Aestheticians frequently encounter clients with sensitive skin conditions. While a professional’s scope of practice does not allow them to treat eczema, rosacea, or psoriasis, they can provide treatments that supplement the care the client receives from their medical provider. By gaining an in-depth knowledge of each condition, its causes, and standard treatment options, professionals can combine empathy and understanding with superior skin health services to deliver first-rate therapies to this select group of clients.
Eczema, or dermatitis, is the name for a group of non-contagious skin conditions that present with symptoms of inflammation, pruritis (itchiness), and erythema (redness). Over 30 million Americans suffer from one or more forms of eczema which primarily appears on the hands, feet, face, and torso.
The most common form seen in the spa, atopic dermatitis, affects over 18 million Americans. It can present in infancy, teenage years, or adulthood. Individuals with a family history of atopic dermatitis, asthma, or hay fever have a higher risk of developing atopic dermatitis.
Symptoms include itchiness, redness, rash, dry or scaly skin, and open, crusty, or weepy lesions. If an infection develops from scratching, small pustules may form. Lichenification (skin thickening) can occur from excessive scratching and rubbing.
Contact dermatitis has two sub-classifications dependent on exposure to an irritant or allergen. Allergic contact dermatitis occurs with exposure to pollen, dust mites, or other allergens. Irritant contact dermatitis occurs with exposure to irritants like household cleaners. Symptoms include itchiness, redness, rash, swelling, bumps, and blisters. The best treatment for contact and irritant dermatitis is to avoid the offending agent.
The exact cause of eczema is unknown. However, genes and certain triggers are factors. Individuals with eczema have an immune system that over-reacts to outside stimuli producing inflammation. In turn, inflammation triggers the erythema, discomfort, and pruritis.
Researchers have discovered that some individuals suffering from eczema have a mutation of the FLG gene responsible for creating the protein filaggrin. Filaggrin is found in the granules in epidermal skin cells of the stratum granulosum. The epidermis acts as a barrier, inhibiting penetration of toxins, allergens, and bacteria. Filaggrin plays an essential role in the skin’s barrier function. Filaggrin attracts and binds structural proteins, forming tight bundles, flattening, and strengthening the cells to create a strong barrier. The breakdown of the filaggrin proteins leads to the production of molecules, including pyrrolidone carboxylic acid (PCA), that are part of the skin’s natural moisturizing factor which helps to maintain skin hydration. Filaggrin also assists with the maintenance of the slightly acidic pH of the skin (approximately 5.5) which is another essential aspect of barrier function.
Without adequate amounts of filaggrin, a weakened skin barrier can allow moisture to escape through transepidermal water loss. Additionally, bacteria, viruses, toxins, and allergens can penetrate with ease. The weakened barrier causes dry and infection-prone skin.
Research using probiotics to alter the skin’s microbiome is promising. A study discovered that parabens, commonly used as preservatives in skin care products, inhibit the growth of roseomonas mucosa (a gram-negative bacteria), suggesting that parabens might hinder the skin’s defenses against eczema.1
Prevention of Flareups
The best way to prevent flareups is to recognize and avoid the triggers.
The type and severity of eczema often determine the treatment. The medical provider determines the appropriate regimen based on the client’s condition. Knowledge of both clinical care and homecare remedies can help the aesthetician identify the best aesthetic regimens to complement the client’s current medical treatment.
A regular bathing and moisturizing routine using a gentle, soap-free cleanser and an emollient cream with humectant and occlusive ingredients is recommended to seal in the desperately needed hydration. Pat the skin dry with a towel (no rubbing) and apply moisturizer while the skin is slightly damp. Well-moisturized skin decreases dryness and keeps out allergens.
A 10-minute lukewarm bleach bath (using unconcentrated bleach) sounds harsh but can be calming and can prevent infection. The amount of chlorine is similar to the amount found in a swimming pool: approximately half a cup of bleach for a standard 40-gallon bathtub. The client should only utilize this therapy with their health care provider’s permission and must be sure to thoroughly rinse the skin with fresh warm water to remove all bleach residue.
