NVQ Level 2 Beauty Therapy Student Copy Facials 20 Consultation

NVQ level 2 beauty therapy student copy Facials 20 Consultation

Facial Consultation

One of the most i mportant parts of the treatment is the con- sultation. At this point, you will discuss the client’s needs and decide what needs to be done to meet those needs. In order Contents for the client to be satisfied with the treatment you need to know what was expected. As a therapist, you must therefore be good at encouraging clients to give you this information. In order to do this you must therefore have the following: • Good communication skills – both verbal (talking) and non- verbal (body language). Examples of good body language are good posture, eye contact, smiling, encour- aging head nods. • Good questioning techniques - this is vital to gain the information that you require to carry out the treat- ment. • Open questions – this type of question begins with How? Where? When? Why? and encourages the client 1 Benefits of a facial to give much more information. Use open questioning The first part of techniques wherev er possible during the consultation the consultation and treatment. is greeting the Facial • Closed questions - questions beginning with Do? Is? are client and making types of closed questions. If you use these types of t h e m f e e l questions, you will only get a yes or no answer, which will comfortable. It lead to a one, sided conversation. is important that Why Have A Facial Treatment? • Good observation skills – you need to be able to read your you welcome the client’s body language as it will help you to understand how client, preferably your client it feeling. greet them by A beauty therapist needs to have a • It is also important that you speak clearly and accurately thorough knowledge of facial their name, and when carrying out the treatment. introduce yourself treatments, skincare advice and • Sometimes a client may not understand what you are saying by name before products in order for the client to and in this situation, it is important that you adapt your beginning the consultation to meet the needs of the client. For example, you feel confident in the therapists consultation. may show pictures of the stages of the facial. If the client skills. does not understand always try a different approach, and if in

doubt ask for help. A therapist therefore needs to understand the benefits of a general facial treatment – these are outlined below. In addition, each skincare company will design their facial to have additional benefits, and these are called unique selling features. 26 Preparation of the work area For this reason you will often find that facial procedures vary greatly.

A facial is a treatment to the face and neck and it is carried out for the following reasons: 27 Preparation of the client & • to improve the appearance of the skin • to balance out problems of the skin • to deep cleanse the skin the therapist • to help improve muscle tone • to speed up cell renewal therefore helping to slow down the ageing process • to keep the skin soft by removing dead skin cells • for relaxation and pampering • to encourage the client to look after their skin at home 29 Facial routine

It is common practice for a facial treatment to take approximately 1 hour to 1 hour 15 minutes. 30 Male facial

2 Legislation Adapting the Facial Procedure for a Male Client

When working in a salon or a spa you will often find that your client base is not just female it is becoming more and more popular for med to have 4 Industry Codes of Practice & beauty treatments, with facials being a fashionable choice.

Hygiene Salons are being created that target a male client base and are doing this by: • Creating a more unisex environment, moving away from

pastel pinks etc. • Including a list of treatments for men on their treatment menu. 10 Professional Ethics • Purchasing a men’s skincare range. • Promoting a retail range of men’s skin care products.

How to Adapt the Facial Routine When carrying out a facial treatment on a male client you may need to adapt your procedure, taking into account the points outlined below: • Encourage your client always to have a shave on the morning of their 13 Contra-indications visit, in order to make the treatment more comfortable. • If the client has a beard or moustache then avoid that area, otherwise you will have difficulty removing the products later. • When cleansing and massaging try to work with the natural grain of the hair growth, rather than going against it as it can be uncomfortable. • You do not need to apply a headband if the client has short hair. • You should still carry out an eye cleanse, although miss out the mascara removal stage. • Normally you will need to apply all movements using a firmer pressure. • Try to use your sponges as much as possible when removing products as cotton wool can stick to the beard. • Spend extra time exfoliating the beard area. • Most men prefer products that feel light on their skin, so where possible select gel or lotion based products throughout the treatment. 31 Skin analysis 59 Steam procedure

34 Skin types & conditions 62 Extractions Skin Types and Conditions

There are various skin types and conditions that you must be able to analyse in order to give the client the best possible treatment and advice.

Skin types can be influenced by: 64 Facial massage

Facial Massage hormones

poor age nutrition Facial massage is an important part of the facial treatment; it

is usually this that the client illness stress most looks forward to. A good massage is continuous, has good rhythm and is applied with the correct pressure and depth for the individual client.

skin

medication incorrect products

Effects/Benefits of Massage

When massage is performed correctly it has the following effects: • Relaxes the client psychologically (in their mind). smoking • and Aids desquamation. genetics alcohol • Increased blood circulation in the area improves the colour of the skin- intake resulting in erythema. living & • Increased blood flow to the area brings fresh oxygen and nutrients and working removes waste products. The blood nourishes the skin cells and conditions encourages them to reproduce. • Increased blood circulation to the muscles improves muscle tone and strength. The main skin types are: These could be present on either a: • Due to the blood circulation being increased the tissues become warm ƒ oily ƒ mature akin which encourages the tissues to relax. • Stimulation of the lymphatic circulation helps to remove waste products ƒ dry ƒ young skin and toxins from the area. This helps to reduce puffiness. ƒ combination • Stimulation increases the temperature of the skin which relaxes the ƒ normal pores and follicles aiding deeper absorption of the massage medium. • Stimulation of the sebaceous and sweat glands increases the production In order to be able to recognise the skin types you must be able to of sebum and sweat which has a deep cleansing effect on the skin and understand how to recognise the characteristics that you will see. helps to maintain the skin’s natural oil and moisture balance. • Sensory nerve endings are soothed or stimulated depending on the massage technique used.

43 Threats to the skin 71 Setting masks

44 Products & equipment 75 Non-setting masks

Non-setting Masks

45 Eye make-up & cleansers There are 3 different types of non-setting masks: • Cream • Natural • Warm oil 47 Cleansing procedure

51 Toners Cream masks Cream masks are professionally manufactured and come ready prepared. You apply in a thin layer with a mask brush and leave for approximately 10-15 minutes, after which you remove with sponges. Each mask will contain different biological ingredients and so the mask suitability will depend on the instructions for use. 52 Moisturisers Task Research the different types of cream non-setting masks available for use in your salon. Explain the skin types and conditions they are suitable to be used on.

55 Exfoliants

57 Warming the skin 78 Specialist products 99 Ethnic variations in the skin

structure Facial treatments

82 Aftercare advice Ethnic variations in skin structure

86 Contra-actions Recognised variations The client’s skin structure Colours produced by Wood’s light varies depending on their ethnic origin. Skin type Colour

Balanced Purple/blue Black skin Dry Weak violet Black skin will usually look shiny, and it is often Oily Coral pink presumed that the client’s 88 Structure of the skin Hydrated Strong violet skin is oily. Black skin’s generally produce more Thin horny layer Purple sebum and sweat than a Thick horny layer Strong white white Caucasian skin and also have less vellus hair Dead skin cells Silvery white than white or Asian skin. characteristics. Pigmentation Brown Quite often the epider mis sunburn and premature

is thicker and also ageing as it has limited Asian skin desquamates quicker defence to the sunlight. Asian skin quite often has resulting in the skin White skin will usually have irregular pigmentation, 90 Cross section of the skin appearing grey. Erythema fewer and less active often under the eye area Remember: would normally be seen as sebaceous glands than the and around the mouth. It redness, however on a other skin types. • No matter what the is common for the client to black skin it will look skin colour they have a have more vel lus hair. The Chinese skin similar number of purple. The hair follicles diagram sweat glands are usually Oriental skin contains me lan oc y tes . In dark are curved and ther efore larger and more numerous. more melanin than white skins the melanosomes ingrowing hairs are quite The client’s skin usually a r e l a r g e a n d common if the client has skins, although less than ages well as the protein Cross Section Of The Skin distributed singularly. waxing treatments on t he the ot her two types. T his fibres of the skin In white face. skin rarely shows signs of And Its Appendages degenerate slowly. skins they bl e mi s h es as t he

are smaller The most accurate way of sebaceous glands are less White skin and distrib- examining a black skin active. Scarring is more Have a relatively low uted in during skin analysis is by likely to occur resulting in amount of melanin clusters. using a Wood’s light. This unevenness, hyper- Task compared to the other skin lamp produces deep pigmentation and pitting. types. The skin is often Label the diagram of the cross section of the skin ultra-viol et rays t hat This skin has the least comparatively thin and produce a different amount of body hair. prone to fr eckles. This coloured glow on t he skin skin type is more prone to Hair shaft dependi ng on its

103 Skeleton Sebaceous Epidermis gland Papillary Blood layer of supply dermis 105 Muscles Nerve Hair ending follicle Arrector pili muscle Reticular layer of dermis 108 Blood

Dermal papilla Subcutaneous Sweat layer gland 109 Lymph

Muscles

Muscles are responsible for the movement of the body or within the body. Within the face, they produce facial expressions. They are also responsible for maintaining posture and producing heat to maintain the body temperature. The majority of the muscles in the body are attached to bones by tendons; however, the muscles of the face tend to inert into each other. Muscles are made up of tiny elastic fibres that have the ability to: 91 Appendages of the skin • shorten or contract • spring back to its original form after contraction - like elastic • stretch when relaxed • respond to stimuli provided by nerve impulses

The face, neck and shoulder muscles 94 Functions of the skin

97 Effects of ageing of the

skin

Task Label the diagram of the muscles of the head, face, neck, shoulders, and chest. 1

Facial

Why Have A Facial Treatment?

A beauty therapist needs to have a thorough knowledge of facial treatments, skincare advice and products in order for the client to feel confident in the therapists skills.

A therapist therefore needs to understand the benefits of a general facial treatment – these are outlined below. In addition, each skincare company will design their facial to have additional benefits, and these are called unique selling features. For this reason you will often find that facial procedures vary greatly.

A facial is a treatment to the face and neck and it is carried out for the following reasons:

• to improve the appearance of the skin • to balance out problems of the skin • to deep cleanse the skin • to help improve muscle tone • to speed up cell renewal therefore helping to slow down the ageing process • to keep the skin soft by removing dead skin cells • for relaxation and pampering • to encourage the client to look after their skin at home

It is common practice for a facial treatment to take approximately 1 hour to 1 hour 15 minutes.

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Legislation That You Need To Be Aware Of As A Therapist

Health and Safety at Work Act 1974 This piece of legislation gives responsibilities to both the employer and the employees.

Employers must provide: • Access to a health and safety policy. • Proper safety procedures e.g. fire exits and evacuation procedure. • Safe equipment that is serviced regularly. • Adequate training in safety procedures for all staff. • A workplace that is both safe and meets health requirements.

Employees (you the therapist) must: • Follow health and safety procedures that your employer provides you with. • Act to protect yourself and others, such as clients and work colleagues. • Treat all equipment properly and report any faults that you notice to your manager.

The Workplace (Health, Safety and Welfare) Regulations 1992 This act covers things such as toilet facilities, minimum working temperature, adequate lighting, adequate ventilation, appropriate floor covering, drinking water and staff area. In the staff area/rest room there should be adequate facilities to protect non-smokers from smokers and arrangements for pregnant women or nursing mothers.

Electricity at Work Regulations Act 1992 This act states that: • You should always check electrical equipment before use. • A qualified electrician should check all pieces of electrical equipment in the workplace annually. • Any equipment that is broken or damaged should not be used. This includes things such as exposed wires, cracked sockets etc. • Sockets should never be overloaded.

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The precautions that should be followed when using electrical equipment are as follows: • Equipment must comply with British Safety Standard. • The equipment must be wired correctly and checked by a qualified electrician every 12 months - a sticker would indicate this. • Place electrical equipment on a solid, stable trolley. • Place the equipment within easy reach to prevent over stretching of wires. • No liquids should be near the electrical equipment. • Leads should not be dangling. • Equipment must be cleaned regularly. • Always check the equipment is working properly before use – remember it is your responsibility to check the equipment every time.

Control of Substances Hazardous to Health Regulations (COSHH) 2002 These regulations explain how hazardous substances should be used, stored and disposed of. All employees should be made aware of the risks of such substances and where necessary be given further training.

In order to comply with COSHH the employer should follow the procedures outlined below: • Identify substances used in the workplace that may be hazardous. • Assess the risks of each substance. • Try to replace a hazardous substance with a less hazardous alternative. • Decide what precautions are needed, i.e. wearing gloves when handling a substance. • Preventing or controlling exposure to certain substances. • Ensuring that control measures are used and maintained. • Monitoring exposure. • Ensuring employees are properly informed, trained and supervised.

Detailed instructions must be kept regarding any products considered hazardous.

As a therapist, you should know how to: 1. Store in the correct place. 2. Follow any precautions needed when using the substance. 3. Use the substance correctly. 4. Dispose of the substance correctly.

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Industry Codes Of Practice Sterilisation And Hygiene

Hygiene Hygiene is very important to a therapist because correct hygiene: • prevents infection (for both the therapist and client) • prevents offensive odours • gives a professional image to the client

As therapists, no matter what we are doing, we must be aware that we have high standards to prevent cross infection and secondary infection occurring.

Cross infection occurs due to certain micro-organisms (germs such as fungus, virus or bacteria) being contagious and these may then be transferred through: a) Direct contact – for example through personal contact, touch, inhaling air-borne droplets such as coughing. b) Indirect contact – for examples from tools which are not sterile, from a person to an object e.g. a person with an infection uses a towel and does not wash it, you then use the dirty towel and catch the infection.

Secondary infection occurs because germs enter a cut or broken skin. For example, if the client has a small graze and you use unhygienic practices, the graze could become infected.

Personal appearance of the therapist As a therapist, you are required to present a professional image at all times. In order to do this you should: • Have clean teeth and avoid eating strong smelling foods and smoking. • Bathe daily and wear deodorant. • Wear a subtle, professionally applied make-up. • Ensure you have a clean, pressed overall daily. • Secure your hair away from the face if it is long. If hair is shorter it should be presented in a way that does not interfere with the treatment. Remember if you touch your hair at any time during the treatment, you are required to wash your hands each time. • Have clean nails that are free from enamel and are short, so as not to interfere with the treatment.

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• Cover any cuts on the hands with a waterproof plaster • Wear only minimal jewellery. Only a plain wedding band or stud earrings are allowed. (No facial piercings). • Wear shoes that are clean, low heeled and fit securely around your feet. • Wear tights to protect legs/feet and to prevent offensive odours. • Not go into work/college if you have an infectious disease such as impetigo.

Sterilisation and sanitisation Sterilisation is the total destruction of all living micro-organisms and their spores. Sanitisation is the destruction of some, but not all micro-organisms. It inhibits their growth. Disinfect is to use a chemical that kills micro-organisms but not their spores. They keep the micro-organisms at an acceptable level.

