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What’s Inside
THIS COURSE SATISFIES ELECTIVE REQUIREMENT Chapter 1: Manicuring and Your Client’s Health
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Nail technicians must protect their clients during nail services through a health evaluation. The first thing clients must do upon entering a new salon or spa is complete a new client sheet, sometimes referred to as a health sheet or health evaluation sheet. Many salons and spas bypass their use because they believe it takes up service time, and others feel it is unnecessary, thinking, “What harm can a manicure or pedicure do?” No state specifically requires them, so why should they take the time? This course will cover services you should not perform on clients that have certain health conditions, but is not exclusive to all conditions a client may have.
THIS COURSE SATISFIES CHEMICAL MAKEUP REQUIREMENT Chapter 2: Our Body’s Chemistry: Hair, Skin, and Nails
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The cosmetology industry survives on human services focusing on the Integumentary System, and therefore in order to provide quality cosmetic services, it is essential that licensed cosmetologists have a working understanding of the functions, chemical makeup, and proper treatment of the organs within the Integumentary System: skin, hair, and nails. THIS COURSE SATISFIES WORKERS’ COMPENSATION REQUIREMENT Chapter 3: An Overview of the Workers’ Compensation System in Florida This chapter identifies the primary responsibilities of the Florida Division of Workers’ compensation, and what the duties for each department are. It will also discuss the benefit rights of the injured worker and how to file a claim and resolve a dispute. THIS COURSE SATISFIES HIV/AIDS REQUIREMENT Chapter 4: HIV/AIDS and Cosmetology: Protecting Your Clients and Yourself Learning about HIV/AIDS and recognizing commonly believed myths and misconceptions about the disease is important to professional cosmetology and the salon industry, as business is built upon customer relationships This chapter covers the two primary areas of law pertaining to the practice of cosmetology in the State of Florida and will also show excerpts of documents that will clarify regulations and explain legal responsibilities and obligations. THIS COURSE SATISFIES ENVIRONMENTAL ISSUES REQUIREMENT Chapter 6: Environmental Safety: Hazardous Chemicals in the Salon Setting In the salon setting, one of the most important environmental factors is the presence of chemicals and hazardous materials. Multiple chemicals can be found within the salon setting, from the everyday products that are used on clients or the cleaning supplies used. THIS COURSE SATISFIES OSHA REQUIREMENT Chapter 7: OSHA Responsibilities for the Salon In this chapter the learner will be able to address safety and health issues in the workplace, be able to describe employer responsibilities, and know the purpose of OSHA laws and regulations. THIS COURSE SATISFIES SANITATION AND STERILIZATION REQUIREMENT Chapter 8: A Matter of Life or Death: Sanitation and Sterilization in the Salon Industry Infection and germs are a concern in the salon industry and can even be a matter of life and death. Following proper sanitation and sterilization practices can help prevent the spread of these killer organisms. Final Examination Answer Sheet and the provision of quality and fair services to all customers. THIS COURSE SATISFIES LAWS AND RULES REQUIREMENT Chapter 5: Florida Laws and Rules
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©2024: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Colibri Healthcare, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge in the areas covered. It is not meant to provide medical, legal or professional services advice. Colibri Healthcare, LLC recommends that you consult a medical, legal or professional services expert licensed in your state. Colibri Healthcare, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing, but does not represent or warrant that it will apply to your situation or circumstances and assumes no liability from reliance on these materials. COSMETOLOGY CONTINUING EDUCATION Book Code: NTFL1024 i
Frequently Asked Questions
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Mandatory Subjects
10 (All hours are allowed through home-study).
Biennial renewals are due October 31. How much will it cost?
All requirements can be found in this book.
Course Title
Price
10 Hour CE Update for Nail Specialist
$22.95
How do I complete this course and receive my certificate of completion? See the following page for step by step instructions to complete and receive your certificate. Are you a Florida board-approved provider? Colibri Healthcare, LLC, is an approved provider by the Florida Board of Cosmetology (Provider #0008051). Are my credit hours reported to the Florida board? Yes. We report your hours electronically to the Florida Department of Business and Professional Regulation (DBPR) within one business day after completion. What information do I need to provide for course completion and certificate issuance? Please provide your license number on the test sheet to receive course credit. Your state may require additional information such as date of birth and/or last 4 of Social Security number; please provide these, if applicable. Is my information secure? Yes! We use SSL encryption, and we never share your information with third-parties. We are also rated A+ by the National Better Business Bureau. What if I still have questions? What are your business hours? No problem, we have several options for you to choose from! Online at EliteLearning.com/Cosmetology you will see our robust FAQ section that answers many of your questions, simply click FAQs at the top of the page, e-mail us at office@elitelearning.com, or call us toll free at 1-855-769-9888, Monday - Friday 9:00 am - 6:00 pm, EST and Sat. 10:00 am - 4:00 pm EST. Important information for licensees: Always check your state’s board website to determine the number of hours required for renewal, mandatory subjects (as these are subject to change), and the amount that may be completed through home-study. Also, make sure that you notify the board of any changes of address. It is important that your most current address is on file.
