1. Unit 204: Provide facial skin care treatment
Online revision : skin types, skin warming & brush cleansing

2. Skin types There are three basic skin types: Dry Combination Oily
(Handout 16)

3. Oily skin: This skin type is most common in adolescents and young adults due to the hormonal changes that take place, as the stimulation of the male hormone androgen stimulates the sebaceous glands.
Oily skin looks shiny and skin tends to be coarse and thick. Pores are larger and more visible. Due to the excess oil, the skin is prone to shininess and there is more of a tendency toward papules, pustules, comedones and whiteheads. Skin colour can be sallow.

4. Dry skin: This skin type is lacking in moisture, sebum or both
Dry skin: This skin type is lacking in moisture, sebum or both. The skin tends to have flaky skin patches, fine lines around the eyes and mouth. The skin texture tends to be coarse and thin. Milia are often found around the eye and cheek area. However, sometimes this dryness can be brought on by not drinking enough water, certain types of heating in winter, and being exposed to certain weather conditions for prolonged periods of time, these environmental factors can therefore cause dehydration of the skin.

5. Combination skin (the most common skin type): Combination skin is partly dry and partly oily. The term ‘T-zone’ refers to combination skin types where the forehead, nose and chin are oily but the cheeks and the area around the eyes is neither normal nor dry.

6. The ‘T zone’ is often accompanied with:
enlarged pores
coarse thick skin
sallow colouring
good skin tone
pustules, comedones

7. Dry areas are often accompanied by:
poor moisture content
small to medium pores
sensitivity and high colour
poor skin tone
broken capillaries on cheek and near the eyes

8. Normal skin: This skin is generally found in children and often referred to as balanced, because it is not too dry or too oily. It is soft, plump and with small to medium sized pores. The moisture content is good, with an even texture neither too thin nor too thick.
Normal skin has good elasticity, healthy colour, is usually free from blemishes and is smooth and firm to the touch.

9. Skin conditions Dehydrated skin
This type of skin is one that has lost water from the skin’s tissues. The condition can affect any skin type and can be caused by:
client’s general health – illness, fever (due to fluid loss caused by sweating)
medication
drastic dieting
environment – low humidity or air conditioning.
The skin has the following characteristics:
The skin has a fine orange peel effect due to the lack of moisture, superficial flaking, fine, superficial lines and broken capillaries.
(Handout 17)

10. Mature
The change in appearance of a woman’s skin during ageing is closely related to the slowing down of the production of hormones oestrogen, progesterone and androgen during menopause.

11. The skin has the following characteristics:
The skin becomes dry, as the sebaceous and sudoriferous glands become less active
Loss of elasticity due to the hardening of the elastin fibres, wrinkles appear due to the cross linking and hardening of collagen fibres
Epidermis grows more slowly and the skin appears thinner
Small veins and capillaries show through the skin
Broken capillaries around the nose and cheek area
Facial contours become slack as the muscle tone becomes reduced
Patches of irregular pigmentation appear on the skin’s surface
Waste products are not removed quickly resulting in puffiness of the skin
Blood circulation becomes poor which affects the skin nutrition giving it a sallow appearance
In some instances dermal naevi may enlarge
Verruca filiforms may increase
Hair growth on the chin and upper lip may become darker and coarser due the hormonal imbalance of the body
Dark circles and puffiness may also occur under the eyes

12. Sensitivity
This appears on dry skin types and is characterised by thin, delicate with fine pores, broken capillaries. Tendency to flush easily and may be prone to irritation.

13. Moist skin
This type of skin feels damp and appears moist due to the over secretion of sweat. This can be caused by a hormonal or metabolic imbalance in the body.
The client should:
use a lightweight cleansing preparation
avoid high alcohol skin toning products
avoid spicy foods, alcohol or hot drinks as these will cause the skin capillaries to dilate and therefore increase the skin’s temperature.

14. Oedematous skin
This type of skin appears puffy and swollen because of the excess water being retained in the tissues.
Causes:
Medical condition
Side effect of medication
Hot weather
Local injury
Poor lymphatic and blood circulation
Incorrect diet
Too much salt
Drinking too much coffee, tea or alcohol
The client should seek permission from the doctor before treatment is carried out.

15. The sex of the client
Men tend to have a more acidic skin surface and their stratum corneum is thicker than that of females. Males also have coarse facial hair and shaving regularly removes the stratum corneum cells before they are ready to desquamate naturally. This can cause skin dryness and sensitivity, especially with males using after shave lotions which are very high in alcohol and are applied directly to the skin. It is important that moisturiser is applied to protect the skin
Also the male collagen structure is different from that of females. Sebum and collagen production slows down in menopausal females causing the skin to age. Skin in the male does not seem to age as quickly because their sebum and collagen production remains constant.
Males tend to have a facial to induce relaxation as well as improving their skin condition.