The methods that we use in a facial treatment are: • Always wash hands before and after each client. You should thoroughly wash your hands (it takes up to 3 minutes to destroy all germs). • Cover mask brush, cotton buds etc. with a tissue. • Place sponges and mask brushes in chemical disinfectant for 20-30 minutes before use. • Metal tools (such as a comedone extractor) and plastic spatula should be cleaned with surgical spirit and then placed in either autoclave or chemical sterilising fluid such as Cidex for 20 minutes and then stored in the barbicide jar for the duration of the facial. • Headbands should either be disposable or boil washed after each client. • All towels must be boil washed after each client. • If wooden spatulas are used for the removal of products they should be disposed of after each client. • Only use spatulas to remove products from any containers, never fingers. • Replace lids straight away on all products. • Dispose of waste correctly.

Please note, for sterilisation to be effective the items must be grease free before being sterilised by washing in warm water and detergent or wiping with surgical spirit.

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Methods of sterilisation Autoclave -sterilises by high steam pressure that is higher than boiling point, at varying times - 15 minutes at 121°C to as little as 3 minutes at 134°C. This is considered to be the most effective method of sterilisation – it is used for metal tools and some plastics.

Chemical - sterilises by the action of chemicals - usually Cidex, Marvicide or Formaldehyde. It is suitable for metals and plastics, which need to be immersed for 20 minutes for effective sterilisation.

Glass bead – small glass beads are heated to a high temperature (between 190-300°C). Small metal tools can then be placed in-between the glass beads. The disadvantages are that the tools can become damaged if they are left in for too long. Take care to protect fingers when removing as items become very hot. (Rarely used for a make-up treatment).

Methods of sanitisation UV Cabinet - this has disinfectant properties only and therefore does not sterilise. This is a safe environment for the storage of sterilised tools.

Surgical spirit – has disinfectant properties and is suitable for wiping over tools prior to sterilisation. It is also effectively used for wiping down surfaces.

Sanitising spray – usually in the form of an antiseptic, will destroy or prevent the growth of micro-organisms and is safe to use directly onto the skin.

Barbicide – a chemical that will kill bacteria, however not the spores. It is used for storing metal tools and the plastic spatula during the treatment.

Disinfectant tablet – this tablet is placed in water and dissolves on contact. It is used for sponges and mask brushes as the liquid can penetrate the fibres of these tools.

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Blood spill If any bleeding occurs, this sometimes accidentally happens, it is vital that you understand the correct procedure to follow. • Antiseptic should be applied to cotton wool and pressed onto the skin. This should be disposed into a sharps box or yellow bin liner. • If there is a large blood spill, after applying gloves, neat bleach should be poured onto the object and left for 1 minute, then wash with lots of hot water and detergent.

Disposal of waste All waste (rubbish) must be placed straight into a bin, which has a lid and contains a bin liner. At the end of the day/session this should then be sealed and disposed of immediately into the main bin liner. Any waste that has met body fluids should be placed into a yellow bin liner if a large item, otherwise into a yellow ‘sharps’ container. This will then be collected and incinerated (burnt) at a suitable site.

Surfaces and floors Clean surfaces and floors daily with hot water and detergent and then disinfect with surgical spirit or a similar product. In a training environment the top of the trolley should be wiped over before use every time.

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Task Demonstrate your knowledge about hygiene and safety procedures by answering the following questions.

1. Explain the difference between cross-infection and secondary infection.

2. Explain the difference between sterilisation and sanitisation.

3. What is considered to be the most effective method of sterilisation?

4. Under which Act must employers provide access to a health and safety policy?

5. Which Act states how hazardous substances should be used, stored and disposed of.

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6. Why is good dental care for the teeth and gums important?

7. Who issues the Industry Codes of Practice?

8. How should you correctly dispose of waste?

9. How should you dispose of waste that has come into contact with body fluids?

10. How should you ensure that trolley surfaces are clean?

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Professional Ethics

As a therapist, it is important that you follow a code of professional ethics. This is to ensure that you provide a professional treatment and do not offend anybody. Clients will wish to receive their treatment in a relaxed and professional environment. Examples of professional ethics are: • Do not talk about sex, religion or politics. • Do not speak badly of another colleague or salon. • Do not discriminate. • Only use appropriate language. • Do not entice clients away from another therapist or salon. • Do not keep clients waiting for a treatment. If this is unavoidable then apologise to the client and keep them informed. • Clients’ details are confidential and should not be discussed with other clients etc. • Always give an honest opinion to the client when advising on treatments and products. • Give the client the opportunity to make the decision to talk through the treatment. Some clients like to have a chat, others don’t.

To talk or not to talk? It is common practice during a facial treatment to: 1. Talk about the client’s skin care routine, concerns and how to cleanse their skin during the cleansing procedure and skin analysis. 2. Explain what is being done at each stage and why. 3. Not to talk during the facial massage. 4. As the mask is being removed discuss skin care and aftercare advice. 5. Conclude the treatment by recommending appropriate products and providing samples where necessary.

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Cost Effectiveness

To work cost effectively in all treatments you need to consider three main areas: 1. Minimising waste 2. Being cost effective with your time 3. Charging an appropriate price for the treatment

Minimising waste For a business to run cost effectively and make a profit, it is important that all wastage is minimal. To work cost effectively in a facial treatment: • use the minimal amount of product to produce the desired outcome • split tissues, bedroll and cotton wool • use minimal amount of towels • place tops back on products to work hygienically and prevent spillage • always turn off taps and don’t run the water excessively • store products in the correct environment - usually dark, cool, dry and upright • turn out lights when not in use • switch electrical equipment off when not in use

Remember one of the most important things to be cost effective with is with your treatment time.

Timing of treatments A calculation is made for how long each treatment should take to ensure that the price charged for each treatment is correct and profitable. It is important that you complete the service within the agreed time as: • it prevents time wastage within the salon • clients can calculate the time required for the treatment • clients are not left waiting • an effective appointment system is guaranteed

Pricing structure It is important that you have a price list for all treatments on offer. This is to ensure cost effectiveness, consistency with each treatment and to prevent confusion when calculating clients’ bills. You also need to be aware of the Trades Descriptions Acts 1987, which states what is

©Clare Hargreaves-Norris Facial – students 2004 12 required of the retailer under the act. When working out the price to be charged for the treatment you need to take into account: • treatment time • materials used, obviously the more expensive the product range the more the facial will cost • electricity etc. used • cost and maintenance of equipment • price charged by competing salons • percentage profit required

In some salons, the experience of the therapist is taken into account when deciding what price to charge.

Task Please research in your college salon what is included in the different types of facials and the price charged for each.

Facial What is involved Timing Price

Course of treatments If a client purchases a course of treatments, it is beneficial for both the therapist and the client. They usually come in courses of 5-10 treatments and offer the client the opportunity to receive their treatments at a reduced rate. It is beneficial to the therapist as it guarantees repeat custom and the salon owner will also benefit from an increase in salon turnover.

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Contra-indications

What is a contra-indication?

It is something that prevents or restricts the way in which the treatment is carried out.

It is important that you can recognise a contra-indication so to prevent any further harm to the client or yourself, and to prevent cross-infection and secondary infection.

The contra-indications to a facial treatment that require medical referral are: • Bacterial infection- i.e. impetigo • Viral infection - i.e. herpes simplex, herpes zoster and warts • Fungal - i.e. tinea (ringworm) • Systemic medical conditions - i.e. conjunctivitis • Severe skin conditions and eye infections – i.e. acne vulgaris and boils • Parasitic infestation – i.e. pediculosis and scabies

If the client has any of the above conditions, you must recommend that the client seek medical advice and treatment before proceeding with the facial. It is important that you do not just send the client home, as they need to receive treatment from their doctor in order to prevent the condition from worsening and to alleviate the condition.

It is important that you do not diagnose any of these conditions as it is unprofessional and may worry or upset the client unnecessarily. If you suspect that the client has a contra-indication, you should: 1. Inform the client that there is a possibility of a contra-indication and explain that you cannot carry out the treatment as it may cause harm to the client. 2. If the client wishes for the treatment to be carried out they must bring to you a doctors note. 3. Reassure the client and offer an alternative treatment that is not contra-indicated if possible. 4. Make a note on the record card.

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Contra-indications that restrict the facial treatment: • Recent scar tissue • Eczema of a mild form • Hyperkeratosis • Skin allergies • Cuts or abrasions • Bruising • Styes • Watery eyes

These will restrict your application and should be avoided when proceeding with the treatment. In some cases, the client will have to return for the facial treatment once the contra-indication is no longer present.

How To Recognise Contra-indications Requiring Medical Referral

Bacterial infection Two common bacterial infections that you may come across are impetigo and a boil. If an infection has pus then bacteria is present. Boil A red, raised, painful lump will appear around a hair follicle and then pus will develop. It will extend deeply into the skin and so therefore may cause scarring once the boil has healed. Impetigo A highly contagious inflammatory infection which:

1. initially appears as red, itchy patches/spots

2. the skin then breaks and small blisters appear

3. honey coloured crusts then develop which will leak serum and spread daily

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Viral infection Three common viral infections are: Herpes Simplex (Cold sore) A highly contagious infection that often occur at times of illness, stress or under excessive exposure to wind or sun. A red itchy patch will occur followed by swelling and the formation of blisters around the nose and mouth area. If scratched this causes the release of serum, which forms a crust. Herpes Zoster (Shingles)

This same virus causes chicken pox in children and is thought to lay dormant

in the body. It begins with itching, erythema and inflammation followed by

blisters that develop along the sensory nerve pathway. It is very painful and

often affects the abdomen, chest and one side of the body. Verruca Vulgaris (Warts) A papule/round lump with a rough surface that can vary in size. They can develop individually or in clusters and can spread to other areas. The wart will often be a yellow/greyish colour.

Fungal Infection A fungal infection of the body is called tinea corporis, which is more commonly known as ringworm. A highly infectious condition that easily spreads and is recognised by: 1. firstly, small red pimples appear 2. a flat scaly ring-like lesion forms 3. this heals from the centre outwards

Conjunctivitis This is caused by inflammation of the mucous membrane that covers the eye and lid. This causes the eye to become red, sore and bloodshot. A pussy discharge is often produced which causes the eyelids to stick together. It often feels gritty to the person and is contagious. Quite often it is due to a bacterial infection occurring.

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Severe skin conditions and eye infections

Acne vulgaris This condition is linked to the hormones of the body and is most common in teenage years. It is recognised by: ƒ inflamed skin ƒ papules and pustules ƒ comedones ƒ open pores ƒ seborrhoea (greasy shine) Acne vulgaris is due to the influence of the androgen hormone at puberty and can only be treated once medical approval has been obtained. Acne rosacea This condition is most common in later life and is recognised by: ƒ inflamed skin that often appears in a butterfly shaped panel over the forehead, nose and cheeks ƒ red flush to the skin due to dilated capillaries ƒ sebaceous glands are over stimulated resulting in papules, pustules, open pores and a greasy shine Boil A red, raised, painful lump will appear around a hair follicle and then pus will develop. It will extend deeply into the skin and so therefore may cause scarring once the boil has healed. Blepharitis An infection of the eyelid resulting in: ƒ inflamed lid ƒ eye will look red and sore ƒ the skin around the eye is often dry

Parasitic infestation Pediculosis M ore commonly known as lice. This could be in the form of body lice or more commonly head lice. Lice are small parasites that puncture the skin and then suck out the blood resulting in itching. The lice then lay eggs on the hairs, close to the skin. The un-hatched eggs are known as nits and are recognised as shiny, pearl coloured oval bodies that cling to the hair shaft.

Scabies Tiny itch mites burrow under the epidermis to lay their eggs underneath the skin surface. This results in redness, itching and swelling. Dirt often enters the site, which results in greyish lines forming in the skin.

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Contra-indications That Restrict The Facial Treatment Application

Recent scar tissue Scar tissue is classed as recent if it is less than 6 months old. It would appear as an area of shiny red skin that could be raised or indented. It should be avoided as secondary infection could occur or the scar could re- open.

Eczema of a mild form The client may suffer from a mild form of eczema and if this were the case, it would appear as a small red patch of itchy skin, which can simply be avoided during the treatment.

Hyperkeratosis A chronic thickening of the horny layer of the epidermis. The normal skin markings appear more prominent. It commonly results from chronic scratching or rubbing, and may be associated with conditions such as eczema.

Skin allergies The symptoms of an allergy would be redness, swelling or itching and in severe cases, blisters may develop. A person can develop an allergy at any time.

Cuts or abrasions If a client suffers from cuts or abrasions, the skin would be damaged and dry blood would be present. If the area is unavoidable, it should be covered with a sterile dressing, otherwise avoid when working as secondary infection or cross infection could occur. Gloves could also be worn.

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Bruising The skin would appear a shade of purple to yellow. It is caused by damage to the underlying blood vessels that burst, when pressure is applied, and the blood seeps under the skins surface. Avoid the bruise as pressure would cause discomfort and could worsen the bruise.

Styes This appears as a red, inflamed lump on the eyelid, which can cause discomfort. It is caused by a bacterial infection of the sebaceous gland or eyelash hair follicle, pus may also be present. It should be totally avoided and hygienic practices should be followed.

Watery Eyes Over activity or a blockage of the tear duct causes the eye to water frequently. This can be uncomfortable for the client and the facial may aggravate the condition so ensure that you avoid the area.

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Task Use your research skills to find pictures of the contra-indications to a facial treatment. This is an excellent opportunity to develop your IT skills. Provide a brief description of how you would recognise each condition (use key words only).

Impetigo Herpes simplex image Description image description

Tinea (ringworm) Conjunctivitis image Description image description

Acne vulgaris Scabies image Description image description

Hyperkeratosis Styes image Description image description

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Consultation Techniques

One of the most important parts of the treatment is the consultation. At this point, you will discuss the client’s needs and decide what can be done to meet those needs. In order for the client to be sati sfied with the treatment you need to know what was expected. As a therapist, you must therefore be good at encouraging clients to give you this information. In or- der to do this you must therefore have the following: • Good communication skills – both verbal (talking) and non-verbal (body language). Examples of good body language are good postur e, eye contact, smiling, encouraging head nods. • Good questioning techniques - this is vital to gain the information that you require to carry out the treatment. • Open questions – this type of question begins with How? Where? When? Why? and encourages the client to give much more information. Use open questioning techniques wherever possible during the consultation and treatment. • Closed questions - questions beginning with Do? Is? are types of closed questions. If you use these types of The first part of questions, you will only get a yes or no answer, which will the consultation is lead to a one, sided conversation. greeting the client • Good observation skills – you need to be able to read your and making them feel client’s body language as it will help you to understand how comfortable. It is your client is feeling. important that you • It is also important that you speak clearly and accurately welcome the client, when carrying out the treatment. preferably greet them • Someti mes a client may not understand what you are by their name, and saying and in this situation, it is important that you adapt introduce yourself by your consultation to meet the needs of the client. For name before beginning exampl e, you may show pictures of the stages of the the consultation. facial. If the client does not understand always try a different approach, and if in doubt ask for help.

