26
MILADY STANDARD ESTHETICS ADVANCED 2nd Edition
MILADYSTANDARD ESTHETICS
ADVANCED2nd Edition
39094_00_fm_pi-xxvi.indd i 30/01/12 6:03 PM
39094_00_fm_pi-xxvi.indd ii 30/01/12 6:03 PM
MILADYEDITORIAL CONTRIBUTOR
Judith Culp
CONTRIBUTING AUTHORS 2nd EDITION
STANDARD ESTHETICS
ADVANCED Australia Brazil Japan Korea Mexico Singapore Spain United Kingdom United States
Efrain Arroyave, M.D.Anne BeauchampLinda BertautHelen BickmoreJudith CulpMichelle D’Allaird
Sallie DeitzRamona Moody FrenchPamela Hill, R.N.Mark LeesNatalia MichalunM. Varinia Michalun
Anne MillerPeter T. Pugliese, M.D.Melanie SachsCynthia ShawLaura ToddDavid Vidra and Kris La Chance
2nd Edition
39094_00_fm_pi-xxvi.indd iii 30/01/12 6:03 PM
39094_00_fm_pi-xxvi.indd ii 30/01/12 6:03 PM
MILADYEDITORIAL CONTRIBUTOR
Judith Culp
CONTRIBUTING AUTHORS 2nd EDITION
STANDARD ESTHETICS
ADVANCED Australia Brazil Japan Korea Mexico Singapore Spain United Kingdom United States
Efrain Arroyave, M.D.Anne BeauchampLinda BertautHelen BickmoreJudith CulpMichelle D’Allaird
Sallie DeitzRamona Moody FrenchPamela Hill, R.N.Mark LeesNatalia MichalunM. Varinia Michalun
Anne MillerPeter T. Pugliese, M.D.Melanie SachsCynthia ShawLaura ToddDavid Vidra and Kris La Chance
2nd Edition
39094_00_fm_pi-xxvi.indd iii 30/01/12 6:03 PM
Milady Standard EstheticsAdvanced, 2eMilady
President, Milady: Dawn Gerrain
Director of Content and Business Development: Sandra Bruce
Associate Acquisitions Editor: Philip Mandl
Editorial Assistant: Elizabeth Edwards
Director of Marketing and Training: Gerard McAvey
Marketing Manager: Matthew McGuire
Senior Production Director: Wendy Troeger
Production Manager: Sherondra Thedford
Senior Content Project Manager: Angela Sheehan
Seni or Art Director: Benj Gleeksman
© 2013, 2010 Milady, a part of Cengage Learning
ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution, information networks, or information storage and retrieval systems, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the publisher.
Printed in United States1 2 3 4 5 16 15 14 13 12
Library of Congress Control Number: 2011941421
ISBN-13: 978-1-111-13909-4ISBN-10: 1-111-13909-1
Milady5 Maxwell DriveClifton Park, NY 12065-2919USA
Cengage Learning products are represented in Canada by Nelson Education, Ltd.
For your lifelong learning solutions, visit milady.cengage.com
Visit our corporate website at cengage.com.
Notice to the ReaderPublisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of the product information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that provided to it by the manufacturer. The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein and to avoid all potential hazards. By following the instructions contained herein, the reader willingly assumes all risks in connection with such instructions. The publisher makes no representations or warranties of any kind, including but not limited to, the warranties of fi tness for particular purpose or merchant-ability, nor are any such representations implied with respect to the material set forth herein, and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or part, from the readers’ use of, or reliance upon, this material.
For product information and technology assistance, contact us atProfessional & Career Group Customer Support, 1-800-648-7450
For permission to use material from this text or product,submit all requests online at cengage.com/permissions.
Further permissions questions can be e-mailed [email protected].
39094_00_fm_pi-xxvi.indd iv 30/01/12 6:03 PM
Contents at a GlanceORIENTATION / 1
1 Changes in Esthetics / 2
GENERAL SCIENCES / 17 2 Infection Control / 18 3 Advanced Histology of the Cell and
the Skin / 61 4 Hormones / 100 5 Anatomy and Physiology: Muscles and
Nerves / 122 6 Anatomy and Physiology: The Cardiovascular
and Lymphatic Systems / 144 7 Chemistry and Biochemistry / 163 8 Laser, Light Energy, and Radiofrequency
Therapy / 184
SKIN SCIENCES / 215 9 Wellness Management / 216 10 Advanced Skin Disorders: Skin in
Distress / 230 11 Skin Typing and Aging Analysis / 272 12 Skin Care Products: Chemistry, Ingredients,
and Selection / 288 13 Botanicals and Aromatherapy / 323 14 Ingredients and Products for Skin Issues / 349 15 Pharmacology for Estheticians / 366
ADVANCED ESTHETICS / 393
16 Advanced Facial Techniques / 394 17 Advanced Skin Care Massage / 445 18 Advanced Facial Devices / 492 19 Advanced Hair Removal / 561 20 Advanced Makeup / 602
SPA AND ALTERNATIVE THERAPIES / 651
21 Spa Treatments / 652 22 Complementary Wellness Therapies / 697 23 Ayurveda Theory and Treatments / 726
MEDICAL SCIENCES / 764 24 Working in a Medical Setting / 765 25 Medical Terminology / 780 26 Medical Intervention / 795 27 Plastic Surgery Procedures / 819 28 The Esthetician’s Role in Pre- and Post-Medical
Treatments / 844
BUSINESS SKILLS / 857 29 Financial Business Skills / 858 30 Marketing / 874
References and Resources / 891Glossary/Index / 900
39094_00_fm_pi-xxvi.indd v 30/01/12 6:03 PM
Milady Standard EstheticsAdvanced, 2eMilady
President, Milady: Dawn Gerrain
Director of Content and Business Development: Sandra Bruce
Associate Acquisitions Editor: Philip Mandl
Editorial Assistant: Elizabeth Edwards
Director of Marketing and Training: Gerard McAvey
Marketing Manager: Matthew McGuire
Senior Production Director: Wendy Troeger
Production Manager: Sherondra Thedford
Senior Content Project Manager: Angela Sheehan
Seni or Art Director: Benj Gleeksman
© 2013, 2010 Milady, a part of Cengage Learning
ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution, information networks, or information storage and retrieval systems, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the publisher.
Printed in United States1 2 3 4 5 16 15 14 13 12
Library of Congress Control Number: 2011941421
ISBN-13: 978-1-111-13909-4ISBN-10: 1-111-13909-1
Milady5 Maxwell DriveClifton Park, NY 12065-2919USA
Cengage Learning products are represented in Canada by Nelson Education, Ltd.
For your lifelong learning solutions, visit milady.cengage.com
Visit our corporate website at cengage.com.
Notice to the ReaderPublisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of the product information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that provided to it by the manufacturer. The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein and to avoid all potential hazards. By following the instructions contained herein, the reader willingly assumes all risks in connection with such instructions. The publisher makes no representations or warranties of any kind, including but not limited to, the warranties of fi tness for particular purpose or merchant-ability, nor are any such representations implied with respect to the material set forth herein, and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or part, from the readers’ use of, or reliance upon, this material.
For product information and technology assistance, contact us atProfessional & Career Group Customer Support, 1-800-648-7450
For permission to use material from this text or product,submit all requests online at cengage.com/permissions.
Further permissions questions can be e-mailed [email protected].
