C.O.E. Continuing Education Curriculum Coordinator

CONTINUING EDUCATION

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5 hr. Skin Care Enhancement & TCSG HEALTH AND SAFETY

Course Description Upon completion this course you will have a thorough knowledge of the anatomy of healthy skin care. You will learn about important facts for defining healthy skin care. General skin care routines are discussed which include the use of masks, cleansing techniques, toning, moisturizing, and sun protection. This course will also outline the five categories of skin types.

With emphasis on skin care awareness in the salon, common skin disorders will be covered which will help the cosmetologist and esthetician to identify lesions of the skin. This course will be summed up with important information about sun exposure protection and the ABCDEs of Melanoma. In summary, flash facts about histology of the skin will be demonstrated with pictorial C.O.E.examples. CONTINUING EDUCATION

Anatomy of the Skin

Facts about the skin: The skin is the body's largest organ, covering the entire body. In addition to serving as a protective shield against heat, light, injury, and infection, the skin also:

• Regulates body temperature. • Stores water and fat. • Is a sensory organ. • Prevents water loss. • Prevents entry of bacteria. Throughout the body, the skin's characteristics vary (i.e., thickness, color, texture). For instance, the head contains more hair follicles than anywhere else, while the soles of the feet contain none. In addition, the soles of the feet and the palms of the hands are much thicker.

The skin is made up of the following layers, with each layer performing specific functions:

• Epidermis • Dermis • Subcutaneous fat layer (subcutis)

Epidermis The epidermis is the thin outer layer of the skin which consists of the following three parts: • Stratum corneum (horny layer): This layer consists of fully mature keratinocytes which contain fibrous All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 2 CONTINUING EDUCATION

proteins (keratins). The outermost layer is continuously shed. The stratum corneum prevents the entry of most foreign substances as well as the loss of fluid from the body. • Keratinocytes (squamous cells): This layer, just beneath the stratum corneum, contains living keratinocytes (squamous cells), which mature and form the stratum corneum. • Basal layer: The basal layer is the deepest layer of the epidermis, containing basal cells. Basal cells continually divide, forming new keratinocytes, replacing the old ones that are shed from the skin's surface. The epidermis also contains melanocytes, which are cells that produce melanin (skin pigment). Dermis The dermis is the middle layer of the skin. The dermis contains the following: • Blood vessels • Lymph vessels • Hair follicles • Sweat glands • Collagen bundles • Fibroblasts • Nerves The dermis is held together by a protein called collagen, made by fibroblasts. This layer gives skin flexibility and strength. It also contains pain and touch receptors. Subcutis The subcutis is the deepest layer of skin. The subcutis, consisting of a network of (also known as collagen and fat cells, helps conserve the body's heat and protects the body from the injury by acting as a "shock absorber." subcutaneous layer)

C.O.E. CONTINUING EDUCATION

What is healthy skin?

Your skin is much more than an outer surface for the world to see. It protects you from bacteria, dirt and other foreign objects and the ultraviolet rays of the sun, and contains the nerve endings that let you know if something is hot or cold, soft or hard, sharp or dull. Your skin also plays an important role in regulating your body's fluids and •temperature.

Skin covering the average human body ranges between 1.7 and 2 square meters (~20 square feet) in length and weights about 6 pounds (2.7 kg). With so much skin to care about, lots of people ignore even the basic needs of a healthy skin. You really should pay more attention to it, knowing that the skin is actually one of the most powerful indicators of the overall health. It also eliminates toxins through perspiration via pores which is vital, not to mention the appearance and visual impact it has to people we interact with.

Below the smooth, hairy outer skin, or epidermis, that we see every day is a thick, strong and elastic layer of tissue known as the dermis. The dermis is richly supplied with blood vessels, sweat and oil glands, and nerve endings.

Healthy skin is smooth, with no breaks in the surface. It is warm (not hot or red) and neither dry and flaky nor moist and wrinkled. Healthy skin is a mirror of a healthy body. Healthy skin is well hydrated skin.

General Skin Care Routines

Cleansing

C.O.E. CONTINUING EDUCATION

Cleansing is the first essential step to any daily skin care routine. Cleansing the face at least twice a day is suitable for normal skin. If skin is oily, a more frequent cleansing or about four to five times a day is required. However, products that are water-based and gentle are ideal so as to not over-dry the skin. For dry skin, it is best to avoid frequent washing and a suitable oil-based cosmetic cleanser instead of soap is All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 5 CONTINUING EDUCATION

preferred. There are several alternatives to soap and water cleansing. Cleansers can be in the form of creams, milks, lotions, gels and liquids. All are a mixture of oil, wax and water which have been formulated to suit different skin types. A Cotton -pad dipped in fresh milk available at home, is an equally effective natural cleanser. To complete the cleansing process, the skin must be rinsed with water. Some who wear long wearing foundation may find it beneficial to pre-cleanse the face with a cleansing oil to remove any silicones left over from the foundation.

Masks

Essentially all face masks have some sort of a cleansing action. Various ingredients are used in the masks, depending on the skin type. Clay forms an important constituent of many face masks that helps to remove dirt, sebum, and dead skin to refresh and soften the skin surface. Fullers’ earth is a special type of clay often used in face packs. It contains aluminum silicate and as it dries on the skin, it absorbs the superficial dead cells and blots up any excessive oil. It is therefore excellent for oily skin but should not be used on dry skin. Kaolin is also fine clay which removes grime, oils and dead cells. Again it is best for oily skin and should be avoided on dry skin. Another ingredient of some of the masks is a peeling or exfoliating agent which helps remove the top layer of dead cells from the skin, leaving behind fresh youthful skin. Oatmeal and bran are the commonly used peelers. In addition, natural ingredients such as cucumbers, curds, lemon juice and Brewer's Yeast are added to many masks to restore the acid / alkali balance of the skin. There are three general forms that masks come in: Clay, Peel, and Sheet. The clay formulation is one of the most common. It is usually composed of different clays to draw out the impurities in the skin. Peel masks usually have a gel like consistency and are peeled off of the skin to help exfoliate. Sheet masks are becoming more common in America; they are very popular in Asia. Sheet masks can be used to treat different skin concerns, but one of the most popular concerns is skin brightening.

Toning Many skin care products include skin fresheners, toners and astringents which generally contain alcohol and water. These products are used after cleansing the skin to freshen and tone up and remove any traces All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 6 CONTINUING EDUCATION

of dirt or impurities from the skin, as well as restore the skin’s acid/ alkali balance. Non-alcoholic fresheners are for dry and sensitive skin. Those with alcohol (astringent) are for oily skin. When servicing clients with combination skin, you should use both kinds for the different areas of their face.

Moisturizing

Regular use of a suitable moisturizer benefits the skin as it not only replaces water lost from the skin but also prevents the loss of water. It protects the skin against the drying influences of the environment including the harsh effects of the sun, cold and heat. Tinted moisturizers can be used under foundation cosmetics. It allows make-up to remain moist. Using a moisturizer is particularly beneficial for dry skins. Oil free moisturizers are also available for oily skins. There are two types of moisturizers: Oil - in water emulsions and water -in -oil emulsions. For normal and combination skin, a water based moisturizer containing minimal oil is suitable. Sensitive and dry types of skin need moisturizers containing a high content of oil.

Protecting The sun is the most damaging environmental factor to the health and appearance of skin. Ultraviolet radiation from sunlight can cause permanent damage to the skin causing it to sag, lose elasticity and form wrinkles. Severe sunburn can even cause skin cancer. Therefore, sunscreen and SPF-foundations protect the skin against these damaging effects. They also shield the skin from direct contact with dirt or pollutants in the air and help the skin retain necessary moisture. Sunscreen's come in lotions and creams. A sunscreen with the sun protection factor (SPF) of number 15 can block most of the sun's ultraviolet radiations before it can damage the skin. The SPF number indicates the length of time that the product will protect the skin, i.e. 15 hours. Sunscreens should be applied at least 10 minutes before exposure to the C.O.E.sun to ensure properCONTINUING absorption and effective protection. EDUCATION

Skin Types There are five basic skin types, including:

Normal Skin This type of skin has a fine, even and smooth surface due to having an ideal balance between oil and moisture contents and is therefore neither greasy nor dry. People who have normal skin have small, barely-visible pores. Thus, their skin appears clear and does not develop spots and blemishes. This type of skin needs minimal and gentle treatment.

Dry Skin Dry skin has a parched appearance and tends to flake easily. It is prone to wrinkles and lines due to the inability to retain moisture, as well as, the inadequate production of sebum by sebaceous glands. Dry skin often has problems in cold weather as it dries up even further. Constant protection in the form of a moisturizer by day and a moisture-rich cream by night is essential.

Oily Skin As its name implies, this type of skin’s surface is slightly to moderately greasy, which is caused by the over secretion of sebum. The excess oil on the surface of the skin draws dirt and dust from the environment to stick to it. Oily skin is usually prone to black heads, white heads, spots and pimples. It needs to be cleansed thoroughly every day.

Combination Skin This is the most common type of skin. As the name suggests, it is a combination of both oily and dry skin where certain areas of the face are oily and the rest dry. The oily parts are usually found on a central panel, called T – Zone, consisting of the forehead, nose and chin. The dry areas consist of the cheeks and the areas around the eyes and mouth. In such cases, each part of the face should be treated accordingly where the dry areas are treated as for dry skin and the central panel is treated as for oily skin. There are also skin care products made especially for those who have combination skin.

Sensitive skin Sensitive skin has a very fine texture and is excessively sensitive to changes in the climate. This skin type is easily irritated, bruised and/or scarred from bleaching, waxing, threading, perfumes, temperature extremes, soap, shaving creams, etc. People who belong to this skin type should avoid products with dyes, perfumes, or unnecessary chemical ingredients that may aggravate the skin.

Common Skin Disorders

Acne

What is acne?

Acne is a disorder of the hair follicles and sebaceous glands. With acne, the sebaceous glands are clogged, which leads to pimples and cysts.

Acne is very common - nearly 80 percent of individuals in the US between 11 and 30 years old will be affected by this condition at some point. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of sebum.

How does acne develop?

The sebaceous glands produce oil (sebum) which normally travels via hair follicles to the skin surface. However, skin cells can plug the follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes or P. acnes) begin to grow inside the C.O.E.follicles, causing CONTINUING inflammation. Acne progresses in the following manner: EDUCATION 1. Incomplete blockage of the hair follicle results in blackheads (a semisolid, black plug). 2. Complete blockage of the hair follicle results in whiteheads (a semisolid, white plug). 3. Infection and irritation cause whiteheads to form. Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedo.

Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses).

What causes acne?

Rising hormone levels during puberty may cause acne. In addition, acne is often inherited. Other causes of acne may include the following:

• Hormone level changes during the menstrual cycle in women • Certain drugs (such as corticosteroids, lithium, and barbiturates) • Oil and grease from the scalp, mineral or cooking oil, and certain cosmetics may worsen acne • Bacteria inside pimples Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.

What are the symptoms of acne?

Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following:

• Face • Chest • Upper back • Shoulders • Neck The following are the most common symptoms of acne. However, each child may experience symptoms differently. Symptoms may include:

• Blackheads • Whiteheads • Pus-filled lesions that may be painful • Nodules (solid, raised bumps)

Dry Skin

What is dry skin?

Dry skin is a very common skin condition, usually characterized by irritated skin and itchiness. Dry skin often worsens in the winter, when the air is cold and dry. In addition, frequent bathing can aggravate dry skin. With no treatment, dry skin may become flaky or scaly.

It is important to note, however, that dry skin symptoms may resemble other skin conditions, or result from other disorders such as an under-active thyroid or acquired immune deficiency syndrome (AIDS). Always consult your physician for a diagnosis.

Treatment for dry skin:

Treating dry skin may be as simple as keeping the skin moist by taking fewer baths and using ointments or creams that keep the moisture in. Treatment may also include:

• Avoiding harsh soaps, detergents, and perfumes, which tend to dry the skin C.O.E.• Avoiding CONTINUING rubbing or scratching the skin, which can aggravate the EDUCATION symptoms and cause infection • Applying a salicylic acid solution or cream (which removes the top layer of skin) if the skin is scaly Call your doctor if:

• There is itching without a visible rash. • The itching and dryness are so bad you can't sleep. • You have scratched so hard that you have open cuts or sores. • Home remedies have not relieved the dryness and itching. All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 11 CONTINUING EDUCATION

Psoriasis

What is psoriasis?

Psoriasis is a chronic skin condition characterized by inflamed, red, raised areas that often develop as silvery scales on the scalp, elbows, knees, and lower back. Psoriasis is estimated to affect 7.5 million people in the US.

What causes psoriasis?

The exact cause of psoriasis is unknown, but experts believe that the immune system, genes, and environmental factors play central roles. Normally, old skin cells are replaced with new ones every four weeks. In people with psoriasis, the immune system triggers inflammation, causing new cells to move to the surface every three or four days. The resulting buildup forms the rash. Psoriasis cannot be passed from person to person, but it does tend to run in families.

What are the symptoms of psoriasis?

The following are the most common symptoms of psoriasis. However, each individual may experience symptoms differently, as psoriasis comes in several forms and severities. Symptoms may include:

Discoid psoriasis

Also called plaque psoriasis, this type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds. C.O.E.Guttate psoriasis CONTINUING EDUCATION This type of psoriasis affects mostly children. Symptoms may include many small patches of red, raised skin. A sore throat usually precedes the onset of this type of psoriasis.

