Milady Advanced Esthetics Chapter 10

it usually peaks at about ____% of it's original strength.

80%

This is the hyperpigmentation caused by either trauma, known as POSTINFLAMMATORY HYPERPIGMENTATION, or from exposure to sun after client has picked the lesions raw/

Acne excoriee

then the leukocytes release another special chemical called __________.

Cytokine

D....

Diameter. Melanomas are usually at least the size of a pencil eraser or larger. Regular moles are usually smaller than this.

E...

Evolving. Changes may include darkening or variations in color, moles that itch or hurt, and changes in the shape or growth of the mole.

_______________ are a mixture of dead cell buildup, bacteria, fatty acids from the sebum, and other cellular debris.

Microcomedones

________ decreases blood circulation in the skin and thus impairs blood flow to the tiny vessels that supply the dermis, causing delayed wound healing or complications, such as tissue loss and ____________ _________.

Nicotine, subsequent scarring

_________ _______ (___________ __) occurs in the ye and eyelids resluting in eye redness (bloodshot eyes), swollen eyelids, chalazia, hordelums, eyelid skin telangiectasias, stinging and burning, and other visual problems.

Ocular rosacea (subtype 4)

What is cytokine?

a chemical released by cells that signals other chemical immune responses.

example of stage 1 wound

a mild sunburn

What is the inflammation cascade?

a series of biochemical reactions that occur when the skin is irritated or inflamed.

what is mottling?

a splotchy freckling of pigmentation across the skin. Skin that has been repeatedly burned or has not healed from a sunburn before additional sun exposure is especially vulnerable.

grade 2 acne

a very large number of closed comedones, with occasional pustules or papules. Grade 2 acne is often associated with comedogenic skin care products or cosmetics

________ _______ are red or pigmented rough patches of skin and often can be crusty, scaly, and rough to the touch. Sometimes they feel like __________ __ _________ sticking out of the skin when they are touched with the fingers.

actinic keratosis, small needles or splinters

There is also the risk of respiratory irritation from the inhalation of plume, the....

airborne particles of ablated or treated tissue caused by certain medical light or laser therapies.

Another name for inflammation cascade

arachidonic cascade

3rd degree burns...

are much deeper and much more life-threatening. They may involve deep dermal burns and may also involve burn injuries to the muscle and even the bones.

As the blood transports the necessary immune system components, the site becomes red because of the ______ ____.

blood flow

Grade 1 acne

mostly open and closed comedones with an occasional pimple. Grade 1 acne is typical of a teenager just beginning puberty but also characteristic of adult clients who have acne-prone skin. This is the most typical grade of acne seen by estheticians.

Hyperpigmentation first appears as __________.

mottling

Stage 4 wounds, the deepest injuries, involve....

muscle and bone exposure.

Vasoconstriction

narrowing of the blood vessels

a _________ is similar to a papule, but it is deeper in the skin and feels very solid and sore.

nodule

subclinical inflammation is...

not visible. This is potentially more damaging, because you may not treat what you can't see.

_________ ____________, rarely develop into inflammatory lesions. Unfortunately, the same cannot be said for closed comedones.

open comedones

In other words, it is the sudden irritation, rather than the traditional and slower buildup of cells in a comedo, that causes these __________ ___________.

papular lesions

Many women notice that premenstrual flare-ups result in sore, inflamed _______.

papules.

always have a physician's permission to help a client who has undergone ________ treatment. Treat the skin as you would an ___________ skin, staying away from any exfoliants, stimulants, fragrances or essential oils, and heavy occlusive products.

radiation, ultrasensitive

__________ ____________ is a hereditary condition in which these ells are retained. The dead cells stick to the surface of the skin and begin lining the inside walls of the follicle (causing cell build up).

retention hyperkeratosis

__________, formerly known as acne (.........) and sometimes referred to as adult acne, is a disorder of the skin characterized by redness (erythema), flushing (sudden dilation of capillaries causing sudden diffuse redness, often accompanied with a feeling of heat, and turning red very easily), telangiectasias (dilated or distended capillaries)

rosacea

_________ _________ (overgrown oil glands) are small, doughnut-shaped lesions that often look like large, open comedones.

sebacioius hyperplasias

____________ _________ are large, flat, crusty-looking, brown, black yellowish, gray or sometimes flesh-colored lesions that are often found on the faces of older clients with sun-damaged skin.

seborrheic keratoses

a wound of the skin can be very _________ and still cause skin problems

small

what is a chalazia?

small lumpy, cysts in the eyelids

what is hordeolums?

stye

Papulopustular rosacea

subtype 2. often resembles acne but often there are no clogged pores or comedones present.