16. Different skins
In black and white skin there is no difference in the sweat and sebaceous gland activities, but the amount of melanin varies which results in the different skin and hair colour.
There are two forms of melanin pigment:
Eumelanin which is produced in brown skin colours.
Phaeomelanin which is found in lighter skins.
Both forms of pigment can be found together but the amount will vary.
People that originate from hot climates have more melanin and a darker pigment than those people who originate from cooler climates and have less melanin and a lighter pigment.

17. African – Caribbean
The skin colour is dark and ranges to almost black tones due to the large amount of melanin that absorbs the ultra violet light.
When black skin is exposed to ultra violet light, it becomes darker and darker, which is due to the hyper-pigmentation – the uneven patches of skin tone which are darker than the surrounding skin.
Blemished skins must be treated with care as scars may occur as the skin heals. Scars may become keloids. This is when scars become enlarged and project above the skin’s surface.
Hyper-pigmentation may also occur following skin inflammation such as acne vulgaris. Keloids can become hyper-pigmented if exposed to the sun in the early stages of their formation.
Vitiligo is a large problem when it occurs in dark skins as it appears very obvious.
Male clients have a tendency towards pseudo folliculitis which is an inflammatory skin disorder. This occurs as the hair tends to be coarser and curly and tends, as it grows out of the skin, to curl back and re enter it, causing it to in grow. The skin then becomes irritated and inflamed.
Dermatosis papulosis nigra – flesh moles can also occur. These are either black or brown hyper-pigmented markings that look like moles, and are quite commonly found on the cheek area. Their cause is unknown but can be hereditary, and is more common in females than males.

18. Asian
The colour of the skin has a light to dark skin tone, due to the increased melanin with yellow undertones.
There is a tendency towards a hyper-pigmentation that appears as dark patches of skin.
In females there is a tendency towards superfluous facial hair.

19. Oriental
This type of skin has more melanin present and has a yellowish tone.
Oriental skins are more prone to hyper-pigmentation and tend to be oily.
Blemishes should be treated with care as scarring and hyper-pigmentation could result due to the increased levels of melanin.
The female skin is generally smooth with very little facial hair.

20. Caucasian
The skin colour is white, containing less melanin and therefore has less defence against ultra violet light.
Sun damage results in the skin burning and also premature ageing.
The caucasian skin has a tendency to show freckles due to the uneven distribution of melanin in the skin.

21. Skin warming
Steam is an ideal method of warming the skin as this has both a stimulating and cleansing effect.
Skin warming is often incorporated into the facial treatment after the manual cleansing has taken place, to make it more receptive to subsequent treatments.
(Handout 22)

22. The effects are:
opens the pores
stimulate the blood and lymphatic circulation to the area
softens the cells of the epidermis
helps desquamation
improves the sebaceous gland activity
Improves the skin colour.

23. Steam is provided by an electric vapour unit, in which distilled water is heated electrically, resulting in a fine mist being produced over the client’s facial area. Once the steam settles onto the skin it is absorbed by the surface epidermal cells, which then become softened and can then be gently loosened with an exfoliation treatment.

24. Contra-indications:
Asthma or cold conditions
Claustrophobia
Excessive dilated capillaries
Skin with reduced sensitivity
Vascular disorders
Diabetes

25. Facial steamer
Ensure that the client’s eyes are protected with damp cotton wool and any areas of delicate skin must be protected with barrier cream or damp cotton wool.
Explain to the client what sensation they should expect to feel, how long the treatment will take and the effect it will have on the skin.
Steaming can be done between 3-20 minutes, but this depends on the type of skin (greasy skins normally require a longer time).

26. The distance of the steamer from the face will usually depend on the skin type. The following is a guide (always follow manufactures’ instructions):
Dry skin/Mature: 15ins (40cm)
Normal skin: 12ins (30cm)
Greasy skin: 10ins (25cm)
Many vapour units produce ozone when the oxygen in the steam is passed over a high intensity quartz mercury ac tube.
Ozone is good for blemished, greasy skin types. Ozone is drying and anti-bacterial. You have to follow the health and safety rules regarding ozone treatments and ensure ozone is only used in well ventilated rooms and only for short periods of time.

27. After applying the steam vapour, blot the skin dry with a tissue and proceed to remove any blockages. At the end of the treatment it is important to always turn off the machine and unplug it.
Contra-actions – steaming
Scalding caused by the machine spitting from a faulty steam jet or by the vessel being over filled
Over stimulation of the skin due to incorrect application, distance and duration of the steam

28. Task
State the benefits of skin warming treatments.
Questions
For what type of skin conditions would you be required to adapt your facial steamer treatment?
How would you adapt the steamer treatment?
Who is responsible for the safety of the electrical equipment in your salon?
Give the safety precautions you need to follow when carrying out a facial steaming treatment?