Licensing board contact information: Florida Department of Business and Professional Regulation (DBPR) Division of Professions I Board of Cosmetology 2601 Blair Stone Road I Tallahassee, Florida 32399 I Phone: (850) 487-1395 | Fax: (850) 488-8040 Website: http://www.myfloridalicense.com/DBPR/cosmetology/ ii
Book Code: NTFL1024
COSMETOLOGY CONTINUING EDUCATION
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COSMETOLOGY CONTINUING EDUCATION
Book Code: NTFL1024
Chapter 1: Manicuring and Your Client’s Health (Satisfies Elective Requirement)
Learning objectives After completing this course, the learner should be able to: Describe the symptoms of people who are allergic to EMA. Name the first symptom usually evident when one is allergic to polish. Name the three chemicals that are being formulated out of polishes. Explain why manicuring has become popular again in the nail industry. Nail technicians must protect their clients during nail services through a health evaluation. The first thing clients must do upon entering a new salon or spa is complete a new client sheet, sometimes referred to as a health sheet or health evaluation sheet . Many salons and spas bypass their use because they believe it takes up service time, and others feel it is unnecessary, thinking, “What harm can a manicure or pedicure do?” No state specifically requires them, so why should they take the time? Why? Because some clients have chronic conditions that can affect their capability or the protocol for their services, nail technicians should know their conditions and be trained in
List five conditions that must be on the health history sheet. List three conditions that disqualify clients from soaking. Provide the reasons for not trimming cuticles. Describe a soakless pedicure. List three reasons why a patient would have a soakless pedicure.
HEALTH AND THE MANICURIST
how to deal with them, and when not to or how to perform the services. The protocols of the services must be changed for some clients, and some should not have one at all. The only way to discern these clients is through the health list on their sheet. Unfortunately, it appears that no schools are training students on how to get this information. And just as important, an informed manicurist can protect herself from contracting an infection and can prevent later clients from getting it as well. Below is a typical all-services health questionnaire list. Some add “or a history of” to their request for information.
Client Health Sheet Your health background is important to the provision of safe services. Please circle any conditions you have, medications you take or activities you do that are listed below.
Blood pressure (high or low)
HIV/AIDS
Stroke
Cold hands and feet
Nail or foot fungus
Kidney problems
Tuberculosis
Experienced a sunburn
Bleeding disorders
Anemia
Any skin disease
Scoliosis
Use Accutane ®
Lymphedema
Digital herpes
Arthritis, tendinitis, bursitis
Open lesions of any kind
MRSA
Cancer
Foot bone abnormalities
Undergo chemotherapy
Diabetes (I or II)
Antibiotics
Hepatitis A, B, or C
Fibromyalgia
Varicose veins
Use medications that cause skin light sensitivity
Heart problems
Arteriosclerosis
Undergone hormone replacement
Stress-related condition
Use oral acne products
Have extremely sensitive skin
Thyroidism (hyper or hypo)
Use a tanning bed
Use heparin/similar meds
● High blood pressure (hypertension) can cause fluid buildup and swollen hands and feet. The effects of high blood pressure on the nervous and circulatory systems can cause pain, loss of sensation (neuropathy) and tingling in the feet and can increase the susceptibility for infection and foot ulcers and thus increase the potential for infections and ulcers that can lead to amputations or even death. The technician should assume that clients with longstanding high blood pressure do not have full feeling in their feet because of damage to the nerves in the feet, and they heal poorly because of damage to the blood vessels in the feet. Massage is contraindicated for any person with high blood pressure. Soaking is also contraindicated; a soakless pedicure is indicated.
Below are details involving the particular conditions and precautions for providing manicure and pedicure services to clients with the conditions and meds that are listed on the above example of a health sheet. The information does not cover all the needed information – that would take a book. It is the responsibility of each individual manicurist to seek out this valuable information. Clients with certain conditions should check with their physician for permission to have pedicures. Blood pressure (high or low) is the relationship of the vascular pressure needed to move sufficient blood to achieving homeostasis in the organs.