Wet wrap therapies are beneficial for rehydration. They also help topical medication to penetrate more efficiently. To use this option, clients should apply moisturizer and any topical medications, followed by wrapping dampened gauze or cotton to the affected skin. Then, the client should follow the damp wrap layer with a dry cloth over the top of the dampened wrap and complete the process with nighttime clothing to keep the wraps in place. They should leave this on for several hours, staying moist, or overnight.
Many over-the-counter products – including gentle cleansers, mild steroids, moisturizers, petroleum jelly, mineral oil, and coal-tar-based products, amongst many others – are available to help prevent and control eczema flareups. Clients must be sure to read the labels and follow directions.
Clients should apply all topical over-the-counter and prescription medications as directed by the healthcare provider. Topical steroids reduce cutaneous inflammation. They also tighten and constrict the capillaries, which decreases erythema. They are not intended for long-term use; sensitive areas, including eyelids and genitals, should always be avoided. Topical calcineurin inhibitors (TCIs) can be used for extended periods to control symptoms and reduce flareups because they do not contain steroids. TCIs inhibit the stimulation of the inflammatory cascade, keeping eczema in check. Prescription-grade topical skin barrier medications made from lipids and ceramides help prevent transepidermal water loss and protect against irritants penetrating the skin’s barrier. Topical phosphodiesterase 4 (PER) inhibitors block the PDE4 enzyme, reducing inflammation both on and below the skin’s surface and can be used for extended periods.
Biologics are injectable drugs engineered from proteins derived from living cells or tissues. Biologics target the immune system to slow down its reaction, enabling the reduction of inflammation, redness, itchiness, and rashes.
Phototherapy, or light therapy, incorporates ultraviolet light to slow inflammation and mitosis. A hand-held device or a walk-in light source somewhat similar to a tanning booth may be used. Treatments take place in a doctor’s office several times a week and therapy can last weeks or months.
Immunosuppressant medications suppress the immune system, which reduces inflammation. They can be taken orally or by injection. Methotrexate, cyclosporine, and mycophenolate are three current medications used off label to treat eczema.
Rosacea is a chronic, but treatable, vascular skin condition that is estimated to affect 415 million people worldwide. It usually presents as redness in the central portion of the face when the patient is in their 30s. Left untreated, the condition worsens, resulting in more persistent redness and vascularity. Inflammatory pimples often develop and, in severe cases, the nose may grow swollen and bumpy from excess tissue. Up to 50% of patients have watery, bloodshot eyes that feel dry and irritated. Rosacea is most prevalent in people of northern or eastern European descent; however, all ethnicities can develop this condition.
Primary presentations on the central face include flushing, persistent redness, dilated capillaries, and papules and pustules. Secondary features include irritated eyes, burning or stinging, itchiness, dry skin, plaques, thickened skin, and edema.
Medical science is still looking for the cause of this condition. Knowledge of rosacea’s signs and symptoms enables the control of the condition with medical therapy and lifestyle changes while a search for the cure continues.
Facial redness presents because the client has an increased number of capillaries (which increases blood flow) that are closer to the surface of the skin. Eyelids may become red and swollen and styes are common. Crusts may accumulate around the eyelids or eyelashes and clients may notice visible blood vessels around the lid margins. Severe cases of ocular rosacea can result in corneal damage and loss of vision without medical intervention.
Clients must see a dermatologist or other qualified physician for diagnosis and appropriate treatment before their disorder becomes increasingly severe and affects their quality of life.