39094_00_fm_pi-xxvi.indd iv 30/01/12 6:03 PM
Contents at a GlanceORIENTATION / 1
1 Changes in Esthetics / 2
GENERAL SCIENCES / 17 2 Infection Control / 18 3 Advanced Histology of the Cell and
the Skin / 61 4 Hormones / 100 5 Anatomy and Physiology: Muscles and
Nerves / 122 6 Anatomy and Physiology: The Cardiovascular
and Lymphatic Systems / 144 7 Chemistry and Biochemistry / 163 8 Laser, Light Energy, and Radiofrequency
Therapy / 184
SKIN SCIENCES / 215 9 Wellness Management / 216 10 Advanced Skin Disorders: Skin in
Distress / 230 11 Skin Typing and Aging Analysis / 272 12 Skin Care Products: Chemistry, Ingredients,
and Selection / 288 13 Botanicals and Aromatherapy / 323 14 Ingredients and Products for Skin Issues / 349 15 Pharmacology for Estheticians / 366
ADVANCED ESTHETICS / 393
16 Advanced Facial Techniques / 394 17 Advanced Skin Care Massage / 445 18 Advanced Facial Devices / 492 19 Advanced Hair Removal / 561 20 Advanced Makeup / 602
SPA AND ALTERNATIVE THERAPIES / 651
21 Spa Treatments / 652 22 Complementary Wellness Therapies / 697 23 Ayurveda Theory and Treatments / 726
MEDICAL SCIENCES / 764 24 Working in a Medical Setting / 765 25 Medical Terminology / 780 26 Medical Intervention / 795 27 Plastic Surgery Procedures / 819 28 The Esthetician’s Role in Pre- and Post-Medical
Treatments / 844
BUSINESS SKILLS / 857 29 Financial Business Skills / 858 30 Marketing / 874
References and Resources / 891Glossary/Index / 900
39094_00_fm_pi-xxvi.indd v 30/01/12 6:03 PM
Chemical Reactions / 169Understanding Chemistry Notation / 170Chemicals Found in the Skin and Body / 171Chemical Terms Estheticians Should Know / 173Botanical Chemistry / 174Essential Oil Chemistry / 177
8 LASER, LIGHT ENERGY, AND RADIOFREQUENCY THERAPY / 184Th e History of Light and Energy Devices / 186Physics / 187Safety Governmental Agencies / 193Safety / 196Laser Th erapy / 201Intense Pulsed Light (IPL) / 205Radiofrequency Devices / 208Light-Emitting Diodes (LEDs) and Low-Level Light Th erapy / 210
Conclusion / 211
PART 3 SKIN SCIENCES / 215 9 WELLNESS MANAGEMENT / 216
Nutrients and Diet / 218Nutrition and Aging / 222Eff ects of Stress on the Body / 225Becoming Proactive in Stress Management / 227
10 ADVANCED SKIN DISORDERS: SKIN IN DISTRESS / 230Th e Infl ammation Cascade / 232Wound Healing / 233Injuries from Laser and Other Treatment Th erapies / 240Short-Term Sun Damage / 241Long-Term Photo-Aging / 244Skin Cancers / 245Other Sun-Related Skin Growths / 249Acne / 251Rosacea / 262When to Refer a Client for Medical Evaluation / 267
11 SKIN TYPING AND AGING ANALYSIS / 272Fitzpatrick Skin Typing / 274Other Skin Typing Systems / 277Th e Aging Analysis / 279Th e Glogau Scale / 279Rubin Classifi cation / 280Oriental Refl ex Zones of the Face / 281Hormonal Balance and Skin Identifi cation / 284Skin Categories / 286
12 SKIN CARE PRODUCTS: CHEMISTRY, INGREDIENTS, AND SELECTION / 288Why People Use Performance Skin Care Cosmetics / 291
Cosmetic Ingredient Categories / 291Product Penetration / 293Alpha Hydroxy Acids / 294Beta Hydroxy Acids / 306Retinoids and Retinoid Derivatives / 307Free Radicals / 308Sunscreens / 310Antioxidants / 313Moisturizers—Th e Essential Need for Skin Hydration / 316
Botanicals / 317Understanding Organic / 318Nanotechnology / 318
13 BOTANICALS AND AROMATHERAPY / 323What Are Botanical Ingredients? / 325Plant Compounds and Extracts / 326Methods of Botanical Extraction / 326Eleven Botanicals for Skin Care / 328Aromatherapy and Essential Oils / 332What Essential Oils Can Do / 333Essential Oil Chemistry / 334Contraindications / 337Th irteen Essential Oils / 338Application of Essential Oils / 342Recipes for Skin and Spa / 344Th e Aromatherapy and Botanical Practice / 344Holistic Consultation / 345Legal Considerations / 345
14 INGREDIENTS AND PRODUCTS FOR SKIN ISSUES / 349Products for a Successful Home Care Regimen / 352
Line Selection for Designing a Successful Home Care Regimen / 358
How Products Are Developed / 361
15 PHARMACOLOGY FOR ESTHETICIANS / 366Initial Consultation / 369Th e FDA and Drugs / 370Prescription Drugs / 370Drug Classifi cations / 371Over-the-Counter (OTC) Drugs / 372
vii
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ContentsProcedures at a Glance / xPreface / xiAbout the Authors / xviAcknowledgments / xxiii
PART 1 ORIENTATION / 1 1 CHANGES IN ESTHETICS / 2
Th e Global Evolution of Spas and Spa Treatments / 4Advanced Education and Employment Opportunities / 7
Developing Critical-Th inking Skills / 10Enhancing Soft Skills / 12Privacy Laws / 13Professional Organizations and Publications / 14
PART 2 GENERAL SCIENCES / 17 2 INFECTION CONTROL / 18
Rules and Regulations Governing Workplace Safety / 20
Hepatitis / 23Human Immunodefi ciency Virus (HIV) / 25Tuberculosis / 25Community-Acquired MRSA / 26Th e Principles of Infection Control / 28Gloves / 35Cleaning, Decontaminating, and Sterilizing Reusable Equipment / 39
Potential Hazards for an Esthetician / 47Basic Safety Guidelines / 49OSHA Inspections / 50
3 ADVANCED HISTOLOGY OF THE CELL AND THE SKIN / 61Cellular Structure and Function / 65A Brief Overview of Skin Structure and Function / 68Th e Cells of the Epidermis / 69Major Cells in the Dermis / 72How Keratinocytes Replace the Stratum Corneum / 74
Proteins of the Dermis—Th e Extracellular Matrix (ECM) / 76
Th e Cell Cycle / 78An Introduction to Embryology—Th e Stem Cell / 80Th e Major Tissues in the Body / 82Th e Basic Immune System / 82Th e Mechanism of Exfoliation—Th e Desmosomes / 84Skin Penetration and Permeation / 86Sensory Nerves and Perception in the Skin / 88
4 HORMONES / 100What Are Hormones? / 103Th e Endocrine Glands / 103Other Hormonal Disorders Th at Aff ect the Skin / 105Hormones Produced by the Ovaries and Testes / 108Th e Hormonal Phases of Life / 109Hirsutism / 118Obesity, Anorexia, and Hormones / 118
5 ANATOMY AND PHYSIOLOGY: MUSCLES AND NERVES / 122Muscle Types / 125Function of Skeletal Muscles / 127Muscles of the Head and Face / 128Muscles of the Neck / 131Facial Nerve Patterns / 132Muscles of the Arms and Shoulders / 133Muscles of the Torso / 135Muscles of the Legs / 137
6 ANATOMY AND PHYSIOLOGY: THE CARDIOVASCULAR AND LYMPHATIC SYSTEMS / 144Th e Cardiovascular System / 146Blood / 146Th e Heart / 149Heart Disease / 152Th e Arterial System / 152Th e Venous System / 155Th e Lymphatic System / 158
7 CHEMISTRY AND BIOCHEMISTRY / 163Reference Tools / 165Principles of Chemistry / 165
vi
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Chemical Reactions / 169Understanding Chemistry Notation / 170Chemicals Found in the Skin and Body / 171Chemical Terms Estheticians Should Know / 173Botanical Chemistry / 174Essential Oil Chemistry / 177
8 LASER, LIGHT ENERGY, AND RADIOFREQUENCY THERAPY / 184Th e History of Light and Energy Devices / 186Physics / 187Safety Governmental Agencies / 193Safety / 196Laser Th erapy / 201Intense Pulsed Light (IPL) / 205Radiofrequency Devices / 208Light-Emitting Diodes (LEDs) and Low-Level Light Th erapy / 210
Conclusion / 211
PART 3 SKIN SCIENCES / 215 9 WELLNESS MANAGEMENT / 216
Nutrients and Diet / 218Nutrition and Aging / 222Eff ects of Stress on the Body / 225Becoming Proactive in Stress Management / 227
10 ADVANCED SKIN DISORDERS: SKIN IN DISTRESS / 230Th e Infl ammation Cascade / 232Wound Healing / 233Injuries from Laser and Other Treatment Th erapies / 240Short-Term Sun Damage / 241Long-Term Photo-Aging / 244Skin Cancers / 245Other Sun-Related Skin Growths / 249Acne / 251Rosacea / 262When to Refer a Client for Medical Evaluation / 267
11 SKIN TYPING AND AGING ANALYSIS / 272Fitzpatrick Skin Typing / 274Other Skin Typing Systems / 277Th e Aging Analysis / 279Th e Glogau Scale / 279Rubin Classifi cation / 280Oriental Refl ex Zones of the Face / 281Hormonal Balance and Skin Identifi cation / 284Skin Categories / 286
12 SKIN CARE PRODUCTS: CHEMISTRY, INGREDIENTS, AND SELECTION / 288Why People Use Performance Skin Care Cosmetics / 291
Cosmetic Ingredient Categories / 291Product Penetration / 293Alpha Hydroxy Acids / 294Beta Hydroxy Acids / 306Retinoids and Retinoid Derivatives / 307Free Radicals / 308Sunscreens / 310Antioxidants / 313Moisturizers—Th e Essential Need for Skin Hydration / 316
Botanicals / 317Understanding Organic / 318Nanotechnology / 318
13 BOTANICALS AND AROMATHERAPY / 323What Are Botanical Ingredients? / 325Plant Compounds and Extracts / 326Methods of Botanical Extraction / 326Eleven Botanicals for Skin Care / 328Aromatherapy and Essential Oils / 332What Essential Oils Can Do / 333Essential Oil Chemistry / 334Contraindications / 337Th irteen Essential Oils / 338Application of Essential Oils / 342Recipes for Skin and Spa / 344Th e Aromatherapy and Botanical Practice / 344Holistic Consultation / 345Legal Considerations / 345
14 INGREDIENTS AND PRODUCTS FOR SKIN ISSUES / 349Products for a Successful Home Care Regimen / 352
Line Selection for Designing a Successful Home Care Regimen / 358
How Products Are Developed / 361
15 PHARMACOLOGY FOR ESTHETICIANS / 366Initial Consultation / 369Th e FDA and Drugs / 370Prescription Drugs / 370Drug Classifi cations / 371Over-the-Counter (OTC) Drugs / 372
vii