Pustular psoriasis

Symptoms may include small pustules (pus-containing blisters) all over the body or just on the palms, soles, and other small areas.

The symptoms of psoriasis may resemble other skin conditions. Always consult your physician for a diagnosis.

How is psoriasis diagnosed?

When the condition progresses to the development of silvery scales, the physician can usually diagnose psoriasis with a medical examination of the nails and skin. Confirmation of diagnosis may be done with a skin biopsy (taking a small skin specimen to examine under a microscope).

Treatment for psoriasis

Specific treatment for psoriasis will be determined by your physician based on:

• Your age, overall health, and medical history • Severity of the condition • Your tolerance of specific medications, procedures, or therapies • Expectations for the course of the condition • Your opinion or preference The goal of treatment is to reduce inflammation and slow down the rapid growth and shedding of skin cells. At the present time, there is no cure for psoriasis. Treatment may include:

• Ointments and creams (to moisturize the skin) • Sunlight or ultraviolet light exposure (under a physician's supervision) • Steroids (such as cortisone creams) • Vitamin D cream • Creams containing salicylic acid or coal tar • Anthralin--a drug that treats the thicker, hard-to-treat patches of psoriasis. • Methotrexate--an anti-cancer drug that interrupts the growth of skin cells. • Oral or topical retinoids • Immunosuppressive medications (such as Cyclosporine) Outlook

There is no known way to prevent psoriasis. Although it is a life-long condition, it often can be controlled with appropriate treatment. Keeping the skin clean and moist, and avoiding person-specific psoriasis triggers (excessive stress, for example) may help decrease flare-ups.

Keratosis Pilaris

What is keratosis pilaris?

Keratosis pilaris is a common skin disorder characterized by small, pointed pimples. The pimples usually appear on the upper arms, thighs, and buttocks. The condition worsens in the winter and usually clears up in the summer. Keratosis pilaris has no known cause, but tends to run in families.

This disorder does not get worse over time. It is harmless, and often disappears as the person ages.

Treatment for keratosis pilaris:

Usually no treatment is necessary for keratosis pilaris, since it normally clears up by itself. Treatment may include:

• Using petroleum jelly with water, cold cream, or salicylic acid (which removes the top layer of skin) to flatten the pimples • Using a tretinoin cream (a drug which is chemically related to vitamin A) Contact your health care provider if the condition does not respond to over-the-counter moisturizing lotions. Since this is a common, harmless skin condition, you can also discuss it during a routine office visit.

Pityriasis Rosea C.O.E. CONTINUING EDUCATION

What is pityriasis rosea?

Pityriasis rosea is a mild, but common, skin condition. Characterized by scaly, pink, inflamed skin, the condition can last from four to eight weeks and usually leaves no lasting marks.

What causes pityriasis rosea?

The cause of pityriasis rosea is not known, but it is commonly believed to be caused by a virus. It is usually seen in children, adolescents, and young adults. Most people with the rash are 10 to 35 years of age.

The condition is more prevalent in spring and fall.

What are the symptoms of pityriasis rosea?

Pityriasis rosea usually starts with a pink or tan oval area (sometimes called a herald or mother patch) on the chest or back. The main patch is usually followed (after a couple of weeks) by smaller pink or tan patches elsewhere on the body--usually the back, neck, arms, and legs.

The following are other common symptoms of pityriasis rosea. However, each individual may experience symptoms differently. Symptoms may include:

• Fatigue • Aches • Itching The symptoms of pityriasis rosea may resemble other skin conditions. Always consult your physician for a diagnosis.

How is pityriasis rosea diagnosed?

Pityriasis rosea is usually diagnosed based on a medical history and physical examination. The rash of pityriasis rosea is unique, and the diagnosis is usually made on the basis of a physical examination. In addition, your physician may order the following tests to help aid in the diagnosis:

• Blood tests • Skin biopsy--the removal of some of the diseased skin for laboratory analysis. The sample of skin is removed after a local anesthetic is administered. Treatment for pityriasis rosea

Specific treatment for pityriasis rosea will be determined by your physician based on:

• Your age, overall health, and medical history • Extent of the rash • Your tolerance for specific medications, procedures, or therapies • Expectations for the course of the rash

• Your opinion or preference The goal of treatment for pityriasis rosea is to relieve symptoms associated with the condition, such as itching. Treatment may include:

• Medicated lotions and creams (to soothe the itching) • Medications by mouth (to ease the itching) • Cool baths with or without oatmeal (to soothe the itching) • Ultraviolet exposure (under a physician's supervision) • Cool compresses (to soothe the affected skin) There is no cure for pityriasis rosea. The condition will usually resolve on its own in about six to 12 weeks. Normally, it does not return.

Rosacea

What is rosacea?

Rosacea is a common skin condition that usually only affects the face and eyes. Characterized by redness, pimples, and broken blood vessels, rosacea tends to begin after middle age (between the ages of 30 and 60) and is more common in fair-skinned people.

The cause of rosacea is unknown. An estimated 14 million people in the US have rosacea.

What are the symptoms of rosacea?

Rosacea often begins with easy blushing and flushing of the facial skin. Eventually, redness will persist around the nose area, extending to the rest of the face. Rosacea has a variety of clinical symptoms and is C.O.E.classified into theCONTINUING following four types, based on these different symptoms: EDUCATION Type Symptoms

Prerosacea Frequent episodes of blushing and flushing of the face and neck

Vascular rosacea Swelling of blood vessels under the facial skin, leading to swollen, warm skin (common in women)

Inflammatory Formation of pimples and enlarged blood vessels on the face rosacea

Rhinophyma Enlarged oil glands in the nose and cheeks that cause an enlarged, bulbous red nose

Sebaceous Cysts

What are sebaceous cysts?

Sebaceous cysts are harmless, slow-growing bumps under the skin, often appearing on the scalp, face, ears, back, or groin area. The cysts usually contain dead skin and other skin particles.

Treatment for sebaceous cysts:

Warm moist compresses placed over the cysts may help them drain and heal. Sebaceous cysts can usually be treated by a physician by puncturing the top and removing its contents.

However, large cysts may reappear and may have to be surgically removed. If a cyst becomes swollen, tender, large, or infected, treatment may include administering antibiotics and then surgically removing the cyst.

Section 2

Skin Disorder Awareness in the Salon

While the level of knowledge needed by scientists is not necessary for cosmetologists, a thorough knowledge of the underlying structures of the skin nails and hair will benefit you in your role. Such knowledge will help you achieve the best possible results when providing hair, skin, and nail care services while at the same time providing the utmost protection for your client.

Your training will help you to become familiar with common disorders and diseases of the skin and allow you to recognize those conditions that cannot be treated or serviced by a cosmetologist. Thoroughly analyzing the functions and components of the skin is the best way to understand how the skin works. With proper care, the skin can stay young and radiant-looking for many years.

This course contains extensive new terminology which will seem overwhelming at first. We will cover the material in detail and introduce several exercises and activities that can be used to help you retain the terminology and definitions.

The skin is the largest and one of the most important organs of the body. A healthy skin is slightly moist, soft and flexible. It possesses a slightly acid reaction and is free from any disease or disorder. The ideal feel and appearance of skin is smooth and fine-grained. That feel and appearance is known as skin texture. Hairs, nails, sweat and oil glands, which are all very important to the cosmetologist, are considered appendages of the skin. It is important to note that the skin on the eyelids is the thinnest of the entire body while the skin on the palms of the hand and soles of the feet is the thickest. Continued pressure on any part of the skin will result in calluses. The skin on the scalp has larger and deeper follicles to accommodate the longer hair found on the head. C.O.E.Lesions of theCONTINUING Skin EDUCATION • Skin lesions are abnormal changes in the structure of an organ or tissue. • Lesions are divided into three categories: o Primary o Secondary o Tertiary • Cosmetologists are only concerned with primary and secondary lesions. All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 19 CONTINUING EDUCATION

Primary Skin Lesions • Macules: discoloration appearing on the skin's surface o Freckles are an example of macules. • Lentigines: technical term for freckles • Papules: hardened red elevations of the skin in which no fluid is present o A large papule is known as a tubercle. o A pimple is an example of a papule. • Vesicles: fluid filled elevations in the skin caused by localized accumulation of fluids or blood just below the epidermis. • Macules and papules may cause vesicles. • Herpes Simplex: also known as fever blister, is a contagious, chronic condition caused by a single vesicle or a group of vesicles on a red swollen base. o Appears on the lips, nostrils, or other parts of the face. o Services should not be performed when herpes simplex is present. • Bulla: Lesion, and larger vesicles with a clean watery fluid o Located below the skin o Occur in second-degree burns. • Pustules: Small elevations of skin; similar to vesicles, but contain pus o They are white or yellow in color and may be surrounded by a reddish inflamed border. o An example of a pustule is a pimple with pus. • Wheals: Solid formation above the skin, sometimes caused by an insect bite or allergic reaction o May be accompanied with itching or tingling o An example of a wheal is hives or an insect bite. • Tumors: Solid masses in the skin, which may be soft or hard o An example of a small tumor is a nodule. Secondary Lesions

• A secondary skin lesion is the progressed stage of a disease. • Needs to be treated by a dermatologist or a physician • Scales: Dead cells of the uppermost layer of the epidermis that shed. o Psoriasis and dandruff are examples of scales • Psoriasis: Round, dry patches of skin, covered with rough silvery scales. o It is chronic, but not contagious. • Crust: Dried masses that come from the remains of an oozing sore. o An example: scab on a sore • Excoriations: mechanical abrasions or injury to the epidermis o Occur when an insect bites or scab is scratched o An example of an excoriation is a scratch • Fissure: Cracks in the skin

o Cracks or lines that go deep into the underlying dermis o Occur when skin is exposed to wind, cold, or water and loses its flexibility o An example of a fissure is a chapped lip • Scars: Forms from a lesion when injury extends deep into the dermis • Keloids: Thick scars • Ulcers: Open lesions that are visible on the surface of the skin o Services should not be performed when ulcers are present.

Pigmentation Abnormalities

• Pigmentation Abnormalities are conditions with little or too much color in certain areas of the skin. • Melanoderma: Hyper-pigmentation caused by over activity of the melanocytes in the epidermis o Examples of melanoderma are chloasma and lentigines. • Chloasma: Group of brownish macules usually on the hands and face o Also known as liver spots • Moles: Small, brown pigmented spots that may be elevated. o Some contain hair, but should not be removed o A physician should be seen if there are any changes in the appearance of a mole. o Moles are the cause of some skin cancers. • Naevus: Birth mark or a congenital mole • Leukoderma: Hypo-pigmentation (lack of pigmentation) of the skin caused by a decrease in melanocytes. • Albinism: Congenital failure of the skin to produce melanin pigment o A person with albinism has very fair skin, white hair, and pink eyes. o They are sensitive to light and sun. • Vitiligo: Oval or odd shaped patches of white skin that do not have normal pigmentation. o Usually appear on the face, hands, and neck

Disorders of the Sebaceous Glands

 Comedones: Also known as blackheads; masses of sebum (oil) locked inside the hair follicle  Milia: Also known as whiteheads; caused by accumulation of hardened sebum beneath the C.O.E.skin CONTINUING EDUCATION  Acne: Chronic inflammatory disorder of the sebaceous glands o Acne occurs in two stages: acne simplex and acne vulgaris. o A person with acne vulgaris should seek a physician  Rosacea: Also known as acne rosacea; a chronic inflammatory congestion of the cheeks and nose; papules and pustules are sometimes present. o Services should not be performed when rosacea is present.

 Asteatosis: dry, scaly skin caused by low sebum production  Seborrhea: Excessive secretion of the sebaceous glands.  Steatoma: Also known as a sebaceous cyst or wen; subcutaneous tumor of the sebaceous glands, filled with sebum  Furuncles: Also known as boil; appears in the dermis and the epidermis and are caused by acute staphylococcal infection. o Usually are hair follicle infections  Carbuncles: Larger than furuncles; located above and below the skin are caused by acute staphylococcal infection of several adjoining hair follicles.

Disorders of the Sudoriferous Glands

 Bromidrosis: Foul-smelling perspiration  Anhidrosis: Lack of perspiration; caused by fever or disease  Hyperhidrosis: Over-production of perspiration; caused by excessive heat or body weakness  Miliaria Rubra: Acute eruption of small red vesicles; caused by excessive heat  Services should not be performed when Miliaria Rubra is present.

Keep the following facts in mind before performing a service on any client who may have a skin disorder: Cosmetologists and estheticians are not dermatologist or physicians who diagnose and treat skin diseases and disorders. It is very important that you are able to recognize different skin conditions in-order to protect yourself and your client. However, coming in contact with skin every day should encourage you to be cautious when you find cases of severe skin disorders.

THE SUN AND YOUR SKIN

Skin Damage Overexposure to ultraviolet (UV) radiation from the sun can cause significant damage to your skin.

