SE Ch.4 – Disorders & Diseases of the Skin

1. What is the medical study of the skin called?


2. Why can’t an esthetician diagnose disorders or diseases?

It is outside of their scope of practice.

3. Name and define the primary lesions.
Refer to Table 4–1: Primary Lesions.

4. Name and define the secondary lesions

Refer to Table 4–2: Secondary Lesions.

5. Describe the differences between the three types of skin cancer.

  • Basal cell carcinoma is the most common and least severe type of skin cancer. It is caused primarily by overexposure to UV radiation.
  • Squamous cell carcinoma is a more serious condition than basal cell carcinoma. Squamous cells can grow and spread to other areas of the body.
  • Malignant melanoma is deadlier because it can spread (metastasize) throughout the body, to internal organs via the lymphatics and bloodstream.

6. Explain the checklist system used to identify skin cancers.

Answer: The American Cancer Society recommends using the ABCDE Skin Cancer Checklist to help make potential skin cancer easier to recognize. When checking existing moles, look for changes in any of the following:

  • A: Asymmetry—The two sides of the lesion are not identical.
  • B: Border—The border is irregular on these lesions.
  • C: Color—Melanomas are usually dark and have more than once color or colors that fade into one another.
  • D: Diameter—The lesion in a melanoma is usually at least the size of pencil eraser.
  • E: Evolving—Melanoma as a lesion often changes appearance.

7. Explain the difference between an open and a closed comedone.

Comedones (singular: comedo) involve a noninflamed buildup of cells, sebum, and other debris inside follicles. An open comedo is a blackhead open at the surface and exposed to air. When the follicle is filled with an excess of oil, a blackhead forms. It is dark because it is exposed to oxygen and oxidation occurs. A closed comedo forms when the opening of the follicle is blocked with debris and white cells. It is also referred to as a whitehead, but should not be confused with the more hardened white type of papules called milia.

8. Describe the four grades of acne.

Refer to Table 4–4: Grades of Acne.

9. Give examples of three different kinds of medications used to treat acne.

Refer to Table 4–5 Common Medications Used in the Treatment of Acne.

10. Describe how an esthetician could help a client with PCOS.

Performing hair removal treatments with waxing or laser services can help keep unwanted hair under better control. Skin care treatments using ingredients that influence the formation of comedones keep the stratum corneum thin. Treatments that influence acne breakouts, like microdermabrasion, high frequency, and an ultrasonic skin scrubber, are helpful. Additionally, providing emotional support can help your client.

11. Explain the progression of rosacea.

Rosacea is a progressive disorder that starts with flushing and increasing bouts of redness. Visible vessels and skin sensitivity are symptoms. The symptoms can progress to pustular-type breakouts that can be confused with acne. Rosacea can affect the eyes as well, causing chronic bloodshot eyes, some clear to yellowish discharge, and irritation. In advanced cases, the rosacea can cause skin thickening, particularly around the nose. This symptom is called rhinophyma.

12. List four rosacea triggers.

Vasodilation (vascular dilation) of the blood vessels makes rosacea worse. Spicy foods, alcohol, caffeine, temperature extremes, heat, sun, and stress aggravate rosacea symptoms.

13. Summarize how to treat rosacea.

Rosacea treatments should include medical intervention. Antifungal skin care, calming skin care, soothing facials with high frequency, and limited steam can help. Laser and radio frequency treatments can also help.

14. List three disorders characterized by hyperpigmentation.

  • Melasma is a hormonal disorder characterized by symmetrical pigmentation patterns on the face.
  • Lentigo are small flat brown spots; often caused by sun exposure.
  • Ephelids are also called freckles.
  • Nevus or birthmark.
  • Poikilodermaof Civatte is sun damage characterized by dark reddish-brown discoloration on the sides of the neck with light skin under the chin.
  • Postinflammatory hyperpigmentation is skin pigmentation of browns and reds due to inflammation after a skin injury such as a pimple, ingrown hair, or other attack on the epidermis.
  • Tan is an increase in melanin production due to exposure to UV radiation resulting in a darkening of the skin.

15. Describe tinea versicolor and its treatment.

Tinea versicolor, also called pityriasis versicolor, is a fungal condition that inhibits melanin production. It is not contagious because it is caused by yeast, a normal part of the human skin. It is characterized by white, brown, or salmon-colored flaky patches. It can be treated with antifungal cream, other medication, or selenium sulfide shampoos.