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● Low blood pressure (hypotension) is having lower-than- normal blood pressure that can cause insufficient blood and oxygen to the organs. This can result in temporary or permanent damage to organs. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel lightheaded, dizzy or even faint. Going from a sitting or lying position to a standing position often brings out symptoms of low blood pressure. This occurs because standing causes blood to “settle” in the veins of the lower body, and this can lower the blood pressure. If the blood pressure is already low, standing can make the low pressure worse, to the point of causing symptoms of light headedness, even fainting. Nail technicians should assume every client is hypotensive when standing from a chair or getting out of a pedicure chair and offer their aid. A person who usually has normal blood pressure is in a state of ultra relaxation and her blood pressure may go down to a point where it can cause her to fall or stumble when getting out of the chair. Diabetes mellitus (1 or 2) , usually referred to as diabetes, is a chronic disease in which a person has high blood sugar either because the pancreas does not produce enough insulin or because cells do not respond to the insulin that is produced. Blood sugar indicates the concentration of sugar (glucose) in the blood. Glucose, the primary source of energy for the body’s cells, is transported from the intestines or liver to body cells via the bloodstream and is made available for cell absorption. Insulin is a hormone produced by the body primarily in the pancreas. Insulin also provides signals to several other body systems, and is the chief regulatory metabolic control in humans. The human body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis (“balanced”). Diabetes affects the entire life of a diabetic, from how the person eats to the long-term health of the heart, kidneys and feet. People suffering from diabetes have one of two types of diabetes mellitus, 1 or 2. Type 1 diabetes usually is diagnosed before age 20 but can occur at any age including adulthood, especially in those in their late 30s and early 40s. The pancreas produces little or no insulin. It may develop very abruptly over a period of a few days or weeks and shows itself in the following three-step sequence: 1. Increased blood glucose. 2. Increased use of fats for energy and for the formation of cholesterol by the liver. 3. Depletion of the body’s protein stores. This will show as a sudden drop in body mass that isn’t stopped even when eating large amounts of food. A sufferer will also feel very fatigued and generally “under the weather,” and experience intense thirst. The distinguishing characteristic of patients with Type 1 diabetes is that they are life-long dependent on exogenous insulin (injections). They require long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. The pedicurist must assume this client has some degree of neuropathy (loss of feeling in the feet). Generally, Type 1 insulin- dependent clients cannot be soaked because they are prone to extremely dry skin that can easily become infected. Always assume the diabetic person has some vascular damage in the feet, and that gentleness is important in massage. Type 2 diabetes results from the combination of resistance to insulin and inadequate insulin secretion. It is characterized by hyperglycemia and associated with microvascular (such as retinal, renal, possibly neuropathic), macrovascular (such as coronary, peripheral vascular), and neuropathic (such as autonomic, peripheral) complications. Type 2 diabetics may or may not be dependent upon insulin for life and may be on oral medications. They may at some time become insulin dependent, sometimes due to obesity. Always ask whether this person is insulin
dependent and if his or her doctor has given permission for the person to have a pedicure. Do not soak an insulin-dependent diabetic. Type 2 diabetes is far more common than Type 1 , accounting for 80-90 percent of all known cases of diabetes in the United States. In most cases, the age of onset is more than 40 years, with the majority diagnosed between the ages of 50 and 60. Unlike Type I, this type develops slowly and can go unnoticed for some time. Arteriosclerosis – To accommodate the pressure created by the pumping of the heart, arteries must stretch with each heartbeat. Half the deaths in the United States each year are caused by cardiovascular diseases, which are accompanied by circulatory problems. The single greatest killer of Americans today is hardening of the arteries or arteriosclerosis, which prevents the arteries from stretching with the pumping of the heart. Persons with circulatory problems cannot be soaked nor have massage on their legs . Reflexology may be appropriate. Lymphedema – Lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and may cause localized and chronic fluid retention and tissue swelling of the extremities, called lymphedema. Primary lymphedema is hereditary, while secondary lymphedema is caused by infection, cellulitis, damage to the lymph system, and chemotherapy. Early diagnosis is difficult, though the sufferer may report “heaviness.” Generally, by the time of diagnosis, it is incurable. The lymphatic system is a parallel vascular system to the artery/ venous blood system that returns interstitial fluids to the bloodstream where they are returned to the tissues. The soleus muscle, also known as the calf pump, executes movement of lymph from the legs towards the heart and back into the blood system. As a person walks, the soleus contracts, squeezing lymph up the leg via the lymphatic vessels. When the muscle relaxes, valves in the vessels shut, preventing the fluid from returning to the lower extremities. Symptoms may include severe fatigue; a heavy swollen limb or localized fluid accumulation in other body areas, including the head or neck; discoloration of the skin overlying the lymphedema; and eventually, deformity of varying degrees. Only persons with minor swelling should experience pedicures, and they should not be soaked . This person should be massaged very gently upward. A trained lymphatic therapist can perform lymphatic drainage on early- stage lymphedema, a technique that must be specific and requires training. The technique requires the therapist to manipulate other areas of the body and should not be performed by a manicurist. Foot/bone abnormalities – Foot deformities, whether congenital or acquired, can cause pain for the client if the technician is not knowledgeable about the deformity. For example, hallux valgus, a bunion, often causes the client pain, and extreme pain occurs if the pedicurist performs