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ContentsProcedures at a Glance / xPreface / xiAbout the Authors / xviAcknowledgments / xxiii
PART 1 ORIENTATION / 1 1 CHANGES IN ESTHETICS / 2
Th e Global Evolution of Spas and Spa Treatments / 4Advanced Education and Employment Opportunities / 7
Developing Critical-Th inking Skills / 10Enhancing Soft Skills / 12Privacy Laws / 13Professional Organizations and Publications / 14
PART 2 GENERAL SCIENCES / 17 2 INFECTION CONTROL / 18
Rules and Regulations Governing Workplace Safety / 20
Hepatitis / 23Human Immunodefi ciency Virus (HIV) / 25Tuberculosis / 25Community-Acquired MRSA / 26Th e Principles of Infection Control / 28Gloves / 35Cleaning, Decontaminating, and Sterilizing Reusable Equipment / 39
Potential Hazards for an Esthetician / 47Basic Safety Guidelines / 49OSHA Inspections / 50
3 ADVANCED HISTOLOGY OF THE CELL AND THE SKIN / 61Cellular Structure and Function / 65A Brief Overview of Skin Structure and Function / 68Th e Cells of the Epidermis / 69Major Cells in the Dermis / 72How Keratinocytes Replace the Stratum Corneum / 74
Proteins of the Dermis—Th e Extracellular Matrix (ECM) / 76
Th e Cell Cycle / 78An Introduction to Embryology—Th e Stem Cell / 80Th e Major Tissues in the Body / 82Th e Basic Immune System / 82Th e Mechanism of Exfoliation—Th e Desmosomes / 84Skin Penetration and Permeation / 86Sensory Nerves and Perception in the Skin / 88
4 HORMONES / 100What Are Hormones? / 103Th e Endocrine Glands / 103Other Hormonal Disorders Th at Aff ect the Skin / 105Hormones Produced by the Ovaries and Testes / 108Th e Hormonal Phases of Life / 109Hirsutism / 118Obesity, Anorexia, and Hormones / 118
5 ANATOMY AND PHYSIOLOGY: MUSCLES AND NERVES / 122Muscle Types / 125Function of Skeletal Muscles / 127Muscles of the Head and Face / 128Muscles of the Neck / 131Facial Nerve Patterns / 132Muscles of the Arms and Shoulders / 133Muscles of the Torso / 135Muscles of the Legs / 137
6 ANATOMY AND PHYSIOLOGY: THE CARDIOVASCULAR AND LYMPHATIC SYSTEMS / 144Th e Cardiovascular System / 146Blood / 146Th e Heart / 149Heart Disease / 152Th e Arterial System / 152Th e Venous System / 155Th e Lymphatic System / 158
7 CHEMISTRY AND BIOCHEMISTRY / 163Reference Tools / 165Principles of Chemistry / 165
vi
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PART 6 MEDICAL SCIENCES / 764 24 WORKING IN A MEDICAL SETTING / 765
Medical Esthetics / 767How Estheticians Work with Physicians / 768Scope of Practice / 769Th e Medical Esthetic Practice / 770Training and Education / 771Interfacing with Medical Professionals / 773
25 MEDICAL TERMINOLOGY / 780How Medical Terminology Works / 782Th e History of Medical Terminology / 783Th e Basics of Medical Terminology / 783Root Words / 785Prefi xes / 786Suffi xes / 791Pronunciation / 792
26 MEDICAL INTERVENTION / 795Medical Intervention Defi ned / 797Introduction to Botox Cosmetic / 800Introduction to Dysport / 800Introduction to Dermal Fillers / 803Introduction to Sclerotherapy / 811Introduction to Medical Peels / 812
27 PLASTIC SURGERY PROCEDURES / 819Face-Lift (Rhytidectomy) / 821Forehead Lift (Brow Lift) / 823Eye Lift (Blepharoplasty) / 825Nose Job (Rhinoplasty) / 827Facial Implants / 828Breast Implants (Augmentation Mammoplasty) / 830Breast Lift (Mastopexy) / 832Breast Reduction (Reduction Mammoplasty) / 833Breast Reconstruction / 835Tummy Tuck (Abdominoplasty) / 838Liposuction (Suction-Assisted Lipoplasty) / 840
28 THE ESTHETICIAN’S ROLE IN PRE- AND POST-MEDICAL TREATMENTS / 844Pre-Medical or Laser Intervention / 846Cancer Patients / 849Pre-Surgical Home Care / 849Post-Procedure Guidelines / 850When to Refer Back to the Physician / 855
PART 7 BUSINESS SKILLS / 857 29 FINANCIAL BUSINESS SKILLS / 858
Calculating Business Risk / 860Th e Business Plan / 860Financial Planning / 862Protecting Business Assets / 865Employee Compensation / 866Understanding the IRS / 868
30 MARKETING / 874Th e Defi nition of Marketing / 876Customer Value / 878Strategic Value / 879Customer Relationship Management / 879Th e Promotion Mix / 880Th e Marketing Plan / 884Th e Brochure, or Menu of Services / 885Th e Internet / 886Th e Use of Technology / 886Marketing Responsibly / 888
REFERENCES AND RESOURCES / 891
GLOSSARY/INDEX / 900
ix
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PART 4 ADVANCED ESTHETICS / 393
16 ADVANCED FACIAL TECHNIQUES / 394Treatment Variations / 396Rosacea and Sensitive Skin Treatments / 401Clinic Exfoliation Treatments / 403Mask Th erapies / 416
17 ADVANCED SKIN CARE MASSAGE / 445Massage Contraindications / 447Advanced Facial Movements / 448Selecting and Incorporating Advanced Movements / 449Advanced Neck and Décolletage Movements / 451Advanced Back Movements / 455Shiatsu Massage for the Face / 456Refl exology / 457Stone Massage Techniques / 458Lymphatic Massage for the Face and Neck / 460Machine-Aided Facial Lymphatic Massage / 465Post-Massage Care / 465
18 ADVANCED FACIAL DEVICES / 492Th e Purchasing Process / 494Skin Analysis Devices / 497IPL Facial Rejuvenation / 497Laser and IPL Hair Removal / 502Laser Hair Removal Treatment / 508Light-Emitting Diodes (LEDs) / 513Photodynamic Th erapy (PDT) / 514Machine-Aided Microdermabrasion / 515Ultrasonic Technology / 518Microcurrent Technology / 519Electrodesiccation Devices (Radiofrequency) / 522Dermaplaning / 523Skin Needling / 523Management of Complications / 523
19 ADVANCED HAIR REMOVAL / 561Safety and Disinfection First / 563Hirsutism and Hypertrichosis / 564Th reading / 566Sugaring / 568Hard Wax / 574Soft Wax / 574Product Evaluation / 576Advanced Facial Waxing / 576
Speed Waxing and Body Techniques / 580Advanced Male Waxing / 586Electrolysis / 589Hair Removal and Plastic Surgery / 593
20 ADVANCED MAKEUP / 602Mineral Makeup / 604Minerals for Camoufl age / 609Airbrush Makeup and Spray Tanning / 614Eyelash Perming / 624Semipermanent Eyelash Extensions / 625Permanent Cosmetics / 631
PART 5 SPA AND ALTERNATIVE THERAPIES / 651
21 SPA TREATMENTS / 652Understanding Spas and Th eir Services / 654Topics to Consider When Performing Body Treatments / 656
Preparing the Client / 661Th e Popularity of Body Wraps and Masks / 664Types of Body Wraps / 665Hydrotherapy and Other Specialty Treatments / 674
22 COMPLEMENTARY WELLNESS THERAPIES / 697Complementary Wellness / 699Energy Basics / 700Energy Management / 702Th e Chakra System / 705Reiki Hands-On Healing / 708Energy Th erapies / 710Crystals and Gemstones / 711Introducing Energy-Balancing Treatments to Clients / 718
23 AYURV EDA THEORY AND TREATMENTS / 726What Are Ayurvedic Treatments? / 728What Makes a Spa Treatment Ayurvedic? / 729Five Ayurvedic Principles to Apply to Treatments / 729Th e Th ree Doshas / 730Vata Body-Mind Characteristics / 734Pitta Body-Mind Characteristics / 735Kapha Body-Mind Characteristics / 736Ayurvedic Skin Care Treatments / 737
viii
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PART 6 MEDICAL SCIENCES / 764 24 WORKING IN A MEDICAL SETTING / 765
Medical Esthetics / 767How Estheticians Work with Physicians / 768Scope of Practice / 769Th e Medical Esthetic Practice / 770Training and Education / 771Interfacing with Medical Professionals / 773
25 MEDICAL TERMINOLOGY / 780How Medical Terminology Works / 782Th e History of Medical Terminology / 783Th e Basics of Medical Terminology / 783Root Words / 785Prefi xes / 786Suffi xes / 791Pronunciation / 792
26 MEDICAL INTERVENTION / 795Medical Intervention Defi ned / 797Introduction to Botox Cosmetic / 800Introduction to Dysport / 800Introduction to Dermal Fillers / 803Introduction to Sclerotherapy / 811Introduction to Medical Peels / 812
27 PLASTIC SURGERY PROCEDURES / 819Face-Lift (Rhytidectomy) / 821Forehead Lift (Brow Lift) / 823Eye Lift (Blepharoplasty) / 825Nose Job (Rhinoplasty) / 827Facial Implants / 828Breast Implants (Augmentation Mammoplasty) / 830Breast Lift (Mastopexy) / 832Breast Reduction (Reduction Mammoplasty) / 833Breast Reconstruction / 835Tummy Tuck (Abdominoplasty) / 838Liposuction (Suction-Assisted Lipoplasty) / 840
28 THE ESTHETICIAN’S ROLE IN PRE- AND POST-MEDICAL TREATMENTS / 844Pre-Medical or Laser Intervention / 846Cancer Patients / 849Pre-Surgical Home Care / 849Post-Procedure Guidelines / 850When to Refer Back to the Physician / 855
PART 7 BUSINESS SKILLS / 857 29 FINANCIAL BUSINESS SKILLS / 858
Calculating Business Risk / 860Th e Business Plan / 860Financial Planning / 862Protecting Business Assets / 865Employee Compensation / 866Understanding the IRS / 868
30 MARKETING / 874Th e Defi nition of Marketing / 876Customer Value / 878Strategic Value / 879Customer Relationship Management / 879Th e Promotion Mix / 880Th e Marketing Plan / 884Th e Brochure, or Menu of Services / 885Th e Internet / 886Th e Use of Technology / 886Marketing Responsibly / 888
REFERENCES AND RESOURCES / 891
GLOSSARY/INDEX / 900
ix
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PART 4 ADVANCED ESTHETICS / 393
16 ADVANCED FACIAL TECHNIQUES / 394Treatment Variations / 396Rosacea and Sensitive Skin Treatments / 401Clinic Exfoliation Treatments / 403Mask Th erapies / 416