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During the consultation, you would: • Introduce yourself and exchange pleasantries. • Complete the record card. • Discuss the client’s requirements. *See examples of questions below. • Suggest a treatment to meet the client’s needs. • Explain the treatment procedure. • Discuss cost, time, frequency and possible courses of treatments. • In some instances, you would have to explain aftercare/homecare advice and advise that products would need to be purchased in order to achieve the result desired. This is to ensure that the client understands the commitment etc. required if a certain result is to be achieved

* Questions to ask • Have you been to the salon before? • Have you had a facial before? • What is the main reason for your visit today? (Pampering, to improve skin condition) • Was everything satisfactory after your last treatment?

Record keeping A record card should be completed for all treatments and contains confidential personal information about each client that is specific to each treatment. They should be stored in alphabetical order by surname in a locked metal filing cabinet or box. This should be easily accessible to the therapist, when ready to perform a treatment. This information could also be updated onto a computer system but you must be aware of your responsibilities under the Data Protection Act.

A record card should contain the following information:

• Client’s name • Address • Telephone number • Doctors name and telephone number • Any medical details • List to check for contra-indications • Treatment aims and outcomes • Treatment plan on which to base future treatments

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• Services, specific products used and retail sales • Client’s signature

In addition, for a facial treatment you will also need to note down: ¾ Current skin care routine ¾ Results of skin analysis ¾ All products used

After each treatment, you should update the record card. This would be particularly useful in the following instances: • You need to contact a client urgently due to a cancellation, double booking etc. • You need to check up on a particular detail of the treatment. • If another therapist is to take over the treatment. • The client wishes to purchase a product that you had used in a previous treatment.

Data Protection Act 1984 If you place client details on the computer, you will be required to comply with the Data Protection Act. It is important that you follow the rules as peoples lives can be affected by incorrect data for example people can be refused jobs or credit because of this. There are eight principles of good practice that should be followed. When processing data on the computer it should be: 1. Fairly and lawfully processed 2. Processed for limited purposes 3. Adequate, relevant and not excessive 4. Accurate 5. Kept for no longer than is necessary 6. Processed in line with the data subjects rights 7. Secure 8. Only transferred to countries outside the EU with adequate protection

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Treatment plan A treatment plan is carried out to give you and the client a plan to follow in order to achieve the best results possible to meet the client’s needs. Your client’s needs will mainly be discussed during the consultation however, some additional information may be gained during the facial and this should be added to the record card at the end of the treatment.

When deciding on a treatment plan you should firstly consider what to carry out in the treatment that you are about to carry out and then consider what to do in subsequent treatments and how frequent they should be. In order to make this decision you need to consider: • The client’s wishes. • The outcome that the client is expecting. • The cost involved – discuss alternatives. • How much spare time the client has available • The lifestyle factors that may affect their skin condition. • Their occupation – some occupations demand that the client looks their best. • The client’s skin care routine.

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Task Please complete the following questions to demonstrate your knowledge of the consultation procedure.

1. Why is it important to use open-ended questions?

2. How should you greet a client?

3. Please give three examples of body language.

4. Give four examples of good professional ethics.

5. When should you complete the record card?

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6. What should you do during the consultation?

7. If you place client details on the computer what act are you required to comply with?

8. What factors should you take into consideration when deciding on a treatment plan?

9. If during the consultation, a client did not appear to understand what you were saying, what would you do?

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Preparation Of The Work Area

You should firstly sterilise all tools and then prepare your work area with the required equipment.

You should prepare your work area by considering the following points: 1. Adequate ventilation or heating – open windows/doors, turn heating on/off. 2. Subtle lighting – it is recommended that you use additional light such as a magnifying light when carrying out a skin analysis. Otherwise, the lighting should be dim so that it is not bright on the client’s eyes; the client needs to be able to relax. 3. Ambience – the room should smell pleasant, you may need to use aromatherapy oils or air fresheners. You should also consider the use of appropriate relaxing background music during the treatment (the radio would be inappropriate for a facial treatment). 4. Two chairs will be required. 5. An adequate supply of freshly laundered towels will be needed. 6. A blanket may be needed to keep the client warm during the treatment. Alternatively, some salons use a heated electrical blanket underneath the bed cover to keep the client warm. 7. A supply of bedroll, cotton wool and tissues are available. 8. All products are available. 9. Record card and pen should be placed on the bottom shelf of your trolley. You may need to check details of the client’s previous treatments.

Tip The products should be placed on the trolley in the order they are to be used. Place the trolley on your working side i.e. right side if

right handed, and make sure that you do not

have to stretch to reach the products.

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Preparation Of The Client And Therapist

The client should be prepared for the treatment by: 1. Asking them to remove jewellery from the area, contact lenses and glasses if worn. 2. Clothing to the upper body should be removed (underclothes should be kept on however; the shoulder area must be free from straps). 3. Explain to the client how to lie on the bed - flat and straight, preferably without the legs crossed. 4. A large towel should be provided for clients to cover themselves with. 5. The client should be left in privacy to prepare for the treatment.

On your return, you may wish to cover the client over with a blanket and then apply a headband to secure all hair away from the face. The couch may be positioned in a slightly inclined position or flat, in which case the therapists chair should be at the appropriate height so that no stretching is required and all of the face and shoulders are visible to the therapist.

Some clients cannot lie flat and need to be raised so therefore the therapist will need to stand throughout the treatment.

In addition, the client may prefer to have additional support behind their knees or neck, so always check client comfort throughout the treatment.

Therapists posture Remember that it is very important that a good posture be maintained throughout the treatment for your own comfort and safety.

When sitting - the therapist should sit in a chair with a back, at the correct height for the treatment. Both feet should be placed on the floor, at shoulder distance and directly under the knees. The back should be straight and shoulders pushed back when possible.

When standing – place both feet on the floor at shoulder distance apart without pushing back on the knee joints. Weight should be evenly distributed between both legs. The back should be straight and shoulders pushed back slightly when possible.

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Task

1. If you did not maintain good posture during your treatments what could happen?

2. How do you maintain the client’s modesty during a facial treatment?

3. Why do you think that it is important to maintain the client’s modesty during treatment?

4. In order to allow the client to relax during the facial, what should you consider when preparing the treatment room environment?

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Facial Routine

1. Greet the client by name, introduce yourself and take them to the treatment area. 2. Seat and carry out the consultation (do not forget to ask general questions first) & complete record card checking for contra- indications. 3. Ask client to remove jewellery, contact lenses, glasses and necessary clothing and explain how to lie on the couch. 4. When the client is on the couch, cover them over and secure their hair with a clean headband. 5. Wash your hands. 6. Commence with eye cleanse (refer to page 47). 7. Lip cleanse (refer to page 47). 8. Superficial cleanse to remove surface make-up (refer to page 48). 9. Carry out the skin analysis using magnifying light (refer to page 31). If you are using steam in your facial, switch the steamer on now. 10. Deep cleanse using appropriate product (refer to page 49). 11. Tone and blot with a tissue. 12. Exfoliant may be applied at this point (refer to page 55). 13. Facial steamer (refer to page 59). 14. If extraction is required, it should be carried out at this point. 15. Tone and blot. 16. Perform facial massage routine (refer to handout). 17. Remove excess product if required. 18. Apply mask and leave for 10-20 minutes (check manufacturers instructions) – (refer to page 31). 19. Remove mask with either damp sponges or a hot towel. 20. Tone and blot with a tissue. 21. Apply eye product and neck product if required. 22. Apply moisturiser, avoiding the eye area. 23. Slowly sit the client up and show them the result. 24. Check that the finished result and the treatment are to the client’s satisfaction. 25. Go through aftercare advice and recommend products for use at home. 26. Complete the record card. 27. Ask client to dress and then accompany them back to reception to re- book their next appointment. 28. Tidy work area and dispose of waste materials accordingly.

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Adapting The Facial Procedure For A Male Client

When working in a salon or a spa you will often find that your client base is not just female. It is becoming more and more popular for men to have beauty treatments, with facials being a fashionable choice.

Salons are being created that target a male client base and are doing this by: • Creating a unisex environment, moving away from pastel pinks etc.

• Including a list of treatments for men on their treatment menu. • Purchasing a men’s skincare range. • Promoting a retail range of men’s skin care products.

How to Adapt the Facial Routine When carrying out a facial treatment on a male client you may need to adapt your procedure, taking into account the points outlined below: • Encourage your client always to have a shave on the morning of their visit, in order to make the treatment more comfortable. • If the client has a beard or moustache, avoid that area, otherwise you will have difficulty removing the products later. • When cleansing and massaging try to work with the natural grain of the hair growth, rather than going against it, as it can be uncomfortable. • You do not need to apply a headband if the client has short hair. • You should still carry out an eye cleanse, although miss out the mascara removal stage. • Normally you will need to apply all movements using a firmer pressure. • Try to use your sponges as much as possible when removing products as cotton wool can stick to the beard. • Spend extra time exfoliating the beard area. • Most men prefer products that feel light on their skin, so where possible select gel or lotion based products throughout the treatment.

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Skin Analysis

Use the following assessment techniques to ensure a correct skin analysis: 1. Look 2. Touch 3. Question

Look - use the magnifying light to look for characteristics and conditions to guide you in making a decision as to the client’s skin type. You would also look for areas that are showing signs of ageing.

Touch - using your fingers touch the client’s skin to feel the texture of the skin, muscle tone, elasticity, skin tone, amount of subcutaneous tissue and sebaceous secretions.

Questioning - determine their skin care routine, the type of products they are using and for what skin type and finally if they have any problems with their skin. It is important that you get the client’s point of view!

Questions to ask ƒ Have you had a facial before? ƒ How long has it been since your last facial? ƒ How was your skin after your last facial? ƒ Have you noticed any problems with your skin? ƒ Have you noticed any areas of dryness/oiliness? ƒ What is the main reason for you having a facial today?

It is vital that you assess the skin correctly; otherwise, incorrect products and pressure could be applied resulting in an ineffective treatment. It is also important that you find out the clients

©Clare Hargreaves-Norris Facial – students 2004 32 requirements from the treatment i.e. just because the client has blackheads do not automatically presume that they want them extracting.

Note - the products/frequency that the client is using them can affect the current skin condition. It is important that you gain information on the client’s skin care routine and the products used. Do not presume that if the client is cleansing, toning and moisturising that the skin care routine is perfect as they may be using the wrong products or applying them incorrectly.

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Skin Analysis Chart

Forehead

Nose

Eye Area

Cheeks & Sides of Face

Chin

Neck

Muscle Tone: Skin Te xture: Elasticity:

Skin Type:

List the conditions found in each area of the face and neck in the boxes provided

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Skin types and conditions

There are various skin types and conditions that you must be able to analyse in order to give the client the best possible treatment and advice.

Skin types can be influenced by:

hormones

poor age nutrition

illness stress

skin medication incorrect products

smoking and genetics alcohol intake

living & race & working colour conditions

The main skin types are: These could be present on either a: ƒ oily ƒ mature akin ƒ dry ƒ young skin ƒ combination ƒ normal

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In order to be able to recognise the skin types you must be able to understand how to recognise the characteristics that you will see. Skin characteristics/conditions

Sensitive Sensitivity can accompany any skin type and if present, the skin would be prone to irritation, erythema and broken capillaries. There are two types of sensitive skin: Touch sensitive - is sensitive to touch, heat and embarrassment and therefore needs to be treated gently. Otherwise, it can be treated using products for its main skin type. Allergic sensitive - is prone to allergic reactions and must be treated with products that are designed for treating a sensitive skin. They will contain very natural ingredients, which have often been dermatologically tested for sensitive skins. These products will normally be labelled hypoallergenic.

Dehydrated The skin tissues are lacking in water and all skin types can be affected. The characteristics of a dehydrated skin are: • Superficial criss-cross lines. • Broken capillaries. • Skin feels tight. • A clean, non-greasy tight shine is present in severe cases.

The factors that can contribute to a dehydrated skin are: • Diet; due to lack of water intake (recommend 6-8 glasses of water per day). • Environment - air conditioning and central heating in the care, home or workplace would cause dehydration. • Medication that the client is taking. • Illness - especially fevers which would cause loss of fluids from the body.

Seborrhoea This is the result of over active sebaceous glands producing too much sebum; therefore, a greasy shine appears on the surface of the skin. This condition accompanies oily and combination skins.

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Comedone This is the technical term for a blackhead. Comedones most commonly accompany an oily or combination skin. They are caused by an overproduction of sebum blocking the pore and when the sebum encounters oxygen, the oxidising effect starts to darken the sebum, turning it into a black dot. Make-up and dirt may also block the pore making the comedone look even darker. Comedones are extracted by gently squeezing between fingers protected by tissues or by using a comedone extractor.

Papules and pustules Papules are red spots caused by inflammation of the sebaceous gland. Pustules are yellow spots also caused by inflammation of the sebaceous glands; however, infection is also present, in the form of bacteria. They commonly occur on oily and combinations skins due to the overactive sebaceous glands. However, they can occur on other skin types as hormonal imbalances (often due to the menstrual cycle or stress) can cause them to appear.

Open pores The pores are more visible and appear enlarged. Open pores are common on oily areas of the skin. Once the pores have enlarged, they can never return to normal size, so you will often see open pores on mature skins or on skins that have previously been oily or combination. Do not presume that just because the pores are open that the skin is oily, as this is a common mistake.

Milia These are often present on a dry skin and are caused by overproduction of dry skin cells causing a blockage of the sebaceous gland. They appear as a small white pearl under the skins surface, often around the eye or cheek areas. Exfoliating and applying moisturiser on a regular basis can loosen milia. Alternatively, a qualified therapist can use a sterile needle to pierce the skin and extract the milia.

Broken capillaries Commonly found on the cheeks or nose area these appear as small red/pink threads under the skins surface, most. Broken capillaries occur when the capillary walls constrict (narrow) and dilate (widen) too quickly causing the muscles in the walls to tear. This in turn allows the blood to seep out resulting in broken capillaries.

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Dehydrated, dry and sensitive skins often have thin skin that provides less protection and therefore, these skin types are the most commonly effected. Common causes of broken capillaries are: • Hot conditions. • Wind blowing on the face. • Burning i.e. sunburn. • Moving from one extreme temperature to another. • Pressure i.e. squeezing spots or glasses pressing on the face.

Broken capillaries can be prevented by avoiding all of the above. Once formed they can be treated by a specialist form of electrolysis. There are also specialist creams on the market that aim to strengthen the capillary walls thus reducing the redness.

