfecting solutions, and the area must be sanitized thoroughly.
Treatment Room Sanitation
Consistently disinfect treatment tables, countertops, and any other surfaces that come into contact with clients or equipment.
Replace towels, linens, and bed covers between clients to avoid bacterial accumulation.
Make sure all products (such as creams and oils) are applied with clean, sterile tools to prevent contamination.
Key Bloodborne Pathogens in the Aesthetic Industry
Hepatitis B (HBV)
A viral infection that affects the liver, potentially leading to chronic liver disease, cirrhosis, and liver cancer. It is transmitted through exposure to infected blood, which can occur during treatments like microneedling or extractions that break the skin barrier.
Hepatitis C (HCV)
A virus that also targets the liver and spreads through direct blood-to-blood contact. It is a major concern for medical estheticians, especially when using tools that can puncture the skin, such as needles or lancets.
HIV (Human Immunodeficiency Virus)
The virus responsible for AIDS, HIV can be transmitted through blood and other body fluids. Although the risk of transmission during aesthetic treatments is low, it remains a concern if appropriate safety measures are not followed.
INFECTION CONTROL
Infection control is crucial during clinical medical esthetician treatments to ensure the safety of both the client and the practitioner. The nature of esthetic procedures—ranging from facials to more invasive treatments like microneedling, chemical peels, or laser therapy—often involves working with the skin and, in some cases, breaking the skin barrier. This makes strict infection control protocols essential to prevent the spread of bacteria, viruses, or fungi.
“What you need to know” Many of us go to the spa, salon to relax and get pampered. Most spas work hard to make sure their clients enjoy a safe service. However, there are many ways that serious infections can be spread at the spa if proper steps to prevent infections are not taken. These infections include Mycobacterium, Pseudomonas, Hepatitis B, Hepatitis C, and skin and nail fungus. (Depending on treatment) Some of these infections can be very difficult to treat.
Hand Hygiene
The most effective way to prevent the spread of infection is regular and thorough handwashing.
Follow steps below:
Wash hands with soap and water for at least 20 seconds before and after each treatment.
Use hand sanitizer with at least 60% -70% alcohol if soap and water are not available.
Avoid touching the face or skin after touching equipment, products, or surfaces.
Personal Protective Equipment (PPE)
PPE serves as a barrier between the esthetician and the client, reducing the risk of cross-contamination.
Items to Use
Gloves: Wear disposable gloves during treatments that involve touching the skin directly, such as facials, chemical peels, waxing, or microneedling. Change gloves frequently.
Face Masks: Wear a mask, especially during procedures that generate aerosols or involve close contact with the client’s face. This helps prevent the spread of airborne pathogens.
Protective Eyewear: (in some treatments) Use eyewear to protect against accidental splashes of chemicals or liquids during treatments.
*Hair Tied back (during the treatments)
Sterilization and Disinfection of Equipment and Tools
Tools and Equipment: Any tools or devices used during treatments (e.g., tweezers, extractors, microdermabrasion tips, brushes, bowls) must be disinfected or sterilized to prevent contamination.
Sterilization: Autoclaves are used for sterilizing tools that come in direct contact with bodily fluids or broken skin (e.g., microneedles for microneedling, or tweezers).
Disinfection: Use hospital-grade disinfectants for items that cannot be autoclaved, such as, LED light devices, and non-invasive tools.
Single-Use Items: Use disposable items wherever possible (e.g., cotton pads, gloves, applicators, sheets) and dispose of them immediately after use.
Proper Storage: Store disinfected or sterilized tools in clean, dry, and covered containers to maintain their sterility.
Sanitizing the Treatment Area
Keeping the treatment area clean and disinfected helps prevent contamination of surfaces and equipment.
Procedure
Clean and disinfect treatment beds, chairs, and all surfaces that the client may come in contact with before and after each session.
Ensure that any equipment used on multiple clients (e.g., chairs, devices) is disinfected between uses.
Regularly clean and disinfect doorknobs, light switches, counters, and any other frequently touched surfaces.