17 ADVANCED SKIN CARE MASSAGE / 445Massage Contraindications / 447Advanced Facial Movements / 448Selecting and Incorporating Advanced Movements / 449Advanced Neck and Décolletage Movements / 451Advanced Back Movements / 455Shiatsu Massage for the Face / 456Refl exology / 457Stone Massage Techniques / 458Lymphatic Massage for the Face and Neck / 460Machine-Aided Facial Lymphatic Massage / 465Post-Massage Care / 465
18 ADVANCED FACIAL DEVICES / 492Th e Purchasing Process / 494Skin Analysis Devices / 497IPL Facial Rejuvenation / 497Laser and IPL Hair Removal / 502Laser Hair Removal Treatment / 508Light-Emitting Diodes (LEDs) / 513Photodynamic Th erapy (PDT) / 514Machine-Aided Microdermabrasion / 515Ultrasonic Technology / 518Microcurrent Technology / 519Electrodesiccation Devices (Radiofrequency) / 522Dermaplaning / 523Skin Needling / 523Management of Complications / 523
19 ADVANCED HAIR REMOVAL / 561Safety and Disinfection First / 563Hirsutism and Hypertrichosis / 564Th reading / 566Sugaring / 568Hard Wax / 574Soft Wax / 574Product Evaluation / 576Advanced Facial Waxing / 576
Speed Waxing and Body Techniques / 580Advanced Male Waxing / 586Electrolysis / 589Hair Removal and Plastic Surgery / 593
20 ADVANCED MAKEUP / 602Mineral Makeup / 604Minerals for Camoufl age / 609Airbrush Makeup and Spray Tanning / 614Eyelash Perming / 624Semipermanent Eyelash Extensions / 625Permanent Cosmetics / 631
PART 5 SPA AND ALTERNATIVE THERAPIES / 651
21 SPA TREATMENTS / 652Understanding Spas and Th eir Services / 654Topics to Consider When Performing Body Treatments / 656
Preparing the Client / 661Th e Popularity of Body Wraps and Masks / 664Types of Body Wraps / 665Hydrotherapy and Other Specialty Treatments / 674
22 COMPLEMENTARY WELLNESS THERAPIES / 697Complementary Wellness / 699Energy Basics / 700Energy Management / 702Th e Chakra System / 705Reiki Hands-On Healing / 708Energy Th erapies / 710Crystals and Gemstones / 711Introducing Energy-Balancing Treatments to Clients / 718
23 AYURV EDA THEORY AND TREATMENTS / 726What Are Ayurvedic Treatments? / 728What Makes a Spa Treatment Ayurvedic? / 729Five Ayurvedic Principles to Apply to Treatments / 729Th e Th ree Doshas / 730Vata Body-Mind Characteristics / 734Pitta Body-Mind Characteristics / 735Kapha Body-Mind Characteristics / 736Ayurvedic Skin Care Treatments / 737
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2–1: Proper Hand Washing Technique / 51
2–2: Preparing Tools and Implements for Sterilization / 53
2–3: Policy and Procedure for Operating Autoclaves / 55
16–1: Thermotherapy for Clogged Pores / 421
16–2: Treatment for Sensitive Skin / 425
16–3: Manual Microdermabrasion / 429
16–4: Alpha Hydroxy Acid (AHA) Treatment / 433
16–5: Jessner’s Solution or 20 Percent BHA Treatment / 437
16–6: Application and Removal of a Powder Alginate Mask / 441
17–1: Shiatsu Massage for Head and Neck / 466
17–2: Ear Refl exology Massage / 470
17–3: Stone Massage for the Face / 472
17–4: Manual Lymph Drainage Massage / 478
17–5: Machine-Aided Lymph Drainage / 486
18–1: IPL Photorejuvenation / 525
18–2: Performing Laser or IPL Hair Removal Treatments / 530
18–3: LED Skin Treatment / 533
18–4: Machine-Aided Microdermabrasion / 536
18–5: Ultrasonic Facial / 541
18–6: Handheld Ultrasonic and Microcurrent Service / 547
18–7: Microcurrent Lift and Firm Facial and Hand Treatment / 551
18–8: Electrodesiccation Treatment for Skin Tag / 556
19–1: Brazilian Bikini Wax / 595
20–1: Maximum-Coverage Airbrushing / 636
20–2: Eyelash Perming / 639
20–3: Applying Semipermanent Eyelash Extensions / 643
20–4: Lash Extension Removal / 648
21–1: Steps for a Body Scrub with Hydrating Pack/Mask / 677
21–2: Applying and Removing Seaweed Wrap / 681
21–3: Herbal Body Wrap / 686
21–4: Soothing Leg Treatment / 691
22–1: 30-Minute Mini–Wellness Procedure / 719
23–1: Basic Marma Point Massage / 746
23–2 Shirodhara Treatment / 754
Procedures List
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Now that you have the foundations of your esthetic training, you are ready to journey into all of the aspects open to those with more advanced education. It is a new frontier ripe with opportunity for success and personal satisfaction. The need for professional estheticians with advanced skills continues to grow in new and exciting ways, providing ample room for personal success in a variety of career paths.
As you move forward from your basic training, consider the many options open to the highly skilled technician, and you will approach your course of study with a positive attitude, study skills and habits, and perseverance, even when the going gets tough. Stay focused on your goal—to become skilled far beyond the level of a basic licensed esthetician and to create more options as you move forward in your career. If any problems arise that may prevent you from reaching your goal, talk to your instructor or support team.
Organization and ChaptersBy learning and using the tools in this text together with your teachers’ instruction, you will develop the abilities needed to build a loyal and satisfied clientele. To help you locate information more easily, the chapters are grouped into seven main parts:
Part One, Orientation, provides an in-depth look at the evolution of esthetics and its advancements and opportunities in today’s world, in addition to learning problem solving and critical thinking and enhancing soft skills.
Part Two, General Sciences, presents scientific knowledge necessary for the safe practice of esthetics. Chapters include topics on state laws and organizations, infection control principles, bacteriology, anatomy and physiology, chemistry, and equipment safety tips and training.
Part Three, Skin Sciences, opens with the effects of proper nutrition and stress on the body and prepares students with the information to address and identify clients’ skin issues and plan for the best treatment protocols through skin analysis, selection of ingredients and products, and even aromatherapy.
Part Four, Esthetics, begins with descriptions of the hands-on, step-by-by step procedures for employing both equipment and non-equipment techniques in the treatment room. Readers can gain a diverse repertoire of treatment variations and information on safely customizing treatments to meet an individual client’s needs.
Part Five, Spa and Alternative Therapies, discusses the wide array of specialty spa treatments that technicians can incorporate into their own signature services; products such as body wraps and masks; and Ayurveda and other alternative healing techniques. Part Five also touches on the importance of client privacy and preparation.
Part Six, Medical, offers a glimpse into working in a medical setting, including surgical treatments; pre- and postoperative care; and medical intervention products, such as Botox, dermal fillers, and injection vein therapy.
Part Seven, Business Skills, provides an overview of operating your own business, including drafting a business and financial plan, calculating the risks, and complying with legal guidelines to marketing your salon or spa.
New to This EditionIn this edition we have updated resources and information to reflect the latest industry trends and information. Some chapters have been streamlined, some expanded. We have rearranged some to enhance the learning experience based on your input.
Preface
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2–1: Proper Hand Washing Technique / 51
2–2: Preparing Tools and Implements for Sterilization / 53
2–3: Policy and Procedure for Operating Autoclaves / 55
16–1: Thermotherapy for Clogged Pores / 421
16–2: Treatment for Sensitive Skin / 425
16–3: Manual Microdermabrasion / 429
16–4: Alpha Hydroxy Acid (AHA) Treatment / 433
16–5: Jessner’s Solution or 20 Percent BHA Treatment / 437
16–6: Application and Removal of a Powder Alginate Mask / 441
17–1: Shiatsu Massage for Head and Neck / 466
17–2: Ear Refl exology Massage / 470
17–3: Stone Massage for the Face / 472
17–4: Manual Lymph Drainage Massage / 478
17–5: Machine-Aided Lymph Drainage / 486
18–1: IPL Photorejuvenation / 525
18–2: Performing Laser or IPL Hair Removal Treatments / 530
18–3: LED Skin Treatment / 533
18–4: Machine-Aided Microdermabrasion / 536
18–5: Ultrasonic Facial / 541
18–6: Handheld Ultrasonic and Microcurrent Service / 547
18–7: Microcurrent Lift and Firm Facial and Hand Treatment / 551
18–8: Electrodesiccation Treatment for Skin Tag / 556
19–1: Brazilian Bikini Wax / 595
20–1: Maximum-Coverage Airbrushing / 636
20–2: Eyelash Perming / 639
20–3: Applying Semipermanent Eyelash Extensions / 643
20–4: Lash Extension Removal / 648
21–1: Steps for a Body Scrub with Hydrating Pack/Mask / 677
21–2: Applying and Removing Seaweed Wrap / 681
21–3: Herbal Body Wrap / 686
21–4: Soothing Leg Treatment / 691
22–1: 30-Minute Mini–Wellness Procedure / 719
23–1: Basic Marma Point Massage / 746
23–2 Shirodhara Treatment / 754
Procedures List
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Our industry is hungry for knowledge and, while we have tried hard to satisfy you, many chapters could be turned into a book on their own, and this is not feasible in a text. But here are just some of the things you can look forward to:
Chapter 4 Hormones: more detail on how hormones affect us and our skin in all aspects of our lives.