Hyper pigmentation This is when the skin has areas of darker coloured skin – it has increased pigment production. In general the darker the skin the more pigment is present. The colour of the skin is influenced by the amount of melanin being produced. Hyper pigmentation is common during pregnancy due to hormonal influences and in old age when people develop liver spots (sometimes referred to as age spots). To prevent pigmentation patches occurring, advise the use of a sun block. Darker patches of skin can be disguised by the use of a concealer.

Hypo pigmentation This is when the skin has areas of paler coloured skin – it has decreased pigment production. A common medical condition that would display paler patches of skin is vitiligo. Hypo pigmentation can be disguised with the use of a concealer. Also, advise the client to use a sun block to protect against burning caused by the sun’s rays.

Dermatosis papulosa nigra This condition most often occurs on the faces of people of Hispanic or black origin and consists of 1-5mm brown-black papules that have a stuck- on appearance. It can occur from adolescence and is more common in females than males. It is also more common in darker pigmented black skin and may be hereditary. It can be treated by advanced electrolysis methods.

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Pseudo folliculitis This is inflammation of the hair follicles due to bacterial or fungal infections. The area around hair follicles looks inflamed and acne-like, and often extrudes puss. It can occur in all skin and hair types and is not always related to shaving. Pseudo folliculitis barbae Commonly known as shaving bumps, is a widespread problem among people with curly hair and dark skin. As the hair follicle grows out of the skin, it immediately curls and re-enters the skin. The skin reacts to it as a foreign body and becomes inflames and irritated, creating bumps. Sometimes these bumps become quite large and can be somewhat relieved by using topical steroids. A more common method of eliminating these bumps is pulling the ingrown hair out after each shaving, which is painful and time-consuming. This condition can be treated on tanned or dark people by the use of laser treatment.

Keloids A keloid is a scar that does not know when to stop growing. When the skin is injured, cells grow back to fill in the gap. In a keloid scar, the cells keep on reproducing, the result being overgrown scar tissue that looks shiny and is often dome-shaped. They can range in colour from slightly pink to red or dark brown. They feel hard and thick and are always raised above the surrounding skin.

People of African or Asian descent are more likely to develop Keloids than people with lighter skin. They are most commonly located on the chest, upper back, and shoulders although can be found anywhere where scar tissue has occurred. This condition can be treated by surgery, laser, cortisone injections or freezing.

Ingrowing hairs Ingrowing hairs are hairs that are trapped below the skin surface and there are three different types that can develop: • A coiled ingrowing hair - this appears as a black dot or dome in the skin. • An infected ingrowth - this would usually have a pustular raised head, contained within would be the ingrowing hair. • A flat hair growing underneath the skin - this would look like a small thread and can be released with tweezers or a sterile needle by piercing the skin gently to release the hair at the root end.

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Ingrowing hairs can occur due to dead skin cells building up over the hair follicle. This is common after shaving or waxing an area. The client should be advised to exfoliate and moisturise regularly to prevent ingrowing hairs.

Description of the main skin types

Oily This skin type is most common in teenage years although can be found on skins of all ages. This skin type has overactive sebaceous glands, which are controlled by the hormone levels. Common characteristics that you will see all over the face on this skin type are: • Open pores. • Papules (red spot). • Pustules (pustular spot). • Comedones. • Seborrhoea, producing a greasy shine. • A build up of dead skin cells making the skin appear coarse in texture.

Dry This skin type is often associated with mature skins although can be found on skins of all ages. The sebaceous glands of this skin type are under-active and do not produce sufficient sebum. Using products that are too harsh for the skin may also cause the skin to become dry. This skin will often have: • Dry flaky patches, which may become red and irritated. • Tight pores. • Eyebrow dandruff. • Milia – often found on the skin around the eyes and cheeks.

Combination This is a combination of two skin types with the skin typically having: ƒ An oily ‘T Zone’ that comprises of the forehead, nose and chin. You will see some or all of the following: comedones, papules, pustules, open pores and a greasy shine. ƒ The cheeks and neck will be either normal or dry. In these areas, you will see the recognised characteristics for that skin type.

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Normal This skin type is quite rare and can only truly be called normal if it is seen on a young skin. It can be recognised by: • Good skin tone and texture. • Even colour. • No signs of any of the characteristics mentioned previously.

Mature The word mature is associated with clients of a more mature age although in the beauty industry a client over the age of 25 is generally classed as mature. A mature skin often has characteristics of a dry skin although it can be present with any of the other skin types mentioned. A mature skin will show signs of some, or all of the following in varying degrees: • Expression lines appear, particularly around the eye area. • Loss of elasticity. • Facial contours may become slack. • Epidermis becomes thinner. • Broken capillaries often appear around the eye area. • Irregular patches of pigmentation form liver spots. • Blood circulation is not as efficient and therefore the skin often appears sallow. • Metabolic rate slows down therefore waste products are not removed as effectively and therefore the skin often looks puffy. • Fatty deposits are often laid down. • Pores look more enlarged as the skin is not as tight.

Young A skin is classed as young up to the age of 25. It will show none of the characteristics listed above. It will therefore have: ƒ No expression lines. ƒ Good elasticity. ƒ No irregular pigmentation. ƒ Good blood supply. ƒ No dropped contours.

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Task In the table below, explain the key points that you would use when describing the skin types/conditions.

Sensitive Dehydrated Normal

Oily Dry Keloids

Combination Pustules Pseudo folliculitis barbae

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Task Explain the advice you would give for the different skin conditions.

Touch sensitive skin

Dehydrated

Milia

Broken capillaries

Hyper pigmentation

Dermatosis papulosa nigra

Pseudo folliculitis barbae

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Facial treatments

Threats to the skin

Prevention is better than cure! There are a variety of facto rs which can affect the appearance and condition of the skin, most of which can lead to premature ageing. It is important that you make your clients aware of these factor s and reinforce that prevention is better than cure! UV RAYS - are in the sluggish circulation or ALCOHOL — has a atmos pher e every day, not certain skin disorders such dehydrating effect on the as psoriasis. A facial body and skin. It also Key factors: just when the sun is shining. Although sunshine treatment can not only prevents the absorption of has a positive effect on reduce the effects of certain vitamins. Advise • UV rays the mind and produces a stress but also be seen by the client not to drink tan, thus inducing a feeling the client as a way of al cohol , how ever i f thi s i s • Free radicals of well being, it relieving stress. unavoidable water should unfortunately causes skin SMOKING – slows down be drank to replenish the cell respiration as it body. If a client drinks a • Stress burni ng (ca use d by UVB ) and ageing (caused by restricts the amount of lot of alcohol you will often UVA). It is important that nutrients that the cells find that broken capillaries • Smoking you recommend all clients develop along with sluggish (even clients with a black skin, this leaves the client • Caffeine skin) to use a moisturiser looking much older. every day w hi ch has an SPF MEDICATION - has various effects on the skin • Alcohol factor and to increase their protection when the ranging from flui d sun comes out in the retention, dehydration, • Medication summer months. receive. It also makes the pigmentation problems and FREE RADICALS - are removal of waste products sebaceous gland conditions. molecules which are in the less effective. Smoking It is important that you environment 24 hours a produces a chemical that check if the client is day. They are highly destroys vitamin C, which taking any medication when reactive and breakdown interferes with the deciding on the the proteins of the skin production of collagen contributing factors to the causing premature ageing. t her efor e causi ng client’s skin type. It is vital that a premature ageing. moisturiser is used both CAFFEINE - can affect day an d ni g ht w hi ch wi l l the skin if consumed in protect against the free large quantities (more than radicals. On the product four cups per day) by look for the words blocking t he absor ption of anti-oxidant or free nutrients. Caffeine is radical scavengers. present in tea, coffee, STRESS — can cause cocoa and fizzy drinks. various problems within Instead recommend the skin ranging from caffeine free products and tension lines, dark circles, herbal teas.

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Products And Equipment Required For A Facial Treatment

Remember, you will need a choice of products depending on the client’s skin type.

Products and Equipment Checklist

Plastic spatula

Headband

Mask brush

Sponges

Damp cotton wool

Tissues

Cotton buds

Bowl

Barbicide jar

Eye make-up remover

Cleanser

Toner

Exfoliant

Massage medium

Mask

Tape measure – if steaming

Steamer

Record card and pen

Lined waste bin

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Eye Make-up Remover

This product is designed to remove make-up from the delicate eye tissues. It usually comes in a lotion or a gel or gel formulation and can be: ƒ Oil based - for removal of waterproof mascara and oil based eye shadow. ƒ Water based, non-oily - used for removing normal mascara, working on sensitive eyes, contact wearers or clients wearing individual false eyelashes.

For ease, the eye make-up should be removed first and to prevent the make-up from being smeared around the face during the cleansing routine. Advise the client to follow the guidelines below when removing the eye make-up as incorrect technique can cause premature wrinkles to occur: • Gently support the eye. • Remove mascara first by brushing down the eyelashes. • Always use gentle circular motions, never rub the eye. • Always use a separate piece of cotton wool for each eye.

Cleansers

Cleansing products are used to remove make-up and dirt from the skin and are applied at the beginning of the facial treatment. They are with the fingertips, using light upward strokes and removed using damp cotton wool, warm water, mitts or sponges.

Benefits of cleansing: • Removes sebum, make-up, dirt and pollution from the skins surface. • Improves the circulation to the area due to the application technique. • Aids with desquamation.

Cleansers are available in a variety of formulations: ƒ Creams ƒ Milks ƒ Lotions ƒ Gels ƒ Foaming facial washes ƒ Facial bars

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Cream These have a richer texture as they have a higher composition of oil than water. It is a water in oil emulsion. They are effective at removing heavy make-up, treating dry/mature skins and are used for deep cleansing.

Milk Are lighter in texture and contain more water than a cream cleanser as they are an oil in water emulsion. They are more suitable for treating sensitive, normal, dehydrated and combination skins. Most commonly used for a superficial cleanse.

Lotion A detergent solution in water that quite often contains anti-bacterial ingredients. Suitable for young, oily and combination skins.

Gel These are a solution of detergent in water and sometimes have a medicated base. They are not very effective at removing make-up. They are recommended for use on oily to combination skins.

Foaming facial wash Contain a detergent and other ingredients chosen for specific skin types. This product foams when applied with water and needs to be rinsed off. It is suitable for normal, combination and oily skins. It is worth noting that they are not as effective as facial cleansers at removing make-up.

Facial bar Similar to soap however, where as soap is very drying on the skin these products have been designed to match the skins pH balance and not strip it as soap can. It can be used on normal, combination and oily skins that are not sensitive. It is worth noting that they are not as effective as facial cleansers at removing make-up.

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Cleansing Procedure

It is important that a superficial cleanse is carried out before the skin analysis if the client is wearing make-up, so that the therapist can see the condition of the client’s skin.

Eye cleanse If the client is wearing mascara start at step 1, if not start at step 4. An eye cleanse should always be carried out even if the client is not wearing make-up as grease and dirt still needs to be removed.

1. Place a cotton wool shield under each eye and ask the client to close their eyes. 2. Apply eye make-up remover to a cotton bud and gently stroke down the lashes to remove mascara. Use a separate cotton bud for each eye. 3. Remove the cotton wool shields. 4. Start on the left eye and use a piece of damp cotton wool with eye make-up remover to circle outwards over the upper lid and inwards underneath the eye whilst supporting with the other hand. 5. Use a piece of damp cotton wool to remove eye make-up remover. Use the same method for removal as in step 4. 6. Repeat steps 4 & 5 on the client’s right eye. 7. Ask the client to look up and sweep under the eyelashes with damp cotton wool to remove any excess product.

Remember to use a separate piece of cotton wool for each eye for hygiene purposes.

Lip cleanse 1. Apply cleanser to a damp cotton wool pad. 2. Support the corner of the mouth and wipe from the left side over half of the bottom lip and half of the upper lip. 3. Repeat procedure on the right side of the mouth as in step 2. 4. Use damp cotton wool pads to remove cleanser following step 2 and 3.

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Superficial cleanse procedure The superficial cleanse uses a light cleansing product that emulsifies with the make-up, oils and dirt on the skin. The product is applied to the skin with the fingers and then removed with damp cotton wool pads.

It is important that a superficial cleanse is carried out before the skin analysis if the client is wearing make-up, so that the therapist can see the condition of the client’s skin.

Take suitable cleansing milk or lotion from container and warm in hands. Apply a surface layer to the face and neck. 1. Start at the left side of the neck and perform light, upward alternate effleurage stokes moving over to the right side and back again. 2. Perform alternate thumb circles to the chin. 3. Alternate, light effleurage, upwards and outwards, to the left cheek. 4. Repeat the same procedure to the right cheek. 5. Finger circles to the corners of the mouth. 6. Finger circles to the corners of the nostrils and over the nose. 7. Use the fingers to apply large circular movements over the cheeks, work upwards and outwards. 8. Circle with the ring fingers, upwards and outwards, around the eyes. 9. Circular movements with the fingers over the forehead. 10. Apply light effleurage to the forehead. 11. Complete with pressure to the temples. 12. Remove with damp cotton wool pads in each hand using a similar procedure as above. 13. Now proceed onto the skin analysis.

Deep cleanse A second cleanse follows (referred to as a deep cleanse) to remove any ingrained dirt or make-up from the pores. It is applied using deeper pressure and generally a thicker cleansing cream. The client should be encouraged to deep cleanse as it: • Improves the circulation to the area, bringing fresh oxygen and nutrients to the cells, therefore improving cell regeneration. • Aids with desquamation of the skin cells. • Has a warming effect on the skin, which opens the pores allowing absorption of the cleanser so it can dissolve ingrained make-up, dirt and sebum. • Aids with the removal of waste products.

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Take suitable cleansing cream from container, warm the product in hands and apply an even layer to the face, neck and décolleté – starting at the décolleté, work up over the neck, cheeks and forehead.

Apply the following movements using firmer pressure than that used in the superficial cleanse 1. Start at the left side of the neck and perform light, upward alternate effleurage stokes moving over to the right side and back again. 2. Perform alternate thumb circles to the chin. 3. Alternate, light effleurage, upwards and outwards, to the left cheek. 4. Repeat the same procedure to the right cheek. 5. Finger circles to the corners of the mouth. 6. Finger circles to the corners of the nostrils and over the nose. 7. Use the fingers to apply large circular movements over the cheeks, work upwards and outwards. 8. Circle with the ring fingers, upwards and outwards, around the eyes. 9. Circular movements with the fingers over the forehead. 10. Apply light effleurage to the forehead. 11. Complete with pressure to the temples. 12. Remove with sponges or mitts and warm water.

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Facial Cleansing Routine

Apply layer of 1. Effleurage to the 2. Alternate thumb cleansing product neck, left side first circles to the chin

3. Effleurage to left 4. Effleurage to right 5. Finger circles to cheek cheek corner of mouth

6. Finger circles to 7. Large circles to 8. Circles around the nostrils and nose the cheeks eyes

9. Circles to the 10. Effleurage to the 11. Pressure to forehead forehead temples

Draw onto the pictures each movement of the cleansing routine to help you remember.