Disposing of Contaminated Waste Properly
Proper waste disposal helps prevent the spread of infection and contamination.
Procedure
Dispose of used cotton pads, gloves, applicators, and other single-use items in biohazard waste bags.
Sharps containers should be used for any sharp objects, such as needles from microneedling treatments, to prevent injury or contamination.
Empty and replace waste containers regularly.
Disinfection of the Client’s Skin
Cleaning the client's skin before the treatment is crucial to reduce the risk of infection.
Procedure
Thoroughly cleanse the client's face and any treatment areas with antiseptic or disinfectant wipes or solutions before starting the procedure.
For treatments like chemical peels or microneedling, disinfecting the skin helps remove bacteria or contaminants that could be introduced into the skin during the treatment.
Avoid Cross-Contamination
Preventing cross-contamination between the client, equipment, and practitioner is key to maintaining a sterile environment.
Procedure
Do not touch products directly with your hands; use spatulas or applicators instead.
Avoid touching your face, phone, or other non-sterile objects after touching the client’s skin or equipment.
If tools like tweezers or extraction tools are used on one client, they should be cleaned or sterilized before being used on another client.
Client Health Screening and Consultation
Screening clients for any health issues or contraindications can prevent complications that may lead to infections.
Procedure
Perform a thorough consultation with the client, including reviewing any current skin conditions (e.g., active acne, open sores, or rashes) and medical history (e.g., recent surgeries, infections, or skin treatments), refer to contraindication slide
Never perform treatments on clients with active infections, skin diseases, or conditions that may compromise healing or cause complications.
Post-Treatment Care and Aftercare Instructions
Proper post-treatment care ensures that the skin heals without complications and reduces the risk of infection.
Procedure
Advise clients on post-treatment care, including keeping treated areas clean, avoiding touching the skin with dirty hands, and using appropriate skincare products.
Encourage clients to avoid exposing treated skin to direct sunlight, as this can increase the risk of infection or complications, particularly after invasive treatments.
Recommend gentle, non-irritating skin care products for aftercare and explain the signs of infection to watch for (e.g., redness, swelling, pus).
Monitoring for Adverse Reactions
Early detection of any adverse reactions (e.g., redness, swelling, or infection signs) allows for quick intervention.
Procedure
Continuously monitor clients during and after treatments for any signs of irritation or infection.
If an infection or adverse reaction occurs, refer the client to a medical professional for treatment.
Please refer to: https://globalwellnessinstitute.org/wp-content/uploads/2020/07/Presentations-1.pdf
SKIN TYPING
The Fitzpatrick Skin Typing Scale is a widely used classification system that categorizes human
skin into six different types based on their response to sun exposure
Type I: Very fair skin, always burns, never tans.
Often with red or blonde hair, light eyes, and pale skin. Highly sensitive to UV exposure and sunburns easily.
Example: People with fair skin who are very prone to sunburn.
Type II: Fair skin, usually burns, tans minimally.
Fair skin with light eyes and blonde or light brown hair. Can burn quickly, but may develop a light tan.
Example: Individuals with fair skin who burn but tan with difficulty.
Type III: Medium skin, sometimes burns, gradually tans.
People with light to medium skin who may burn slightly but tan gradually and easily.
Example: Individuals with olive or light brown skin.
Type IV: Olive skin, rarely burns, tans easily.
Medium to dark skin tone, rarely burns, and develops a deep tan.
Example: Individuals with Mediterranean or Asian ancestry.
Type V: Dark brown skin, very rarely burns, always tans.
Dark brown or dark skin, typically not prone to sunburn.
Example: People with Middle Eastern, Hispanic, or African ancestry.
Type VI: Very dark skin, never burns, deeply pigmented.
Very dark skin that rarely burns and has a high degree of pigmentation.
Example: Individuals of African, Afro-Caribbean, or South Asian descent.
Lancer Skin Type Classification
Dr. Harold Lancer’s skin typing system is based on skin tone, skin sensitivity, and oil levels. It’s a simpler system compared to the Fitzpatrick scale, and it categorizes skin into four primary types:
Type 1: Normal Skin
Balanced skin with no excess oil or dryness. No significant acne, blemishes, or skin conditions.