the foot pulling massage movement on the toes. Massage on any foot with deformity is contraindicated because they are very susceptible to injury and high pain upon manipulation. Recent sun or use of sun bed – Use of a tanning bed or recent exposure to the sun can cause skin irritation that is not evident if it was experienced just before the treatment. The result may be a burn-like response to massage or products that can become blisters, or the outer layer of the epidermis may peel, and sometimes an open lesion may develop. Do not perform any treatments or massage on a client who has recent overexposure to the sun or uses a sun bed service. Skin disease of any kind – Not only is it reasonable to ask this question for the safety of the client regardless of whether the disease is active, it also is important for the safety of the nail professional. Conditions range from actinic keratosis to melanoma, and the technician should seek thorough education on the topics. Many are non-pathological and will not prevent
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resulting urine to the bladder to be removed from the body upon urination. Chronic kidney disease is a gradual and usually permanent loss of kidney function over time. With loss of kidney function, there is an accumulation of water, waste and toxic substances in the body that are normally excreted by the kidney. Acute kidney failure develops rapidly, over days or weeks. Loss of kidney function also causes other problems, such as anemia, high blood pressure, acidosis (excessive acidity of body fluids), disorders of cholesterol and fatty acids, and bone disease. Manicurists and pedicurists will usually see swelling (“puffiness”) of the appendages and should act accordingly – no soaking and careful upward massage movements. Varicose veins – Healthy veins contain about 70 percent of the body’s blood at any one time. Since blood returning to the heart from the lower part of the body must move against gravity, most of the larger veins contain one-way valves to keep the blood from pooling in the feet and legs, or moving backwards. Varicose veins have valve problems allowing the blood to move backward, and they become swollen because of the blood they are being forced to hold that is not moving upward properly. Eventually, they do not function properly. Advanced varicose veins can also be predisposed to ulceration. After veins develop valve problems, the blood re- routes through smaller, more superficial veins. Massage of the legs is not an option with these clients and can be painful and dangerous. Soaking is also not an option above the feet/ankle. Bleeding disorders – Usually a lack of clotting capabilities, bleeding disorders can be the cause of easy bruising and nonstop bleeding from a minor cut. Most are from taking medications to prevent strokes and other illnesses that can be caused by clotting of the blood. These clients should not have their cuticles trimmed – none, and any use of metal implements should be extremely gentle, if used at all. Massage should be gentle and slow. Hepatitis A, B, or C is an inflammation of the liver usually caused by a pathological microbial invasion. Hepatitis is generally covered in pre-license courses, so discussion here will be short. These illnesses are highly contagious, no matter their mode of transfer, and OSHA requires all personal service providers, including nail technicians, to assume every client is infected, no matter whether they are or not, or whether they disclose their illness or not. This requires the use of personal protective equipment and a high level of infection control in every service. Stroke – It is important that salon employees know the signs of a stroke and immediately call 911 when they see them. Fast treatment is imperative to positive recuperation. Remember, women may report unique stroke symptoms, including: ● Sudden face and limb pain. Open lesions of any kind prevent services by manicurists and pedicurists. Coverage does not protect the technician from transfer of an infection. Cold hands and feet can indicate a circulatory problem or reduced blood flow to those limbs. This also can be a symptom of Reynaud’s Disease, a circulatory disease. Even low blood pressure can cause reduced blood flow and cold hands or feet. Hypo-thyroidism also can cause cold hands and feet. Whatever the reason, and there are many potential ones, it is important for the technician to consider a reduced blood flow, which can cause a propensity to infection and slow healing. Extreme care should be taken with this client to prevent injury. Massage is usually no problem and increases blood flow, and therefore the supply of oxygen to the area and the friction can warm the skin and appendage. ● Sudden hiccups. ● Sudden nausea. ● Sudden general weakness. ● Sudden chest pain. ● Sudden shortness of breath. ● Sudden palpitation.
manicures and pedicures, but others will. Psoriasis will disqualify treatment because it can harm the client. An example of a pathological skin infection that will not allow a manicure or pedicure is shingles, which can occur on the legs. Digital herpes – A viral infection that is not only very contagious when active, it is contagious for a time before symptoms are evident on the skin. Sufferers will say the skin may tingle before the actual breakout, so the client may recognize an eminent breakout. DH is a recurring infection, and can be activated by many activities, such as stress and even the use of implements on the area with aggression. This client must be treated gently, and the nail technician must wear gloves at all times when working with him or her. Working on the affected nails last may be a wise decision to prevent spreading the infection to other fingers. No heavy massage should be performed on a client who has a recurrent though not manifesting disease. Heavy massage can activate a recurrent skin disease. Nail or skin fungus – A very common infection, fungus is very contagious. Nail and foot fungus are from the same dermatophyte but can be active on only one or both the nails and the skin of the foot. (On the hands, it usually is only on the nails.) No client with nail or foot fungus should be given a beauty service on that area of the body. Tuberculosis (TB) – One of the oldest human diseases infecting an estimated 16.2 million people, tuberculosis remains one of the leading causes of death and illness in the world. The bacterium is spread from person to person as it is carried by droplets expelled when coughing, sneezing, speaking, and laughing. The symptoms include dry persistent cough, bloody sputum, intermittent fevers, and flushed complexion. A simple skin test and chest x-ray are used to confirm diagnosis and several