Chapter 7 Chemistry and Biochemistry: details on how to make this valuable science more understandable and useful.
Chapter 8 Laser, Light Energy, and Radiofrequency Therapy: clarification on the role of manufacturers in the classification process and updates in this rapidly changing field.
Chapter 11 Skin Typing and Aging Analysis: rearrangement to consolidate information and provide new information including the Roberts Skin Typing System, which is crucial for anyone using light therapy devices.
Chapter 12 Skin Care Products: Chemistry, Ingredients, and Selection: a whole new look provides the latest information about topics from AHAs to sun protection with a lot more in between.
Chapter 18 Advanced Facial Devices: many new updates, including the addition of laser hair removal to the light devices section in order to keep all advanced devices in the same chapter.
A Fresh DesignMilady Standard Esthetics: Advanced, 2nd edition includes more than 1,200 full-color illustrations and photographs, along with a new text design similar to the eleventh edition of Milady Standard Esthetics: Fundamentals for easy transition from the basic to the more advanced material. The procedures are formatted with clear, easy-to-understand directions and step-by-step photographs to help students visualize important techniques.
Educational Elements of This EditionMany features are included to help you recognize and master key concepts and techniques.
Learning ObjectivesAt the beginning of each chapter is the list of learning objectives, which is the important information in the chapter you will be expected to know. Icons placed within the chapter indicate that a learning objective has been completed.
Chapter GlossaryAt the beginning of each chapter is a list of key terms. The first time a key term is used and defined in the text, it will appear in boldface. All key terms and their definitions are included in the glossary at the end of the chapter as well as in the Glossary/Index at the end of the text. The glossary terms and definitions from Milady Standard Esthetics: Fundamentals, Eleventh Edition, also appear in the back-of-book Glossary and Index for easy reference.
Why Study This?Milady knows, understands, and appreciates how excited students are to delve into the newest and most exciting skin care trends, and we recognize that students can sometimes feel restless spending time learning the basics of the profession. To help you understand why you are learning each chapter’s material and to help you see the role it will play in your future career as an esthetician, Milady has added this new section to each chapter. The section includes three or four bullet points that tell you why the material is important and how you will use the material in your professional career.
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F O C U S ON
Throughout the text are boxes in the outer column that draw attention to various skills and concepts that will help you obtain your goal. The “Focus On . . .” pieces target all aspects of personal and professional development. These topics are crucial to your success as a student and as a professional.
ACTIVITY
The “Activity” boxes offer engaging and timely classroom exercises that will help you understand firsthand the concepts explained in the text.
Did You Know?The “Did You Know?” features call attention to a special point and provide information that will enhance your understanding of what you are learning in the text.
REGULATORY AGENCYA L E RT
Laws differ from region to region, so it is important to contact state boards and provincial regulatory agencies to learn what is allowed and not allowed where you are studying. The “Regulatory Agency Alert” icon appears in this text next to procedures or practices that are regulated differently from state to state, alerting you to refer to the laws in your region. Your instructor will provide you with contact information.
The “FYI” features offer additional important information related to the content.
CAUTION!
Some information is so critical for your safety and the safety of your clients that it deserves special attention. The text directs you to this information in the “Caution!” features found in the margins.
Here’s a Tip
These helpful hints draw attention to situations that may arise or give you quick ways of doing things. Look for these tips in procedures and throughout the text.
Review QuestionsAt the end of each chapter is a list of questions designed to test your understanding of the information just presented. Your instructor may ask you to write the answers to these questions as an assignment or to answer them orally in class. If you have trouble answering a question, go back to the chapter, review the material, and try again.
ResourcesThe resources offer Web addresses and references for additional information and activities. You can find this information in the back of this textbook.
xiii
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Our industry is hungry for knowledge and, while we have tried hard to satisfy you, many chapters could be turned into a book on their own, and this is not feasible in a text. But here are just some of the things you can look forward to:
Chapter 4 Hormones: more detail on how hormones affect us and our skin in all aspects of our lives.
Chapter 7 Chemistry and Biochemistry: details on how to make this valuable science more understandable and useful.
Chapter 8 Laser, Light Energy, and Radiofrequency Therapy: clarification on the role of manufacturers in the classification process and updates in this rapidly changing field.
Chapter 11 Skin Typing and Aging Analysis: rearrangement to consolidate information and provide new information including the Roberts Skin Typing System, which is crucial for anyone using light therapy devices.
Chapter 12 Skin Care Products: Chemistry, Ingredients, and Selection: a whole new look provides the latest information about topics from AHAs to sun protection with a lot more in between.
Chapter 18 Advanced Facial Devices: many new updates, including the addition of laser hair removal to the light devices section in order to keep all advanced devices in the same chapter.
A Fresh DesignMilady Standard Esthetics: Advanced, 2nd edition includes more than 1,200 full-color illustrations and photographs, along with a new text design similar to the eleventh edition of Milady Standard Esthetics: Fundamentals for easy transition from the basic to the more advanced material. The procedures are formatted with clear, easy-to-understand directions and step-by-step photographs to help students visualize important techniques.
Educational Elements of This EditionMany features are included to help you recognize and master key concepts and techniques.
Learning ObjectivesAt the beginning of each chapter is the list of learning objectives, which is the important information in the chapter you will be expected to know. Icons placed within the chapter indicate that a learning objective has been completed.
Chapter GlossaryAt the beginning of each chapter is a list of key terms. The first time a key term is used and defined in the text, it will appear in boldface. All key terms and their definitions are included in the glossary at the end of the chapter as well as in the Glossary/Index at the end of the text. The glossary terms and definitions from Milady Standard Esthetics: Fundamentals, Eleventh Edition, also appear in the back-of-book Glossary and Index for easy reference.
Why Study This?Milady knows, understands, and appreciates how excited students are to delve into the newest and most exciting skin care trends, and we recognize that students can sometimes feel restless spending time learning the basics of the profession. To help you understand why you are learning each chapter’s material and to help you see the role it will play in your future career as an esthetician, Milady has added this new section to each chapter. The section includes three or four bullet points that tell you why the material is important and how you will use the material in your professional career.
xiixii
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F O C U S ON
Throughout the text are boxes in the outer column that draw attention to various skills and concepts that will help you obtain your goal. The “Focus On . . .” pieces target all aspects of personal and professional development. These topics are crucial to your success as a student and as a professional.
ACTIVITY
The “Activity” boxes offer engaging and timely classroom exercises that will help you understand firsthand the concepts explained in the text.
Did You Know?The “Did You Know?” features call attention to a special point and provide information that will enhance your understanding of what you are learning in the text.
REGULATORY AGENCYA L E RT
Laws differ from region to region, so it is important to contact state boards and provincial regulatory agencies to learn what is allowed and not allowed where you are studying. The “Regulatory Agency Alert” icon appears in this text next to procedures or practices that are regulated differently from state to state, alerting you to refer to the laws in your region. Your instructor will provide you with contact information.
The “FYI” features offer additional important information related to the content.
CAUTION!
Some information is so critical for your safety and the safety of your clients that it deserves special attention. The text directs you to this information in the “Caution!” features found in the margins.
Here’s a Tip
These helpful hints draw attention to situations that may arise or give you quick ways of doing things. Look for these tips in procedures and throughout the text.
Review QuestionsAt the end of each chapter is a list of questions designed to test your understanding of the information just presented. Your instructor may ask you to write the answers to these questions as an assignment or to answer them orally in class. If you have trouble answering a question, go back to the chapter, review the material, and try again.
ResourcesThe resources offer Web addresses and references for additional information and activities. You can find this information in the back of this textbook.
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STUDENT SUPPLEMENTS
SUPPLEMENT TITLE SUPPLEMENT DESCRIPTION
Exam Review • Contains chapter-by-chapter questions in multiple-choice format to help prepare for the written portion of licensure exams.
• Revised to meet the most stringent test-development guidelines.
• Questions are for study purposes only and are not the exact questions that will be seen on licensure exams.
Workbook • Designed to reinforce classroom and textbook learning.
• Contains chapter-by-chapter exercises.
• Included are fi ll-in-the-blank exercises, matching exercises, short-answer questions, crossword puzzles, word searches, and illustrations to label, all coordinated with material from the text.
Step-by-Step Procedures • Can be used in conjunction with the textbook or on its own to brush up on key procedures.
• Each procedure step is clearly explained and is accompanied by full-color photos.
• At the end of each procedure you will fi nd a rubric to note, organize, and interpret data gathered from observations of student or professional performance.
Student CD • Interactive resource designed to reinforce classroom learning, stimulate the imagination, and aid in preparation for board exams.
• Includes:
• More than 100 video clips that demonstrate procedures and theoretical concepts.
• Chapter quizzes that provide 10 questions at a time but draw from a quiz bank of more than 1,200 questions.
• An arcade with four different types of games.
• An audio glossary that pronounces each term and provides the defi nition.
• Content follows and enhances Milady Standard Esthetics Advanced.
Extensive Teaching and Learning PackageAlthough Milady Standard Esthetics: Advanced is the center of the curriculum, students and educators have a wide range of supplements from which to choose. All supplements have been revised and updated to compliment the new edition of the textbook.