Ideal for: Most skincare products and treatments.
Type 2: Oily Skin
Excessive oil production, especially in the T-zone (forehead, nose, chin). Prone to clogged pores and acne.
Ideal for: Oil-free, non-comedogenic skincare products that control oil production.
Type 3: Dry Skin
Lacks moisture, may feel tight or rough. Can have flakiness or dullness. More prone to wrinkles and fine lines.
Ideal for: Hydrating, moisturizing products rich in humectants and emollients.
Type 4: Sensitive Skin
Prone to redness, irritation, itching, and reactions to products or environmental factors. Can be due to conditions like rosacea or eczema.
Ideal for: Gentle, hypoallergenic, and soothing skincare products with calming ingredients.
Key Uses: Helps professionals recommend customized skincare regimens based on individual skin needs. Focuses on the balance of skin’s oil levels and sensitivity.
Rubin Classification
The Rubin Classification is a system used to categorize skin types based on their response to
chemical peels. This classification assesses skin types and assigns them to various levels based
on their ability to tolerate different concentrations of peeling agents.
The Taylor Hyperpigmentation Scale is a classification system designed to assess the severity of hyperpigmentation in the skin, taking into account factors such as color, extent, and distribution.
The Kawada Skin Classification System is a method used to assess and categorize skin aging. It evaluates key signs of aging, such as wrinkles, pigmentation, skin laxity, and texture, and classifies them into four distinct grades.
The Glogau Scale is a classification system created to evaluate facial aging and guide treatment decisions. It assesses key signs of aging, such as wrinkles, skin texture, pigmentation, and vascular changes.
The Bauman Skin Type Solution is a classification system designed to identify an individual’s skin type and recommend customized skincare routines. It evaluates various skin factors, including oiliness, sensitivity, pigmentation, and resilience, to categorize individuals into distinct skin types.
The Goldman World Classification of Skin Type is a system developed to categorize skin types based on their response to laser and light-based treatments. It takes into account factors such as skin color, sun sensitivity, and the likelihood of adverse reactions.
Bioderma Skin Typing System (Hydration and Sensitivity)
Bioderma, a well-known skincare brand, classifies skin based on hydration levels and sensitivity:
Skin Type 1: Dehydrated Skin (lacks water content, not oil).
Skin Type 2: Sensitive Skin (can react to products easily).
Skin Type 3: Combination Skin (T-zone is oily, cheeks are dry or normal).
Skin Type 4: Oily Skin (excessive sebum production).
The Willis and Earles Scale, also referred to as the Willis and Earles Phototypes, is a classification system that assigns numerical values to various skin types based on their response to ultraviolet radiation.
Important Resources:
Skin typing: Fitzpatrick grading and others
Fitzpatrick skin typing: Applications in dermatology
Find Your Fitzpatrick Skin Type
Additionally, you can do your research and find more information on this topic. There have been more articles online that mention it is time to change Fitzpatrick skin typing. It’s important to stay updated with industry trends and have updated info.
PHARMACOLOGY FOR SKIN PROFESSIONALS
Pharmacology of dermatological therapeutics refers to the study of how drugs interact with the skin, the body's largest organ, and their therapeutic applications in the treatment of various cutaneous (related to skin) disorders. The skin serves both as a protective barrier against external insults and as a site for the absorption of pharmacological agents. In dermatology, pharmacological interventions are employed either topically or systemically, depending on the nature and severity of the skin condition being treated.
TOPICAL DRUGS
Topical medications are applied directly to the skin, and they are the most commonly used treatments in dermatology. They are preferred because they allow for localized treatment with fewer systemic side effects.
SYSTEMATIC DRUGS
In some dermatologic conditions, topical treatments may not be sufficient, and oral or injected medications are needed to treat more severe or widespread conditions.
Corticosteroids (Steroids)
Corticosteroids are anti-inflammatory drugs commonly used to treat inflammatory skin conditions like eczema, psoriasis, dermatitis, and rashes.