antibiotics must be taken for at least 6 months in order to eradicate the disease. The doctor will advise the patient when he or she is not contagious; until that time the person is extremely contagious and may be advised to wear a mask over the mouth and nose. The disease is currently becoming resistant to the prescribed antibiotics due in part to patients not completing the full course of treatment. Arthritis, tendonitis, and bursitis – Any term with “itis” at the end indicates inflammation. Arthritis is inflammation of the joints, tendonitis is inflammation of the tendons, and bursitis is inflammation of the bursa (bursa sacs exist on the feet). These conditions can be extremely painful and prevent treatment. Massage is usually not performed on these persons by a manicurist to prevent further damage. Thyroidism (hyper or hypo) – This is an autoimmune disease of the thyroid gland located on the front part of the neck below the thyroid cartilage (Adam’s apple). The gland produces thyroid hormones, which regulate body metabolism. Thyroid hormones are important in regulating body energy, the body’s use of other hormones and vitamins, and the growth and maturation of body tissues. Diseases of the thyroid gland can result in either overproduction (hyperthyroidism) or underproduction (hypothyroidism) of the thyroid hormone, or goiter (enlargement of the thyroid with hyperthyroidism or hypothyroidism but also with benign and malignant – cancerous – nodules). There are many causes, from chemotherapy to genetics and family history. Many symptoms exist, from fatigue to weight gain and depression for hypothyroidism to hyperactivity and weight loss for hyperthyroidism. It is not an easy disease to diagnose. These clients are prone to very dry skin and should not be soaked unless a deep hydration treatment is performed. They are also prone to crevices over their calluses on the heel, indicating they should not be soaked. Kidney problems – The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. They act as a filtering system, removing waste products and excess water from the blood then sending the
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Anemia is a low red blood cell count, which decreases oxygen delivery to every tissue in the body . Symptoms can be varied and wide-ranging, from fatigue to fainting to heart palpations. A person with anemia should be considered a slow healer, so gentle use of implements is important. It is also imperative that those instruments be sterilized to prevent the transfer of infection. Cancer in any form is devastating to the client and his or her family. A person who has had cancer or is in treatment for it must be treated gently and with high-level infection control. Always ask whether the person has permission from his or her doctor to have the treatment. Unless the person’s skin has become dry as a side effect of chemotherapy, these clients enjoy a soaking in a whirlpool tub. MRSA (methicillin resistant Staphylococcus aureus); HA-MRSA (hospital-associated methicillin resistant Staphylococcus aureus); and CA-MRSA (community-associated methicillin resistant Staphylococcus aureus – This infection is from the bacteria Staphylococcus aureus, a microbe that is routine in the flora on our body. When it becomes out of balance in the body past healthy tolerance or a cut on the skin occurs, it can become pathological (capable of causing illness). MRSA in hospitals is called hospital-associated methicillin Staphylococcus aureus (HA-MRSA), where it primarily was found. However, it has spread into our environment. Known as community-associated methicillin Staphylococcus aureus (CA-MRSA), it and HA-MRSA are causing illnesses that kill more people every year than HIV and hepatitis. MRSA is very contagious and is spread by touch between people (direct transfer) and between people and surfaces, such as towels, the clothing of others, just about everything (indirect transfer). The problem is its resistance to cure. Nail technicians are especially susceptible to CA-MRSA because they touch and hold the hands and feet of clients who may be ill or “colonized,” meaning they carry the MRSA infection in out- of-normal numbers but it is not pathogenic to them. Studies show that 30 percent of the U.S. population is colonized, so it is probable that some persons in each nail clientele are colonized with the easily transmittable Staph microbe. These microbes can be passed on to a new host who may become infected and very ill – possibly their nail technician. Symptoms of CA-MRSA infection proceed through stages, with each worse than the last. Too quickly, if not treated, it can carry the infection into the inner body and to the person’s organs. Then it is difficult to treat, and it can kill the sufferer. Even the first stage is treated with very heavy antibiotics because MRSA proceeds through the stages quickly. It must be stopped as early as possible. Many nail technicians have reported incidences of being infected and not knowing what the lesion was until someone suggested they go to the emergency room ASAP. Because MRSA infections can be so serious and are sometimes deadly, it is important to learn to recognize the symptoms of one so that your early treatment can be initiated. The first symptom of MRSA is a little red bump or bumps on the skin that appear like spider or other bug bites. (For a very short time it isn’t even Medications and activities The client health sheet is also important to nail technicians because many of the listed medicines or activities can increase adverse responses of the skin to some treatments. Antibiotics – Clients taking antibiotics may respond to products or treatments as they would not any other time; irritation and exaggerated redness can result in lesions, even scarring in those with slow healing problems. Accutane® and other oral acne products – Use of these medications can cause the skin to turn red, even become inflamed or blister even though it is not in the specific area of the medication application. The skin of the client is very sensitive to scrubbing. No AHA or retinoid product should be used on this