Groundbreaking studies funded by the National Rosacea Society focusing on the immune system discovered cathelicidin antimicrobial peptides (CAMPs) affect clients with rosacea differently than healthy individuals. CAMPs speed up physical repair but worsen rosacea symptoms. Researchers Dr. Yoshikazu Uchida and Dr. Peter Elias examined elements along the CAMP production pathway and found a lipid substance known as SP1 that is responsible for increased CAMP synthesis. They also discovered another lipid metabolite, C1P, that stimulates the production of other protective peptides which, in turn, decreases the number of CAMPs. New medications that can intersect the production of these protective peptides may lead to new rosacea therapies.2
Dr. Anna DiNardo and her research team discovered that mast cells play a role in the stimulation of certain types of cathelicidins, an enzyme involved in the immune system response that is over-produced in people with rosacea. Dr. DiNardo’s team determined that mast cells in mice exposed to PACAP – a neuropeptide, produced enzymes that triggered cathelicidin production. This chain reaction did not occur in mice bred to lack mast cells. Additional research is needed to discover if a mast cell stabilizer known as cromolyn sodium will decrease rosacea symptoms.3
Oral and topical medications treat the various signs and symptoms associated with the disorder. Rosacea-specific therapies are available in various formulations for each client.
Redness, papules, and pustules are treated with oral and topical therapy for immediate improvement, followed by long-term use of an anti-inflammatory for maintenance. Telangiectasias and rhinophyma are best addressed by lasers, intense pulsed light sources, or other medical and surgical devices. Ocular rosacea is treated with anti-inflammatory medications and recommendations from an ophthalmologist or optometrist.
The aesthetician must treat the skin very gently. Irritation and heat exacerbate the condition. Avoid the use of harsh chemical peels, scrubs, hot steam, microdermabrasion, or anything abrasive. Consider replacing the European massage with something lighter, like manual lymphatic drainage or pressure point, to minimize flushing due to stimulating circulation.
It is best to avoid aromatherapy or the use of any fragrances on sensitive skin. Consider using a cool spray in place of steam (found in multi-function machines) or adding a Lucas Championaire to the equipment arsenal. Mild chemical peels stimulate cellular renewal replacing damaged skin cells with healthy new ones. Incorporate calming, hydrating, and anti-redness ingredients into masks and serums.
Skin Care Routine
Gentle skin care products used daily will calm the skin. Clients should wash with a mild cleanser, rinse with lukewarm water, and blot dry. Suggest non-irritating skin care products as needed and a broad-spectrum mineral sunscreen with an SPF of 30 or higher.
Look for products with ingredients that address: inflammation, such as argan oil, niacinamide, linoleic acid, azelaic acid, ginger extract, bisabolol, green tea, lavender, jasmine, rose, tea tree, and thyme; barrier function, like niacinamide and linoleic acid; and redness, such as sulfur, caffeine, asparagopsis armata, and ascophyllum nodosum. Also, look for antioxidant-rich ingredients like argan oil, soothing and calming ingredients like aloe, hydrating ingredients like honey, hyaluronic acid, and glycerin, and healing ingredients like argan oil, lavender, jasmine, rose, tea tree, and thyme. A physical sunscreen that includes zinc oxide and titanium dioxide is a good idea, as well.
Avoid products with ingredients that sting, burn, or cause additional redness including: fragrances, peppermint oil, eucalyptus oil, drying alcohols, witch hazel, or foaming cleansers, which can be drying. Green-tinted makeup foundations can be used to counter redness, followed by a foundation with natural yellow tones. Avoid pink or orange hues.
Lifestyle and Environmental Factors
To supplement medical therapies, rosacea clients can improve their skin health by identifying and avoiding lifestyle and environmental factors that trigger flareups. Identifying these factors is an individual process because what causes a flareup in one person may not affect another.
More than 125 million individuals worldwide have psoriasis. Science is still searching for a cure, so patients must work to manage their symptoms. Psoriasis has several forms, with the most common being plaque psoriasis, which presents as a patchy, red rash with silvery, white scales. This form appears most often on the scalp, elbows, knees, and lower back. Psoriasis is an autoimmune disease that must be diagnosed by a physician.