Examples: Hydrocortisone, betamethasone, clobetasol.
Systemic Antibiotics
Used for widespread bacterial skin infections or acne.
Examples: Doxycycline, tetracycline, minocycline, cephalexin.
Topical Antibiotics
These are used to treat bacterial skin infections, such as impetigo, acne, or infected wounds.
Examples: Mupirocin, clindamycin, and fusidic acid.
Systemic Antifungals
Used for more severe or widespread fungal infections, such as
systemic candidiasis or nail infections.
Examples: Itraconazole, fluconazole, terbinafine.
Topical Antifungals
These are used for fungal infections of the skin, such as ringworm, athlete’s foot, and fungal nail infections.
Examples: Clotrimazole, ketoconazole, terbinafine.
Oral Retinoids (Systemic Retinoids)
Oral retinoids are used in the treatment of severe acne,
psoriasis, and other dermatologic conditions that do not
respond to topical treatments.
Examples: Isotretinoin (Accutane).
Topical Immunomodulators
Topical calcineurin inhibitors are used to treat conditions like atopic dermatitis and psoriasis, where corticosteroids might be less suitable.
Examples: Tacrolimus (Protopic), pimecrolimus (Elidel).
Immunosuppressive Drugs
These are used in the treatment of autoimmune skin disorders
like lupus, pemphigus vulgaris, and severe psoriasis.
Examples: Methotrexate, azathioprine, cyclosporine.
Emollients and Moisturizers
These are used to hydrate and protect the skin, particularly in conditions like eczema, psoriasis, and dry skin (xerosis).
Examples: Petrolatum, glycerin, urea-based creams.
Biologic Agents
Biologics are newer treatments, typically used for chronic
or severe autoimmune skin conditions like psoriasis or atopic
dermatitis.
Examples: Adalimumab (Humira), ustekinumab (Stelara),
dupilumab (Dupixent).
Retinoids
Topical retinoids are used primarily in the treatment of acne, psoriasis, and signs of aging.
Examples: Tretinoin, adapalene, tazarotene.
Combination Therapies: Often, a combination of topical treatments (e.g., corticosteroids with antibiotics or antifungals) may be used to treat complex or mixed skin conditions.
Sun Protection: Many dermatologic drugs, such as retinoids, antibiotics, and antifungals, can increase the skin’s sensitivity to sunlight, requiring the use of sunscreen or avoidance of direct sun exposure.
Conclusion
Pharmacology in dermatology is crucial for managing a wide variety of skin conditions, from infections and inflammation to chronic diseases and cosmetic concerns. Understanding the mechanisms of action, side effects, and appropriate use of dermatologic drugs helps healthcare providers optimize treatment for skin conditions while minimizing risks to the patient.
INJECTABLE TREATMENTS (Medical interventions)
Please check rules and regulations/licenses required in your country to become an Injector. Since, every country has different rules around it.
Some medical estheticians work under the supervision of licensed medical professionals with injectable treatments such as:
Botox and Dysport: neurotoxins used to treat wrinkles.
Dermal fillers: Hyaluronic acid fillers and their uses (e.g., lip augmentation, volume loss).
Along with Injectables, Plastic surgeries can be considered as medical interventions for many aesthetic treatments, if a client mentions in the medical intake form that they have undergone a surgery recently especially in the treatment area it is a contraindication.
Common surgeries may include (but are not limited to)-
Rhinoplasty: Nose surgery
Mastopexy: Breast Lift
Genioplasty: Chin Augmentation
Rhytidectomy: Facelift
Liposculpture: removing localized fat deposits from areas such as the abdomen, thighs, arms, chin, or back.
Blepharoplasty: Eyelid surgery
Brow Lift (Forehead lift)
It's essential to be familiar with the various terms used in plastic surgeries and injectable treatments. This knowledge ensures that, as professionals, we can understand and respond appropriately if a client brings up these topics.
ACNE
Acne is a frequent/common dermatological condition that arises when hair follicles become obstructed by excess sebum, dead skin cells, and occasionally pathogenic bacteria. This leads to the formation of various types of lesions, including comedones (blackheads and whiteheads), pustules, papules, and cysts.