surrounded by redness.) But it doesn’t stop there. The area quickly becomes inflamed and painful, and then develops a boil that is draining or is full of pus. Within three to four days it becomes a deep, damaging abscess that penetrates the skin. By then, the person likely has sought help from a physician or emergency room and been prescribed heavy antibiotics even before lab tests confirm the probable diagnosis. At the same time, the person feels fatigued, much like the day before experiencing the flu, and is becoming irritable. If it does not get better immediately, even stronger antibiotics are prescribed. If it does not begin to get better, other symptoms, such as fever, difficulty breathing, chills or chest pain, would typically be signs of a more serious MRSA infection that has spread beyond the skin and to the blood, lungs or other part of his body. These symptoms require intense and extensive medical attention and possibly hospitalization in an infectious ward of a hospital. It is not unusual for such a person to be off work for months and become permanently incapable of working, or unable to work in a personal care or food industry. (18) MRSA is so infectious and dangerous that it is one of the major reasons nail technicians should use gloves when working on clients. A person with even a first-stage lesion – which looks like a bug bite – should not be provided a service in a salon. Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons and other soft tissues. The causes and methods of prevention are unknown. These clients should be treated with gentleness and with questions during the treatment concerning their comfort. These clients enjoy being soaked in a whirlpool and experiencing paraffin and heat. Massage can feel wonderful or be excruciatingly painful. Always be aware of your client’s responses to touch. Stress-related conditions sometimes manifest on clients as being directly related to stress or the flare-up can be attributed to “nerves.” Hives can be caused directly from stress, and flares of eczema, psoriasis and vitiligo and other skin conditions can be directly related. Do not perform services on clients who have lesions on their skin of any kind, no matter the cause. Scoliosis is a sidewise curvature of the spine away from the middle. Knowing a person has scoliosis is not so much a consideration of the precautions of services as a reminder of thoughtfulness towards the comfort of the client. Nail technicians should always ask these clients how they could be made most comfortable. Sensitive skin – Some clients have skin that will respond with irritation with little cause. Even use of a scrub or an exfoliation glove on the arms or legs or even massage can cause them irritation. If clients mark “sensitive skin” on the health sheet, ask questions about the degree of their sensitivity and watch the color of their skin for any indication it is beginning to redden. Do not perform more than a few seconds of a scrub, and be gentle. Massage should not be intense or aggressive. If redness occurs, cool compresses should be applied on a reddened area to relieve the sensitivity. client because these products cause reactions, sometimes even skin lifting, on persons who are on them. Rapid exfoliants – Products such as Retin A and other vitamin A products may cause skin to respond with high irritation and blistering, even lifting of the epidermis if certain products (such as AHAs) are used in a treatment. Never use AHA or peeling products on this client’s skin. Exfoliation products, AHAs – The use of products with these ingredients on skin that is continually exposed to the sun, such as the hands, can develop hyperpigmentation. Hand lotions with an SPF ingredient should be sold to these clients for application in the morning and after each hand washing to refract the UVB
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treatments should be performed on these clients. Massages should be gentle. Reflexology by an expert reflexologist is a great massage for these clients during their pedicures. These clients should not have their fingers or feet soaked; low heat is applied when they are in heat mitts; don’t even consider medium heat because their skin may respond with a burn. Paraffin is not performed on these clients. Medications causing light sensitivity – Clients taking medications that cause them to be light sensitive cannot have LED treatments unless their physician says the exposure is acceptable. Manicurists must know the existing and past health conditions and medications of their clients and their relevance to the services they are providing their clientele. The only way this can happen is through a new client sheet that contains a health section. At each service, the manicurists should ask the client whether any health changes have occurred since the last service and note those changes in the client’s record for use in client evaluation at future appointments. podiatrist and never provide any opinion whatsoever about a condition for several reasons: ● The podiatrist referred to will not be pleased with any comment other than “You need to see a podiatrist, and this is whom I recommend.” ● The salon and nail technician may lose future referrals from this podiatrist or bring a call from him or her reminding the professional not to do such. ● It is against the law in every state for a non-medical professional to diagnose or treat a pathological condition . ● A nasty lawsuit may follow if the diagnosis is incorrect. ● The technician can be turned in to the state board for an illegal act. ● The salon and professional can lose their licenses. Nail technicians need to consciously practice how to avoid discussing possible conditions on the feet and offering medical advice other than “you need to go to a podiatrist.” If not, they will slip and provide an opinion for which they have no training and that is illegal to offer. Clients will ask, even press the technician for an opinion, so it is important to define what to say to avoid giving one. It is best to have the cards close by of a podiatrist with whom the salon has a relationship; provide the card to the client. Some technicians even call the office to make the client an appointment or will forward a picture taken on their phone to the office for the podiatrist. Referrals from the podiatrist of their patients can be nurtured when a nail technician refers clients to the podiatrist’s offices, especially if the nail technician is trained to work with the chronically ill ( www.medinails.com ) and uses an autoclave in implement infection control. Some technicians believe soakless services have a unique protocol and that special training is necessary. It does not. It merely means that in a manicure, the fingertips are not soaked, and in a pedicure the feet are not soaked in water, whirlpool or otherwise. That step is replaced by moisturizing and softening the hands and feet another way. It is known by several names: waterless manicure or pedicure, dry manicure or pedicure, soakless manicure or pedicure. Reasons for preferring soakless include: ● The protocol is not waterless. Water is used several times through wet towels. ● The protocol is not dry. Wet towels are used several times during the service. ● Soakless is exactly what it is. Neither fingers nor feet are soaked in water.