29. Hot towel
This is an alternative treatment to steaming if an electrical vapour unit is not available.
Using small towels, heat them in a bowel of clean hot water.

30. Application
Ensure the client is seated in a semi reclined position. Neatly fold a small clean towel and immerse it into very warm water. Standing behind the client, squeeze out the excess water, open it up over your hands before placing it on your client’s face and then mould it to the client’s facial contours, ensuring the client’s mouth and nostrils are left uncovered.
Press the towel gently against the client’s face for 2 minutes then remove the towel as soon as it cools down, and replace with another heated towel. Continue to replace the towels for 10 minutes.

31. Comedone extraction Equipment required: Disposable rubber gloves
Medical swabs
Sharps disposable container
Facial tissues
Stainless steel comedone extractor
Disposable milia extractor needle
After warming the skin the mouth of the follicle is more relaxed and will allow for easier comedone extraction. If the comedones have been present for a long time a longer period of steaming or skin softening treatment may be required before they are released.

32. Comedone extraction cont.
You will need a magnifying lamp to help you be more accurate when removing the comedones. It is important to avoid bruising or damaging the skin.
There are two methods for removing comedones.
Using a sterile looped comedone extractor, apply light pressure around the comedone to ease it out.
You may need to apply gentle pressure with your fingers at the sides of the comedone using the pads of the index fingers wrapped in a tissue to ensure that it is fully removed.
You must be careful not to apply strong pressure or else you can damage the skin.

33. Comedone extraction cont.
Contra-actions
Skin bruising could occur if too much pressure is applied.
Capillary damage may result if too much force is applied, causing the surrounding blood capillaries to rupture causing permanent skin damage.

34. Milia extraction
Milia are extracted after a skin warming treatment. Hold the point of the extractor parallel to the skin’s surface and superficially pierce the epidermis. This will make an opening through which the sebaceous matter can pass out onto the skin surface. Use either a comedone extractor or tissue wrapped around the index finger, applying gentle pressure. A mild antiseptic soothing lotion should be applied after extraction to help the skin heal.
A small scab will form over the skin breakage and it is important the client follows the home care instructions.

35. Exfoliation
Exfoliation is a technique used to accelerate the process of desquamation – the removal of dead skin cells from the stratum corneum in the epidermis. This treatment is normally carried out after the skin has been cleansed and toned.
Benefits
Dead skin cells, debris and grease are removed from the skin’s surface
The skin’s appearance is improved as fresh cells are exposed
Skin preparations are more easily absorbed
Blood circulation is mildly stimulated, which brings nutrients and oxygen to the skin cells and therefore improving the skin’s colour.

36. Exfoliation cont. Contra-indications Exfoliation should be avoided if:
the client has a sensitive skin or a vascular disorder such as damaged broken veins or telangectasia
exfoliants may be chemical, vegetable origin or a mechanical exfoliation may be used.

37. Pore grains
This is a base of liquid or cream containing spheres of crushed nuts or polished plastic which is gently massaged over the skin’s surface.

38. Biochemical skin peel
Natural acids derived from sugar cane, milk and fruits are applied to the skin as a mask.
The natural acids dissolve all the dead surface cells and stimulate the skin’s circulation.
These are available to suit all skin types.

39. Clay exfoliants
These have a clay base which is applied like a face mask. As the mask dries it absorbs the dead skin cells and sebum. The mask is then gently stroked away using the pads of the fingers.

40. Mechanical exfoliation
Mechanical exfoliation or facial brushing
This treatment softens and cleanses the skin removing the dead skin cells and excess sebum as the soft hair bristles rotate over the skin’s surface.

41. Brush cleansing
This may be combined with a gentle soap free cleanser where the soft complexion brush is dampened and used in small circular movements over the face and neck to distribute the cleanser and work it into the pores. It sometimes is used along with the exfoliator and the treatment lasts for 3-5 minutes depending on the skin type. It deep cleanses the skin and removes dead skin cells and loosens skin blockages. It leaves the skin glowing and refreshed as the circulation is increased.

42. Mechanical rotary brush cleansing
This piece of electrically powered equipment has a variety of applicator heads, which may be used as an alternative to manual cleansing. The treatment with the rotary brush system can be adapted by using different applicator heads and by varying the speed and direction controls (if applicable). Once the treatment is complete, the face is wiped over with damp sponges and the skin is now ready for the next stage of your facial.

43. Sponge head: used dampened with a soap free cleanser or exfoliator
Soft brush head: available in a range of shapes and sizes for deep cleansing, exfoliating, and massaging different facial and body areas.
Bristle brush: particularly good for male clients to deep cleanse. Exfoliates and stimulates strong, firm skins. Not for use on sensitive areas.
Pumice head: used as a peeling stone for reefing very coarse skin textures.

44. Contra-indications to brush cleansing
Broken skin, infected skin, dilated capillaries, very loose crepey skin, inflamed or irritated skin, very sensitive skin.