CATEGORIES of ACNE
EXAMPLE
Non-inflammatory types
(e.g., blackheads and whiteheads) are less severe and involve clogged pores without inflammation.
Severe types
(e.g., cystic acne, acne conglobata) involve deep, painful, and large lesions and often result in scarring.
Inflammatory types
(e.g., papules, pustules) involve redness, swelling, and pus.
An overview of the most common types:
(Acne Vulgaris is the most common type of acne)
Inflammatory Acne
Inflammatory acne occurs when the clogged pores become infected or inflamed, leading to the formation of more painful and visible lesions. The common types include:
Papules: Small, red, raised bumps on the skin. These are early signs of inflammation and do not have pus.
Pustules: Similar to papules but with a visible white or yellow center containing pus. These are often painful and may occur after a papule becomes infected.
Cystic Acne
Cystic acne is the most severe form of acne and involves the formation of deep, large, painful cysts under the skin. These cysts are filled with pus and can cause significant inflammation. They are more prone to scarring and may require oral medications, such as antibiotics or isotretinoin, for treatment.
Acne Vulgaris
Acne vulgaris is the most common type of acne and refers to a wide range of acne lesions, including blackheads, whiteheads, pimples, papules, pustules, and cysts. It generally occurs during puberty but can persist into adulthood. The condition can range from mild (primarily comedonal acne) to severe (with nodules and cysts).
Hormonal Acne
Hormonal acne is linked to fluctuations in hormones, especially during puberty, menstruation, pregnancy, or due to conditions like polycystic ovary syndrome (PCOS). It typically appears on the lower face, jawline, and chin areas and can include both comedonal and inflammatory acne.
Occupational Acne
This is a form of acne that develops due to exposure to certain substances in the workplace, such as oils, industrial chemicals, or cosmetics. The irritation from these substances leads to clogged pores and the development of acne.
Nodulocystic Acne
This type of acne is more severe and involves deep, painful, inflamed lesions that are larger and harder than pustules and papules. Nodulocystic acne includes:
Nodules: Large, solid lumps beneath the skin. They are painful and can take weeks or months to heal. They do not contain pus but can scar the skin.
Cysts: Deep, fluid-filled lesions that are similar to boils. They are often very painful, and when ruptured, they can lead to scarring. Cystic acne is typically the most severe form of acne and often requires medical treatment.
Acne Mechanica
Acne mechanica is a type of acne caused by friction, pressure, or heat. It is common among athletes or individuals who wear tight-fitting clothing or headgear. Sweat, heat, and friction cause the hair follicles to become clogged, leading to breakouts. This type of acne is often seen on the forehead, back, and shoulders.
If acne is persistent or severe, a dermatologist can offer personalized treatment options to help manage the condition effectively.
SKIN ANALYSIS & ASSESSMENT
Being able to perform a thorough skin analysis before the treatment is crucial:
Visual examination: Assessing texture, tone, and any visible conditions.
Skin type classification: Dry, oily, combination, sensitive, and their needs.
Use of diagnostic tools: Devices like Wood’s lamps, skin hydration meters, and other diagnostic equipment.
Assessing skin health: Understanding factors that affect skin health like hydration, elasticity, and pigmentation.
Skin Condition Identification
Acne: Comedonal, inflammatory, cystic, or hormonal acne.
Hyperpigmentation: Dark spots, age spots, or melasma caused by sun exposure or hormonal changes.
Rosacea: A chronic condition causing redness and visible blood vessels, often on the cheeks and nose.
Eczema or Psoriasis: Chronic inflammatory conditions that cause dry, red, itchy patches on the skin.
Sun Damage: Early or advanced signs of sun-induced skin changes, such as wrinkles, sunspots, and rough texture.
Medical History and Lifestyle Factors
Medications: Some medications, like isotretinoin or hormonal treatments, can affect skin appearance.
Diet and hydration: Diets rich in vitamins, antioxidants, and hydration can support healthy skin, while poor nutrition or dehydration may cause dryness or breakouts.