Phymatous Rosacea

subtype 3. Has a thickened appearance and results in an enlargement of the nose or other facial areas.

almost every skin symptom connected to aging is directly related to _____ ________.

sun exposure

A __________ is really a medical condition and therefore not the domain of the esthetician. Suggest applying cool packs, taking a cool bath with _________ added to the water, applying plain ________ to the area, or using over the counter anesthetic sprays, if the client is not allergic to them.

sunburn, vinegar, yogurt

2 categories of wounds

superficial (surface only) and deeper (then into the 4 stages)

the _________ ________ will continue to increase for up to one year after the injury; however, the repaired wound will never be as strong as the __________ ______.

tensile strength, original skin

so what does hyperkeratosis mean?

the process of keratinization (turnover of cells) occurs at a rate much faster than normal.

Wound contracture begins at...

the tail end of the proliferative phase.

examples of 1st degree burns

minor kitchen burns and minor sunburn

__________ originates in the melanocytes-- they pigment-producing cells.

Melanoma

Example of a stage 3 wound

3rd degree burn, extends into the dermal tissue and is classified as a subcutaneous injury.

Hyper means....

"more than normal"

Systemic Corticosteroids and other immunosuppressants

-decreases epithelialization -decreases collagen production by fibroblasts.

Diseases that can cause immunosuppression

-diabetes mellitus -liver failure -kidney failure -asplenism (no spleen) -alcoholism

common rosacea triggers

-heat exposure -sun exposure -alcoholic beverages (especially red wine) -exercise (body heat) -saunas and steam baths -hot beverages -spicy food -citrus fruits or juices -caffeine -emotional stress

these are all problems directly related to sun exposure

-hyperpigmentation -leathery texture -roughness -wrinkles -some forms of hypopigmentation -severe elastosis -chest and cleavage wrinkling -splotchiness -couperose and telangiectasias -flares of rosacea -neck texture problems -severe dehydration -barrier function problems

Melanocytes are located not only in the skin but also in the ............. and other tissues that contain melanocytes.

-intestines -eye, brain -spinal cord

the proliferative phase usually begins about _________ after the injury or incision.

1 week

example of a stage 2 wound

2nd degree sunburn. this may involve a blister where epidermolysis is occurring (the epidermis is lifting off the dermis). This is classified as a dermal injury, and no esthetic services should be performed because of the heightened risk of infection.

The ABCDEs of Melanoma...

Asymmetric Border Color Diameter Evolving

A....

Asymmetric, The melanoma lesion is usually growing to one side of the lesion and is uneven.

______ ____ _______ are the most common kind of skin cancers.

Basal cell carcinomas

B....

Border. The borders of melanomas are uneven and not smooth.

What are matrix metalloproteinases?

Chemicals that break down substances in the skin. These enzymes break down collagen, elastin, and hyaluronic acid which are responsible for the smoothness, firmness and moisture content of the skin.

C....

Color. Melanomas are often dark and black and are usually splotchy and not one color.

Likewise, whenever you see redness in the skin, whether it's a burn, an acne pustule, or a flare of rosacea, some sort of inflammation is in process, as well as _________ ________.

Immune function

When a cell is inflamed, it releases special chemicals called

Inflammatory mediators

The cytokine signals cells to produce "self destruct" enzymes called _________ ____________________

Matrix metalloproteinases (MMPs)

__________________ ______ (__________) is the scientific name of the bacterium that causes acne vulgaris. These bacteria are anaerobic, which means they cannot survive in the presence of oxygen.