Wrinkles

• UVA rays from the sun can penetrate deep into your skin and damage collagen, which is the protein that holds your skin together in a firm and smooth way. Collagen and elastin fibers weaken faster when skin is frequently exposed to ultraviolet (UV) rays without proper protection. • UVA breaks down the collagen structure which results in wrinkles. • UVB rays, also called burning rays; cause sunburn and tanning of the skin by affecting the melanocytes (cells of the epidermis that produce melanin). These rays are not as deep as UVA but are equally damaging to the skin and eyes. They do, however, contribute to the body’s synthesis of vitamin D. • Once collagen is damaged, it cannot re-build itself. All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 22 CONTINUING EDUCATION

• Up to 80% of skin aging is caused by the sun. Freckles/Sun Spots

• Freckles and sun spots are signs of skin damage and develop as a result of too much sun exposure. • Freckles and sun spots are frequently found on face, legs and back of hands. Individuals who sunbathe regularly may develop freckles and sun spots all over their skin. Sun Tan

• Contrary to popular belief, a tan is not “healthy.” A tan is a sign that damage has been done to your skin. • When exposed to the sun’s UV rays, your skin’s melanocytes produce melanin, the dark pigment that creates a tan. A tan is your skin’s attempt to prevent UV rays from doing any further damage to the sensitive skin cells in your epidermis. • A tan does not help protect your skin from getting sunburn in the future. A tan is equivalent to merely an SPF 4! Sunburn

• Overexposure to the sun’s UV rays results in a painful sunburn. UV rays penetrate deep into the layers of your skin and kill living skin cells. • In response to this trauma, your body’s immune system increases blood flow into the damaged area so white blood cells can remove the dead skin cells. This blood flow is what causes your sunburned skin to become warm and red. • There is substantial evidence that sunburns can lead to DNA damage. Repeated sunburns dramatically increase your risk of developing skin cancer because of this damage to your DNA. SUN EXPOSURE PRECAUTIONS • Wear protective lotion. Sunscreen with SPF (sun protection factor) of 15 is recommended. • Avoid prolonged exposure. (Especially during peak hours of 10:00 a.m. and 3:00 p.m.) • Apply sunscreen liberally after swimming. (Apply periodically throughout day as a precaution) • Use full or broad spectrum sunscreen. (These filter out UVA and UVB rays of the sun) Check expiration dates on products. • Avoid exposing children under 6 months. • Wear hat and protective clothing outdoors. Since repeated sunburns can increase your risk of developing skin cancer, lets now consider the ABCDE C.O.E.Cancer Checklist. CONTINUING EDUCATION

Melanoma Checklist

Even if you have carefully practiced sun safety all summer, it's important to continue being vigilant about your skin in fall, winter, and beyond. Throughout the year, you should examine your skin head-to-toe once a month, looking for any suspicious lesions. Self-exams can help you identify potential skin cancers early, when they can almost always be completely cured.

First, for a successful self-exam, you obviously need to know what you're looking for. As a general rule, to spot either melanomas or non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma), take note of any new moles or growths, and any existing growths that begin to grow or change significantly in any other way. Lesions that change, itch, bleed, or don't heal are also alarm signals.

It is so vital to catch melanoma, the deadliest form of skin cancer, early that physicians have developed a specific strategy for early recognition of the disease: the ABCDEs.

The ABCDEs of Melanoma

Asymmetry means one half of a mole does not match the other half. Normal moles are symmetrical. When checking your moles or freckles, draw an imaginary line through the middle and compare the two halves. If they do not look the same on both sides, have it checked by a dermatologist.

If the border or edges of the mole are ragged, blurred, or irregular, have it checked by a dermatologist. Melanoma lesions often have uneven borders.

A mole that does not have the same color throughout or that has shades of tan, brown, black, blue, white, or red is suspicious. Normal moles are usually a single shade of color. A mole of many shades or that has lightened or darkened should be checked by a doctor. C.O.E. CONTINUING EDUCATION

A mole is suspicious if the diameter is larger than the eraser of a pencil. Benign moles are usually less than 6 millimeters in diameter.

If a portion of the mole appears elevated, or raised from the skin, have it looked at by a doctor. Melanoma lesions often grow in size or change in height rapidly. A mole that is evolving—shrinking, growing larger, changing color, begins to itch or bleed—should also be checked.

CHECK YOUR BODY ONCE A MONTH

Examine your skin after a shower while skin is wet. A common location for melanoma in men is on the back, and in women, the lower leg. But check your entire body for moles or suspicious spots once a month. Start at your head and work your way down. Check the "hidden" areas: between fingers and toes, the groin, soles of the feet, the backs of the knees. Check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Be especially suspicious of a new mole. Take a photo of moles and date it to help you monitor them for change. Pay special attention to moles if you're a teen, pregnant, or going through menopause, times when your hormones may be surging.

It is very important that cosmetologist and estheticians know what products can penetrate the skin and what effects they will have on clients. By learning to identify the various diseases and disorders of the skin, you will be able to provide more effective and safe services for your clients.

Flash Facts: Histology of the Skin

ACNE Skin disorder characterized by chronic inflammation of the sebaceous glands from retained secretions

ALBINISM Congenital leukoderma or absence of melanin pigment of the body, including the skin, hair, and eyes ANHIDROSIS Deficiency in perspiration, often result of fever or certain skin diseases

ASTEATOSIS Condition of dry, scaly skin due to deficiency or absence of sebum; caused by old age and by exposure to cold

BASAL CELL Most common and least CARCINOMA severe type of skin cancer; often characterized by light or pearly nodules

BROMHIDROSIS Foul-smelling perspiration, usually noticeable in the armpits or on the feet C.O.E. CONTINUING EDUCATION

BULLA Large blister containing a watery fluid; similar to a vesicle but larger

CHLOASMA Condition characterized by increased pigmentation on the skin, in spots that are not elevated

COLLAGEN Fibrous protein that gives the skin form and strength

COMEDONES Blackheads

CRUST Dead cells that form over a wound or blemish while it is healing; an accumulation of sebum and pus, sometimes mixed with epidermal

CYST Abnormal sac containing fluid above and below the skin

ECZEMA Inflammatory, painful itching disease of the skin, acute or chronic in nature, presenting many forms of dry or moist lesions C.O.E. CONTINUING EDUCATION

ELASTIN Protein base similar to collagen that forms elastic tissue

EXCORIATION Skin sore or abrasion produced by scratching or scraping

FISSURE Crack in the skin that penetrates the dermis, such as chapped hands or lips

HERPES SIMPLEX Fever blister or cold sore

HYPERHIDROSIS Excessive sweating, caused by heat or general body weakness

HYPERTROPHY Abnormal growth of the skin

KELOID Thick scar resulting from C.O.E. CONTINUING EDUCATIONexcessive growth of fibrous tissue

KERATOMA Acquired, superficial, thickened patch of epidermis commonly known as callus, caused by pressure or friction on hands and feet

LENTIGINES Freckles

LEUKODERMA Skin disorder characterized by light abnormal patches; caused by burn or congenital disease that destroys the pigment- producing cells

MACULA Small, discolored patch; freckle

MALIGNANT Most serious form of MELANOMA skin cancer; often characterized by black or dark brown patches on the skin that may appear uneven in texture, jagged, or raised

MELANIN Tiny grains of pigment deposited in the stratum germinativum of the epidermis and the papillary layers of the dermis

MILIA Prickly heat; acute inflammatory disorder of the sweat glands

MOLE Small, brownish spot or C.O.E. CONTINUING EDUCATIONblemish on the skin

NEVUS Small or large malformation of the skin due to abnormal pigmentation or dilated capillaries

PAPULE Pimple

PSORIASIS Skin disease characterized by red patches; covered with white silver scales usually found on scalp, elbows, knees, chest, and lower back

PUSTULE An inflamed pimple containing pus

ROSACEA Chronic congestion appearing primarily on the cheeks and nose, characterized by redness, dilation of the blood vessels, and the formation of papules and pustules

SCALE Any thin plate of epidermal flakes, dry or oily, such as abnormal or excessive dandruff

SCAR Light-colored, slightly raised mark on the skin formed after an injury or lesion

C.O.E. CONTINUING EDUCATION

SEBORRHEA Skin condition caused by an abnormal increase of secretion from the sebaceous glands

SKIN TAG Cutaneous outgrowth of the skin

SQUAMOUS CELL Type of skin cancer CARCINOMA more serious than basal cell carcinoma; often characterized by scaly red papules or nodules

STAIN Abnormal brown or wine-colored skin discoloration with a circular and irregular shape

STEATOMA Sebaceous cyst or fatty tumor

TAN Change in pigmentation of skin caused by exposure to the sun or ultraviolet rays

TUBERCLE Abnormal rounded, solid lump above, within, or under the skin C.O.E. CONTINUING EDUCATION

TUMOR Abnormal cell mass, varying in size, shape, and color

ULCER Open lesion on the skin or mucous membrane of the body, accompanied by pus and loss of skin depth

VESICLE Small blister or sac containing clear fluid, lying within or just beneath the epidermis

VITILIGO Milky-white spots (leukoderma) of the skin; acquired condition

WHEAL Itchy, swollen lesion that lasts only a few hours; caused by a blow, insect bite, urticaria, or sting of the nettle

C.O.E. CONTINUING EDUCATION

GEORGIA TCSG HEALTH AND SAFETY—3 HRS.

COURSE TABLE OF CONTENTS

SECTION 1: SKIN, DISEASES, DISORDERS

 Anatomy and Histology of the Skin

o Nerves of the Skin

o Glands of the Skin

o Nourishment of the Skin

o Functions of the Skin

o Terminology

 Diseases and Disorders

o Skin Conditions/Descriptions

o Nail Diseases/Disorders

o Hair Disease/Disorders

o Skin Conditions/Descriptions

SECTION 2: BLOODBORNE PATHOGENS

 What are Bloodborne Pathogens?

 Hepatitis B Virus (HBV)

 Human Immunodeficiency Virus (HIV)

 Signs and Symptoms

 Transmission

 Transmission Routes

 Risk Factors and Behaviors

 Personal Protective Equipment

SECTION 3: DECONTAMINATION & STERILIZATION

 Common Questions

 HIV

 Precautions

SECTION 4: DECONTAMINATION AND INFECTION CONTROL

 Professional Salon Environment

 Safety Precautions

 Material Safety Data Sheet (M.S.D.S.)

 Organizing an M.S.D.S. Notebook

SECTION 5: GEORGIA STATE BOARD OF COSMETOLOGY SANITARY REGULATIONS FOR SALONS AND SCHOOLS C.O.E. CONTINUING EDUCATION SECTION 6: APPENDIX A GEORGIA STATE BOARD OF COSMETOLOGY GLOSSARY OF LEGAL

DEFINITIONS

Georgia Department of Technical and Adult Education

Skin, Diseases, Disorders

C.O.E. CONTINUING EDUCATION

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 43 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 44 of 202

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by Georgia Department of Technical and Adult Education.

Skin, Diseases, Georgia Department of Technical and Adult Education iii Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 45 of 202

C.O.E. be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

C.O.E. CONTINUING EDUCATION

C.O.E.

Table of Contents

Skin, Diseases, Disorders ...... 1

Introduction ...... 1

Objectives ...... 2

Anatomy and Histology of the Skin ...... 3

Nerves of the Skin ...... 5

Glands of the Skin ...... 5

Nourishment of the Skin ...... 6

Functions of the Skin ...... 6

Skin, Diseases, Georgia Department of Technical and Adult Education v Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 47 of 202

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Terminology ...... 7

Diseases and Disorders ...... 11

Skin Conditions /Descriptions ...... 12

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Skin, Diseases, Disorders

Introduction

The flexible, waterproof, tough protective covering known as the skin is the largest organ in the body both by weight and surface area. Skin accounts for approximately 16% of the body’s weight.

Healthy skin has a fine texture that is slightly moist, soft, and flexible. Varying in thickness, the skin is thinnest on the eyelids and thickest on the palms and soles. A callous can be caused by continuous friction on any part of the skin.

The skin has appendages that include the hair, sweat and oil glands, and the nails. Composed of the substance known as keratin, this protein gives the

skin its protective ability. The skin is slightly acidic in pH, which enables good immunity responses to intruding organisms. Normally the skin separates the internal environment from the external. However skin diseases and Skin, Diseases, Georgia Department of Technical and Adult Education 1 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 49 of 202

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infections can invade that barrier. For this reason, a thorough understanding of the histology of the skin and its diseases and disorders is needed for a better position to give clients professional advice.

C.O.E. CONTINUING EDUCATION

Skin, Diseases, Georgia Department of Technical and Adult Education 1 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 50 of 202

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Objectives

Upon completion of this course, trainees will be able to:

• Explain the structure and the composition of the skin.

• Identify the functions of the skin.

• Describe terms relating to skin disorders.

• Recognize which skin diseases/disorders may be dealt with in the salon and which should be referred to a physician.

• Identify online dermatology resources.

2 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 51 of 202

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Anatomy and Histology of the Skin

The two major divisions of the skin are the dermis and the epidermis.

The outermost layer of the skin is the epidermis that is composed of sheets of dead cells that serve as the major waterproof barrier to the environment. The epidermis is the visible layer of skin. This layer contains numerous nerve endings, but no blood vessels. The human epidermis is renewed every

15-30 days.

C.O.E. CONTINUING EDUCATION

Skin, Diseases, Georgia Department of Technical and Adult Education 3 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 52 of 202

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The epidermis consists of many layers. The stratum corneum is the outer layer that is often called the horny layer. Cells are continually being shed and replaced. This layer of skin for the most part is dead – it is composed of cells that are almost pure protein.

The stratum lucidum consists of translucent cells through which light can penetrate.

The stratum granulosum, known as the granular layer, consists of cells that resemble granules. These cells are transforming into a harder form of protein.