Sleep and stress levels: Lack of sleep and high-stress levels can affect skin health, contributing to conditions like acne or dull skin.
PHYSICAL VS CHEMICAL SUNSCREEN
Physical Sunscreens (Inorganic Sunscreens)
Physical sunscreens, also known as mineral sunscreens, rely on inorganic minerals like zinc oxide and titanium dioxide to provide UV protection. These ingredients work by forming a physical barrier on the skin that reflects or scatters UV radiation.
The primary active ingredients in physical sunscreens are zinc oxide and titanium dioxide, both of which offer broad-spectrum protection against both UVA and UVB rays.
Example
Zinc oxide is widely regarded as the most effective broad-spectrum sunscreen agent, offering protection from both UVA and UVB radiation. It has been shown to provide excellent protection against UVA1 and UVA2 (320-400 nm), which are responsible for skin aging and DNA damage.
While physical sunscreens are considered safe for all skin types, they may leave a white cast due to the reflective nature of the active ingredients. This can be a concern for individuals with darker skin tones, though newer formulations have addressed this by using micronized or tinted versions.
Chemical Sunscreens (Organic Sunscreens)
Chemical sunscreens contain organic (carbon-based) compounds that absorb UV radiation and convert it into heat, which is then released from the skin. These compounds are designed to absorb either UVA (which causes photoaging and deeper skin damage) or UVB (which causes sunburn and superficial skin damage), or both.
Chemical sunscreens typically contain a combination of ingredients, such as oxybenzone, avobenzone, octinoxate, octocrylene, and homosalate. These ingredients have absorption spectra that allow them to absorb UV light effectively.
Avobenzone is a commonly used chemical filter that absorbs UVA rays, particularly in the UVA range (340-400 nm), which is associated with deeper skin damage and skin aging. This makes chemical sunscreens containing avobenzone particularly useful for broad-spectrum protection
Chemical sunscreens are often favored by individuals with oily skin or those who prefer a more cosmetically elegant finish because they are typically lighter in texture and absorb more easily into the skin without leaving a white cast.
Note- No sunscreen is applied on the skin right after the microneedling session.
What is Microneedling?
Microneedling, also known as collagen induction therapy (CIT), is a minimally invasive clinical procedure that uses fine needles to create controlled micro-injuries in the skin. This process stimulates the body's natural wound healing response, promoting collagen and elastin production. It is performed with a medical-grade micro needling pen.
Benefits of Microneedling
Microneedling offers a range of benefits for skin health and rejuvenation, including:
Enhanced Collagen Production: Stimulates fibroblasts to produce collagen and elastin, improving skin texture and elasticity.
Reduction of Fine Lines and Wrinkles: Helps diminish the appearance of facial aging signs.
Scar Reduction: Effective in treating acne scars, surgical scars, and stretch marks.
Improved Skin Tone and Texture: Reduces hyperpigmentation, melasma, and uneven skin tone.
Minimize Pore Size: Helps tighten enlarged pores, making skin appear smoother.
Enhanced Absorption of Topical Treatments: Increases penetration of active ingredients such as hyaluronic acid, vitamin C, and growth factors.
Hair Growth Stimulation: Encourages hair follicle activity, particularly in androgenetic alopecia treatments.
Indications for Microneedling
Microneedling is used in the management of various dermal concerns, including:
Superficial Fine lines and wrinkles
Acne scars and post-inflammatory hyperpigmentation
Enlarged pores
Stretch marks
Melasma and hyperpigmentation
Sun damage and photoaging
Surgical scars
Skin laxity and poor texture
Contraindications (not suitable for)
Microneedling is generally a safe procedure, but certain conditions may contraindicate the procedure:
Active Skin Infections or Conditions: Bacterial, viral (e.g., herpes simplex), or fungal infections.
Severe Acne or Rosacea: Active inflammatory acne or severe rosacea can worsen with microneedling
Keloid-Prone Skin: Individuals with a history of keloid scarring may be at risk of excessive scarring.
Blood Clotting Disorders or Anticoagulant Therapy: Increased risk of bleeding and delayed healing.