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Toners

A toner is a liquid that is applied after the cleansing process to: 1. Remove any traces of cleanser, make-up or dirt. 2. Leave the skin feeling refreshed. 3. Have a mild tightening effect on the pores.

Toners can be applied to the skin in different ways: • On damp cotton wool (most frequently used method). • Spraying using a vaporiser or from the bottle. • By applying a tonic gauze mask, a piece of gauze is covered with toner and left on the face for a few minutes.

After any of the above application techniques, it is important that you blot the face to prevent the toner evaporating as it is believed that this action can cause dehydration or broken capillaries to occur.

There are three main categories of toners:

1. Skin Bracers or Fresheners These are the mildest form of toners; they contain virtually no alcohol (0-10%), water and a humectant such as glycerine. Humectants help to keep the moisture in the upper layers of the epidermis by preventing the moisture from evaporating from the skin. A popular example is rose water. A popular example is rose water, which is suitable for dry, sensitive, dehydrated and mature skins.

2. Skin Tonics These are slightly stronger and contain a small quantity of alcohol (up to 20%), water and a humectant ingredient. Orange flower water is an example of a skin tonic and is recommended for young, normal to combination skins.

3. Astringents These are the strongest form of toner and contain a high proportion of alcohol (20-60%), antiseptic ingredients, water and a humectant ingredient. Please note that dehydration is likely to occur if the toner contains more than 50% alcohol. Witch hazel is an example of an astringent. They are designed for use on oily or blemished skins. They are not suitable for dry or sensitive skins.

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Moisturisers

A moisturiser balances out the skins natural moisture content (sebum and water) by re-hydrating and protecting. A moisturiser can contain varying ingredients for each skin type depending on the result required. A moisturiser does not just put moisture back into the skin it can also balance the skin thereby normalising it. A moisturising product has the following benefits: • Softens the skin. • Protects against make-up, dirt, pollution and the elements. • Prevents against natural moisture loss from the deeper layers of the skin. • Protects against the effects of free radicals if an anti-oxidant ingredient is present. • If the product contains an SPF factor, it will protect against UV ray damage. • Normalises the skin. • Provides a smooth base to apply make-up onto. • Helps to prevent any pigmented make-up products from penetrating the skin. • Plumps the skin tissue minimising the appearance of fine lines. • It may contain anti-ageing ingredients such as collagen.

The skin can also moisturise itself naturally by: • The sebum lubricates the skin and reduces water loss. • The fats form a cement, which holds the cells together to form a barrier against water. • The Natural Moisturising Factor of the skin (NMF) is a mixture of substances that balance moisture inside the skins cells.

Moisturisers are formulated depending on the skin type they have been designed for. There are also different formulations depending whether the product is designed for day or night use.

Moisturising cream A richer moisturising cream would be more suitable for dry and mature skins. It would contain about 15-40% oil to 60-85% water.

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Moisturising milk These contain higher water content (at least 85%) and absorb quickly into the skin without leaving a greasy film. They are suitable for normal, combination, sensitive and dehydrated skins.

Moisturising lotion A lotion would be a preferred formula for an oily or young skin and would contain 10-15% oil to 85-90% water. It will also contain other ingredients that help to reduce sebum and comedone production.

In most moisturisers a product called a humectant will be used e.g. glycerine and this is used to attract moisture to the skin. An emollient ingredient is also used to soften the skin.

Day moisturisers These are lighter in formulation and should generally contain SPF and anti-oxidant ingredients. They are formulated to suit the different skin types and so their ingredients will differ.

Night moisturiser These will generally be richer in formulation to allow the products to penetrate over the night and should contain anti-oxidant ingredients. They will also be formulated to suit the different skin types.

Method of application Use the fingertips of both hands to apply the moisturiser: 1. Apply small dots to the face and neck area avoiding the delicate eye area. 2. Use light upward strokes to distribute the product evenly – there should be no need to massage into the skin unless you have applied too much product. 3. If you have used the correct amount it will penetrate the skin within a few minutes, however if too much has been applied blot with a tissue to remove excess.

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Task Please answer the following questions to demonstrate your knowledge of the cleansing, toning and moisturising procedure:

1. What advice would you give to the client when removing the eye make- up?

2. What is the benefit of cleansing the skin?

3. What are the benefits of toning the skin?

4. What are the benefits of moisturising the skin?

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Exfoliants

Exfoliants, facial scrubs or peels are used after the cleansing procedure to: ƒ Remove any dead skin cells from the skin’s surface. ƒ Brighten the appearance of the skin. ƒ Allow for deeper penetration of any further products applied to the skin. ƒ Make the skin surface appear smoother.

They are suitable for all skin types however, care should be taken over areas of sensitivity or broken capillaries.

Facial scrub/exfoliant A facial scrub will contain fine granules, which remove the dead skin cells when massaged over the face. It is important that when purchasing a skin scrub you check that the granules are spherical. Usually the granules will be man made or from an ingredient that grows in a spherical shape. Avoid products that are made from fruit or nut stones as these have to be cut down and can therefore scratch the skin’s surface. A common natural ingredient of an exfoliant is oatmeal. A facial scrub is normally used on any skin type with a build up of congestion or dead skin cells. It is most suitable for use on a normal, oily, combination, dry and young skin.

Application technique: 1. Remove a small amount of product and apply lightly to the face with the fingertips. 2. Quite often, the product will be diluted with a small amount of water by dipping the fingers into the water. 3. Apply the product with the fingertips using small circular movements for 1-2 minutes. Concentrate on areas of congestion or dead skin cell build up. 4. Remove with sponges or mitts and warm water.

Facial peels Facial peels are applied to the face in a thin layer, like a mask, and removed by rubbing the surface with the fingertips. It is the action of the fingers moving over the product that results in the exfoliating effect. In addition, peels often contain a very small proportion of alpha

©Clare Hargreaves-Norris Facial – students 2004 56 hydroxyl acids (AHA) which are naturally occurring fruit acids. This results in a gentle chemical reaction accruing which dissolves dead epidermal cells. A facial peel is most suitable for mature, dehydrated and sensitive skins.

Application technique for all skin types except sensitive: 1. Apply a thin layer to the face and neck. 2. Leave to dry for 1-2 minutes (always check manufactures instructions). 3. Place tissues behind the neck to catch any particles. 4. The skin in gently supported and the product is removed using a rubbing action. 5. Remove any excess product with damp cotton wool.

Application technique for sensitive skin: 1. Apply a thin layer to the face and neck. 2. Apply the facial steamer over the peel. 3. Leave the product on the face for the 5-minute duration – the chemical reaction will gently dissolve any dead epidermal cells (check manufacturers instructions). 4. Remove steamer and remove peel with damp sponges.

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Warming The Skin

There are two methods of warming the skin either using warm towels or a steamer. Steaming is the most effective method of warming the skin, however warm towels is a cheap alternative.

Warm towels A warm towel can be applied to the clients skin to remove the mask or to warm the skin if a steamer unit is not available. The towel is placed under a hot running tap with a part left free for the therapist to hold. When the water is warm enough the towel should be squeezed out to remove excess water and then applied over the skin for a few minutes. Apply the towel in a horseshoe shape, leaving a gap for the nostrils to enable the client to breathe.

Steaming Steaming the face is a very effective means of warming the skin. An electrical vapour unit is used to heat water to boiling temperature to produce steam (like a kettle). It is an effective treatment to apply prior to extracting comedones. It also warms and relaxes the skin and muscles prior to facial massage.

Contra-indications to Steam • Highly vascular skin (lots of broken capillaries) • Highly sensitive skin • Acne rosacea (butterfly shaped acne found on mature clients) • Acne vulgaris (oily skin with a high number of papules and pustules) • Sunburn or any other burns • Claustrophobia • Nervous clients

Vapour/Steam Unit Most vapour units will have the ability to produce ozone as well as steam. Ozone is produced by passing the steam over a UV light, however it is thought that it could cause cancer (carcinogenic) and is therefore rarely used. If ozone is to be used it must be in a well-ventilated room and only for a short period.

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Effects of steam Effects of ozone

• Sweat glands produce • Bactericidal (prevents perspiration formation of bacteria) • Deep cleansing • Germicidal (destroys germs) • Opens pores • Healing • Sebum is produced • Drying • Relaxes muscles and nerves As you can see this would be • Increases circulation – beneficial for an oily, congested or resulting in erythema acne prone skin. • Skin is softened • Desquamates the skin

Precautions • Check all wires, plugs and switches before use. • Check for sticker to show that a qualified electrician has checked the steamer in the last 12 months. • Make sure the steamer is filled up to the guideline with water otherwise, it will start to spit or dry out. • Check if the steamer only uses distilled water first. • Do not allow the steamer to heat up over yourself, the client, the floor or any electrical sockets. • Make sure that you switch on steam and not ozone. • When the client is in position switch the steamer on facing away from the client, once you have adequate steam turn towards the client, otherwise it could spit over the client. • The steam should not be positioned over the client so that it could fall on them. • Use a towel to protect your hand when removing the steamer afterwards.

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Steam procedure 1. Check steamer and fill with water. 2. Switch on the steamer 5-10 minutes before it is needed (usually after skin analysis). 3. Prepare the client’s skin. 4. Position the client appropriately. 5. Explain how the treatment will feel to the client (warm and enveloping). 6. Protect the client’s eyes and any broken capillaries with damp cotton wool pads. 7. Facial exfoliant/peel may now be applied if required. 8. Turn the steamer off whilst you correctly position. 9. Apply steamer at correct distance – use tape measure. 10. Now turn the nozzle away from the client and turn the steamer back on. 11. When steam is being produced carefully turn nozzle back so that the steam hits the client’s face centrally. 12. Make a note of the time – check correct time for client’s skin type. 13. Apply scaling fluid to any areas of comedones. 14. At end of the treatment turn off steamer, unplug and place a towel over. Safely remove away from the client. 15. Blot the client’s skin with a tissue. 16. Extract any comedones now.

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Application techniques The steamer can be applied either from the front, slightly to the side or from behind the clients head.

Front - this is beneficial if the client’s areas of skin congestion are mainly on the lower face – chin, jaw, lower nose and cheeks. Take care when applying from the front to ensure that the steam does not burn the inside of the client’s nose. 1. Raise the couch so that the client is semi-reclined. 2. Ask the client to turn their head to the side. 3. Apply the steamer from the side of the couch, so that it is not on top of the client. 4. Ensure the steam hits the client’s face centrally.

Behind - this is beneficial for a client who feels slightly claustrophobic, suffers with slight breathing problems, and has a blocked nose or asthma. If the client’s skin congestion is more on the top of the nose or forehead then this would be the best way to apply the steam. 1. The client should be inclined only a small amount. 2. Protect the clients hair with a towel. 3. Place the steamer from behind the client’s head; ensure the nozzle is in line centrally with the top of the clients head.

Application Distances and Timings

Sensitive 20 inch

Dry 18 inch

Normal 16 inch

Combination 14 inch

Oily 12 inch

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Task 1. Complete the application and timing table for the different skin types.

Skin type Distance Timing Sensitive

Dry/dehydrated

Normal

Combination

Oily

2. Explain the effects of the steam treatment on the different skin types.

Sensitive skin -

Dry/dehydrated skin –

Normal skin -

Combination skin –

Oily skin –

3. Explain the effects of ozone on the skin.

4. Explain the effects of steam on the skin

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Extractions

Extractions are only performed once the skin has been warmed, as this will aid the extraction procedure. The extraction procedure is used to remove any comedones or milia from the skin; each involves a different method of extraction. If the client suffers from severe congestion then do not attempt to carry out all the removals in one session, as it would be uncomfortable and leave the skin irritated.

Equipment The following equipment and material will be required in addition to the usual facial products: • Disposable rubber gloves • Medical swabs or antiseptic • Comedone extractor • Milia extractor (special sterile needle) • Sharps disposable container if milia extractor is used • Barbicide jar

Comedone extraction Once the skin has been warmed the comedones can be extracted using either the comedone extractor or by wrapping tissues around the index fingers. As gentle pressure is applied around the comedone, it should leave the skin as a visible plug.

Precautions should be taken not to obstruct the clients breathing or to press on the cartilage of the nose. Too much pressure could also cause bruising or broken capillaries to occur.

Milia extraction Due to the possibility of the skin bleeding during this procedure, it is becoming increasingly likely that salons will no longer offer this service. As a needle is being used it is very easy to pierce the therapists own skin when the procedure is being carried out. Great care must be taken.

Disposable gloves must be worn for this treatment and all waste must be disposed of in sharps box. The skin should be pierced using the milia

©Clare Hargreaves-Norris Facial – students 2004 63 extractor, which makes a small opening for the milia to pass out through. The milia either will adhere to the end of the needle or will need to be gently squeezed out. Antiseptic should be applied to the skin once the milia extraction is complete.

There is a possibility that the skin may scab over after the extraction procedure. These scabs will be very small and will heal within a few days, however it is important that the client does not pick at the scabs as this will interfere with the healing process.

Take precautions not to obstruct the clients breathing or to press on the cartilage of the nose. Milia should never be removed from around the eye area as the tissue is very delicate and no pressure should be applied to the eye socket. If the milia extractor is inserted too deeply it could cause scarring, so great care must be taken.

Note It is important that all the skin blockage is removed during the extraction process otherwise infection may occur.

Task

1. Why are extractions only performed once the skin has been warmed?

2. What can be extracted from the skin?

3. If there is a lot of congestion why should you not attempt to carry out all the removals in one session?

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Facial Massage

Facial massage is an important part of the facial treatment; it is usually this that the client most looks forward to. A good massage is continuous, has good rhythm and is applied with the correct pressure and depth for the individual client.

Effects/benefits of massage When massage is performed correctly, it has the following effects: • Relaxes the client psychologically (in their mind). • Aids desquamation. • Increased blood circulation in the area improves the colour of the skin- resulting in erythema. • Increased blood flow to the area brings fresh oxygen and nutrients and removes waste products. The blood nourishes the skin cells and encourages them to reproduce. • Increased blood circulation to the muscles improves muscle tone and strength. • Due to the blood circulation being increased, the tissues become warm which encourages the tissues to relax. • Stimulation of the lymphatic circulation helps to remove waste products and toxins from the area. This helps to reduce puffiness. • Stimulation increases the temperature of the skin, which relaxes the pores and follicles aiding deeper absorption of the massage medium. • Stimulation of the sebaceous and sweat glands increases the production of sebum and sweat which has a deep cleansing effect on the skin and helps to maintain the skin’s natural oil and moisture balance. • Sensory nerve endings are soothed or stimulated depending on the massage technique used.