Plaque psoriasis symptoms include flaking, inflammation, and thick, white, silvery, or red patches of skin.
An overactive immune system, the body’s defense against germs, causes psoriasis. It is a chronic skin condition. The body’s immune system mistakes healthy skin cells for damaged ones, then attacks them as if it were fighting an infection. The body responds to the attack by making new skin cells every few days instead of the usual 28 days. The newly formed cells build up on the skin’s surface and form a rash.
Psoriasis may be treated by using creams, steroids, biologics, laser, and phototherapy, amongst many other options.
Treatment options depend upon the level of the condition. A client is considered to have mild psoriasis, if it covers less than 3% of the body, moderate, when coverage ranges from 3% to 10%, and severe, if over 10%.
The client’s physician will determine the best treatment plan for each individual case. At-home treatments include:
There are a number of natural remedies that may be helpful, as well. Exposure to sunlight may be useful, as UVB rays from the sun work like UVB phototherapy. Aloe is calming and tea tree oil is antibacterial – it will fight any infection from scratching. Oatmeal baths calm irritated skin and epsom salt baths remove dead skin. Studies show that turmeric in foods or taken as a supplement may cut down flareups.
Light therapy (UVB phototherapy): UVB penetrates the skin to slow the growth of skin cells in an affected area. Skin is exposed to a UVB light source for a set length of time on a regular schedule. Phototherapy can be administered in a medical office or at home. PUVA is a form of phototherapy that combines a medicine called psoralen with UVA light. Excimer laser is FDA-approved for treating chronic, localized psoriasis plaques by emitting a high-intensity beam of UVB light. Biologics can be taken at home orally or by injection or IV in a medical facility.
Aesthetic Therapies: Blue LED light therapy addresses the bacterial components associated with psoriasis, while red addresses the inflammation. Massage can relax the client; stress is a trigger for flareups. Superficial chemical peels can exfoliate surface plaque buildup as long as they are mild; salicylic acid is FDA-approved to treat psoriasis.
Climatotherapy: Dipping into the Dead Sea has been said to improve psoriasis. A combination of the salty water and abundant sunshine is believed to be healing. Recent studies report improvements in psoriatic skin after taking the Dead Sea plunge. Many clients report having no symptoms for months afterward.
Prevention or Management of Flareups
Researchers know that approximately 10% of the population carries the gene for predisposition but only 2% to 3% develop the disease, which leads them to believe that environment and lifestyle choices play a factor.
Just as with eczema, a regular bathing and moisturizing routine using a gentle, soap-free cleanser and an emollient cream with humectant and occlusive ingredients to seal in hydration is ideal. Clients should pat the skin dry with a towel (no rubbing) and apply moisturizer while the skin is slightly damp. They should use a physical broad-spectrum sunscreen with zinc oxide or titanium dioxide for UVA and UVB protection.
Armed with the knowledge of sensitive skin presentations, their causes, treatments, and suggested homecare, skin care professionals can deliver exemplary services and product recommendations to a select group of clients that need empathy, understanding, and a gentle touch. There is nothing more fulfilling than seeing an impact made on someone’s life.
1 Research funded by the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and published May 3, 2018, in the journal JCI Insight.
2 “A novel therapeutic approach via modulation of sphingolipid signaling in rosacea.” National Rosacea Society. https://www.rosacea.org/grants/reports-on-completed-research.
3 “Mast cells play a direct role in the activation of certain types of cathelicidins.” National Rosacea Society. http://www.rosacea.org/grants/reports-on-completed-research.
4 National Eczema Association. https://nationaleczema.org.
5 National Roscaea Society. https://rosacea.org.
6 National Psoriasis Foundation. https://www.psoriasis.org.
Rosacea is a skin condition that affects as many as 1 in 20 people and, because it mainly affects the face, it presents a significant problem for everything from makeup applications to facials. When treating a person with rosacea, here’s what you should and shouldn’t do.