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The stratum mucosum is also known as the basal cell layer. Basal cells are continuously being reproduced. It is the deepest layer of the epidermis. This layer also contains melanocytes that produce the coloring matter known as melanin and determines skin color. Melanocytes also react to ultraviolet rays to darken the skin for added protection.

The middle layer, the dermis, provides a tough, flexible foundation for the epidermis. In the dermis, body temperature is regulated by sweat glands and blood vessels. It also contains arector pilli muscles, papillae, and hair follicles. Nerve endings send sensations of pain, itching, touch, and temperature to the brain. The skin is moisturized by oil glands that produce sebum.

The dermis consists of two layers. The papillary layer connects the dermis to the epidermis. Tactile corpuscles are nerve fiber endings that contain looped capillaries. Tactile corpuscles are responsible for the sense of touch. The papillary layer also contains some of the melanin.

The reticular layer is the deepest layer of the dermis. It contains fat cells, blood vessels, lymph vessels, oil glands, sweat glands, hair follicles, C.O.E. CONTINUINGand arrector pilli muscles. The reticular layer suppli EDUCATIONes the skin with oxygen and nutrients.

Subcutaneous tissue is the fatty layer found below the dermis. It is also called the adipose or the subcutis tissue. It varies in thickness according to age, sex, and general health of the individual. The subcutaneous tissue contains fats 4 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 54 of 202

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for energy, gives smoothness and contour to the body, and acts as a protective cushion for the outer skin. Arteries and lymphatics maintain circulation to

the body.

4 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 55 of 202

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Anatomy and Histology of the Skin

Nerves of the Skin

Sensory nerves are receptors and send messages to the brain causing reactions to heat, cold, touch, pressure, and pain.

Motor nerve fibers, attached to the hair follicles, are distributed to the arrector pilli muscles which may cause goose flesh when you are frightened or cold.

The secretory nerve fibers regulate the excretion of perspiration from the sweat glands and regulate the flow of sebum to the surface of the skin.

Glands of the Skin C.O.E. CONTINUING EDUCATION There are two types of duct glands contained in the skin that pull out minerals from the blood to create new substances. The suderiferous glands are the sweat glands and the sebaceous glands are the oil glands.

Skin, Diseases, Georgia Department of Technical and Adult Education 5 Disorders CONTINUING EDUCATION

Sweat glands excrete perspiration. This secretion is odorless when excreted, but in a short period of time produces an offensive odor due to the bacteria on the skin’s surface feeding on the fats of its secretion. Perspiration is controlled by the nervous system. About 1-2 pints of liquid containing salts are excreted daily through the sweat pores in the skin. The sweat glands consist of a coiled base or fundus and a tube-like duct that ends at the skin surface forming the pores. Sweat glands are more numerous on the palms, soles, forehead, and armpits. Body temperature is regulated by the sweat glands that also aid in the elimination of waste.

Oil glands secrete sebum through little sacs whose ducts open in to the hair follicles. These glands are found in all parts of the body with the exception of the palms and soles. The oily substance produced by the oil glands is called sebum. Sebum lubricates the skin and preserves the pliability of

the hair. When the duct becomes clogged with hardened sebum, a blackhead is formed.

Skin, Diseases, Georgia Department of Technical and Adult Education 5 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 57 of 202

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Nourishment of the Skin

Blood and lymph circulate through the skin providing nourishment essential

for growth and repair of the skin, hair, and nails.

Functions of the Skin

The major functions of the skin are sensation, heat regulation, absorption, protection, excretion, and secretion. The functions of the skin can easily be remembered using the acronym: SHAPES

S – ensation – response to heat, cold, pressure, and pain

H – eat regulation – maintains body temperature of 98.6

A – bsorption - substances can enter the body through the skin C.O.E. CONTINUINGand affect it to a minor deg EDUCATIONree

P – rotection – from bacterial invasion

E – xcretion – sweat glands excrete perspiration

6 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 58 of 202

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S – ecretion - sebum is secreted by the sebaceous glands

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Anatomy and Histology of the Skin

Terminology

Dermatology study of the skin, its nature, functions, and treatment

Dermatologist a medical skin specialist

Disease a pathological condition of the body, organ, or mind making it incapable of carrying on normal functions

Disorder abnormal condition usually not contagious

Immunity freedom from or resistance to disease C.O.E. CONTINUINGIntegumentary system one of the 10 systems EDUCATION of the body; pertains to the

skin, its appendages and functions

Pathology study of disease

Skin, Diseases, Georgia Department of Technical and Adult Education 7 Disorders CONTINUING EDUCATION

Etiology study of the causes of diseases

Trichology study of hair

Diagnosis recognition of a disease by its symptoms

Prognosis foretelling of the probable course of a disease

Objective symptom visible symptom

Subjective symptom symptom that can be felt by client, but not by observation

Acute rapid onset with severe symptoms of short duration

Skin, Diseases, Georgia Department of Technical and Adult Education 7 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 61 of 202

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Chronic long duration, usually mild, but often recurring

Infectious invasion of body tissue by bacteria that cause disease

Contagious communicable; by contact

Occupational due to certain kinds of employment

Seasonal influenced by weather

Parasitic caused by vegetable or animal parasites

Pathogenic produced by disease causing bacteria

Systemic due to over or under functioning of the internal glands

C.O.E. CONTINUING EDUCATION

Venereal disease acquired by sexual contact

Epidemic emergence of a disease that affects a large number of people simultaneously 8 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 62 of 202

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Allergy reaction due to extreme sensitivity to normally harmless substances

Inflammation skin disorder characterized by redness, pain, edema, and heat

Rhytidectomy face lift

Blepharoplasty eyelid surgery

Chemical peel chemical solution applied to skin areas causing a mild, controlled burn of the skin

8 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 63 of 202

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Anatomy and Histology of the Skin

Rhinoplasty plastic surgery of the nose

Mentoplasty chin surgery

C.O.E. CONTINUINGDermabrasion sandblasting irregularities EDUCATION of the skin Injectable fillers tiny injections of collagen to soften wrinkles Retin–A

prescription cream used in the treatment of acne

Skin, Diseases, Georgia Department of Technical and Adult Education 9 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 64 of 202

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Notes:

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 65 of 202

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10 Skin, Diseases, Disorders

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Diseases and Disorders

In a salon, you will come in contact with diseases and disorders of the skin and its appendages: the hair and nails. Your license requires you to be responsible for the recognition of potentially infections diseases. Some disorders can be treated in cooperation with and under the supervision of

a physician.

Skin, Diseases, Georgia Department of Technical and Adult Education 11 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 67 of 202

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Skin Conditions /Descriptions

WARNING: NEVER TRY TO DIAGNOSE A DISEASE; ALWAYS REFER TO A PHYSICIAN.

NOTE: COLOR CHANGES, A CRACK ON THE SKIN, A TYPE OF THICKENING, OR ANY DISCOLORATION, RANGING FROM SHADES OF RED TO BROWN AND PURPLE TO ALMOST BLACK, MAY BE SIGNS OF DANGER AND SHOULD BE EXAMINED BY A DERMATOLOGIST.

CAUTION: DO NOT TREAT OR REMOVE HAIR FROM MOLES.

Condition/ Description C.O.E. CONTINUINGDisease/Disorder EDUCATION

Pigmented Lesions

Lentigo small, yellow to brown spots

12 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 68 of 202

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Chloasma moth patches, liver spots = increased deposits of pigment

Naevus birthmark (portwine or strawberry) small-large malformation of skin due to pigmentation or dilated capillaries

Leucoderma abnormal light patches due to congenital defective pigmentations

Vitiligo acquired condition of leucoderma-may affect skin or hair

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Diseases and Disorders

Albinism congenital absence of melanin pigment

Stain abnormal, brown, skin patches having a circular

& irregular shape

Disorders of the Sebaceous Glands

Comedones blackheads, a worm-like mass of keratinized cells

& hardened sebum

Milia whiteheads, an accumulation of dead, C.O.E. CONTINUINGkeratinized cells and EDUCATION sebaceous matter trapped beneath

the skin

Skin, Diseases, Georgia Department of Technical and Adult Education 13 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 70 of 202

C.O.E. Acne Simplex chronic inflammatory disorder usually related to hormonal changes & overactive sebaceous glands

Acne Vulgaris acne-pimples

Acne Rosacea chronic inflammatory congestion of the cheeks

& nose

Seborrhea/Seborrhea overactive sebaceous glands-often the basis of acne

Oleosa = Oily Dandruff

Steatoma wen or sebaceous cyst (subcutaneous tumor)

ranges in size from a pea to an orange

Asteatosis dry, scaly skin characterized by absolute or partial deficiency of sebum

Furuncle boil-a subcutaneous abscess that fills with pus

C.O.E.

Cysts sac-like, elevated (usually round) area, contains liquid or semi-liquid substance-when a follicle ruptures deep within the dermis & irritating oil

& dead cells seep into the surrounding tissuesoften cause acne pits

Pimples follicle filled with oil, dead cells, & bacteriainflammation causes white blood cells to rush to fight bacteria creating a pus

Disorders of the Sudoriferous Glands

Bromidrosis osmidrosis=foul-smelling perspiration

Anhidrosis lack of perspiration

C.O.E. CONTINUING EDUCATION Hyperhidrosis excessive perspiration

Miliaria Rubra prickly heat-eruptions of small red vesicles accompanied by burning & itching-caused by excessive heat

14 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 72 of 202

C.O.E.

Hypertrophies

Keratoma callus-superficial, round, thickening of the epidermis caused by friction (inward growth is called a corn)

Mole a small, brown spot-believed to be inheritedmay be flat or deeply seated-pale tan-brown or bluish black

Verruca wart, a viral infection of the epidermis-benign

C.O.E.

Diseases and Disorders

Skin Tag bead-like fibrous tissue that stands away from the flat surface-often a dark color

Polyp growth that extends from the surface or may also grow with the body

Inflammations

Eczema dry or moist lesions accompanied by itching, burning, & various other unpleasant sensationsusually red-blistered, & oozing

Psoriasis rarely on the face, lesions are round, dry patches C.O.E. CONTINUINGcovered with coarse, EDUCATION silvery scales-if irritated, bleeding points occur-may be spread to larger area-not contagious

Herpes Simplex/ fever blisters/cold sores-single group of vesicles

Herpes Zoster = Shingles on a red swollen base

Skin, Diseases, Georgia Department of Technical and Adult Education 15 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 74 of 202

C.O.E.

Allergy Related Dermatitis

Dermatitis allergy to ingredients in cosmetics, etc.- Venenata protection is the prevention-gloves, etc.

Dermatitis dermatitis that occurs after an injection of a substance

Medicamentosa

Urticaria hives-inflammation caused by an allergy to specific drugs/foods

C.O.E.

Primary Skin Lesions

Macule small, discolored spot or patch on the skin's surface, neither raised nor sunken-ex: freckles

Papule small elevated pimple containing no fluid, but may have pus

note: yellow or white fatty papules around the eyes indicate an elevated cholesterol level-refer to a physician (xanthelasma).

Wheal itchy, swollen lesion that lasts only a few hoursex: mosquito bite

Tubercle solid lump larger than a papule-projects above the skin or lies with-sized from pea to hickory nut

C.O.E. CONTINUING EDUCATION

Tumor external swelling-varies in size, shape & color

Vesicle blister with clear fluid-lie within or just beneath the epidermis-ex: poison ivy 16 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 76 of 202

C.O.E.

Bulla blister containnig a watery fluid-larger than a vesicle

Pustule elevation with inflamed base, containing pus

Secondary Skin Lesions

Scale accumulation of epidermal flakes, dry or greasyex: abnormal dandruff

Crust accumulation of serum & pus-mixed with epidermal material-ex: scab

16 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 77 of 202

C.O.E.

Diseases and Disorders

Excoriation abrasion produced by scratching or scraping-ex:

raw surface after injury

Fissure crack in the skin penetrating into the dermis

Ulcer open lesion on skin or mucous membrane, accompanied by pus & loss of skin depth

Acne Scars

Ice Pick Scar large, visible, open pores that look as if the skin C.O.E. CONTINUINGhas been jabbed withEDUCATION an ice pick-follicle always looks open-caused by deep pimple or cyst

Acne Pit Scar slightly sunken or depressed appearance-caused by pimples/systs taht have destroyed the skin & formed scar tissue

Skin, Diseases, Georgia Department of Technical and Adult Education 17 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 78 of 202

C.O.E.

Acne Raised Scar lumpy mass of raised tissue on the surface of the skin-caused where cysts have clumped together

Contagious Disorders

Tinea ringworm, due to fungi

Tinea Capitis - Ringworm of Scalp (plant or vegetable

Tinea Sycosis - Barber's Itch parasites)-small reddened Tinea Favosa - Honeycomb Ringworm patch of little blisters that Tinea Unguium - Ringworm of Nails spread outward and heal in Athlete's Foot - Ringworm of Feet the middle with scaling

C.O.E.

CAUTION! NEVER ATTEMPT TO DIAGNOSE BUMPS, LESIONS, ULCERATIONS, OR DISCOLORATIONS AS SKIN CANCER, BUT YOU SHOULD BE ABLE TO RECOGNIZE THE CHARACTERISTICS OF SERIOUS SKIN DISORDERS AND SUGGEST THAT THE CLIENT

SEE A PHYSICIAN OR DERMATOLOGIST.