16. List the inflammations of the skin.

  • Dermatitis: generalized term that refers to an inflammatory condition of the skin; various forms include lesions such as eczema, vesicles, and papules
  • Contact dermatitis: inflammatory skin condition caused by an allergic reaction from contact with a chemical or other substance
  • Allergic contact dermatitis: caused by exposure to and direct skin contact with an allergen
  • Atopic dermatitis: a chronic, relapsing form of dermatitis (atopic means “excess inflammation from allergies”); irritants and allergens trigger reactions that include dry, cracked skin
  • Eczema: inflammatory, painful, itching disease of the skin; acute or chronic in nature, with dry or moist lesions; this should be referred to a physician
  • Irritant contact dermatitis: irritant reactions affect everyone who comes in contact with an irritant
  • Perioral dermatitis: acne-like condition around the mouth; consists mainly of small clusters of papules; may be caused by toothpaste or face products
  • Seborrheic dermatitis: form of eczema characterized by inflammation, dry or oily scaling or crusting, and/or itchiness; often appears in the eyebrows, on the scalp and along the hairline, in the middle of the forehead, and along the sides of the nose; one cause is inflammation of the sebaceous glands
  • Stasis dermatitis: poor circulation in the lower legs can create a chronic inflammatory state; the legs may sometimes have ulcerations, along with scaly skin, itching, and hyperpigmentation; the hyperpigmentation is caused by hemosiderin staining, a brown-reddish discoloration due to the iron deposits in the blood leaking into the tissues

17. What are four hypertrophies of the skin?

  • Hyperkeratosis: Thickening of the skin caused by a mass of keratinocytes.
  • Keratoma: An acquired thickened patch of epidermis. A callus caused by pressure or friction is a keratoma. If the thickening also grows inward, it becomes a corn.
  • Keratosis: An abnormally thick buildup of skin cells.
  • Keratosis pilaris: Redness and bumpiness in the cheeks, upper arms, or thighs; caused by blocked follicles. It has the appearance of “chicken skin.”
  • Mole: A pigmented nevus; a brownish spot ranging in color from tan to bluish black. Some are flat, resembling freckles; others are raised and darker.
  • Psoriasis: An itchy skin disease characterized by red patches covered with white-silver scales; caused by an overproliferation of skin cells that replicate too fast. Psoriasis is usually found in patches on the scalp, elbows, knees, chest, and lower back.
  • Skin tag: A small outgrowth or extension of the skin that looks like a flap. They are benign and are common under the arms, on the neck, or breast area from friction.

18. How is keratosis pilaris treated?

Topical chemical exfoliants that keep the follicles free of keratin, like AHA or BHA products, along with light mechanical exfoliation can help.

19. Name and define nine contagious skin and/or nail disorders.

  • Conjunctivitis, pinkeye—inflammation of the mucous membrane (conjunctiva) around the eye due to chemical, bacterial, or viral causes; very contagious. It can be treated with antibiotics.
  • Herpes simplex virus 1—fever blisters or cold sores; recurring viral infection; a vesicle or group of vesicles on a red, swollen base. The blisters usually appear on the lips or nostrils. Herpes simplex virus 1 causes cold sores and lesions around the mouth. It is a contagious disease treated with antiviral medication to shorten the outbreak.
  • Herpes simplex virus 2—genital herpes; never work on clients with active herpes lesions. Peels, waxing, or other stimuli may cause a breakout, even if the condition is not currently active.
  • Herpes zoster, shingles—a painful skin condition due to reactivation of the chickenpox virus; also known as the varicella-zoster virus (VZV).
  • Impetigo—a bacterial infection of the skin that often occurs in children; characterized by clusters of small blisters or crusty lesions filled with bacteria. It is extremely contagious.
  • Onychomycosis—fungal infection; thick, brittle, discolored nails.
  • Tinea—fungal infections. Fungi feed on proteins, carbohydrates, and lipids in the skin. Tinea pedis, athlete’s foot, is a fungal infection that can be treated with antifungal topical powders, sprays, or creams.
  • Tinea corporis,ringworm—caused by a fungus; is not a worm. It looks like a skin irritation that spreads into a circular infection that is red and scaly.
  • Verruca,wart—a hypertrophy of the papillae and epidermis caused by a virus. They are not cancerous, but they are contagious.

20. Which contagious diseases contraindicate skin care treatments?

Do not perform services on anyone with a contagious disease because it can spread and infect others.

21. Describe dermatillomania and how it is treated.

Dermatillomania is a form of an obsessive-compulsive disorder in which the person picks at their skin to the point of injury, infection, or scarring. Treatment includes cognitive behavior therapy, hypnosis, and medication.

22. Explain the behavior of a person with body dysmorphic disorder.

Body dysmorphic disorder is a psychological disorder in which the client has a preoccupation with their appearance. They do not have a realistic picture of what they look like. They tend to fixate on minor appearance imperfections and see them as disfiguring.

23. Describe edema, erythema, and pruritis.

  • Edema: Swelling from a fluid imbalance in the cells or from a response to injury, infection, or medication.
  • Erythema: Redness caused by inflammation.
  • Pruritus: The medical term for itching; persistent itching.

24. Explain five sudoriferous gland disorders.

  • Anhidrosis: A deficiency in perspiration due to failure of the sweat glands; often results from a fever or skin disease. Anhidrosis requires medical treatment.
  • Bromhidrosis: Foul-smelling perspiration, usually in the armpits or on the feet. Bromhidrosis is caused by bacteria and yeast that break down the sweat on the surface of the skin.
  • Hyperhidrosis: Chronic excessive perspiration caused by heat, genetics, stress, or medications.
  • Diaphoresis: Excessive perspiration due to an underlying medical condition. Menopause is an example.
  • Miliaria rubra: Also known as prickly heat; acute inflammatory disorder of the sweat glands; results in the eruption of red vesicles and burning, itching skin from excessive heat exposure.