Autoimmune Diseases: Conditions such as lupus or psoriasis may lead to unpredictable healing responses.
Recent Use of Isotretinoin (Accutane): Patients should wait at least 6-8 months post-treatment due to impaired skin healing.
Pregnancy and Breastfeeding: Limited studies on safety, so caution is advised.
Poor Wound Healing Ability: Diabetes or other chronic conditions that impair healing.
* (print the contraindications for your reference)
Why Choose Professional Microneedling Over At-Home Microneedling?
While at-home microneedling may seem like a convenient and cost-effective option, professional microneedling offers safer, more effective, and long-lasting results
Why choosing a professional is the better option?
Professionals use 1.0mm – 2.5mm needle length, reaching the dermis where collagen and elastin production occurs, making it far more effective for scars, wrinkles, and deep skin concerns.
At-home users risk infection, irritation, or skin damage if the device is not properly sanitized or if the skin isn’t prepared correctly.
Professional microneedling stimulates long-term collagen production, providing noticeable improvements in skin texture, firmness, and scars after a few sessions.
Many at-home users apply too much pressure or roll too aggressively, leading to micro-tears in the skin rather than controlled micro-injuries.
Instructions for the client (Pre session)
No active ingredients (such as retinol, Benzoyl peroxide, Glycolic, salicylic acid) 4-5 days prior to the treatment.
No blood thinner, Please avoid fish oil (if applied) day of treatment since it is considered a blood thinner.
Avoid anti- inflammatory medications/tablets 2-3 days prior to the session (because it can interfere with the inflammatory process and we need that for the wound healing response)
Clients, who are prone to cold sores, must take antiviral 2 days prior to treatment, because sometimes, microneedling treatment could trigger cold sores.
No Black Coffee on the day of treatment, since it is also a blood thinner and also causes dehydration.
BEST SERUMS FOR MICRONEEDLING
Hyaluronic Acid (HA) – Hydration & Healing
Hydrates the skin, reduces inflammation, and promotes faster healing.
Best For: All skin types, especially dry and sensitive skin.
Most Commonly used serum, Best part about it is that our skin naturally has Hyaluronic acid present in it. So, there is less chance of any adverse effects.
Growth Factors & Peptides – Skin Repair & Rejuvenation
Stimulate collagen production, speed up healing, and improve skin elasticity.
Best For: Anti-aging, wrinkles, scars, and damaged skin.
Best applied after microneedling for enhanced results.
Vitamin C (L-Ascorbic Acid) – Brightening & Antioxidant Protection
Fights free radicals, reduces hyperpigmentation, and boosts collagen.
Dull skin, uneven tone, and pigmentation.
Please note: Only use after the skin has calmed down (24–48 hours post-procedure). Using it immediately after microneedling may cause irritation.
Niacinamide (Vitamin B3) – Redness Reduction & Barrier Repair
Calms redness, strengthens the skin barrier, and reduces inflammation.
Sensitive skin, acne-prone skin, and rosacea.
Safe to use after microneedling (avoid using during the procedure).
Platelet-Rich Plasma (PRP) – Regeneration & Collagen Boosting (done by licensed Nurses or dermatologist)
Uses the patient's own platelets to accelerate healing and tissue repair.
Anti-aging, scars, and deep rejuvenation.
Applied immediately after microneedling by professionals.
SERUMS TO AVOID AFTER MICRONEEDLING
❌ Retinol & Retinoids – Too harsh, can cause excessive irritation.
❌ Exfoliating Acids (AHA/BHA) – Can lead to burning, peeling, and sensitivity.
❌ Benzoyl Peroxide – Too drying and irritating for healing skin.
❌ Alcohol-Based Products – Can cause extreme dryness and irritation.