Extremely Serious Disorders-Skin Cancers

Basal Cell Carcinoma least malignant-most common skin cancer- characterized by light or pearly nodules & visible blood vessels

Squamous Cell Carcinoma scaly, red papules-blood vessels are not visible- more serious than basal cell

Malignant Melanoma most serious-characterized by dark brown, black, C.O.E. CONTINUINGor discolored patches EDUCATION on the skin

Tumor abnormal growth of swollen tissue

Nail Diseases/Disorders

18 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 80 of 202

C.O.E.

Onychophagy nail biting

Onychogryposis overcurvature of the nail-clawlike

Pterygium sticky overgrowth of the cuticle

Eggshell Nail extremely thin nail

Leuconychia white spots under the nail plate

C.O.E.

Diseases and Disorders

Paronychia bacterial inflammation of tissue (perionychium)

around the nail

Tinea Corporis ringworm of the hand

Tinea Pedia ringworm of the foot

Agnail hangnail

Onychia an inflammation somewhere in the nail

Onychocyanosis blue nail (usually caused by poor circulation)

Hematoma Nail bruised nail (usually caused by a hammer or

slammed door) C.O.E. CONTINUING EDUCATION

Tinea Unguium onychomycosis-ringworm of the nail

Onychorrexis split or brittle nails with a series of lengthwise ridges

Beau's Lines ridges/corrugations/furrows

Skin, Diseases, Georgia Department of Technical and Adult Education 19 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 82 of 202

C.O.E. Onychatrophia atrophy or wasting away of the nail

Onychocryptosis ingrown nail

Onychauxis overgrowth of the nail plate

Onychosis any nail disease

Onychophosis accumulation of horny layers of epidermis under the nail

C.O.E.

Hair Disease/Disorders

Pityriasis Capitis dry dandruff

Simplex

Pityriasis Capitis greasy dandruff

Steatoids Seborrhea Oleosa

= Oily Dandruff

Trichoptilosis split hair ends

Trichorrehexis Nodosa knotted

C.O.E. CONTINUINGTinea Favosa honeycomb ringworm EDUCATION Tinea Capitis ringworm of the scalp

Tinea Sycosis barber's itch

20 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 84 of 202

C.O.E.

Androgenetic Alopecia common hereditary hair loss

Alopecia Adnata loss of hair shortly after birth

Alopecia Areata hair loss in patches

Alopecia Follicularis hair loss caused by inflammation of hair follicles

Alopecia Prematura hair loss early in life

Alopecia Senilis hair loss from old age

Alopecia Totalis hair loss from entire scalp

Alopecia Universalis hair loss from entire body

C.O.E.

Diseases and Disorders

Traction/Traumatic patchy hair loss sometimes due to repetitive

Alopecia traction on the hair by pulling or twisting

Postpartum temporary hair loss at the conclusion

Alopecia of pregnancy

Telogen Effluven hair loss during the telogen phase of the hair growth cycle

Canities gray hair

Pediculosis Capitis headlice

C.O.E. CONTINUINGMonilithrix beaded hair EDUCATION

Fragilitis Crinium brittle hair

Hirsuities/Hypertrichosis superfluous hair, excessive

Skin, Diseases, Georgia Department of Technical and Adult Education 21 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 86 of 202

C.O.E. Scabies contagious disease caused by the itch mite

Impetigo/Infantigo highly contagious bacterial infection, usually staphylococcal

Discoid Lupus chronic autoimmune disorder, causes red

Erythematosus (DLE) often scarring plaques, hair loss, &

internal effects

Keloids forms when excess collagen forms at the site of a haeling scar-overhealing

Asteatosis excessive dry skin

C.O.E.

Websites: Online Dermatology Resources

http://tray.dermatology.uiowa.edu/DermImag.htm

http://www.medic.mie-u.ac.jp/derma/world/worldd1.html

http://www.skin-information.com/

http://www.skin-disease.com/

http://www.skin-cancers.net/

http://www.age-spot.com/

C.O.E. CONTINUING EDUCATION http://www.i-wrinkle.com/

http://www.i-wrinkle.com/

22 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 88 of 202

C.O.E.

http://www.asds-net.org American Society of Dermatologic Surgery

http://www.aad.org American Academy of Dermatology

22 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. CONTINUINGContinuing Education. TheEDUCATION course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 89 of 202 C.O.E.

Diseases and Disorders

Skin Conditions /Descriptions

WARNING: NEVER TRY TO DIAGNOSE A DISEASE; ALWAYS REFER TO A PHYSICIAN.

C.O.E. CONTINUING EDUCATION CAUTION: DO NOT TREAT OR REMOVE HAIR FROM MOLES.

Condition/ Description

Disease/Disorder

CONTINUING EDUCATION

Pigmented Lesions

Lentigo small, yellow to brown spots

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. CONTINUINGE. Continuing Education. EDUCATION The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 91 of 202 C.O.E.

Chloasma moth patches, liver spots = increased deposits of pigment

Naevus birthmark (portwine or strawberry) small-large malformation of skin due to pigmentation or dilated capillaries

Leucoderma abnormal light patches due to congenital defective pigmentations

C.O.E. CONTINUING EDUCATION Vitiligo acquired condition of leucoderma-may affect skin or hair

Albinism congenital absence of melanin pigment

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. CONTINUINGContinuing Education. TheEDUCATION course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 93 of 202 C.O.E.

Stain abnormal, brown, skin patches having a circular

& irregular shape

Disorders of the Sebaceous Glands

Comedones blackheads, a worm-like mass of keratinized cells

& hardened sebum

C.O.E. CONTINUING EDUCATION

Milia whiteheads, an accumulation of dead, keratinized cells and sebaceous matter trapped beneath the skin

Acne Simplex chronic inflammatory disorder usually related to hormonal changes & overactive sebaceous glands

Acne Vulgaris acne-pimples

Acne Rosacea chronic inflammatory congestion of the cheeks & nose

Seborrhea/Seborrhea overactive sebaceous glands-often the basis of acne

Oleosa = Oily Dandruff

C.O.E. SteCONTINUINGatoma wen or sebaceous cyst (subcutan EDUCATIONeous tumor) ranges in size from a pea to an orange

Asteatosis dry, scaly skin characterized by absolute or partial deficiency of sebum

Furuncle boil-a subcutaneous abscess that fills with pus

Cysts sac-like, elevated (usually round) area, contains liquid or semi-liquid substance-when a follicle ruptures deep within the dermis & irritating oil

& dead cells seep into the surrounding tissuesoften cause acne pits

Pimples follicle filled with oil, dead cells, & bacteriainflammation causes white blood cells to rush to fight bacteria creating C.O.E. CONTINUINGa pus EDUCATION

Disorders of the Sudoriferous Glands

Bromidrosis osmidrosis=foul-smelling perspiration

Anhidrosis lack of perspiration

Hyperhidrosis excessive perspiration

Miliaria Rubra prickly heat-eruptions of small red vesicles accompanied by burning & itching-caused by excessive heat

Hypertrophies

Keratoma callus-superficial, round, thickening of the epidermis caused by friction (inward growth is called a corn)

Mole a small, brown spot-believed to be inheritedmay

be flat or deeply seated-pale tan-brown or bluish black

Verruca wart, a viral infection of the epidermis-benign

C.O.E. CONTINUING EDUCATION

Skin Tag bead-like fibrous tissue that stands away from the flat surface-often a dark color

Polyp growth that extends from the surface or may also grow with the body

Inflammations

Eczema dry or moist lesions accompanied by itching,

burning, & various other unpleasant sensationsusually red-blistered, & oozing

Psoriasis rarely on the face, lesions are round, dry patches covered with coarse, silvery scales-if irritated, bleeding points occur-may be spread to larger area-not contagious

C.O.E. CONTINUING EDUCATION

Herpes Simplex/ fever blisters/cold sores-single group of vesicles

Herpes Zoster = Shingles on a red swollen base

Herpes Simplex Herpes Zoster

Allergy Related Dermatitis

Dermatitis allergy to ingredients in cosmetics, etc.- Venenata protection is the prevention-gloves, etc.

Dermatitis dermatitis that occurs after an injection of a substance

Medicamentosa

Urticaria hives-inflammation caused by an allergy to specific drugs/foods

C.O.E. CONTINUING EDUCATION

Primary Skin Lesions

Macule small, discolored spot or patch on the skin's surface, neither raised nor sunken-ex: freckles

Papule small elevated pimple containing no fluid, but may have pus note: yellow or white fatty papules around the eyes indicate an elevated cholesterol level-refer to a physician (xanthelasma).

Wheal itchy, swollen lesion that lasts only a few hoursex:

mosquito bite

C.O.E. CONTINUING EDUCATION

Tubercle solid lump larger than a papule-projects above the skin or lies with-sized from pea to hickory nut

Tumor external swelling-varies in size, shape & color

Vesicle blister with clear fluid-lie within or just beneath the epidermis-ex: poison ivy

Bulla blister containnig a watery fluid-larger than a vesicle

Pustule elevation with inflamed base, containing pus

Secondary Skin Lesions

Scale accumulation of epidermal flakes, dry or greasyex:

abnormal dandruff

Crust accumulation of serum & pus-mixed with epidermal material-ex: scab

Excoriation abrasion produced by scratching or scraping-ex:

raw surface after injury

Fissure crack in the skin penetrating into the dermis

Ulcer open lesion on skin or mucous membrane, C.O.E. CONTINUINGaccompanied by pus & loss of skinEDUCATION depth

Acne Scars

Ice Pick Scar large, visible, open pores that look as if the skin has been jabbed with an ice pick-follicle always looks open-caused by deep pimple or cyst

Acne Pit Scar slightly sunken or depressed appearance-caused by pimples/systs that have destroyed the skin & formed scar tissue

Acne Raised Scar lumpy mass of raised tissue on the surface of the skin-caused where cysts have clumped together

C.O.E. CONTINUING EDUCATION

Contagious Disorders

Tinea ringworm, due to fungi

Tinea Capitis - Ringworm of Scalp (plant or vegetable

Tinea Sycosis - Barber's Itch parasites) -small reddened Tinea Favosa - Honeycomb Ringworm patch of little blisters that Tinea Unguium - Ringworm of Nails spread outward and heal in Athlete's Foot - Ringworm of Feet the middle with scaling

Extremely Serious Disorders-Skin Cancers

Basal Cell Carcinoma least malignant-most common skin cancer characterized by light or pearly nodules & visible blood vessels

C.O.E. CONTINUING EDUCATION Squamous Cell Carcinoma scaly, red papules-blood vessels are not visible more serious than basal cell

Malignant Melanoma most serious-characterized by dark brown, black, or discolored patches on the skin

Tumor abnormal growth of swollen tissue

Nail Diseases/Disorders

Onychophagy nail biting

C.O.E. CONTINUING EDUCATION

Onychogryposis overcurvature of the nail-clawlike

Pterygium sticky overgrowth of the cuticle

Eggshell Nail extremely thin nail

Leuconychia white spots under the nail plate

Paronychia bacterial inflammation of tissue (perionychium)

around the nail

Tinea Corporis ringworm of the hand

Tinea Pedia ringworm of the foot C.O.E. CONTINUING EDUCATION

Agnail hangnail

Onychia an inflammation somewhere in the nail

Onychocyanosis blue nail (usually caused by poor circulation)

Hematoma Nail bruised nail (usually caused by a hammer or

slammed door)

Tinea Unguium onychomycosis-ringworm of the nail

C.O.E. CONTINUING EDUCATION

Onychorrexis split or brittle nails with a series of lengthwise ridges

Beau's Lines ridges/corrugations/furrows

Onychatrophia atrophy or wasting away of the nail

Onychocryptosis ingrown nail

C.O.E. CONTINUING EDUCATION

Onychauxis overgrowth of the nail plate

Onychosis any nail disease

Onychophosis accumulation of horny layers of epidermis under the nail

Hair Disease/Disorders

Pityriasis Capitis dry dandruff

Simplex

Pityriasis Capitis greasy dandruff

Steatoids Seborrhea Oleosa

= Oily Dandruff

Trichoptilosis split hair ends

Trichorrehexis Nodosa knotted

Tinea Favosa honeycomb ringworm

Tinea Capitis ringworm of the scalp

C.O.E. CONTINUING EDUCATION

Tinea Sycosis barber's itch

Androgenetic Alopecia common hereditary hair loss

Alopecia Adnata loss of hair shortly after birth

Alopecia Areata hair loss in patches

Alopecia Follicularis hair loss caused by inflammation of hair follicles

Alopecia Prematura hair loss early in life

Alopecia Senilis hair loss from old age

Alopecia Totalis hair loss from entire scalp

Alopecia Universalis hair loss from entire body

Traction/Traumatic patchy hair loss sometimes due to repetitive

Alopecia traction on the hair by pulling or twisting

Postpartum temporary hair loss at the conclusion

Alopecia of pregnancy

C.O.E. CONTINUING EDUCATION

Telogen Effluven hair loss during the telogen phase of the hair growth cycle

Canities gray hair

Pediculosis Capitis headlice

Monilithrix beaded hair

Fragilitis Crinium brittle hair

Hirsuities/Hypertrichosis superfluous hair, excessive

Scabies contagious disease caused by the itch mite

Impetigo/Infantigo highly contagious bacterial infection, usually staphylococcal

Discoid Lupus chronic autoimmune disorder, causes red

C.O.E. CONTINUING EDUCATION

Erythematosus (DLE) often scarring plaques, hair loss, &

internal effects

Keloids forms when excess collagen forms at the site of a healing scar-overhealing

Asteatosis excessive dry skin

C.O.E.