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Massage manipulations There are a series of five groups of massage techniques, which are known as: • Effleurage • Petrissage • Tapotement • Frictions • Vibrations

Effleurage - is a continuous stroking movement that is applied with the palm of the hand and fingers in the direction of venous return. This technique has a light even pressure that is applied in a rhythmical manner to induce a feeling of relaxation.

Uses: • Introduces the client to the therapists touch at the beginning of the treatment. • Links massage movements and completes the massage treatment. • Relaxes tight muscles prior to deeper work for example kneading. • Warms and relaxes the tissues. • Aids lymphatic drainage. • Assists the blood flow on its journey back to the heart. • Soothes nerve endings.

Petrissage - involves a series of movements that lift/press the tissues away from/against the underlying structures. Pressure is varied and involves a variety of movements that include kneading, picking up, rolling, pinching, knuckling and scissors.

Uses: • Relieves tension nodules within the muscles – commonly found in the trapezius. • Improves muscle tone. • Increases the production of sebum and sweat. • Assists with the removal of waste products. • Stimulates cell regeneration.

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Tapotement (also known as percussion) - this movement is performed in a brisk, light, stimulating manner so that the hands/fingers break contact with the skin. Tapotement movements include clapping and tapping. Due to its stimulating nature, you would not normally apply tapotement over areas of sensitivity.

Uses: • Improves tone on areas of loose and crepey skin. • Stimulates the circulation resulting in erythema. • Stimulates the sensory nerve endings.

Frictions – this is a small penetrating movement that is applied to a localised area. It is performed with the fingers or thumbs in a circular or transverse (cross over) direction. Pressure is applied and then released to relieve specific tension.

Uses • Breaks down scar tissue and adhesions. • Helps to loosen areas of congestion and dead skin cells. • Relieves tension – used on small areas.

Vibrations - are applied by the therapist placing their arms into a static contraction, which results in the muscles contacting rapidly to produce a vibrating effect. Alternatively, if this is not possible the therapist can produce a trembling effect.

Uses: • Relaxes the client as it has a mild sedating effect. • Stimulates the nerve endings without causing any surface irritation to the skin.

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Massage mediums The facial massage may be performed using a variety of massage products: • Oil - used on a normal to all skin types. Pure sweet almond oil is suitable for a sensitive skin. Oil produces the required amount of slip without providing a rich nourishing effect as it tends to lay on the skin’s surface. • Cream - used on a dry, mature skin type. Its rich formula enables it to have nourishing effects on the skin. • Talc - used on an oily skin. Its dry powder formulation makes it effective at absorbing oil from the skin and will not provide any moisturising effects to the skin. This does not however provide much slip and so takes a bit of practice to work with effectively. • Gel – used on normal to oily skin types. This contains a high content of water and minimal oil. It provides a reasonable slip without feeling greasy on the skin.

Adapting the facial massage routine The facial massage procedure will normally take between 15-20 minutes. The procedure should be adapted slightly depending on: 1. The clients skin type. 2. Areas of concern – i.e. expression lines around the eye area. 3. Areas of sensitivity. 4. Clients expectations or needs. 5. The amount of muscle/adipose tissue. 6. Areas of tension. 7. Desired outcome – i.e. would the client prefer to relax or feel invigorated.

Sensitive skin • Use a lighter pressure over the face and possibly neck. • Spend a reduced amount of time on the face and more time on the neck, chest and shoulders. • Avoid tapotement moments over areas of sensitivity. • Use pure almond oil or a facial massage product designed for a sensitive skin.

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Dry skin • Use a slightly firmer pressure to stimulate the sebaceous glands. • Spend extra time performing frictions over dry areas to remove dead skin cells. • Use a massage cream.

Oily skin • Use a slightly lighter pressure over the oily areas. • Spend less time on the face and more time on the neck and shoulders to prevent over stimulation of the skin. • Perform frictions over areas of congestion. • Massage with talc, gel or a massage oil formulated for an oily skin.

Combination skin • When applying the techniques use lighter pressure over the oily T- zone. • To loosen areas of congestion apply frictions over the area. • Massage with a gel or oil.

Mature skin • Spend additional time over areas that are showing signs of ageing for example around the eyes, frown lines, naso-labial fold and jowls. • If the skin is loose, the most suitable movements are vibration, tapotement and light effleurage. • Use a slightly firmer pressure to stimulate the sebaceous glands. • Use a massage cream.

Facial massage routine Facial massage routines vary greatly depending on who is teaching the routine and the range of skin care products being used. Companies are constantly developing new massage routines in order to have a unique selling point to that of their competitors. Facial massage routines can be developed from basic principles such as Swedish massage, pressure point massage or lymphatic drainage.

Your tutor will provide you with a copy of the facial massage routine that is being taught by your college/training provider.

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Task Please answer the following questions to demonstrate your knowledge of the facial massage procedure.

1. What is the main use of effleurage in a massage?

2. What is the aim of kneading?

3. What is tapotement?

4. How would you adapt your massage for a client with an oily skin?

5. How would you adapt your massage for a client with a mature skin?

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6. How long should the facial massage procedure normally take?

7. The circulation is effected when massaging the skin. Please explain how this affects the underlying structures.

8. How would you adapt your massage for a male client?

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Mask Therapy

A mask is applied towards the end of a facial treatment, after the steam/massage. All masks will fall into one of two categories – setting or non-setting. The main benefit of a facial mask is to deep cleanse and desquamate the skin. However depending the ingredients within the mask, it will produce varying benefits, for example: ƒ Soothing ingredients will de-sensitise skin and reduce erythema. ƒ Moisturising ingredients will soften and nourish the skin. ƒ Astringent ingredients will have a tightening effect on the skin. ƒ Absorbent ingredients will absorb oils and dead skin cells etc. will adhere to the mask when removed.

Setting Masks

Clay based masks The powder ingredients of the clay mask absorb sebum and dead skin cells from the surface of the skin. There are various clay masks available and you would select the clay mask powder for the action that you require. Below is a list of powder ingredients listed in order from the gentlest to the most stimulating:

Calamine is a pale pink coloured powder that has soothing and calming properties on the skin. It is suitable for use on mature, sensitive, dehydrated and dry skins.

Magnesium is a white powder that has toning effects and is used for open pores, mature, normal or dry skins.

Kaolin is a cream/grey coloured powder, which has a stimulating effect on the skins surface that helps with the removal of waste products. It is suitable for a young, combination or oily skin.

Fuller’s Earth is a dull green coloured powder and is very stimulating, deep cleansing and drying. It is therefore only used on oily skins with a sluggish circulation, as it will have a reddening effect on the skin.

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Flowers of sulphur is a yellow coloured powder, which has a drying effect on the skin. Because of the effects, it is only used on papules or pustules.

In order for the masks to become active and useable, they must be made into a paste by adding a suitable liquid, which is referred to as an active lotion. There are different liquids to choose from depending on the result required. The liquids are listed from the most gentle to the most stimulating:

Distilled water contains no ingredients or ions and is therefore suitable for sensitive and dehydrated skins.

Almond oil is a pure soothing oil with mild stimulating properties; it does not allow the mask to set and is suitable for a dry or mature skin.

Rose water is a skin freshener and has a mild toning effect; it is therefore suitable for a normal, sensitive or dry skin.

Orange flower water is slightly more stimulating skin tonic that is suitable for normal to combination and young skins.

Witch hazel has astringent properties and is good for blemishes as it has an antiseptic property. It is suitable for blemishes, combination and oily skins.

Preparation and application technique for a clay based setting mask 1. Place one-two scoops of the chosen clay powder in a bowl and then a few drops of the active liquid. 2. Use a spatula to mix until a smooth paste is obtained. 3. Apply with a sterile mask brush starting at the neck and working upwards. Avoid the eyes, nostrils, lips, eyebrow and hairline. 4. Place damp cotton wool pads over the eyes. 5. Leave to set for 10-15 minutes. You will be able to see when the mask is ready as it sets and start to crack. Avoid letting the mask dry out totally as it will dry out the surface layers of the skin. 6. Dampen the mask down firstly with warm sponges. 7. Remove using upward strokes, constantly rinsing the sponges until the entire mask is removed. 8. Wipe over with damp cotton wool pads and tone to ensure all mask is removed.

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Paraffin wax mask Made from paraffin, which is mixed with petroleum jelly or acetyl alcohol to improve its spreading properties. It is heated to 49°C and applied as a liquid to the skin with a mask brush, over a piece of gauze.

Uses • It will improve a dry or dehydrated skin. • Mature skin will be regenerated. • Sluggish skins will benefit from increased circulation. • Uneven skin textures will benefit.

It is not recommended for use on acne rosacea, acne vulgaris, claustrophobic clients or extremely sensitive or vascular skins.

Effects and benefits • Increases circulation to the area therefore bringing fresh oxygen and nutrients to the skin tissues. • Encourages deeper penetration of any product applied prior to the paraffin wax. Thus aiding dry skin conditions. • Relaxes and warms the muscles and tissues. • Aids desquamation. • Produces erythema. • Induces a feeling of relaxation. • Soothes the sensory nerve endings. • Encourages the skin to perspire flushing out any impurities and therefore having a deep cleansing effect. • Softens and smoothes the skin.

Procedure for paraffin wax mask application 1. Switch with heater on about 30 minutes prior to use. 2. Continue with facial routine up to and including massage. 3. Leave massage product on the skin to encourage deeper penetration. 4. Place eye pads over the eyes. 5. Collect paraffin wax. 6. Cut the gauze to size and make a small hole for the nostrils and mouth. 7. Place the gauze over the client’s face and neck. 8. Place paper tissue behind the client’s neck to catch any drips. 9. Test the paraffin wax on your wrist to check temperature is suitable. 10. Check the temperature with the client by placing a small amount on their neck. If the temperature is comfortable then continue.

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11. Commence at the neck and work upwards to cover the face and neck – you will normally apply about three layers to build up the thickness. 12. Leave on for 10-15 minutes. 13. To remove gently peel off in one piece, starting at the neck. 14. Remove any remaining product, tone and moisturise.

Peel off masks Peel off masks are usually made from gel or latex. A film is left over the skin that causes the skin to perspire underneath, having a deep cleansing effect.

The gel masks come ready prepared by the manufacturer and are usually applied using a mask brush in the normal manner. As the mask makes contact with the skin, it starts to dry and set. After 15 minutes, the mask is peeled off starting at the neck. These masks can be suitable for most skins depending on the ingredients and the manufacturers instruction.

The latex mask will normally have to be mixed by the therapist and is usually made by adding water to the mask to make a smooth consistency. It is then applied to the skin (with or without gauze depending on the manufacturers instructions) using a spatula. Avoid the usual areas and apply cotton wool pads to protect the client’s eyes. This is left on the skin for around 15-20 minutes as the mask sets to a rubbery consistency. The mask is then peeled off in one piece, starting at the neck. These masks have a firming and tightening effect & are recommended for mature, dry and dehydrated skins.

Thermal mask These types of masks contain various active ingredients including mineral oils and are usually very deep cleansing. The ingredients are mixed and applied to the face and neck area avoiding the eye area. A piece of gauze is usually applied underneath to aid with application and removal, although you must always check the manufacturer’s instructions. The mask warms on contact with the skin and remains on the skin for 15 minutes. Due to the warming effect, it causes the pores to open therefore having a deep cleansing effect similar to a heat treatment. As the mask starts to cool it will set and this has a tightening effect on the pores. This mask is suitable for most skin types, except for sensitive skins.

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Non-setting Masks

There are three different types of non-setting masks: • Cream • Natural • Warm oil

Cream masks Cream masks are professionally manufactured and come ready prepared. You apply in a thin layer with a mask brush and leave for approximately 10-15 minutes, after which you remove with sponges. Each mask will contain different biological ingredients and so the mask suitability will depend on the instructions for use.

Task Research the different types of cream non-setting masks available for use in your salon. Explain the skin types and conditions they are suitable to be used on.

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Natural masks Are made from natural ingredients such as vegetables and fruit, which are rich in vitamins and minerals. The therapist will prepare the mask depending on the client’s skin type. When preparing the mask you will need to mix liquid ingredients with dry ingredients to make a consistency that can be applied to the skin. The mixture is applied between layers of gauze for ease of application and removal and left for 10-15 minutes. Do not forget to protect the client’s

eyes with damp cotton wool pads.

Natural mask ingredients

Ingredient Effect Skin Types Cucumber soothing and cooling with normal, combination and astringent properties oily can also be used as cooling eye pads Kiwi fruit stimulating combination to oily skin Yeast moisturising dry skin Oatmeal desquamating and refining coarse skin with dead skin cells Strawberry astringent combination to oily skin Banana softening and dry skin and sensitive skin desensitising Avocado nourishing and stabilises dry skin and mature skin Ph balance of the skin Egg white Astringent oily skin

Egg yolk Nourishing dry skin

Lemon juice astringent and stimulating combination to oily skin has bleaching effects Cream soothing and nourishing dry skin Natural yogurt soothing and desensitising sensitive skin

Honey toning, tightening, dry skin and mature skin antiseptic and nourishing

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Warm oil mask Plant oil, usually almond oil, is warmed in a bowl by placing a larger bowl of hot water underneath the bowl of oil. The gauze is then soaked in the warm oil. The clients eyes are protected and the gauze is applied to the skin for 10-20 minutes. An infrared lamp is used to keep the mask warm. The treatment helps to soften the skin and is suitable for dry and mature skins.

Timing of mask in relation to the skin type When deciding how long to leave the mask on the skin always refer to the manufacturers instructions. Generally, an oilier skin would normally require the mask to remain on the skin for longer than a sensitive skin. If the correct mask is selected for the clients skin type then the timing will be similar no matter what the skin type.

If a mask is not left on the skin for long enough then the skin will not receive the full benefits, therefore results will be less noticeable. If a mask is left on the skin for too long, then the skin may become dry, tight and possibly irritated.

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Specialist Products

Eye creams Eye creams are applied to the delicate eye area instead of a moisturiser, as it is too rich and can make the eye area appear puffy and irritated. An eye cream will protect the eye tissue, relieve dryness and alleviate fine lines by plumping them out slightly. A very small amount is applied at the moisturising stage, twice daily, with the ring finger, gently patting around the eye area. Most eye creams cannot be applied to the eyelid, so always check manufacturer’s instructions first. Eye creams should be recommended for clients who are 25 years plus.

Eye gels The benefits or using an eye gel are to battle against fatigue, dark circles and puffiness. They are very cooling and will often contain ingredients such as cornflower extract. Apply in the same manner as the eye cream. Eye gel is recommended for clients who are 20 years plus.

Some clients may benefit from the effects of both products, and therefore recommend the application of an eye gel in the morning and eye cream in the evening.