DO: BE PARTICULARLY GENTLE
Rosacea typically reddens skin and it also generates discomfort through stinging or burning sensations, making the affected areas quite sensitive. When a rosacea sufferer seeks skin treatment, they’re looking to relax and feel good about their skin. The only way they can do that is if the professional is gentle with them.
Whenever you need to touch affected skin, or even the area around it, don’t apply much pressure. Pressing too hard will likely cause pain and may even intensify the symptoms. Additionally, avoid anything abrasive. Some treatments aim for exfoliation, but that’s generally unsuitable for rosacea-affected skin.
DON’T: EXPOSE CLIENTS TO TRIGGERS
Rosacea is still a mystery in a lot of ways. We don’t know exactly what causes it or technically what it involves, but we do know some things that are known to trigger rosacea outbreaks. Being careful with rosacea-affected skin means avoiding the following:
Ultraviolet Light: Ultraviolet light is known to damage skin and damage to rosacea-affected skin will worsen the symptoms and increase the difficulty of recovery. Stick with natural light and use ultraviolet protection films on your windows.
High or Low Humidity: With too little moisture, skin will dry up, causing it to crack and form sores. With too much moisture, skin will sweat, leading to irritation.
Harsh Temperatures: Just as humidity can cause issues, being too hot or too cold can worsen rosacea symptoms. Err on the side of coolness if you must, but maintain a comfortable room temperature at all times.
DO: KEEP ASKING CLIENTS FOR FEEDBACK
No matter how much you know about your area of expertise, you can never predict what a client is feeling unless you talk to them. It might feel uncomfortable to bring up rosacea if it hasn’t been mentioned (you’ve simply noticed it), but which is worse: causing a fresh outbreak or causing some mild and brief awkwardness?
Before you begin treatment, ask the client about their skin and get their thoughts on what they’d like. You may find that they know exactly what their skin needs and can guide you accordingly. Or, they might not know what they want but may still be able to tell you what causes them discomfort.
Throughout the treatment, encourage them to let you know if anything you do is unpleasant for them and reassure them that you’ll stop immediately whenever needed. This way, you don’t need to assume anything and, when you finish the treatment, you can be confident that the client had a good experience.
DON’T: APPLY TREATMENTS THAT MIGHT CAUSE ISSUES
Many rosacea sufferers use topical treatments – whether prescribed or otherwise – to alleviate their symptoms. Some may be simple moisturizers, while others may feature active ingredients (even steroids) to achieve more potent effects.
When you first speak to the client about their skin, ask them what treatments they’ve been using (if any) and what substances (again, if any) they’ve been medically advised to avoid. You may find that some of the creams or oils you typically use are likely to cause problems. If in doubt, don’t take the risk – your client’s health is on the line, as is your reputation.
If you know ahead of time that you’re going to be treating a client with rosacea, you may want to consult a doctor or pharmacist to get their assessment of your treatment style. The better you understand the needs of sufferers, the more you’ll be able to cater your approach to them, and the happier everyone will be.
Scott McDougall, MPharm, is the co-founder and registered manager of The Independent Pharmacy, one of the United Kingdom’s leading independent online pharmacies. For more healthcare and treatment advice, visit their website.
When the National Rosacea Society published the first diagnostic guidelines for rosacea in 2002, it ushered in an unprecedented era of research into this widespread, chronic facial skin disorder now estimated to affect more than 16 million Americans. This has led not only to major advances in the understanding of the disease, but important insights into how to recognize and treat it.
“Even though signs of rosacea have been documented in art and literature for centuries, virtually all that is understood about this disorder in medical science has been discovered in the last 15 years,” said Dr. Richard Gallo, chairman of dermatology at the University of California-San Diego, who headed a committee and review panel of 28 rosacea experts in the development of new, updated standard diagnostic guidelines, published late last year.1 “Unlike the mysteries of the past, dermatologists are now able to identify the various signs and symptoms of rosacea based on a thorough understanding of the disease process.”