Georgia Department of Technical C.O.E. anCONTINUINGd Adult Education EDUCATION

Bloodborne Pathogens

C.O.E.

by Georgia Department of Technical and Adult Education.

Bloodborne Georgia Department of Technical and Adult Education iii Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 129 of 202

C.O.E. be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

C.O.E. CONTINUING EDUCATION

C.O.E.

Table of Contents

Introduction ...... 1

Objectives ...... 1

What Are Bloodborne Pathogens? ...... 3

Hepatitis B Virus (HBV) ...... 4

Human Immunodeficiency Virus (HIV) ...... 4

Signs and Symptoms ...... 5

Signs and Symptoms of (HVB) ...... 5

Signs and Symptoms of (HIV) ...... 5

Transmission ...... 7

Transmission Mediums ...... 7

Transmission Routes ...... 8

Risk Factors and Behaviors ...... 9

Personal Protective Equipment ...... 11

Bloodborne Georgia Department of Technical and Adult Education v Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 131 of 202

C.O.E. Decontamination & Sterilization ...... 15

Common Questions ...... 17

Discuss with the class: ...... 17

HBV ...... 17

HIV ...... 18

Precautions ...... 19

Summary ...... 23

C.O.E. CONTINUING EDUCATION

C.O.E.

Introduction

A bloodborne pathogen is a specific cause of disease, such as a virus or bacteria. “Bloodborne” means carried by or in blood and certain other body fluids. AIDS, hepatitis B and C, malaria, and syphillis are examples of diseases that are caused by bloodborne pathogens.

Objectives

Upon completion of this course, you will be able to:

• Discuss bloodborne pathogens,

• Identify two bloodborne pathogens of concern in the workplace,

• Explain how bloodborne pathogens are transmitted,

• List four high risk factors, and

• Discuss the precautions to be used in the workplace.

Bloodborne Georgia Department of Technical and Adult Education 1 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 133 of 202

C.O.E.

Notes:

C.O.E. CONTINUING EDUCATION

C.O.E.

2 Bloodborne Pathogens

C.O.E.

What Are Bloodborne Pathogens?

Two types of pathogens of concern in the workplace are:

1. Hepatitis B Virus (HBV)

2. Human Immunodeficiency Virus (HIV)

Hepatitis B is much more contagious than HIV.

C.O.E. CONTINUING EDUCATION

Bloodborne Georgia Department of Technical and Adult Education 3 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 136 of 202

C.O.E.

Hepatitis B Virus (HBV)

The HB Virus infects the liver: it’s more common than HIV and is a greater risk on the job. Many HBV infected people have no problems or symptoms. Some, however, do develop serious or fatal problems such as cirrhosis, liver cancer, or chronic liver disease. There is a vaccine for HBV which is

dispensed in three doses. Any employee at risk should take the vaccine.

Human Immunodeficiency Virus (HIV)

HIV causes AIDS, it attacks the body’s immune system, reducing its ability to fight disease.

4 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 137 of 202

C.O.E.

To protect yourself against HIV and HBV, avoid direct exposure to infectious blood or body fluids - the prime transmitters of HBV and HIV.

C.O.E. CONTINUING EDUCATION

C.O.E.

Signs and Symptoms

Signs and Symptoms of (HVB)

Discuss and list different signs and symptoms of HVB.

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Signs and Symptoms of (HIV)

Discuss and list different signs and symptoms of HIV.

C.O.E. CONTINUING EDUCATION

C.O.E.

Notes:

C.O.E.

C.O.E. CONTINUING EDUCATION

6 Bloodborne Pathogens

C.O.E.

Transmission

Transmission Mediums

Body Fluids that can transmit infection are:

• Blood

• Semen

• Vaginal secretions

• Cerebrospinal fluid (brain and spinal fluid)

• Synovial fluid (lubricating fluid of joints and tendons)

• Pleural fluid (fluid around the lungs)

• Pericardial fluid (fluid around the heart)

• Peritoneal fluid (fluid in the abdomen)

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C.O.E. • Amniotic fluid (fluid that surrounds an embryo)

• Saliva (in dental procedures)

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C.O.E.

Transmission Routes

HIV and hepatitis are transmitted only in the following ways:

You can’t catch HIV through casual contact, such as touching, hugging, being coughed on or sneezed on or working around someone who has AIDS. Family members and health care workers who are constantly around patients with AIDS do not catch AIDS when they use proper precautions.

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Risk Factors and Behaviors

In light of what we know about the way the HBV and HIV virus are transmitted, risk of exposure to either virus is increased for people who:

• Have unprotected sex or multiple partners.

• Have unprotected sex with an IV drug user.

• Have shared needles while using drugs.

• Have occupational exposure to the blood or body fluids of others.

• Between 1978 and the spring of 1985, received blood or blood products in transfusion.

C.O.E. CONTINUING• Between 1978 and the spring of 1985,EDUCATION received an organ transplant.

• Received artificial insemination from an untested donor.

• Between 1978 and the spring of 1985, received treatment for a clotting disorder. Bloodborne Georgia Department of Technical and Adult Education 9 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 146 of 202

C.O.E. • Have been exposed to blood or body fluids of a person known to have AIDS or be HIV-positive.

• Are immigrants from high risk areas (southeast Asia, Africa, Southern and Central Europe):

• Have tattoos.

• Are family of infected persons.

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C.O.E.

Notes:

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10 Bloodborne Pathogens

C.O.E.

Personal Protective Equipment

"Universal Precautions" is the name used to describe a prevention strategy in which all blood and potentially infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual. In other words, whether or not you think the blood/body fluid is infected

with bloodborne pathogens, you treat it as if it is. This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work pratice controls shall always be utilized in situations where exposure may occur.

Probably the first thing to do in any situation where you may be exposed to bloodborne pathogens is to ensure you are wearing the appropriate personal protective equipment (PPE). For example, you may have noticed that emergency medical personnel, doctors, nurses, dentists, dental assistants, and other health care professionals always wear latex or protective gloves. This is a simple precaution they take in order to prevent blood or potentially infectious body fluids fromcoming in contact with their skin. To C.O.E. CONTINUINGprotect yourself, it is essential to have a barrier betweenEDUCATION you and the potentially infectious material.

Discuss and List 4 Rules to Follow with PPE:

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C.O.E. 2.

If you work in an area with routine exposure to blood or potentially infectious materials, the necessary PPE should be readily accessible. Contaminated gloves, clothing, PPE, or other materials should be placed in appropriately labeled bags or containers until it is disposed of, decontaminated, or laundered. It is important to find out where these bags or containers are located in your area before beginning work.

C.O.E.

This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work pratice controls shall always be utilized in situations where exposure

may occur.

Gloves

C.O.E. CONTINUINGGloves should be made of latex, nitril, rubber, orEDUCATION other water impervious materials. If glove material is thin or flimsy, double gloving can provide an additional layer of protection. Also, if you know you have cuts or sores on your hands, you should cover these with a bandage or similar protection as an additional precaution before donning your gloves. You should always inspect your gloves for tears or punctures before putting them on. If a glove is damaged, don't use it! When taking contaminated gloves off, do so

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C.O.E.

carefully. Make sure you don't touch the outside of the gloves with any bare skin, and

be sure to dispose of them in a proper container so that no one else will come contact with them either.

C.O.E.

Personal Protective Equipment

Goggles

Anytime there is a risk of splashing or vaporization of contaminated fluids, goggles and/or other eye protection should be used to protect your eyes. C.O.E. CONTINUINGAgain, bloodborne pathogens can be transmitted EDUCATION through the thin membranes of the eyes so it is important to protect them. Splashing could occur while cleaning up a spill, during laboratory procedures, or while

providing first aid or medical assistance.

Bloodborne Georgia Department of Technical and Adult Education 13 Pathogens CONTINUING EDUCATION

Face Shields

Face shields may be worn in addition to goggles to provide additional face protection. A face shield will protect against splashes to the nose and mouth.

Aprons

Aprons may be worn to protect your clothing and to keep blood or other contaminated fluids from soaking through to your skin. Normal clothing

that becomes contaminated with blood should be removed as soon as possible because fluids can seep through the cloth to come into contact with skin. Contaminated laundry should be handled as little as possible, and it should be placed in an appropriately labeled bag or container until it is deconaminated, disposed of, or laundered.

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C.O.E.

Notes:

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C.O.E.

14 Bloodborne Pathogens

C.O.E.

Decontamination & Sterilization

All surfaces, tools, equipment and other objects that come in contact with blood or potentially infectious materials must be decontaminated and sterilized as soon as possible. Equipment and tools must be cleaned and decontaminated before servicing or being put back into use.

Decontamination should be accomplished by using:

• A solution of 5.25% sodium hypochlorite (household bleach/ Clorox) diluted between 1:10 and 1:100 with water. The standard recommendation is to use at least a quarter cup of bleach per one gallon of water.

• Lysol or some other EPA-registered tuberculocidal disinfectant.

Check the label of all disinfectants to make sure they C.O.E. CONTINUINGmeet this requirement. EDUCATION

If you are cleaning up a spill of blood, you can carefully cover the spill with paper towels or rags, and leave it for at least 10 minutes. This will help ensure that any bloodborne pathogens are killed before you actually begin cleaning or wiping the material up. By covering the spill with paper towels or rags, you decrease the chances of causing a splash when you pour the bleach on it.

C.O.E.

If you are decontaminating equipment or other objects, you should leave the disinfectant in place for at least 10 minutes before continuing the cleaning process.

Of course, any materials you use to clean up a spill of blood or potentially infectious materials must be decontaminated immediately, as well. This would include mops, sponges, reusable gloves, buckets, pails, etc.

Bloodborne Pathogens Georgia Department of Technical and Adult Education 15

C.O.E.

Notes:

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16 Bloodborne Pathogens

C.O.E.

Common Questions

Discuss with the class:

HBV

What symptoms do I have if I am suffering from hepatitis B infection?

Many people with HBV do not have any symptoms and feel perfectly well. Occasionally, the hepatitis B infection may become active and make the patient feel ill with nausea, have a loss of appetite, and become jaundiced.

What kind of outlook can I expect if I have a hepatitis B infection?

Many patients with the hepatitis B infection can expect to lead a full and C.O.E. CONTINUINGnormal life. It is most important to regard yourself EDUCATION as a normal individual who happens to be infected with hepatitis B. However, it is important to take precautions not to spread the disease and to get medical checkups regularly.

Can I get hepatitis from the vaccine?

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C.O.E. No. The hepatitis vaccine is a safe and highly purified vaccine. It does not contain any blood products or living or dead viruses.

What should be done if the second or third vaccine dose is delayed?

If the doses are delayed for less than one year, the remaining doses can be resumed to complete the vaccination without the need to restart the vaccination series. If the lapsed doses are more than one year apart, extra doses or restarting of the series may be required for high risk individuals.

C.O.E.

HIV

What will the AIDS test tell me?

A positive result indicates the presence of antibodies to HIV, which has been found in people with AIDS.

Does a negative test mean that I am not infected?

Unfortunately, no. Although the test is reliable, there is a “window”- some say it’s six to twelve weeks, some say longer-when you could be developing the antibody, but the test will still be negative. That’s why you need to be retested at six to twelve weeks and again in 6 months.

If you test negative, but still carry HIV, it is still possible to transmit the virus. Counseling will be provided when you receive your test results whether they are negative or positive.

What happens if I test HIV positive?

C.O.E. CONTINUINGCurrently, there is no known therapy to reverse EDUCATIONantibody status. If an employee tests HIV positive, we recommend ongoing medical monitoring and possible anti-retroviral (contains RNA for protein productions) drugs.

What is the prognosis?

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C.O.E.

Research indicates that HIV - positive individuals will eventually develop AIDS. Currently, there is no treatment for AIDS and it is generally believed to be eventually fatal. As discussed previously, there is a vaccine for hepatitis B which is available to all employees at risk.

What HIV symptoms should I watch for?

Almost half of the people who contract HIV experience a flu-like illness six to twelve weeks after exposure. Employees who experience an exposure incident should report any illness that feels like the flu or mononucleosis, especially if

it is accompanied by fever, rash, or swollen glands.

Will my employer know the results of my test?

No. The health care professional will give the results of your tests to you only. All records, including test results, relating to an exposure incident are Strictly Confidential.

C.O.E.

Precautions

The following precautions should be taken by anyone who has had an exposure incident so that others are not exposed.

• Inform sexual or needle-sharing partners so they can be tested for the virus.

• Inform physicians and other health care givers so they can protect themselves.

• Don't give any blood, tissue, organs, or semen.

• Remove the organ donor designation from your driver’s license.

• Hold off on getting pregnant until your health care C.O.E. CONTINUINGprovider says it is okay. EDUCATION

• If you are pregnant, get counseling.

• Don’t breast-feed.

• Be careful not to expose others to your blood or bodily fluids.

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C.O.E. • Don’t share personal items such as toothbrushes, razors, etc.

• Use a bleach solution of 1:10, 70% isopropyl alcohol or other

EPA-approved germicide to clean up any spills of blood.

• Refrain from sexual activity, or at least take the following precautions:

- Limit the number of partners

- Use latex condoms from start to finish, even if your partner is HIV-positive.