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SUPPLEMENT TITLE
Milady Standard Esthetics Advanced Course Management Guide Print Binder
Milady Standard Esthetics Advanced Course Management Guide CD
Milady Standard Esthetics Advanced Instructor Support Slides CD
Milady Standard Esthetics Advanced Student CD School/Network Version
Milady Standard Esthetics Advanced DVD Series
SUPPLEMENT TITLE SUPPLEMENT DESCRIPTION
Interactive eBook • Requires an Internet connection.
• Enables highlighting, note-taking, and bookmarking.
• Has search capabilities.
Milady U Online Licensing Prep
• Provides an alternative way to study for licensure exams, whether taken on a computer or on paper.
• Offers familiarity with a computerized test environment during licensure exam preparation.
• Features include:
• 24/7 availability; students have the fl exibility to study from any computer.
• Chapter tests, quizzes, and comprehensive exams that draw from more than 1,200 multiple-choice questions.
• All questions are available in both English and Spanish.
• Immediate results with rationales to assist with knowledge acquisition.
• Robust reports that help students determine areas of study they need to focus on.
• For more information or to order, visit www.miladyonline.cengage.com.
Educator SupplementsMilady offers a full range of innovative resources created especially for esthetics educators to make the classroom preparation and presentation simple, effective, and enjoyable.
Thank you for choosing Milady as your Total Learning Solutions Provider. For additional information on the student and educator supplements or to place an order, please contact your Milady Sales Representative or visit us online at www.milady.cengage.com.
xv
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STUDENT SUPPLEMENTS
SUPPLEMENT TITLE SUPPLEMENT DESCRIPTION
Exam Review • Contains chapter-by-chapter questions in multiple-choice format to help prepare for the written portion of licensure exams.
• Revised to meet the most stringent test-development guidelines.
• Questions are for study purposes only and are not the exact questions that will be seen on licensure exams.
Workbook • Designed to reinforce classroom and textbook learning.
• Contains chapter-by-chapter exercises.
• Included are fi ll-in-the-blank exercises, matching exercises, short-answer questions, crossword puzzles, word searches, and illustrations to label, all coordinated with material from the text.
Step-by-Step Procedures • Can be used in conjunction with the textbook or on its own to brush up on key procedures.
• Each procedure step is clearly explained and is accompanied by full-color photos.
• At the end of each procedure you will fi nd a rubric to note, organize, and interpret data gathered from observations of student or professional performance.
Student CD • Interactive resource designed to reinforce classroom learning, stimulate the imagination, and aid in preparation for board exams.
• Includes:
• More than 100 video clips that demonstrate procedures and theoretical concepts.
• Chapter quizzes that provide 10 questions at a time but draw from a quiz bank of more than 1,200 questions.
• An arcade with four different types of games.
• An audio glossary that pronounces each term and provides the defi nition.
• Content follows and enhances Milady Standard Esthetics Advanced.
Extensive Teaching and Learning PackageAlthough Milady Standard Esthetics: Advanced is the center of the curriculum, students and educators have a wide range of supplements from which to choose. All supplements have been revised and updated to compliment the new edition of the textbook.
xiv
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SUPPLEMENT TITLE
Milady Standard Esthetics Advanced Course Management Guide Print Binder
Milady Standard Esthetics Advanced Course Management Guide CD
Milady Standard Esthetics Advanced Instructor Support Slides CD
Milady Standard Esthetics Advanced Student CD School/Network Version
Milady Standard Esthetics Advanced DVD Series
SUPPLEMENT TITLE SUPPLEMENT DESCRIPTION
Interactive eBook • Requires an Internet connection.
• Enables highlighting, note-taking, and bookmarking.
• Has search capabilities.
Milady U Online Licensing Prep
• Provides an alternative way to study for licensure exams, whether taken on a computer or on paper.
• Offers familiarity with a computerized test environment during licensure exam preparation.
• Features include:
• 24/7 availability; students have the fl exibility to study from any computer.
• Chapter tests, quizzes, and comprehensive exams that draw from more than 1,200 multiple-choice questions.
• All questions are available in both English and Spanish.
• Immediate results with rationales to assist with knowledge acquisition.
• Robust reports that help students determine areas of study they need to focus on.
• For more information or to order, visit www.miladyonline.cengage.com.
Educator SupplementsMilady offers a full range of innovative resources created especially for esthetics educators to make the classroom preparation and presentation simple, effective, and enjoyable.
Thank you for choosing Milady as your Total Learning Solutions Provider. For additional information on the student and educator supplements or to place an order, please contact your Milady Sales Representative or visit us online at www.milady.cengage.com.
xv
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Chapter 1CHANGES IN ESTHETICS
Orientation
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Chapter 1CHANGES IN ESTHETICS
Orientation
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Learning Objectives
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Key TermsPage number indicates where in the chapter the term is used.
Health Insurance Portability and Accountability Act (HIPAA)pg. 13
holisticpg. 12
spapg. 4
spa therapypg. 4
After completing this chapter, you should be able to:
LO1 Describe the evolution of the esthetics industry.
LO2 Discuss the need for advanced education and list a variety of employment opportunities.
LO3 Identify and discuss the steps of critical thinking and problem solving.
LO4 Explain soft skills and how to incorporate them into your work.
LO5 List Health Insurance Portability and Accountability Act (HIPAA) guidelines and your legal obligations to your clients’ privacy.
LO6 Reference a broad range of resources to assist you in the industry.
1
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CHAP
TER
Chapter Outline• The Global Evolution of Spas
and Spa Treatments• Advanced Education and
Employment Opportunities• Developing Critical-Thinking
Skills• Enhancing Soft Skills• Privacy Laws• Professional Organizations and
Publications
Changes in Esthetics
39094_01_ch01_p1-16.indd 2 31/12/11 9:32 AM
Learning Objectives
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Key TermsPage number indicates where in the chapter the term is used.
Health Insurance Portability and Accountability Act (HIPAA)pg. 13
holisticpg. 12
spapg. 4
spa therapypg. 4
After completing this chapter, you should be able to:
LO1 Describe the evolution of the esthetics industry.
LO2 Discuss the need for advanced education and list a variety of employment opportunities.
LO3 Identify and discuss the steps of critical thinking and problem solving.
LO4 Explain soft skills and how to incorporate them into your work.
LO5 List Health Insurance Portability and Accountability Act (HIPAA) guidelines and your legal obligations to your clients’ privacy.
LO6 Reference a broad range of resources to assist you in the industry.
1
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CHAP
TER
Chapter Outline• The Global Evolution of Spas
and Spa Treatments• Advanced Education and
Employment Opportunities• Developing Critical-Thinking
Skills• Enhancing Soft Skills• Privacy Laws• Professional Organizations and
Publications
Changes in Esthetics
39094_01_ch01_p1-16.indd 2 31/12/11 9:32 AM
When the Roman Empire fell in AD 476, only a few of the original bathhouses escaped destruction. During this time, public bathing was prohibited by the religious culture; some people avoided bathing for years. Most bathhouses were turned into churches because prayer was considered more important than relaxation.
There was not much advancement in spa culture from this time until the thirteenth century, when Moorish influence rose in southern Europe. A fastidious people, the Moors contributed to a resurgence in bathing and in public bath popularity. Again, bathing was primarily for the purpose of relaxation. But medicinal processes, such as bloodletting (the bleeding of the patient), were also performed at the baths. During medieval times, bloodletting, also known as phlebotomy (fluh-BAHT-uh-me), was a popular treatment for a wide variety of ailments. Bloodletters believed that reducing excess blood from the body restored balance and good health. Today’s phlebotomist is a medical professional who draws blood from the body for diagnosis.
The sixteenth century and the Renaissance period saw another decline in the use of public baths. This was due to many factors, including the lack of firewood to heat the bathhouses and water and common public fear that the bathhouse was the cause of diseases such as syphilis and leprosy. Nevertheless, the wealthy continued to visit bathhouses, though they preferred natural sources, such as hot springs or mineral water.
During this time natural mineral springs gained popularity. An attempt was made to analyze the water’s mineral content scientifically to establish if there actually was any therapeutic value in balneology, the study of bathing for health purposes. At this time, the philosophy of drinking the water as well
Although many spa treatments seem new and never before tried, the reality is that most of the spa treatments provided today are derivations of ancient treatments. It is thought that spa treatments began in bathhouses in ancient Greece and in the Roman Empire. Originally, Roman bathing culture had a medicinal focus before evolving toward relaxation. There were three types of bathhouses in Rome: balnea (home), balnea private (private baths), and balnea public (public baths). Known for their vast aqueducts, the Romans created enormous bathhouses on their newly conquered lands, and they combined baths with other healthy endeavors, such as exercise and massage. The best-preserved of the ancient Roman spas is the famous Spa of Bath, England, which allows visitors to see how these baths functioned. Spa treatments highlighted the benefits of mud therapy, and elite Romans began to enjoy these luxuries.
Figure 1–1Spas originally developed as a means of healing via water.
ACTIVITYVisit http://www.romanbaths.co.uk and explore the ancient Roman spa of Bath, England, to appreciate the engineering and advancements of this ancient civilization.
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Changes in Esthet ics 5Part 1: Orientation 1
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from the name of the Belgian town Spa. Other possibilities are that spa is an acronym of the Latin phrase sanitas per aquas (“health through water”) or that it originates from the Latin word spagere (“to scatter, sprinkle, moisten”) (Figure 1–1). All origins communicate the process: the use of water and the implication of healing. The water treatments provided in the spa are variously called balneotherapy, spa therapy, and hydrotherapy; these terms can be used interchangeably.