Lip balms Apply lip balms regularly throughout the day to protect against the elements, moisturise and smooth the lips. Because there are no sebaceous glands present in the surface of the lips, they tend to dry out easily. The lip balm will often contain an SPF factor to protect against burning and UV damage. The therapist should remove the product with a spatula or cotton bud and apply with the ring finger to the lips. Lip balm should be recommended for clients of all ages, both male and female.

Neck creams A neck cream is applied twice daily to the throat area instead of a moisturiser, it is richer in formulation and will contain a strengthening ingredient. Due to the daily movement of the neck and its structure, it can often show signs of ageing earlier than the client’s face. A neck cream is applied to give extra nourishment and support to the neck. Apply the neck cream using upward strokes at the moisturising stage to the neck and décolleté. Recommended for clients who are 35-40 years plus.

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Anti-ageing creams Anti-ageing creams contain specific ingredients that have properties that are believed to slow down the ageing process. They will have a nourishing base and often contain ingredients such as collagen, vitamins, anti-oxidant ingredients and liposomes. These ingredients are believed to regenerate the skin cells and aim to mimic the skins underlying tissues. They can be applied on their own or underneath the day/night cream and should be applied twice daily.

Acne creams Certain acne products can be purchased from a chemist and are designed to remove surface sebum and reduce congestion on the skin’s surface. They often replace traditional cleansers, toners and moisturisers. Some products are applied directly to the affected areas of a clean skin.

The doctor or a dermatologist may prescribe stronger acne creams/medication. Some common examples of products prescribed for severe acne are Retin A, Accutane, antibiotics, contraceptive pill or products containing Oxytetracycline. If a cream is prescribed, it will usually be applied to the affected areas once the skin has been cleansed and toned. Some medication may need to be taken orally on a daily basis.

Retin A, Accutane and other products cause the skin to produce less sebum and so therefore the skin becomes very dry and irritated. If a client is using these products then it is not recommend that you exfoliate the skin.

Serums and ampoules These specialist treatments introduce ingredients into the skin to revitalise and give a ‘pick me up’ effect. They are available in a pump action serum or sealed glass/plastic phials. They are usually applied to the face and neck, under the moisturiser, over a 28-day period as an intensive treatment. Alternatively, they are used as a course, applied 4 times a year or at times of illness/stress. Some serums are designed to be used to the affected areas only, therefore always read the manufacturers instructions first.

Alpha Hydroxy Acid products Alpha Hydroxy Acids, commonly known as AHA’s are naturally occurring fruit acids, which have a chemical exfoliating action on the skin. The appearance of the skin is improved as the product dissolves the dead skin

©Clare Hargreaves-Norris Facial – students 2004 80 cells on the skin surface therefore producing a smoother and more radiant skin. These products are usually recommended for use over 28 days, 4 times a year, although instructions do vary from manufacturer.

Certain exfoliants, peels or masks contain AHA ingredients and will therefore have similar benefits as mentioned above.

Task Research the different specialist products that you use within college/salon and the products that are available on the market.

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Dry Oily Combination Mature Sensitive Dehydrated Cleanser

Toner

Exfoliant

Steamer distance

Steamer time

Massage medium

Setting mask

Non- setting mask

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Aftercare Advice

Aftercare advice is an important part of the treatment as it ensures that the client gets the most from their facial. It is a good idea to advise the client during the cleansing and mask removal procedure as this will save time at the end of the treatment. The aftercare should be as follows although it will vary slightly depending on the clients needs: • Avoid make-up, perfumed products and heat to the face for 6-8 hours to gain full benefits from the cleansing aspect of the treatment and to allow the skin to rebalance. • If the client is very conscious about not wearing make-up a tinted moisturiser, mascara and lipstick may be applied. • Avoid touching the skin for 6-8 hours. • Advise the client to cleanse tone and moisturise twice daily. • Provide advice on the correct skin care products (cleanser, toner and moisturiser) for the client’s skin type. • Recommend exfoliation every 5-7 days. • Mask application twice per week for the client’s skin type. • Explain the correct method of use for all skin care products. • Recommend any specialist products that the client would benefit from using. • Recommend that the client drinks 6-8 glasses of water per day to keep the skin hydrated. • Advise the client when they should return for their next facial. If the client’s skin is in good condition then it is advised that they have a facial every 4 weeks. • If the client’s skin is not in good condition then the client should have a facial more frequently. Recommend weekly facials until an improvement is noticed, then every two weeks, three weeks and finally maintain every 4 weeks. • Ideally a mature client should receive a facial on a weekly basis – however cost, time involved etc. will need to be considered.

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Advice Specific To Skin Type And Conditions

Skin Products Advice Type/Conditions Dry • Use products with a • Use a firmer pressure. creamy formulation. • Always protect the face • Mask should be hydrating when going outside & moisturising. • Recommend exfoliant. Dehydrated • Use products with a water • Drink at least eight glasses base. of water per day. • Mask should be hydrating. • Main way to re-hydrate is • Recommend a peel. from within. • Avoid excessive air conditioning, central heating, sunbeds, and use of false tans. • Caffeine and alcohol will dehydrate. Oily • Use products that are • Use light pressure. water based. • Wash make-up sponges and • Recommend a matifying or brushes regularly. oil control product. • Try not to squeeze spots, • All products should be as scarring will occur. non-comedogenic. • If removing comedones • A deep cleansing mask always warm the skin and that has a clay base is use tissues over fingers. best. • Apply a product directly to • Recommend an exfoliant. spots such as tea tree. Combination • Use products that are • Use a light pressure over milk/water based. T-zone. • Recommend an oil control • Wash make-up sponges and product for T-zone brushes regularly. • All products should be • Try not to squeeze spots, non-comedogenic. as scarring will occur. • A deep cleansing mask is • If removing comedones best. always warm the skin and • Recommend an exfoliant. use tissues over fingers. • Apply a product directly to spots such as tea tree.

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Skin Products Advice Type/Conditions Sensitive • All products should be • Use a gentle pressure when hypoallergenic. applying any products. • Recommend the use of a de-sensitising mask. • An AHA facial peel would be best that can be rinsed off. Mature • Products should be creamy • A firmer pressure should in formulation. be used. • Anti-ageing day • Reinforce the importance moisturiser must contain of using upward strokes. an SPF factor. • Recommend the client • Day and night moisturiser performs facial exercises must be used and should 3-7 times per week. contain anti-oxidant • Client could be advised to ingredients. take supplements such as • Eye and neck cream should Starflower oil or Evening be used. Primrose. • Recommend the use of an anti-ageing mask. • Recommend a facial peel. Young • Products should be water • Reinforce the importance based and light of hygiene. • Day moisturiser should • Recommend regular contain an SPF factor. cleaning of make-up • Recommend a facial sponges and brushes. exfoliant. • Remember that prevention • A balancing mask should is better than cure. be used. • The majority of the damage to our skin is caused by the age of 16.

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Task

Research as many pieces of aftercare advice as possible, that you should inform your client about after a facial treatment. You could also include information on the benefits of the facial treatment. You may wish to produce this in the form of an aftercare leaflet- this would be a good opportunity to develop your IT skills.

Why not try using Microsoft Publisher to produce your leaflet. Simply access publisher and click on brochure or Tip flyer, select your preferred design and create an aftercare leaflet.

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Contra-actions

Contra-action

Allergic reaction Excessive erythema Irritation Blemishes

A contra-action is something undesirable that occurs as a result of the treatment. The client should be made aware that, with all treatments, there is a risk of contra-actions occurring. Possible contra-actions to a facial treatment are as follows:

Allergic reaction – the symptoms would be redness, swelling or itching and in severe cases, blisters may develop. If an allergy develops, remove all products immediately and apply a cold compress.

Excessive erythema - this is when an area shows visible signs of redness, and is often accompanied by an increase in warmth to the area. It is caused by the blood capillaries in the area vaso-dilating resulting in an increase in blood flow to the surface of the skin. This may be a sign of damage to the tissues, due to an allergic reaction due to over use of the steamer, over excessive massage or application of a mask that was too strong for the skin. If it occurs, avoid any products, pressure or heat to the area and a cool compress may help to reduce the redness.

Irritation - may occur during or after the facial and is due to the stimulation of the skin & the warmth produced during the facial. This would appear as a small heat rash & will disappear shortly after the facial.

Blemishes - may occur due to the stimulation of the sebaceous glands during the facial treatment. The blemishes are generally due to appear, however the facial will often stimulate the blemish to appear slightly quicker than normal. A papule or pustule should be treated by applying an antiseptic such as tea tree or witch hazel.

For all of the above contra-actions the therapist must make a note on the record card and list the possible cause. If the client is concerned they should contact the salon for advice, if the reaction is severe they should seek medical advice.

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Anatomy And Physiology

In order for you to be able to competently carry out a facial treatment and understand the effects and benefits, you need to have knowledge of the anatomy and physiology of the head, face, neck and shoulders - that is relevant to the treatment.

Within this section, we will cover:

Structure and function of the skin.

How the natural ageing process affects the skin.

The differences in the skin depending on the client’s ethnicity.

The bones of the head, neck, chest and shoulder girdle.

The position and action of the face, neck and shoulder muscles.

The composition and function of the blood.

The composition and function of the lymphatic system.

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Structure Of The Skin

The skin is made up of three main layers: 1. Epidermis 2. Dermis 3. Subcutaneous layer

1. Epidermis This is the outermost layer of the skin (the part that you can see); it does not have a blood supply of its own and is made up of five layers: • Horny layer – the outer layer of the skin, this is made up of scale like cells that are continuously shed (corn flakes). • Clear layer- this is made up of small transparent cells through which light can pass. This layer is only present in the palms of the hands and soles of the feet. • Granular layer – this layer is usually 1-3 layers thick. The cells have distinct granules and keratin is produced in this layer. • Prickle cell layer – this layer is 3-6 layers thick and the cells are constantly dividing. • Germinating layer – a single basal layer of cells, which contain the pigment melanin. The cells of the epidermis are produced in this layer and each has a distinct nuclei. These cells divide continuously by a process known as mitosis.

Horny layer

Clear layer

Granular layer

Prickle cell layer

Germinating layer

Cross section of the epidermis diagram

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2. Dermis This layer is often referred to as the true skin as it forms the bulk of the skin. The dermis contains two layers: • Papillary Layer – lies directly under the epidermis, it is quite thin and has cone like projections called papillae. It provides nutrients and oxygen to the germinating layer of the epidermis • Reticular Layer – this lies below the papillary layer and is the main portion of the dermis. Within the reticular layer are collagen and elastin fibres. Collagen gives the skin a plump and youthful appearance and is a white fibrous tissue made up of proteins. Elastin gives the skin its elastic properties and is made up of yellow elastic tissue.

Within the dermis are various other structures known as appendages.

3. Subcutaneous Layer This is located under the dermis and is mainly made up of fat cells (adipose tissue). This fatty layer of the skin provides the plump contours of the body, protection, insulation, support and a food supply if needed. A certain amount of fat in the face is beneficial as it plumps out the facial contours making the face look more youthful. If a client loses a lot of weight quite rapidly, you will notice that they look as though they have aged.

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Cross Section Of The Skin And It’s Appendages

Task Label the diagram of the cross section of the skin

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Appendages Of The Skin

Hair

shaft Sweat glands Nail

Dermis Sebaceous Nerves gland

Blood Hair Arrector supply follicle pili muscle

Sweat glands The sweat glands, which are sometimes referred to as the sudoriferous glands, extend from the epidermis into the dermis and are found all over the body, however they are particularly numerous in the palms of the hands and the soles of the feet. There are two different types of glands: 1. apocrine are found mainly in the underarm, breast and groin area. 2. eccrine are found all over the body. They regulate the body temperature by allowing sweat to evaporate from the body.

Hair follicle The hair follicle is an indentation of the epidermis with its walls forming a protective layer that houses the hair.

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Hair shaft The hair shaft is the portion of the hair that lies above the skins surface. It is the visible part that you see such as the eyebrows, eyelashes, body hair and the hair on the head.

Blood supply Blood is supplied to the skin by small blood vessels known as blood capillaries. All parts of our body require a blood supply as it provides the vital oxygen and nutrients that tissues require in order to survive. The capillaries also remove waste products and toxins from the tissues. In addition, the capillaries also help to maintain the body temperature by dilating (widening) and constricting (narrowing).

The dermal papilla is the blood supply for the hair and its follicle. It provides food and oxygen, which are essential for the growth of the hair. The dermal papilla is a separate organ that serves the follicle; it is not part of the hair.

Arrector pili muscle This muscle is attached to the hair follicle and it contracts when you are cold or frightened causing the hair to stand up on end. This action traps a layer of warm air around the body to keep the body warm. When the muscle contracts it pulls on the skin around the follicle opening, therefore producing goose pimples.

Sebaceous glands These glands are found all over the body except for the palms of the hands and the soles of the feet and produce the natural oil of the skin - sebum. The sebaceous glands become more active at puberty due to the increased levels of androgens (male hormone) being produced. Men generally secrete more sebum than women do, and you will usually note that the sebaceous glands become less active as we get older.

Sebum is bactericidal and fungicidal and so prevents against infection, it also provides protection and prevents the skin from drying out.

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Nails The nails are an extension of the epidermis and are therefore an appendage of the skin. They are required to help with grasping and protect the fingertips.

Nerves Sensory nerve endings are found in the skin and detect changes in the environment such as heat, cold, touch, pain and pressure. There are different nerve endings that detect the different sensations. Sensory nerves send messages to our brain to let us know what we are feeling. Motor nerves bring messages from our brain to bring about a response.

For example: Its cold outside

Sensory nerve endings detect the cold and send a message to the brain

Brain sends message via the motor nerve to the arrector pili muscle

Arrector pili muscle contracts

Hair stands on end and traps a warm layer of air

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Functions Of The Skin

There are seven main functions of the skin and these are: Sensation Heat regulation Absorption Protection Excretion Secretion Vitamin D production

Sensation – Sensory nerve endings in the skin detect changes in the environment such as heat, cold, touch, pressure and pain.

Heat regulation - Helps to keep body at a constant temperature of 37°C by dilation (widening) and constriction (narrowing) of the blood vessels. Sweat evaporation also keeps the body cool. The subcutaneous fat insulates the body.

Absorption – The skin can absorb certain particles that are small enough to be absorbed such as female hormones, nicotine patches, ingredients within facial preparations etc.

Protection – Its waterproof coat protects the body against dirt, bacterial infection and chemical attack. In addition: a) The acid mantle of pH 5.5 (made up from sebum and sweat) discourages growth of bacteria and fungi. b) The horny layer of the epidermis acts as a filter against bacteria. c) Melanin in the epidermis protects against damage from ultra violet rays.

Excretion – Waste products such as lactic acid, urea and salts are lost through perspiration, however this is only a minor function.

Secretion - Sebum is secreted by the sebaceous glands.