C.O.E.

Job situations which may result in exposure include:

• Job duties that bring you into contact with needles or other sharp objects such as glass that might be contaminated with infected blood.

• Providing emergency first-aid assistance to co-workers.

C.O.E.Discuss witCONTINUINGh the class other circumstances in whicEDUCATIONh exposure is possible:

It is important that you use universal precautions to prevent becoming infected by contaminated blood. Universal precautions means that all blood and body fluids are considered a potentially infectious.

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C.O.E.

Precautions

When first aid measures are needed, make sure that you adhere to the following:

1. Mouth-to-Mouth Breathing – The safest course of action is to

use a breathing mask whenever you are called on to give mouth- to- mouth resuscitation.

2. Controlling Bleeding – To help the victim without infecting yourself

(or the victim), wear rubber gloves.

While chance of infection on the job are small, why take unnecessary risks with your life? Following the necessary safety precautions is the best way to minimize risks.

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C.O.E.

Notes:

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22 Bloodborne Pathogens

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Summary

Bloodborne pathogens are a very real risk in the workplace. However, protective measures are in place for employees at risk. To avoid infection of bloodborne pathogens, it is very important to follow all precautions.

Knowing how infection occurs is the first step in preventing the spread of disease. Certain factors and behaviors put employees at risk. Avoid these behaviors as much as you can.

Education combined with practicing safe behaviors can save your life.

C.O.E. CONTINUING EDUCATION

C.O.E.

Bloodborne Pathogens Georgia Department of Technical and Adult Education 23

C.O.E.

Georgia Department of Technical C.O.E. anCONTINUINGd Adult Education EDUCATION

Decontamination and Infection Control

C.O.E.

by Georgia Department of Technical and Adult Education.

Decontamination and Infection Georgia Department of Technical and Adult Education iii Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 175 of 202

C.O.E. be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

C.O.E. CONTINUING EDUCATION

C.O.E.

Table of Contents

Decontamination and Infection Control ...... 1

Introduction ...... 1

Objectives ...... 2

Professional Salon Environment ...... 3

Safety Precautions ...... 6

Material Safety Data Sheet (M.S.D.S.) ...... 7

Organizing an M.S.D.S. Notebook ...... 10

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C.O.E.

Decontamination and Infection Control

Introduction

Infection and disease control is one of the most important aspects of being a professional salon operator or owner. Federal and state laws govern what must be done by operators and owners to ensure the safety of the public and that no germs are allowed to spread uncontrolled.

This unit provides you with the necessary elements to help control dangerous disease-causing germs. By following some very important basic procedures and by providing a clean salon it will be easy to provide your clients with the very best professional care without the fear of your clients becoming infected by a disease agent. It is important to understand that the removal of all disease-causing germs in a salon will be almost impossible, but the control of dangerous levels is the key to providing a safe salon. C.O.E. CONTINUING EDUCATION

Objectives

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C.O.E. Upon completion of this course, you will be able to discuss the importance of:

• Decontamination

• Sanitation, disinfecting, and sterilization

• Use of disinfectant products

• Using disinfectants in the salon

• Salon professionalism.

C.O.E.

Decontamination and Infection Control

Professional Salon Environment

Let’s take a close look and see what can be done to identify and control the professional salon environment. Things like tables, chairs, walls, and floors are very likely contaminated with a number of germs that may be very serious disease-causing germs. There may be millions of germs present that do not affect humans when contact is made. However, one case of an infected client can send your career and the reputation of your salon downward. By understanding contamination and knowing the proper techniques of decontamination, shop operators and owners can avoid ugly lawsuits and having the business they worked hard to build destroyed.

It is important to understand the more people that enter the salon environment, the greater the chance that new germs will be introduced and reintroduced as a result of the human contact factor. Control over where and what people do before they get to the salon is impossible to monitor, so contamination concerns must be continuous and ongoing.

C.O.E. CONTINUING EDUCATION Your responsibility as a professional to eliminate and control contamination is vital.

Decontamination of surfaces and tools used in the salon will allow for a safe and professional experience for the client. Contamination can occur in many

Decontamination and Infection Georgia Department of Technical and Adult Education 3 Control CONTINUING EDUCATION

forms and on the surface of equipment, implements, and furnishings may not show signs of contamination. Soiled towels, combs, brushes, and even clippers can and more than likely are sources for contamination if not disinfected or sterilized properly.

Sanitation and disinfection are required in the salon to provide a safe environment for clients, co-workers, employees and oneself. Sanitation is the removal of large amounts of living organisms from a surface. By sanitizing tools and other items used in the salon, bacteria and germs are eliminated or lowered to safer levels. Popular forms of sanitation are described below.

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C.O.E.

• The Heat steam of an autoclave has been used for many

years and has proven to be one of the most dependable forms of sanitizing.

• Hospital-grade disinfectants are used to sanitize surfaces and tools as well.

• Quaternary Ammonium Compounds (quats) are available in liquid or tablet form. Implements should be immersed for 20 minutes or longer to ensure elimination of germs and bacteria.

• Glutaraldehyde is a germicidal used to disinfect and sterilize implements that cannot be heat sterilized.

• Ethyl Alcohol is used as a disinfectant. In order to remain effective, the strength of ethyl alcohol should be no less than 70%.

• Bleach (sodium hypochlorite), commonly known as house hold bleach, has for many years been utilized as a disinfectant at C.O.E. CONTINUINGkilling germs. As a result of more EDUCATIONadvanced techniques now being used, bleach is not the preferred method for decontamination. It is, however, very effective on floors, sinks, and general cleaning around the salon.

• Ultrasonic Cleaners are used in some salons but must be used with a disinfectant. The advantage of this device is that it may

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C.O.E.

reach tiny crevices that may otherwise be omitted in the cleaning and sanitizing process.

• Disinfection is also a part of operating a safe salon.

Disinfection is used when objects can be damaged due to exposure to extreme heat. Disinfection kills microorganisms with the exception of spores. It is important to understand that disinfectants should never be used on clients.

C.O.E.

Decontamination and Infection Control

Note: It is important that directions are followed when using disinfectants. When directions are not followed money can be wasted. Furthermore, by not following directions properly, the product that is to be disinfected may not be if a solution is too weak. It is also important to understand that the disinfectant solution always remain at an effective level. In saying this, always remember to wash all products to be disinfected with soap and water. If you attempt to disinfect soiled implements, the solution may become too weak to do an effective job.

Notes:

C.O.E. CONTINUING EDUCATION

C.O.E.

Decontamination and Infection Control 5

C.O.E.

Safety Precautions

Remember that disinfectants are industrial strength cleaners that are powerful and can be harmful if used improperly. Never use a disinfectant to clean your hands. This is an unsafe practice and can cause skin disease. You should wear protective equipment such as gloves and safety goggles while mixing

chemicals for disinfection control. Use soaking baskets and tongs to insert and remove equipment in disinfectant solutions. Always remember to clearly mark containers that are used for storing disinfectants.

Look at the following definition.

Sanitation is the process of reducing the levels of pathogens found on a surface. While the surface may be clean, there are still many microorganisms residing on the surface. C.O.E. CONTINUING EDUCATION

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C.O.E.

Material Safety Data Sheet (M.S.D.S.)

Every chemical used in the United States must have an M.S.D.S. report developed by the manufacturer that developed the chemical. The purpose of the M.S.D.S. is to report the product name, active ingredients, directions for use, and safety instructions in case of accidents involving the chemical. The following is a break down of the sections on an M.S.D.S. report.

Product information of the chemical is listed at the very start of the report. The Manufacturer’s/Distributor emergency contact number(s) along with product identity, product code number, product use, and hazard classification.

Section I is a listing of the hazardous ingredients found in the product along with specific ingredient codes.

Section 2 is the characteristics both physical and chemical of the product in general. These characteristics include but are not limited to physical state (liquid or solid), odor appearances like smell and color of product.

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C.O.E. Section 3 is fire and explosion hazard information on the product. Usually the fire/flame point will be listed and the level of danger to which this product will burn. Also, the extinguishing procedures are listed here in case there is a need to control a chemical fire as a result of this product.

Section 4 is the reactivity data section. This section lists chemical(s), which this product must not come in contact with to ensure the product remains stable.

Section 5 lists the health hazards and if special precautions need to be followed. This section discusses or lists exposure concerns and first aid procedures to follow in case of an accident.

Section 6 lists control and protective measures that will need to be followed to ensure safe use of the product or chemical.

C.O.E. CONTINUING EDUCATION

C.O.E.

Section 7 are control measures and precautions on the product. Safe handling is necessary to ensure that accidents are minimized. Waste disposal is also listed in this area.

Section 8 is the regulatory information for the product. A listing of active ingredients that must be reported and a record maintained on file (M.S.D.S).

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C.O.E. Material Safety Data Sheet (M.S.D.S.)

Below is an example of an M.S.D.S.

The Clorox Company

7200 Johnson Drive Material Safety Pleasanton, California 94588 Tel. (510) 847-8100 CLOROX Data Sheet

Product: CLOROX GERMICIDAL BLEACH

Description: CLEAR, LIGHT YELLOW LIQUID WITH CHLORINE ODOR Other Designations Manufacturer Emergency Telephone No.

EPA Registration No. 5813-1 The Clorox Company Rocky Mountain Poison Center

Sodium hypochlorite solution 1221 Broadway (800) 446-1014

LiquidII Health chlorine bleachHazard Data Oakland, CA III94612 Hazardous IngredientsFor Transportation Emergencies Chemtrec Causes substantial but temporary eye injury. May Irritate skin. May Clorox Liquid Bleach (800) 424-9300 cause nausea and vomiting if ingested. Exposure to vapor or mist may Irritate nose, throat and lungs. The following medical conditions may be Ingredients Concentration Worker Exposure Limit aggravated by exposure to high concentrations of vapor or mist; heart conditions or chronic respiratory problems such as asthma, chronic bronchitle or, obstructive lung disease. Under normal consumer use conditions the likelihood of any adverse health effects are low. Sodium hypochlorite 5.25% not established

CAS # 7881-52-9

FIRST AID: EYE CONTACT: Immediately flush eyes with plenty of water. If irritation persists, see a doctor. SKIN CONTACT: Remove contaminated clothing. Wash area with water. INGESTION: Drink a glassful of water and call a physician. INHALATION: If breathing None of the ingredients in this product are on the IARC, NTP or OSHA problemsIV Special develop removeProtection to fresh air. and Precautions carcinogenV Transportation list. Occasional clinical and reports Regulatory suggest a low Datapotential for sensitization upon exaggerated exposure to sodium hypochlorite if skin Hygienic Practices: Wear safety glasses. With repeated or prolonged U.S.damage DOT (e.g. Hazard irritation) Class: occurs during Notexposure. restricted Routine clinical tests use wear gloves. conducted on intact skin with Clorox Liquid Bleach found no sensitization C.O.E. CONTINUINGin the test subjects. EDUCATION

U.S. DOT Proper Shipping Name: Hypochlorite solution with not more Engineering Controls: Use general ventilation to minimize exposure to than 7% available chlorine. Not Restricted per 49CFR172.101(c)(12)(lv) vapor or mist.

Work Practices: Avoid eye and skin contact and inhalation of vapor or Section 313 (Title lll Superfund Amendment and Reauthorization Act): mist.VI Spill or Leak Procedures VIIAs a consumerReactivity product, Data this product is exempt from supplier notification requirements under Section 313 Title lll of the Superfund Amendment and Reauthorization Act of 1988 (reference 40 CFR Part 372).

Keep out of reach of children.

CONTINUING EDUCATION

Small Spills (<5 gallons)

(1) Absorb, containerize, and landfill in accordance with local regulations. Stable under normal use and storage conditions. Strong oxidizing agent. Reacts with other household chemicals such as toilet bowl cleaners, rust (2) Wash down residual to sanitary sewer.* removers, vinegar, acids or ammonia containing products to produce hazardous gases, such as chlorine and other chlorinated species Prolonged contact with metal may cause pitting or discoloration. Large Spills (>5 gallons)

(1) Absorb, containerize, and landfill in accordance with local regulations;

wash down residual to sanitary sewer.* -OR - (2) Pump material to waste drum(s) and dispose in accordance with local regulations; wash down residual to sanitary sewer.* Vlll Fire and Explosion Data IX Physical Data Boiling point 212 F, 100 C

Specific Gravity (H2O) 1085 Not flammable or explosive. In a fire, cool containers to prevent rupture and release of sodium chlorate. Solubility in Water complete * Contact the sanitary treatment facility in advance to assure ability to process washed-down material. pH 11.4

C.O.E.

Organizing an M.S.D.S. Notebook

Suggestions for setting up an M.S.D.S. notebook include:

• Using a three-ring binder that pages can easily be placed in or removed from.

• Highlighting specific areas to identify key aspects of the

M.S.D.S. report within the notebook. (see example)

• Alphabetizing the M.S.D.S. reports so that locating the sheets will be fast.

• Clearly mark the notebook on all sides to indicate it as the

M.S.D.S. notebook.

• Use a white or bright colored notebook so it can be easily identified as the M.S.D.S. Notebook.

C.O.E. CONTINUING EDUCATION • When ordering products for the first time, request the company send you a product sheet (M.S.D.S.) page to add to your notebook.

• Remove any M.S.D.S. reports when the product is no longer used in the salon.

10 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 192 of 202

C.O.E.