The Global Evolution of Spas and Spa TreatmentsUnderstanding the history of the spa and spa treatments helps the esthetician know the purpose of a treatment and how the treatment evolved. The origin of the word spa has several possibilities. One theory is that the word may be derived from the Walloon (a dialect of the French language) word espa, which means “fountain” and originates
Esthetician. The term has become common as awareness of skin treatments, hair removal, and more has spread to the masses via magazines, television, and the Internet. No longer a Hollywood beauty secret, estheticians are in demand everywhere. With changing attitudes about aging, the public is seeking out
estheticians, which is resulting in increased industry growth. Esthetics is listed in U.S. Bureau of Labor reports as one of the top ten growth fields for 2008–2018.
Before the twentieth century, beauty techniques developed and transitioned at a snail’s pace. In today’s world, technology and popular demand have brought the industry to an entirely new level of sophistication. New modalities, products, and techniques are constantly popping up in the media. Although some innovations are only smoke and mirrors, many are legitimate and safe and offer significant rewards. More people are making career changes and turning to the satisfying field of esthetics as their new opportunity. This includes people with advanced degrees such as nursing, communication, chemistry, education, and marketing.
As the medical profession has expanded into cosmetic enhancement, opportunities and demands for well-educated estheticians have grown and diversified. Similarly, as the public becomes more informed, estheticians are sought out. Baby boomers’ desire, willingness, and financial ability to do whatever is necessary to lengthen good health and youthfulness have had a huge effect on the industry. So each new technological advance offers the esthetician an opportunity to add to and improve his or her current skill set and to reach a broader market share. Most important, a solid knowledge of the supposed latest and greatest treatments offers the chance to educate the public. A poorly trained or misinformed esthetician is a far greater threat to the industry than the medical profession. That said, if estheticians are to successfully meet challenges, they must constantly seek out education, encourage research, and take the time to root out the facts.
Why Study Changes in Esthetics?Estheticians should study and have a thorough understanding of changes in esthetics because:
• For estheticians to successfully move forward, it is important to know where we have come from and that “new” ideas and trends are often a revision of something from the past. Ancient therapies may offer insights to established client appreciation and effectiveness or value to the new or updated services.
• As our industry expands, more career opportunities develop. Learning about new career opportunities can influence your personal choices and your professional and financial success.
• Learning the skill sets that can help you achieve your personal and professional goals will help make those goals into realities.
• Gaining a rich understanding of practices that ensure a client’s confidentiality by employing HIPAA standards will help you retain clients because of the steps you follow to protect them. Privacy guidelines enhance client trust.
Part 1: Orientation4 Changes in Esthet ics1
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When the Roman Empire fell in AD 476, only a few of the original bathhouses escaped destruction. During this time, public bathing was prohibited by the religious culture; some people avoided bathing for years. Most bathhouses were turned into churches because prayer was considered more important than relaxation.
There was not much advancement in spa culture from this time until the thirteenth century, when Moorish influence rose in southern Europe. A fastidious people, the Moors contributed to a resurgence in bathing and in public bath popularity. Again, bathing was primarily for the purpose of relaxation. But medicinal processes, such as bloodletting (the bleeding of the patient), were also performed at the baths. During medieval times, bloodletting, also known as phlebotomy (fluh-BAHT-uh-me), was a popular treatment for a wide variety of ailments. Bloodletters believed that reducing excess blood from the body restored balance and good health. Today’s phlebotomist is a medical professional who draws blood from the body for diagnosis.
The sixteenth century and the Renaissance period saw another decline in the use of public baths. This was due to many factors, including the lack of firewood to heat the bathhouses and water and common public fear that the bathhouse was the cause of diseases such as syphilis and leprosy. Nevertheless, the wealthy continued to visit bathhouses, though they preferred natural sources, such as hot springs or mineral water.
During this time natural mineral springs gained popularity. An attempt was made to analyze the water’s mineral content scientifically to establish if there actually was any therapeutic value in balneology, the study of bathing for health purposes. At this time, the philosophy of drinking the water as well
Although many spa treatments seem new and never before tried, the reality is that most of the spa treatments provided today are derivations of ancient treatments. It is thought that spa treatments began in bathhouses in ancient Greece and in the Roman Empire. Originally, Roman bathing culture had a medicinal focus before evolving toward relaxation. There were three types of bathhouses in Rome: balnea (home), balnea private (private baths), and balnea public (public baths). Known for their vast aqueducts, the Romans created enormous bathhouses on their newly conquered lands, and they combined baths with other healthy endeavors, such as exercise and massage. The best-preserved of the ancient Roman spas is the famous Spa of Bath, England, which allows visitors to see how these baths functioned. Spa treatments highlighted the benefits of mud therapy, and elite Romans began to enjoy these luxuries.
Figure 1–1Spas originally developed as a means of healing via water.
ACTIVITYVisit http://www.romanbaths.co.uk and explore the ancient Roman spa of Bath, England, to appreciate the engineering and advancements of this ancient civilization.
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from the name of the Belgian town Spa. Other possibilities are that spa is an acronym of the Latin phrase sanitas per aquas (“health through water”) or that it originates from the Latin word spagere (“to scatter, sprinkle, moisten”) (Figure 1–1). All origins communicate the process: the use of water and the implication of healing. The water treatments provided in the spa are variously called balneotherapy, spa therapy, and hydrotherapy; these terms can be used interchangeably.
The Global Evolution of Spas and Spa TreatmentsUnderstanding the history of the spa and spa treatments helps the esthetician know the purpose of a treatment and how the treatment evolved. The origin of the word spa has several possibilities. One theory is that the word may be derived from the Walloon (a dialect of the French language) word espa, which means “fountain” and originates
Esthetician. The term has become common as awareness of skin treatments, hair removal, and more has spread to the masses via magazines, television, and the Internet. No longer a Hollywood beauty secret, estheticians are in demand everywhere. With changing attitudes about aging, the public is seeking out
estheticians, which is resulting in increased industry growth. Esthetics is listed in U.S. Bureau of Labor reports as one of the top ten growth fields for 2008–2018.
Before the twentieth century, beauty techniques developed and transitioned at a snail’s pace. In today’s world, technology and popular demand have brought the industry to an entirely new level of sophistication. New modalities, products, and techniques are constantly popping up in the media. Although some innovations are only smoke and mirrors, many are legitimate and safe and offer significant rewards. More people are making career changes and turning to the satisfying field of esthetics as their new opportunity. This includes people with advanced degrees such as nursing, communication, chemistry, education, and marketing.
As the medical profession has expanded into cosmetic enhancement, opportunities and demands for well-educated estheticians have grown and diversified. Similarly, as the public becomes more informed, estheticians are sought out. Baby boomers’ desire, willingness, and financial ability to do whatever is necessary to lengthen good health and youthfulness have had a huge effect on the industry. So each new technological advance offers the esthetician an opportunity to add to and improve his or her current skill set and to reach a broader market share. Most important, a solid knowledge of the supposed latest and greatest treatments offers the chance to educate the public. A poorly trained or misinformed esthetician is a far greater threat to the industry than the medical profession. That said, if estheticians are to successfully meet challenges, they must constantly seek out education, encourage research, and take the time to root out the facts.
Why Study Changes in Esthetics?Estheticians should study and have a thorough understanding of changes in esthetics because:
• For estheticians to successfully move forward, it is important to know where we have come from and that “new” ideas and trends are often a revision of something from the past. Ancient therapies may offer insights to established client appreciation and effectiveness or value to the new or updated services.
• As our industry expands, more career opportunities develop. Learning about new career opportunities can influence your personal choices and your professional and financial success.
• Learning the skill sets that can help you achieve your personal and professional goals will help make those goals into realities.
• Gaining a rich understanding of practices that ensure a client’s confidentiality by employing HIPAA standards will help you retain clients because of the steps you follow to protect them. Privacy guidelines enhance client trust.
Part 1: Orientation4 Changes in Esthet ics1
39094_01_ch01_p1-16.indd 4 31/12/11 9:33 AM
also included theaters and casinos, became very popular with both the elite and middle classes over the next few decades.
When depression hit in the 1930s, development of spas halted in the United States, and many European spas that had catered to Americans closed. After World War II, with the worldwide economy on the rise, spas regained popularity, and new treatments, such as health and exercise regimens, mud therapy, balneology, and hydrotherapy, were added. Eventually, however, the focus of preventive practice lost ground to the advances of modern medicine. Spas once again went on the decline.
Today, there is a worldwide spa revival that recognizes the benefits of preventive therapies (Figure 1–3). One of the fastest-growing industries in the United States, spas have become an important component of American and global life. According to the 2011 U.S. Spa Industry Report published by the International Spa Association (ISPA), revenues from spas in 2010 were $12.8 billion. This is an increase of $3.4 billion since 2006. Despite economic impacts, spas are growing and expanding to meet
as bathing in the water became commonplace. The general population did not drink a lot of water, and physicians recommended drinking large amounts of the mineral waters for potential curative effects. One early “bath” was used exclusively for drinking mineral water. Additional pools were built for bathing purposes.
During the seventeenth century, the French joined the movement with both hot and cold springs. They used cold springs for drinking therapies only and hot springs for drinking cures as well as bathing. The French took these therapies quite seriously, and it was at this time that physicians became an integral part of the spa experience.
As the popularity of bathing in springs grew, scientists attempted to replicate natural mineral springs’ benefits for medicinal purposes. A nineteenth-century Bavarian monk, Father Sebastian Kneipp, believed that using water to eliminate waste from the body could cure disease. He developed more than 100 different hydrotherapy treatments using water in solid, liquid, and vapor forms to treat individuals. His treatments included washings, wraps, packs, compresses, steam, and baths (Figure 1–2).