General Microneedling Depth Chart
NEEDLE DEPTH
TARGETED SKIN LAYER
USE CASE
0.2mm – 0.5mm
Epidermis
Enhancing product absorption, improving skin hydration, mild texture refinement
0.5mm – 1.0mm
Epidermis/Dermis
Fine lines, mild scars, hyperpigmentation
1.0mm – 1.5mm
Upper Dermis
Moderate wrinkles, acne scars, stretch marks
1.5mm – 2.5mm
Deep Dermis
Deep acne scars, surgical scars, severe stretch marks, skin tightening
MICRONEEDLING POST CARE
First 24-48 hours
✔ Redness & Sensitivity
✔ Mild Swelling & Warmth: Skin may feel tight or irritated.
✔ Pinpoint Bleeding Possible: Usually stops quickly and not serious.
Days 2-7
✔ Redness starts to fade but there might be scabbing.
✔ Some peeling or dryness may occur (DO NOT pick at it).
✔ Skin may feel rough as new collagen forms.
Days 7+
✔ Skin looks brighter, smoother, and more even-toned.
✔ Continue hydrating and protecting your skin.
✔ Full results take 4–6 weeks, as collagen rebuilds.
Please note- Only wear makeup post 48 hours of the session. Preferably mineral makeup.
Apply sunscreen 48 hours post session
ITEMS NEEDED FOR PROFESSIONAL MICRONEEDLING SESSION
Microneedling Device & Accessories
1. FDA-Approved Microneedling Pen
2. Sterile Needle Cartridges (single-use, adjustable depth)
3. Disposable Gloves (medical-grade nitrile or latex)
4. Disposable Face Mask & Headband (to keep hair away from the face)
Pre-Treatment Essentials
Cleansing Products
Gentle, fragrance-free cleanser
Antiseptic Skin Prep (e.g., Chlorhexidine, 70% Isopropyl Alcohol, or Hibiclens)
Numbing Cream
Lidocaine-based topical anesthetic (e.g., BLT cream – Benzocaine, Lidocaine, Tetracaine)
Plastic wrap (to occlude numbing cream for better absorption)
Skin Marker (Optional):
Used to outline areas of concern (e.g., scars, wrinkles, hyperpigmentation)
Serums for Microneedling
Serums to Apply During the Session:
Hyaluronic Acid (HA) → Enhances hydration and glide.
Stem Cells/Growth Factors → Boosts collagen and healing.
Platelet-Rich Plasma (PRP) → Used in "Vampire Facials" for advanced rejuvenation. (done by derms only)
DO NOT use active ingredients like Vitamin C, retinol, or exfoliating acids during microneedling.
Post-Treatment Essentials
Soothing Products
Hyaluronic Acid Serum → Keeps skin hydrated.
Barrier Repair Cream → Aids healing.
Thermal Spring Water Spray→ Reduces irritation.
Sun Protection
Mineral SPF 30+ Sunscreen → Protects against hyperpigmentation.
Post-Procedure Instructions & Aftercare Kit
Patients should receive written aftercare guidelines to ensure proper recovery.
Additional Items for a Clinic Setup
✔ Medical-Grade Sterilization Equipment (Autoclave or UV sterilizer)
✔ Disposable Medical Drapes & Towels (to maintain cleanliness)
✔ LED Light Therapy Device (Optional) (Red light can reduce inflammation post-treatment)
Additional Information
Microneedling devices are utilized to enhance skin texture, reduce the appearance of scars, and promote overall skin rejuvenation. The U.S. Food and Drug Administration (FDA) has authorized specific microneedling devices for medical use, ensuring they meet safety and efficacy standards.
FDA Approval vs. Clearance: It's important to distinguish between FDA "approval" and "clearance." Approval is typically reserved for high-risk medical devices and involves a rigorous review process. Clearance, on the other hand, applies to moderate-risk devices and indicates that the device is substantially equivalent to a legally marketed device.
At-Home Devices: Currently, the FDA has not authorized any microneedling medical devices for over-the-counter sale. Devices available for at-home use may not penetrate the skin deeply and are generally intended for cosmetic purposes, such as exfoliation.
Professional Use: The FDA advises that microneedling devices, especially those that penetrate the skin, should be operated by trained healthcare or certified professionals to ensure safety and effectiveness.
For Reference: https://www.youtube.com/watch?v=kkVJIuNKEOU
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