Vitamin D production – Due to the reaction of sunlight on the skin, a chemical reaction occurs resulting in the production of vitamin D.

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Task Answer the following questions to demonstrate your knowledge of the skin’s structure.

1. What are the three layers of the skin called?

2. What is the uppermost layer of the skin called?

3. When exfoliating, what layer of the skin is removed?

4. What layer of the epidermis produces the new cells?

5. What is the function of the sweat gland?

6. What is the function of the subcutaneous layer?

7. Why is a certain amount of fat in the face beneficial?

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8. What is the function of sebum?

9. What type of nerve is stimulated during a facial treatment?

10. What is the benefit of collagen in the skin?

11. What is the function of elastin?

12. What are the functions of the skin?

13. How does the skin protect itself?

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Ageing Of The Skin

As the natural process of ageing occurs, you will notice many changes within the skin. How a skin ages will depend on many factors, such as: • skin type • skin thickness • threats the skin has been exposed to • how the client has cared for the skin • colour of the skin • genetics inherited from your parents

Some changes in a women’s skin during the ageing process can also be closely linked with the altered production of hormones within the body.

From the age of 25, the skin will start to show signs of ageing. Below is a list of changes that will occur which will become more noticeable over the years:

• A slow down in sebaceous and sweat gland activity causes the skin to become dryer and dehydrated. • Loss of elasticity occurs as the elastin fibres harden. • Hardening of the collagen fibres produces lines and wrinkles. • Because the skin is not as firm, the pores appear more open and visible. • Facial contours become slack as the muscle fibres lose their tone. • As cell replacement slows down the epidermis grows slower and appears thinner. As the skin is more transparent, broken capillaries are more prone and appear more visible. • The bone structure is more prominent as the adipose, skin and muscle tissues become thinner. • Fatty cells are unevenly distributed and form pockets leaving the skin to appear lumpy in places, particularly around the eye area. • Blood circulation slows down & therefore leaves the skin to look sallow. • As the metabolic rate slows down waste products and toxins are not removed as rapidly and so puffiness often occurs. • Liver spots and skin tags often develop and continue to increase in number. • Due to the change in hormone levels, facial hair growth usually occurs on the upper lip & chin & this usually becomes coarser over the years. • Reduction in melanocyte production.

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As the blood supply and cell replacement slows down with the ageing process, it is important that you emphasise the importance of a regular facial.

In your 20’s skin cells replace themselves every 28 days, however as you get older this starts to slow down. A facial is recommended every 28 days to target the new skin cells and to help maintain a constant cell renewal process. A facial will encourage cell renewal and nourish the skin structures, therefore improving all of the skins functions.

Ageing affects areas of the face in different ways

The mouth area

With age, naso-labial folds appear from the corner of the nose to the corner of the mouth, and from the corner of the lips to the jaw line. The lips develop vertical and horizontal wrinkle around them. When we smile, we show less of our teeth as we age and the lips become thinner. The corners of the mouth also begin to droop.

Jaw and chin

With age, jowls appear and the jaw tends to merge with the neck. The chin has a tendency to dip downwards as we get older.

Forehead & Region around the Eyes

Horizontal & vertical forehead wrinkles appear due to the expression lines formed by the frontal muscle. The eyebrows sag and the corners of the eyes droop, giving a sad expression.

Eye area

Loose skin appears above the upper eyelid and this can sometimes cover the whole of the upper eyelid. Loose skin (bags) also appear below the eye area. Creases appear at the side of the eyes, which are called crow’s feet. The corners of the eyes tend to droop, giving a sad expression. Skin tags form around the eye area.

Neck

Wrinkles appear with age and the skin forms bands. Skin tags often appear on the neck area.

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Facial treatments

Ethnic variations in skin structure

Recognised variations

Colours produced by The client’s skin structure Wood’s light varies depending on their ethnic origin. Skin type Colour

Balanced Purple/blue Black skin Dry Weak violet Black skin will usually look shiny, and it is often Oily Coral pink presumed that the client’s Hydrated Strong violet skin is oily. Black skin’s generally produce more Thin horny layer Purple sebum and sweat than a Thick horny layer Strong white white Caucasian skin and also have less vellus hair Dead skin cells Silvery white than white or Asian skin. Quite often the epider mis charact eristics. sunburn and premature Pigmentation Brown is thicker and also ageing as it has limited desquamates quicker Asian skin defence to t he sunlight. resulting in the skin Asian skin quite often has White skin will usually have appearing grey. Erythema irregular pigmentation, fewer and less active Remember: would normally be seen as often under the eye area sebaceous glands than the redness, however on a and around the mouth. It other skin types. • No matter what the black skin it will look is common for the client to skin colour, they have a purple. The hair follicles have more vell us hair. The Chinese skin similar number of are curved and ther efore sweat glands are usually Oriental skin contains melanocytes. In dark ingrowing hairs are quite larger and more numerous. more melanin than white skins the melanosomes common if the client has The client’s skin usually skins, although less than are larg e and waxing treatments on the ages well as the protein the other two types. This distributed singularly. fibres of the skin In white face. skin rarely shows signs of degenerate slowly. skins they bl emi s hes as the

are smaller The most accurate way of sebaceous glands are less and distrib- examining a black skin White skin active. Scarring is more uted in during skin analysis is by Have a relatively low likely to occur resulting in clusters. using a Wood’s light. This amount of melanin unevenness, hyper- lamp produces deep compared to the other skin pigmentation and pitting. ultra-viol et rays t hat types. The skin is often This skin has the least produce a different comparatively thin and amount of body hair. coloured glow on the skin prone to fr eckles. This dependi ng on its skin type is more prone to

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Task

Answer the following questions to demonstrate your knowledge on skin variations and ageing.

1. Why does the bone structure become more prominent as we get older?

2. What happens to the cell replacement with the ageing process?

3. How often do the skin cells replace themselves in a younger skin?

4. Why is it important that you recommend a facial every 28 days?

5. What happens to the mouth area, as we get older?

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6. What will occur around the forehead & region around the eyes, as we get older?

7. What changes will you notice to the eye area of a mature client?

8. What happens to the neck, as we get older?

9. How does a black skin usually look?

10. How would you recognise erythema on a black skin?

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11. What is the most accurate way of examining a black skin during skin analysis?

12. What will you notice about the pigmentation on an Asian client?

13. Which ethnic group has the lowest amount of melanin?

14. What differences would you notice on an Oriental skin?

15. What advice can you give to prevent against signs of ageing?

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Skeleton

As a therapist performing a facial you need to have knowledge of the bones that form the head, neck, chest, and shoulder girdle.

The skeleton has 3 main functions:

1. Protects the internal organs

2. Gives the body its shape

3. Used for muscle attachment

Task Label the diagrams of the skull and shoulder girdle.

Bones of the skull and face

Bones of the shoulder girdle

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Bones of the skull

Bone Position Frontal x1 Forms the forehead and upper eye sockets Parietal x2 Forms the main part of the top and back (upper sides) of the skull Temporal x2 Found at the side of the head, around the ears Sphenoid x1 Forms part of the eye orbit, connects the skull to the face Ethmoid x1 Connects the skull to the face, houses the nerves of the eyes and separates the nasal passages Occipital bone x1 Located at the back of the skull

Bones of the face

Bone Position Mandible x1 The lower jaw bone – only moveable bone in the face Maxilla x2 The upper jaw and soft palate of the mouth Zygomatic bones x2 The cheek bones Turbinate x2 The spongy bones of the nasal passages Lacrimal x2 Forms the inner part of the eye orbit and part of the nasal passages. Houses the tear ducts and these link to the nasal passages Palatine x2 Internal bone found behind the maxilla, forms part of the nasal cavities & the hard palate of the mouth Vomer x1 Inside the nose, divides the nasal passages Nasal x2 Forms the bridge of the nose

Bones of the shoulder girdle, neck and chest

Bone Position Clavicle x2 The collar bones are long and slender, found at the base of the neck from shoulder to the breast bone Scapula x2 The shoulder blades, situated in the upper back Humerus x2 The upper arm Cervical vertebrae x7 The part of the spine that forms the neck Sternum x1 The breast bone – front (anterior) of the body in the centre of the chest

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Muscles

Muscles are responsible for the movement of the body or within the body. Within the face, they produce facial expressions. They are also responsible for maintaining posture and producing heat to maintain the body temperature. The majority of the muscles in the body are attached to bones by tendons; however, the muscles of the face tend to inert into each other. Muscles are made up of tiny elastic fibres that have the ability to: • shorten or contract • spring back to its original form after contraction - like elastic • stretch when relaxed • respond to stimuli provided by nerve impulses

The face, neck and shoulder muscles

Task Label the diagram of the muscles of the head, face, neck, shoulders, and chest.

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The Position And Action Of The Face, Neck, And Shoulder Muscles

Task Complete the position for each muscle in the table:

Muscle Position Action Forehead Frontalis x1 Lifts the eyebrows which cause horizontal creases to appear. Corrugator x1 Draws the eyebrows together, as in frowning. Eyes Orbicularis oculi x2 Closes the eyes and can cause wrinkles at the corner of the eye. Sides of face Temporalis x2 Raises the jaw when we chew (known as mastication).

Masseter x2 Lifts the jaw & exerts pressure on the teeth - mastication. This is the muscle that causes jowls in later life. Cheeks and mouth Zygomaticus x2 Pulls the corners of the mouth upwards and out as in smiling.

Levator labii superioris Lifts the upper lip and x2 assists in opening the mouth. Risorius x2 Pulls the corners of the mouth sideways as in grinning.

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Orbicularis oris x1 Purses the lips and closes the mouth as in kissing or whistling.

Buccinator x2 Maintains tension in the cheeks and used when blowing.

Depressor anguli oris Draws the corner of (triangularis) x2 the mouth downwards producing a sad expression. Chin Mentalis x1 Lifts the skin of the chin and turns the lower lip outwards. Expression of doubt. Neck Platysma x1 Pulls the jaw and lower lip down. Causes the neck to wrinkle. Expression of horror. Sterno-cleido mastoid Flexes the neck, x2 rotates the head from side to side, and bows the head forward. Shoulders and chest Trapezius x1 Elevates and depresses the shoulders. Also draws the head backwards.

Pectoralis (major and Draws the arm in minor) x2 towards the chest.

Deltoid x2 Lifts, extends, and rotates the arm.

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Blood

The blood is the fluid that transports vital substances to all areas of the body. Blood flows around the body by the pumping action of the heart and is carried in vessels known as: • Arteries – carry oxygenated blood from the heart to the rest of the body. • Veins – carry de-oxygenated blood back to the heart from the body. • Capillaries – smallest vessels that carry both oxygenated and de-oxygenated blood.

The functions of blood Blood has four main functions:

1. Transportation • Red blood cells carry oxygen to the cells of the body. • Carbon dioxide is carried back to the lungs • Nutrients such as glucose, vitamins and minerals are carried around the body. • Hormones are transported around the body to their target organs. • All waste materials such as urea are carried in the blood to be removed and excreted, via the kidneys.

2. Defence • The white blood cells fight against disease and microbe entry. • The white blood cells engulf the bacteria and destroy them. • Lymphocytes, specialised white blood cells, produce antibodies which give the body future resistance to re-infection.

3. Regulation • The blood regulates body heat by absorbing it from the liver and muscles as it passes by and then transports it around the body.

4. Clotting • Platelets will clot a damaged area where blood loss has occurred. • Clotting prevents excess blood loss and protects against microbe entry.

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Composition of blood

Blood is made from 55% straw-coloured fluid called plasma and 45% cells.

Plasma is made up of: • Water (90%) • Other (10%) - blood proteins, mineral salts, food substances, waste material, gases, enzymes, hormones and antibodies

Three main types of blood cells: 1. Red blood cells – contain haemoglobin which carries oxygen 2. White blood cells – protect against infection 3. Platelets – bind together to form a clot to heal a wound

Lymph

The lymphatic system is known as the secondary circulation system and is closely linked to the blood. It is a one way drainage system that drains excess tissue fluid and transports it back into the venous system of the blood supply.

The lymphatic system is made up of various structures: •Lymph capillaries – this is the starting point of the process. These are the smallest vessels that collect excess tissue surrounding the cells. •Lymph vessels – capillaries eventually form larger lymph vessels that transport the lymph back towards the venous system. •Lymph nodes – a small cluster of cells that filter the lymph of any toxins or infection. When they are fighting infection they swell and this is what we refer to as swollen glands. •Lymph ducts – these two ducts are located in the chest and drain the lymph back into the venous system.

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The function of the lymphatic system The main functions of the lymphatic system are to: • Drain excess fluid and waste from the tissues. • Transports tissue fluid and proteins back to the blood supply. • Produces lymphocytes which protect and defend the body against infection. • Absorb fat from the intestine and transport to the liver.

Composition of lymph fluid Lymph is a transparent, colourless, watery fluid. It is similar to blood plasma but contains fewer proteins and nutrients. Lymph usually contains the larger particles that could not re-enter the blood supply. Lymph is made up of: • Plasma (watery substance) • Proteins • Waste products • Toxins • Fats • Urea • Gases • Lymphocytes

Roles of blood and lymph in improving skin and muscle condition When the blood and lymph supply are efficient they are effective at improving the skin and muscle condition. When we perform a facial treatment, particularly facial massage, it improves the efficiency of both systems as we stimulate them to perform more effectively.

Effects on the skin: • Lymph helps to remove waste products from the skin and tissues. This prevents the skin from becoming water logged and puffy. • Blood brings fresh oxygen and nutrients to the skin allowing the cells to reproduce more effectively. • Blood removes carbon dioxide and waste from the area so that the cells do not become poisoned. • Skin will look fresher and smoother due to the increase in cell renewal. • The skin will have a healthy glow due to the improved colour that the blood brings.

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Effects on the muscles: • Lymph helps to remove waste products from the muscles. This helps to improve their efficiency. • Blood brings fresh oxygen and nutrients to the muscle cells allowing the cells to reproduce more effectively. • Blood removes carbon dioxide and waste from the area so that the cells do not become poisoned. • The removal of waste products will allow the muscles to look more toned.

Task Answer the following questions to demonstrate your knowledge on the circulatory and lymphatic systems.

1. How is the blood pumped around the body?

2. What is the function of the arteries?

3. What is the function of the veins?

4. What are the 4 main functions of the blood?

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5. What does the blood transport?

6. What is the composition of the blood?

7. What are the 3 main types of blood cells called?

8. What is the function of the lymphatic capillaries?

9. What are lymph nodes and what is their function?

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10. What are the main functions of the lymphatic system?

11. Explain the composition of lymph fluid.

12. Explain the effect of blood and lymph on the skin.

13. Explain the effect of blood and lymph on the muscles.

©Clare Hargreaves-Norris Facial – students 2004