Although the exact cause remains unknown, recent studies have shown that rosacea’s initial redness appears to be the start of an inflammatory continuum triggered by a combination of neurovascular dysregulation and the innate immune system. The most common presentations of signs and symptoms were previously grouped as subtypes, but the new system focuses on the individual characteristics, called phenotypes, that may be different in each sufferer. This new phenotype system encourages consideration of the full range of potential signs and symptoms that may occur in any individual rosacea sufferer, and assessment of severity and the selection of treatment may be more precisely tailored.
According to the new system, a diagnosis of rosacea may be considered in the presence of at least one diagnostic phenotype – either persistent redness of the central facial skin (erythema) or, less commonly, thickened skin in the central face (known as phymatous changes, often on the nose).
Two or more major signs, including papules and pustules, flushing, telangiectasia, and eye irritation (ocular rosacea), may also indicate rosacea. Secondary signs and symptoms, such as burning or stinging, edema, and dry appearance, may also develop but are not diagnostic.
“Although rosacea’s various phenotypes may appear in different combinations at different times, research suggests that all are manifestations of the same underlying disease process, and that rosacea may progress not only in severity but to include additional signs and symptoms,” said Gallo.
Clients who may have rosacea can be referred to a dermatologist for diagnosis and appropriate care and can visit the National Rosacea Society website at rosacea.org.
1 Gallo, RL, RD Granstein, S Kang, et al. “Standard classification and pathophysiology of
rosacea: The 2017 update by the National Rosacea Society Expert Committee.” J Am Acad Dermatol 78, no. 1 (2018): 148-155. doi: 10.1016/j.jaad.2017.08.037.
Emma Terhaar is the National Rosacea Society’s social media editor and a contributing writer for the quarterly publication Rosacea Review. The National Rosacea Society is the world’s largest organization dedicated to improving the lives of the estimated 16 million Americans who suffer from this widespread, but poorly understood, disorder. Visit rosacea.org to learn more.
Rosacea is a chronic, and well-known, skin disorder primarily apparent in the center of the face cheeks, chin, nose, and central forehead and is often characterized by episodes of remissions and flareups.
Rosacea’s symptoms can vary tremendously, but the affected person often looks flushed and red in the center of the face. Rosacea has many causes – from genetics to mites to vascular changes – so, it can be hard to pinpoint why more than 10 million people in the United States suffer from rosacea. Strangely enough, recent scientific discovery has also linked rosacea with hair loss.
Rosacea is quite common. It is often more evident with people that have fair skin, but it can also affect people of Mediterranean, Asian, and African descent. Rosacea occurs in both men and women and can start at any age, but most people start seeing the first prominent signs in their 30s.
Always start a consultation by asking if the client has rosacea. The professional should be aware that rosacea can often be hidden. Some clients’ rosacea may be well controlled because they know what triggers flareups and do a good job controlling symptoms. However, for many, a flareup is never far away and they must use caution when visiting a skin care professional or a dermatologist.
The good news is, there is information on rosacea available online. The National Rosacea Society has an informative website that is an easy reference to understand this highly complex skin condition.
Rosacea can be manifested in various ways within a diverse group of people and can also be linked to lifestyle choices. Because of this, the National Rosacea Society developed a standard classification system that can serve as a diagnostic instrument to investigate the manifestations and relationships of the several subtypes and potential variants of rosacea. Diagnosis should obviously be left to the attending dermatologist, but it is still important for aestheticians to be aware of some of the manifestations and symptoms. They include:
Rosacea is not all encompassing. If the client is red, this does not necessarily rule out other potential skin conditions that may not be associated with rosacea. Some people can have an eruption due to the overuse of corticosteroids on their face.