When Europeans began to immigrate to the United States, they brought the spa concept with them. But it wasn’t until the mid-1800s that hotels and guesthouses built near mineral springs started drawing guests to enjoy the waters. This movement led to what was known as spa resorts. These resorts, which
Figure 1–2Steaming is just one of many hydrotherapy treatments.
Figure 1–3Mud treatments are experiencing renewed popularity.
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Part 1: Orientation6 Changes in Esthet ics1
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Review Questions
GlossaryHealth Insurance Portability and Accountability Act (HIPAA)
a federal act passed in 1996 and enacted on April 14, 2003 outlining federal privacy standards for patients. The act covers access to medical records, notice of privacy practices, limitations on use of personal medical information, prohibitions on using patient information for marketing, stronger state laws, confidential communication, and complaint procedures.
holistic describes the practice and/or philosophy of treating the person as a whole and remaining alert to all of a client’s needs rather than focusing solely on a disease or disorder.
spa a term originally meaning “health through water.” Today it most often refers to day spas or destination spas, where clients can find a wide range of treatments.
spa therapy water treatments provided in a spa.
1. How has the medical community contributed to the esthetics community?
2. Why has advanced esthetics education become so important?
3. From what country is the term spa believed to have originated?
4. What is the meaning of the term spa?
5. List three terms for water treatments.
6. Who is credited with inventing hydrotherapy treatments such as wraps and steam baths?
7. List five different areas in which an esthetician may find employment.
8. List each step in developing critical-thinking skills.
9. List several ways you can tune in to your client’s needs.
10. What is HIPAA and how does it affect you?
16 Changes in Esthet ics1 Part 1: Orientation
39094_01_ch01_p1-16.indd 16 31/12/11 9:34 AM
also included theaters and casinos, became very popular with both the elite and middle classes over the next few decades.
When depression hit in the 1930s, development of spas halted in the United States, and many European spas that had catered to Americans closed. After World War II, with the worldwide economy on the rise, spas regained popularity, and new treatments, such as health and exercise regimens, mud therapy, balneology, and hydrotherapy, were added. Eventually, however, the focus of preventive practice lost ground to the advances of modern medicine. Spas once again went on the decline.
Today, there is a worldwide spa revival that recognizes the benefits of preventive therapies (Figure 1–3). One of the fastest-growing industries in the United States, spas have become an important component of American and global life. According to the 2011 U.S. Spa Industry Report published by the International Spa Association (ISPA), revenues from spas in 2010 were $12.8 billion. This is an increase of $3.4 billion since 2006. Despite economic impacts, spas are growing and expanding to meet
as bathing in the water became commonplace. The general population did not drink a lot of water, and physicians recommended drinking large amounts of the mineral waters for potential curative effects. One early “bath” was used exclusively for drinking mineral water. Additional pools were built for bathing purposes.
During the seventeenth century, the French joined the movement with both hot and cold springs. They used cold springs for drinking therapies only and hot springs for drinking cures as well as bathing. The French took these therapies quite seriously, and it was at this time that physicians became an integral part of the spa experience.
As the popularity of bathing in springs grew, scientists attempted to replicate natural mineral springs’ benefits for medicinal purposes. A nineteenth-century Bavarian monk, Father Sebastian Kneipp, believed that using water to eliminate waste from the body could cure disease. He developed more than 100 different hydrotherapy treatments using water in solid, liquid, and vapor forms to treat individuals. His treatments included washings, wraps, packs, compresses, steam, and baths (Figure 1–2).
When Europeans began to immigrate to the United States, they brought the spa concept with them. But it wasn’t until the mid-1800s that hotels and guesthouses built near mineral springs started drawing guests to enjoy the waters. This movement led to what was known as spa resorts. These resorts, which
Figure 1–2Steaming is just one of many hydrotherapy treatments.
Figure 1–3Mud treatments are experiencing renewed popularity.
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Part 1: Orientation6 Changes in Esthet ics1
39094_01_ch01_p1-16.indd 6 31/12/11 9:33 AM
Review Questions
GlossaryHealth Insurance Portability and Accountability Act (HIPAA)
a federal act passed in 1996 and enacted on April 14, 2003 outlining federal privacy standards for patients. The act covers access to medical records, notice of privacy practices, limitations on use of personal medical information, prohibitions on using patient information for marketing, stronger state laws, confidential communication, and complaint procedures.
holistic describes the practice and/or philosophy of treating the person as a whole and remaining alert to all of a client’s needs rather than focusing solely on a disease or disorder.
spa a term originally meaning “health through water.” Today it most often refers to day spas or destination spas, where clients can find a wide range of treatments.
spa therapy water treatments provided in a spa.
1. How has the medical community contributed to the esthetics community?
2. Why has advanced esthetics education become so important?
3. From what country is the term spa believed to have originated?
4. What is the meaning of the term spa?
5. List three terms for water treatments.
6. Who is credited with inventing hydrotherapy treatments such as wraps and steam baths?
7. List five different areas in which an esthetician may find employment.
8. List each step in developing critical-thinking skills.
9. List several ways you can tune in to your client’s needs.
10. What is HIPAA and how does it affect you?
16 Changes in Esthet ics1 Part 1: Orientation
39094_01_ch01_p1-16.indd 16 31/12/11 9:34 AM
6
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8
PROCEDURE
Proper Hand Washing Technique (continued)
Post-ProcedureInspect your hands, including cuticles, for any visible microabrasions. If any are present, wear gloves to prevent microorganisms from entering this portal.
Clean-up and Disinfection10 Clean and then disinfect the sink area on a routine scheduled basis such
as at the end of the day and/or at the start of the day.
11 Dispose of the paper towel used to disinfect in a trash receptacle.
6 Blot hands dry with a disposable paper towel. Take the time to pat your hands dry. Do not rub your hands together vigorously, as this can cause microscopic abrasions that compromise the skin’s integrity.
4 Choose a clean, disinfected nail brush. Wet the nail brush, pump soap on it, and brush your nails horizontally back and forth under the free edges. Change the direction of the brush to vertical and move the brush up and down along the nail folds of the fingernails. The process of brushing both hands should take about 60 seconds.
7 If the hand washing sink does not have foot controls or an automatic shutoff, use a clean paper towel to turn off the faucet and to handle any doorknobs to avoid recontaminating your hands.
5 Thoroughly rinse your hands, from the top of the wrists down to the fingertips, under warm running water to remove any residual soap.
8 Dispose of the paper towel you used to dry your hands in a trash receptacle.
9 As an optional step, apply hand lotion as needed. Make sure your lotion will not affect your gloves. Do not use any products containing petroleum with latex.
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Part 2: General Sciences52 Infect ion Control2
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1
2
3
PROCEDURE
IMPLEMENTS AND MATERIALS• Nail brush• Soap• Paper towels• Access to sink with hot and
cold running water
PreparationEnsure that the materials are available.
Friction is the most important part of hand washing. Proper hand washing should take approximately 60 seconds.
Procedure1 Wet your hands with warm
running water.
2 Apply soap (either antimicrobial or plain) as directed by the manufacturer and thoroughly distribute it over your hands.
3 Vigorously rub together all surfaces of your lathered hands for 20 seconds, including the following:
a. Between the fingersb. Thumbsc. Wristsd. Nail bedse. Beneath the fingernailsf. Palms of the hands
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2Infect ion Control 51Part 2: General Science 2
39094_02_ch02_p17-60.indd 51 31/12/11 9:41 AM
6
4
75
8
PROCEDURE
Proper Hand Washing Technique (continued)
Post-ProcedureInspect your hands, including cuticles, for any visible microabrasions. If any are present, wear gloves to prevent microorganisms from entering this portal.
Clean-up and Disinfection10 Clean and then disinfect the sink area on a routine scheduled basis such
as at the end of the day and/or at the start of the day.
11 Dispose of the paper towel used to disinfect in a trash receptacle.
6 Blot hands dry with a disposable paper towel. Take the time to pat your hands dry. Do not rub your hands together vigorously, as this can cause microscopic abrasions that compromise the skin’s integrity.
4 Choose a clean, disinfected nail brush. Wet the nail brush, pump soap on it, and brush your nails horizontally back and forth under the free edges. Change the direction of the brush to vertical and move the brush up and down along the nail folds of the fingernails. The process of brushing both hands should take about 60 seconds.
7 If the hand washing sink does not have foot controls or an automatic shutoff, use a clean paper towel to turn off the faucet and to handle any doorknobs to avoid recontaminating your hands.
5 Thoroughly rinse your hands, from the top of the wrists down to the fingertips, under warm running water to remove any residual soap.
8 Dispose of the paper towel you used to dry your hands in a trash receptacle.
9 As an optional step, apply hand lotion as needed. Make sure your lotion will not affect your gloves. Do not use any products containing petroleum with latex.
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Part 2: General Sciences52 Infect ion Control2
39094_02_ch02_p17-60.indd 52 31/12/11 9:41 AM
1
2
3
PROCEDURE
IMPLEMENTS AND MATERIALS• Nail brush• Soap• Paper towels• Access to sink with hot and
cold running water
PreparationEnsure that the materials are available.
Friction is the most important part of hand washing. Proper hand washing should take approximately 60 seconds.
Procedure1 Wet your hands with warm
running water.
2 Apply soap (either antimicrobial or plain) as directed by the manufacturer and thoroughly distribute it over your hands.
3 Vigorously rub together all surfaces of your lathered hands for 20 seconds, including the following:
a. Between the fingersb. Thumbsc. Wristsd. Nail bedse. Beneath the fingernailsf. Palms of the hands
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2Infect ion Control 51Part 2: General Science 2
39094_02_ch02_p17-60.indd 51 31/12/11 9:41 AM