Propionibacterium acnes (P. acnes)

_________ ____ _________ are the second most frequently diagnosed form of skin cancer. They may look like red or pink bumps on the skin.

Squamous cell carcinomas

Erythematotelangiectatic Rosacea

Subtype 1. is characterized by diffuse facial redness, patchy redness in the nose and cheeks and a tendency to turn red extremely easily.

What are inflammatory mediators?

chemicals released by inflamed cells that alert the immune system to the irritation

almost completely caused by long-term sun exposure, ___________, also known as liver spots (although they have nothing to do with the liver), is directly related to ___________ ____ ___________.

chloasma, cumulative sun exposure

______________ ___________, and _______________ for relief of menopausal symptoms count among the most-prescribed drugs for baby boomers, while AHAs, sunscreens, vitamin C, retinoids, mica, and other popular skin care and makeup ingredients are the most-used anti-aging cosmetics on the market today.

cholesterol-lowering, progesterone

what are the 2 levels of inflammation?

clinical and subclinical

sun damage also causes the ________ of some of the blood vessels and __________ blood flow.

collapse, decreased

Grade 4 acne

commonly referred to as cystic acne, with many deep cysts and scar formation. (Refer the client to a physician.)

_______ are deep infections caused by a deep, massive invasion of white blood cells.

cysts

It is essential to keep the wound moist as it heals, because...

dryness impairs efficient migration of the epithelium.

because inflammation ultimately causes activation of the immune system, any type of inflammation can cause _________ due to the immune cells being transported to the inflammation site via the __________.

erythema, blood stream.

__________ is a condition of hyperpigmentation, sometimes referred to as __________ ______, so called because it often occurs in a pattern across the face.

melasma, pregnancy mask

beyond a burn or hyperpigmentation, there is also the risk of a ________ __________ if the client has a history of ________ outbreaks and the area around the mouth is treated, although these outbreaks can occur in other skin areas.

herpetic breakout, herpes

Occasionally, a client will respond to treatment with a mild to severe case of _______ or ________.

hives, stinging

melasma is caused by an imbalance of _________ affecting melanin production and is made worse by _____ __________.

hormones, sun exposure

Hormonal acne is more ____________ and less _____________.

inflammatory, comedonal

The food group that has been consistently implicated in aggravating acne conditions is _________. Foods that, are high in ....... include some types of shellfish, kelp, squid, asparagus, and iodized salt in salty foods.

iodides

A 2nd degree burn...

is a deeper wound, as it has also burned the tissue of the dermis. Blisters occur with second degree burns, and also possible scabbing. Intense redness and almost immediate swelling are characteristics of a second-degree burn as well as considerable pain.

A first-degree burn...

is superficial but may be red and swollen with some pain. It affects only the outer layer of skin, primarily the epidermis, although the dermis is affected by inflammation in some way by any burn, even if the dermal tissue is not directly injured.

The immune system then sends ________ (_________) to the site of inflammation.

leukocytes (white blood cells)

Grade 3 acne

thought of by most people as "typical teenage acne". Very inflamed and red, it involves a large number of open and closed comedones and many papules and pustules as well.

______ ________ is what many refer to as sun spots or sun fungus. These white splotches, which usually appear on the chests and backs of ______ ________, are actually a fungal infection.

tinea versicolor, avid sunbathers

Skin cancer is caused by cells diving __________ _____ _________, while the genetic material in the cells' DNA is _________ and __________ because of cumulative sun exposure.

unevenly and rapidly, damaged, altered

The ________ __________ layer of the dermis can heal from injuries without scarring; however, when the _______ _________ layer is damaged, scars may result.

upper papillary, lower reticular

rosacea is a __________ disorder, meaning that it is related to blood vessels and circulation of the blood.

vascular

During the proliferative phase, there is an increase in the wound's ________ to provide critical nutrients and oxygen to sustain the metabolism of the healing wound, particularly the deposit of _________.

vascularity, collagen.

clinical inflammation is...

visible upon inspection

Vasodilation

widening of the blood vessels

Whenever a client comes in with a comprimised epidermal barrier, you know you are seeing a ________.

wound

what is a stage 1 wound?

wounds only to the epidermis, or superficial.