When seeing clients with obvious evidence of rosacea, the best advice for the professional is to treat their skin very gently, avoiding harsh cleansers, harsh scrubs, and low pH acid peels. Nothing highly abrasive should be used in the affected areas and the choice of moisturizers is important. A clean moisturizer with emollience is likely the best choice.
Many people dealing with rosacea do not understand what triggers flareups. According to a national survey, some of the most common triggers are:
The professional can help clients control rosacea flareups by helping them understand the triggers that cause a flareup. However, the professional should also warn that this is a lifelong condition that needs constant attention. Sunscreen and gentle skin care should be a permanent companion for clients suffering from rosacea to help them control their condition.
1 “Understanding Rosacea.” National Rosacea Society. January 10, 2018.
Christiane Waldron is the founder and CEO of Jenetiqa, a professional luxury skin care company focused on providing highly bio-available skin care products that combine scientifically-proven antioxidants with natural botanicals and skin vitamins. Waldron is a chemical engineer by profession and she is the chief scientist for Jenetiqa. She personally hand picks each ingredient in the formula.
Waldron’s philosophy is to design and formulate multi-tasking products that help address all signs of aging. Jenetiqa is her brain child and she developed a best-selling anti-aging system that is unique in that it provides four treatment products into a simple to use system.
Rosacea is an elusive skin condition that is not well understood. Until now, there has been no guaranteed method to eradicate it. However, recent advancements could offer new treatment options for the condition.
Rosacea has probably been one of the most misdiagnosed and misunderstood skin disorders in the history of the human race. The symptoms of rosacea are so variable that many people have been treated for it when they were actually suffering from other skin disorders; many people who had rosacea were treated for common acne. The term acne rosacea has been a common medical diagnosis until lately. It is now deemed out of date and no longer considered a valid disorder under that name.
According to the textbooks, rosacea is still not fully understood. There are classifications of the condition, but they do not serve any real purpose in the diagnosis or treatment of rosacea. The Demodex mite and related bacteria have been the most commonly assumed cause and, yet, the skin presentation rarely supports that theory. An interesting, but often ignored, association is small intestinal bacterial overgrowth (SIBO), which, in one study, occurred in half of the rosacea cases. This figure directs us to the real problem, which is inflammation in the digestive tract.
Rosacea has long been a frustrating condition for both skin care professionals and those who suffer from the condition. While its cause is not fully understood, it is widely accepted that inflammation plays a primary role.
Rosacea is a common, chronic skin disorder that primarily affects the face. It is characterized by persistent symmetrical flushing and redness to the central face, including the forehead, nose, cheeks, and chin. Rosacea is more common in people ages 30 to 50 and fair-skinned women. It less often effects men and children.
When treating skin conditions, it is essential for the skin care professional to have a thorough understanding of ethnicity and predisposed factors when assessing the client during the initial consultation, treating skin conditions, and determining treatment protocol.
Aestheticians are in the unique position to observe many skin disorders and some diseases. Even though it is out of the aesthetician’s scope of practice to treat skin diseases, having knowledge is power, and skin care professionals should be able to recognize disorders and diseases that require medical referral to a physician or dermatologist. Many chronic conditions require treatment from both a physician and aesthetician; these include keratosis pilaris, acne, rosacea, and skin sensitivities. Many clients struggle with three common skin diseases that are not properly understood by aestheticians.
Many clients may walk through an aesthetician’s door with common facial manifestations, often agonizing over what once was clear skin that has now erupted into inexplicable redness, dryness, skin thickening, and even bumps and pimples that resemble acne. While these symptoms may be a sign of a variety of skin conditions, they may also be characteristic of the widespread, yet poorly understood facial disorder known as rosacea, a chronic skin disease now estimated to affect more than 16 million Americans, many of whom do not know they have it. Knowing how to spot the potential signs and symptoms of this medical disorder before serving a client could be the difference between having a repeat customer and exacerbating their condition.