and UVA rays. The home-care lotions should be 10-15 percent AHAs, and the peels from the facial department that are applied to the calluses in some treatments should be no more than 30 percent AHAs. Some states do not allow nail technicians to use AHAs at all; others have no restrictions. Hormone replacement (HRT) – The person taking this medication (HRT) may have heightened responses to products that have AHAs and Retin A ingredients in them. The skin may become reddened to some degree, or possibly become irritated. (This will not happen if the AHAs are restricted to the calluses.) An added note: A client who is pre-menstrual may respond with more redness than usual to treatment products and exfoliation, even to use of an exfoliation glove or scrub. Chemotherapy – A person on chemotherapy is especially sensitive to irritation, so must be treated gently with products that cannot produce irritation. There is no way to know how their skin will respond because of the continued assault on their bodies. They are also very susceptible to infections and slow healing of any injury, no matter how miniscule. Only basic General information Massage of the hands and feet and arms and legs during a service should never produce pain or discomfort for any client. Always ask several times, quietly, if the movements are comfortable for the client, and change the pressure and movement she is uncomfortable. It is against the law in most states to perform services on anyone with an active infection of any kind, such as foot fungus, tuberculosis, hepatitis, HIV/AIDs, and any active skin condition of any kind that has open lesions. It is not discrimination; it is the law. (Check with your state on this policy. Instead, state rules may instruct you to use universal precautions and proceed.) Never cut or trim the cuticles of a client who has a chronic illness or is prone to infection. More and more states are changing their regulations to “no cuticle trimming” because they recognize the practice allows entry to pathological microbes. Only dead skin should be removed from the eponychium. The flat, even “shelf” of tissue on the anterior of the eponychium is not to be removed; it is the seal to prevent microbes from penetrating beneath. Diagnosing – not Diagnosing of skin and nail disorders can be a serious issue for nail technicians. Know that anything beyond saying a person’s condition is “out-of-normal” is illegal in every state and places the technician and the salon into a precarious position legally. Nail technicians must resist the temptation to say, “this looks like …” when discussing a condition on the feet or nails of their clients; it is a very dangerous phrase when working with them. No matter what, the nail technician must fully defer to a Soakless services A soakless service is an option for both hands and the feet and is an important service for every nail technician to learn, especially when performing pedicures. The reality is that every nail technician should know how to perform this service because many clients cannot be soaked. The reasons for choosing this type of service are: ● Those who cannot be soaked can still enjoy a manicure and pedicure. ● Those who fear contamination in a pedicure tub can enjoy a pedicure. ● The protocol is faster than soak services; it removes the necessity of cleaning and disinfecting the bowl or tub. ● It prevents dehydration of the skin by soaking. ● It is highly moisturizing. ● Some people just prefer the mitts over the soak
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Book Code: NTFL1024
EliteLearning.com/Cosmetology
cleanser.) Rub the cleanser around the foot or lower legs and feet with a comfortable, gentle massage technique (use plenty of cleanser for the massage effect), and then remove well with a warm (never hot) towel. Dry the feet and legs. Cover or wrap the leg and foot whenever not being treated with a towel or the cover sheet. Move to the second foot or leg. 4. Exfoliation . Apply a scrubbing product to the first leg and foot, especially into the calluses. Use effleurage movements and spend no more than 1-2 minutes on the manual exfoliation. Remove with a warm wet towel, dry and then cover the foot and leg with the towel. Perform the same procedure on the second leg, then cover. 5. Massage . Apply an oil or lotion and perform the appropriate massage, according to the health sheet, on the first leg and foot. Apply the eponychium (cuticle) treatment and the callus treatment. If appropriate, apply a mask to the feet, apply paraffin over it and then put on the plastic bag and terry mitts. (Do not use heat mitts over paraffin.) Wrap each foot after its massage to maintain warmth. Move to the second foot. If you are using a mask or a heavy lotion and no paraffin, apply the eponychium treatment, the callus treatment 11 and mask or lotion, place in a bag and in terry or heat mitts or a towel, possibly a warmed one. Move to the second foot and repeat. 6. Callus treatment . Remove the bag or other cover from the first foot, remove the callus treatment with a wet cloth, and perform the callus exfoliation. 7. Eponychium treatment . Remove the cuticle treatment and perform the treatment. After, wrap the foot in a dry towel, leaving the toes exposed. Now move to the second foot. 8. Polish prep/polish . Put on sandals. Cleanse all the nails and then polish. Discuss the home foot care and retrieve the products the person is taking home. 9. Post-polish drying . Move the client to the drying area to sit for 10 minutes. If using a gel polish, cure them as directed. 10. While the person is drying or is getting ready to leave, make the next appointment and provide a card, and clean and reset the pedicure area for the next client. Brush, cleanse and place implements in the autoclave and fill out records.