• Establish an emergency contact sheet that will be the very first page in your M.S.D.S. notebook. List the local emergency numbers for your salon area.

• Add the Centers for Disease Control and the National Poison

Control Center to the emergency contact page.

• Have a sheet that states your salon operators have read and understand the concept of the M.S.D.S. notebook and have them sign a form stating the information has been read. Keep a copy of this form in their employment file.

• Make sure the M.S.D.S. Notebook is located in a place where all employees have access to it and they are aware of its location.

10 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 1 of 202

C.O.E. POST THESE PAGES IN THE SALON/SCHOOL WHERE IT CAN BE READ BY ALL.

Georgia State Board of Cosmetology Sanitary Regulations for Salons and Schools

130-4-.01 Facilities.

(1) All facilities (salons/shops or schools) wherein cosmetology services are practiced or taught within the State of Georgia must provide suitable quarters equipped to give adequate services, subject to inspection by representatives of the Georgia State Board of Cosmetology.

(2) A beauty facility shall have a permanent and definite location in which the cosmetology professions of master cosmetologist, hair designer, nail technician, and/or esthetician, are practiced in accordance with the laws and rules of the Georgia State Board of Cosmetology. All mobile units, including kiosks, carts, mobile homes, trailers, and motor homes, shall not be licensed as salons/shops unless they meet all requirements

of the Board and are permanently anchored on the ground with wheels detached.

130-4-.02 Use of Facility for Home Salon/Shop.

Space used for a cosmetology facility must be separated by tight, ceiling high partitions from residence rooms and must have separate restrooms. The cosmetology facility shall have a separate outside entrance. Separate space must be provided for a cosmetology facility. The use of any such space for sleeping, dining or any other domestic purpose is prohibited.

130-4-.03 Facilities (salon/shop/school).

Space used for a cosmetology facility must be separated by tight, ceiling high partitions from other commercial

facilities. C.O.E. CONTINUING EDUCATION 130-4-.04 Cleanliness.

Walls, ceiling, floors, furniture and equipment must be kept free from excessive dust, dirt and debris. All equipment must be kept in good and safe working condition.

130-4-.05 Plumbing, Hot and Cold Water.

1 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 2 of 202

C.O.E.Each facility must have proper toilet and plumbing facilities and an adequate supply of hot and cold running

water in accordance with recognized health standards.

130-4-.08 Posting of Licenses, Rules, Reports and Inspection Reports.

(1)Each salon/shop shall post in an open area the current salon/shop license issued to them by the Georgia State Board of Cosmetology, or a current copy of the online verification of licensure.

(2) Each person employed in the salon/shop shall post, in an open area, the current license/permit issued to them by the Georgia State Board of Cosmetology or the Georgia State Board of Barbers, or a current copy of the online verification of licensure.

(3) Salons/Shops shall have posted in an open area at all times a copy of the most recent inspection report.

(4) Salons/Shops shall comply with rules for sanitation, health and disinfectants in Chapter 130-5 of the Rules of Georgia State Board of Cosmetology.

(5) Sanitary rules and regulations governing salons or shops in the State of Georgia shall be posted in an open area in the salon/shop so as to be easily read by customers.

130-5-.01 Shampoo Equipment.

Shampoo bowls must be thoroughly cleansed and sanitized.

2 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 3 of 202

C.O.E.130- 5-.02 Linens.

Towels/linens, after being used once, must be placed in a closed container until properly laundered. Clean towels must be kept in a closed cabinet, container, or closet except linens which are designated for use on current patrons.

130-5-.03 Sterilization.

The use of any article that is not properly cleansed and disinfected on any patron is prohibited. Hands must be properly cleansed and sanitized prior to servicing each client.

130-5-.04 Waste and Garbage.

All waste material must be removed daily. Garbage shall be stored in a covered, washable container and shall not be left in the establishment overnight. Each facility must be free from stale food and soiled dishes.

130-5-.05 Cleaning and Recommended Disinfection of Implements.

(1) All multi-use tools, implements, and equipment used for cosmetology services that come in contact with a client must be cleaned of all visible debris after each use and disinfected after each use by complete saturation or immersion for at least 10 minutes in an EPA-registered, hospital-grade disinfectant according to the manufacturer’s directions. Autoclave is an acceptable method of sterilization. Each salon or shop shall provide correct wet disinfection and dry storage standards at all times.

(a) Multi-use items constructed of nonporous materials such as metal, glass, or plastic for use on more than one client include, but are not limited to the following items: nail clippers, cuticle nippers, cuticle pushers, scissors, shears, reusable nail forms, manicure and pedicure bowls, foot files, glass, metal and fiberglass files, C.O.E.metal drill bits, tw eeCONTINUINGzers, comedone extractors, brushes, combs, clips, EDUCATION reusable pencil sharpeners, reusable gloves, and any other metal tools/non-porous implements not listed above.

(b) Single use items shall be discarded after being used one time. These items include: buffers, emery boards, nail files, sleeves and sanders for electric files, orangewood/birchwood sticks, wooden applicator sticks or spatulas, porous foot files, pedicure slippers and toe separators, disposable gloves, paraffin liners, cotton balls, cotton strips or swabs, neck strips and muslin strips or any items that cannot be disinfected.

3 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 4 of 202

C.O.E.(2) W et disinfection standards for tools, implements, or equipment:

(a) After cleaning, all tools, implements and equipment must be disinfected by complete saturation or immersion (enough solution to cover all surfaces of the item) for 10 minutes in an EPA-registered, hospital- grade disinfectant that is bactericidal, viruscidal, fungicidal, and pseudomonacidal. The disinfecting solution must be changed daily and/or prepared according to manufacturer’s directions.

(b) All tools, implements, or equipment that come in contact with blood or body fluids must be disinfected by complete immersion for a minimum of 10 minutes in an EPA registered disinfectant that is effective against HIV-1 and Human Hepatitis B Virus, or tuberculocidal that is prepared and used according to the manufacturer’s directions. Autoclave is an acceptable method of sterilization.

(3) Dry storage standards for tools, implements, or equipment: (a) All disinfected tools and implements shall be stored in a sanitary manner in a covered container. The container must be labeled to show that it contains disinfected tools and implements.

(b) Soiled and dirty tools and implements must be stored in a separate and properly labeled covered container. Soiled and dirty tools and implements shall not be used again until properly cleaned and disinfected according to the procedures stated in this rule.

(4) Hand washing is required before and between providing services to each client. An anti-bacterial soap is recommended to sanitize the hands and the exposed portions of arms before providing services and after smoking, drinking, eating, and using restrooms.

(5) Pedicure equipment cleaning and disinfection procedures to be used for all pedicure equipment that holds water including sinks, bowls, basins, pipe-less, and whirlpool spas are as follows:

4 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 5 of 202

C.O.E.(a) A fter each client, all pedicure units must be cleaned with a chelating soap or detergent with water to remove all visible debris, then disinfected with an EPA registered hospital-grade bactericidal, fungicidal, virucidal, and pseudomonacidal disinfectant used according to manufacturer’s instructions for at least ten (10) minutes. If

the pedicure unit has a foot plate, it should be removed and the area beneath it cleaned, rinsed, and wiped dry. (b) At the end of each day of use, the following procedures shall be used:

1. All filter screens in whirlpool pedicure spas or basins for all types of foot spas must be sanitized. All visible debris in the screen and the inlet must be removed and cleaned with a chelating soap or detergent and water. For all pedicure units, the jet components and/or foot plate must be removed and any debris removed and cleaned. The screen, jet, and/or foot plate must be completely immersed in an EPA-registered, hospital-grade

bactericidal, fungicidal, virucidal, and pseudomonacidal disinfectant that is used according to manufacturer’s instructions. The screen, jet, and/or foot plate should be replaced after disinfection is completed and the system flushed with warm water and low sudsing soap for 5 minutes, rinsed, and drained.

2. After the above procedures are completed, the basin should be filled with clean water and the correct amount of EPA-registered disinfectant. The solution must be circulated through foot spa system for 10 minutes and the unit then turned off. The solution should remain in the basin for at least 6 to 10 hours. Before using the equipment again, the basin system must be drained and flushed with clean water.

(c) Once each week, additional procedures should be performed. After completing the required cleaning procedures for the end of the day, the basin should be filled with water that contains one teaspoon of 5.25% bleach for each gallon of water. The solution should be circulated through the spa system for 5 to 10 minutes and then the solution should sit overnight in the basin, or for at least 6 to 10 hours. Before being used again, the system should be drained and flushed. (d) A record or log book containing the dates and times of all pedicure equipment cleaning and disinfection procedures must be documented and kept in the pedicure area by the salon or shop and made available for review upon request by a consumer and/or an inspector from the Board. (6) Signs shall be posted in clear view in the reception area of the salon/shop as follows: (a) Cosmetology laws, rules, and regulations are available upon request. (b) All cosmetology services shall only be performed on intact, healthy scalp, skin, and nails. C.O.E.(c) Customers should CONTINUING not shave their legs the same day as receiving pe dicEDUCATIONure services to reduce the risk of infection.

(7) Signs shall be posted in clear view in the pedicure services area of the salon/shop as follows: (a) All cosmetology services shall only be performed on intact, healthy scalp, skin, and nails.

5 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 6 of 202

C.O.E.(b) Custo mers should not shave their legs the same day as receiving pedicure services to reduce the risk of infection.

(d) Pumice stones shall not be reused from one customer to another to prevent the spread of bacteria.

130-5-.06 Storage of Preparations.

Creams, lotions and other cosmetics for use on patrons must be kept in sanitary, closed containers.

130-5-.07 Pets.

Pets shall not be allowed in cosmetology facilities, with the exception of animals for handicapped patrons.

130-5-.08 Protective Clothing and Footwear for Patrons.

Patrons in all Georgia Schools/salons/shops shall wear appropriate clothing and footwear to prevent exposure to potential infectious materials.

6 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 7 of 202

C.O.E.130- 5-.09 Protective Clothing.

Cosmetologists, hair designers, nail technicians, and estheticians in Georgia are required to abide by all state laws for cosmetology, hair design, nail care, and esthetics. The professions of cosmetology, hair design, nail technology and esthetics are subject to the guidelines and rules promulgated by Georgia State Board of Cosmetology. Cosmetologists, hair designers, nail technicians, estheticians are also subject to the

provisions of O.C.G.A. §43-1-19. Practitioners of the cosmetology profession in Georgia shall wear appropriate protective clothing for clinical services to prevent occupational exposure to potential infectious materials. Appropriate clothing and footwear may include, but not be limited to, clinical jackets, gloves and/or similar outer garments for the protection from infectious or harmful materials.

C.O.E. CONTINUING EDUCATION

7 Revised November 2008 CONTINUING EDUCATION

Appendix A

Georgia State Board of Cosmetology

Glossary of Legal Definitions

Master Cosmetologist

Any person who performs any one or more of the following services for compensation:

. Cuts or dresses the hair

. Gives facial or scalp massage or facial and scalp treatment with oils or creams and other preparations made for this purpose, either by hand or mechanical appliance

. Singes and shampoos the hair, dies the hair, or does permanent waving of the hair . Braids the hair by hair weaving, interlocking, twisting, plaiting, wrapping by

hand, chemical or mechanical devices, or using any natural or synthetic fiber for extensions to the hair

. Performs nail care, pedicure, or manicuring services as defined in Nail

Technician

. Performs the services of an esthetician as defined in Esthetician or Esthetics

Operator

Such person shall be considered as practicing the occupation of a cosmetologist within the meaning of this Code section; provided, however, that such term shall not mean a person who only braids the hair by hairweaving; interlocking; twisting; plaiting; wrapping by hand, chemical, or mechanical devices; or using any natural or synthetic fiber for extensions to the hair, and no such person shall be subject to the provisions of this chapter. Such term shall not apply to a person whose activities are limited to the application of cosmetics which are marketed to individuals and are readily commercially available to consumers.

8 Revised November 2008 CONTINUING EDUCATION

Hair Designer

Any person who performs any one or more of the following services for compensation:

. Cuts or dresses the hair

. Singes and shampoos the hair or dyes the hair.

Esthetician

A person who, for compensation, engages in any one or a combination of the following practices, esthetics, or cosmetic skin care:

. Massaging the face or neck of a person

. Trimming eyebrows

. Dyeing eyelashes or eyebrows

. Waxing, stimulating, cleansing, or beautifying the face, neck, arms, or legs of a person by any method with the aid of the hands or any mechanical or electrical apparatus or by the use of a cosmetic preparation.

Such practices of esthetics shall not include the diagnosis, treatment, or therapy of any dermatological condition. Such term shall not apply to a person whose activities are limited to the application of cosmetics which are marketed to individuals and are readily commercially available to consumers.

Nail Technician

A person who, for compensation, trims, files, shapes, decorates, applies sculptured or C.O.E.oth erCONTINUINGwise artificial nails, or in any way cares for the nails of thEDUCATIONe hands and feet of another person.

9 Revised November 2008 CONTINUING EDUCATION

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EVALUATION QUESTIONS 1. WERE YOU GIVEN ENOUGH TIME TO COMPLETE THIS CLASS? 2. DID THIS CLASS PROVIDE YOU WITH GREAT INFORMATION? 3. CAN THIS CLASS ASSISIT YOU IN YOUR TEACHING METHODS? 4. WILL YOU RECOMMEND THIS CLASS TO A CO-WORKER?

1 Revised November 2008 0