Though it has been performed for some time, it has only recently hit the mainstream and is enjoying popularity. It can be used for every treatment manicure or pedicure. Basically, the process is the same as its wet version, just without the water soak. A typical soakless protocol is below. Salons or spas still use their spa chairs; clients love the massage and heat of these chairs. The whirlpool bath is covered with a laminate (as with kitchen counters) lid – many of these chairs actually have a lip around the top of the bath in which a customized lid can fit. If not, a lid can be designed that fits over the tub. It is covered with a towel for client’s feet to rest on. Warning : Clients should be immediately trained to not place their weight on the bath cover – no more than on the footrests. Salons or spas that do not have the spa chairs but do have a corner that will hold a facial chair can allow clients to relax while having their pedicure. The chair is covered with a large bath towel for comfort. A screen can be placed between the other clients and the chair for privacy and comfort, or a hospital curtain track can be placed on the ceiling to allow a curtain to be installed and pulled closed during the pedicure. Others use a separate room for one or more of these chairs. Protocol – The basic soakless/waterless pedicure The protocol is written for a pedicure but can easily be changed to that of a manicure. The client can be sitting or laying back but he or she must be comfortable. Have all disinfected implements in a covered container and laying on a towel-covered professional stand along with other supplies. Cover the person with a clean, comfortable blanket, a sheet or sheet towel, or whatever is the salon policy. 1. The client’s health information should be filled out in the waiting room . Seat the person according to policies. Put on gloves. Check the health sheet and feet for contraindications to having a pedicure. If not appropriate, refer the person to a podiatrist and perform a placating pedicure. 2. Examine the feet and legs and discuss any conditions with the person. Adjust your techniques according to the health responses, using precautions for pedicures on at-risk clients. Remove polish, shorten and shape the toenails while discussing the procedure. Suggest services, if different than on the book, and upgrades at this time. 3. Cleanse . Wet the legs, feet and toes with a warm, wet towel and then apply a foam cleanser to your wet hands and work up lather, if possible, or a gel cleanser, rubbing it all over them. (Remember the toenails – use a nailbrush with more Conclusion: The nail industry has changed since its one-service beginning — the manicure – from being an “and we also offer …” service in hair salons to being a well-known niche specialty in the professional beauty industry. No longer is it performed in the corner of a salon or under the hair dryer, and no longer does the nail professional have to have a cosmetology license.
It also has become a multifaceted service industry with multiple services available that require commitment to specialized training. The nail professional of the second decade of the 2000s must commit to meeting a client’s skin and nail needs for the hands and feet and also be fully trained in the health and welfare of today’s more complex clients. The industry and its professionals have indeed come a long way since ancient times and the manicures of the 1940s.
Book Code: NTFL1024
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EliteLearning.com/Cosmetology
Chapter 2: Our Body’s Chemistry: Hair, Skin, and Nails (Satisfies Chemical Makeup Requirement)
Learning objectives Given the course materials, the learner will be able to: List several of the major functions of the Integumentary System. Recognize the six elements that account for over 99% of the human body. Define pH and discuss levels of acidity and alkalinity. Cosmetology is the professional practice of beautifying the skin, hair, and nails: all components of the body’s largest organ system, the Integumentary System . The cosmetology industry survives on human services focusing on the Integumentary System, and therefore in order to provide quality cosmetic services, it is essential that licensed cosmetologists have a working understanding of the functions, chemical makeup, and proper treatment of the organs within the Integumentary System: skin, hair, and nails.
Explain why high pH products may have a drying effect on hair, skin and nails. Recall tips for keeping clients and staff safe from chemical exposure in the salon setting. Relate knowledge of chemical makeup and pH to product selection.
INTRODUCTION
The Integumentary System serves to protect the human body from outside elements. It functions to keep our internal organs free from damage, but also serves many other purposes such as waterproofing and insulating the deeper tissues, regulating temperature, and removing wastes. It serves in the detection of pressure, pain, and sensation and provides for vitamin D synthesis.
The chart below shows some of the major functions of the Integumentary System : Waste removal (excretion) through sweat. Interfaces with the environment as the first line of defense from external factors.
Protects against pathogens and excessive water loss and controls evaporation. Thermoregulation and temperature detection.
Langerhans cells in the skin are part of the adaptive immune system.
Sensory functions from nerve endings indicate touch, pressure, vibration, and tissue injury, etc. Absorbs oxygen, nitrogen, and carbon dioxide - the cells comprising the outermost .25-.20 mm of skin are almost exclusively supplied by external oxygen!
Acts as a water-resistant barrier to hold essential nutrients in the body.
Guards the underlying muscles, bones, ligaments, and internal organs.
Stores lipids and water.
Insulates and cushions.
Produces Vitamin D Folates.
condition. Mastering an understanding of the chemical makeup of the skin, hair, and nails is an important part of being able to provide these services. This course will provide you with the need-to-know information regarding chemical makeup relevant to the salon industry.
For all of the above reasons and more, the Integumentary System is essential to the effective functioning of the entire human body. As a licensed cosmetologist, your job entails not only beautifying the skin, hair, and nails, but also recommending appropriate home-care products to promote and prolong health and keep hair, skin, and nails maintained in the best possible It is impossible to determine the exact chemical composition of the human body, as each cell is a mixture of thousands of different chemicals. However, scientific speculation proposes that the average chemical makeup of the adult human body would be similar to the following formula: H 375,000,000 O 132,000,000 C 85,700,000 N 6,430,000 Ca 1,500,000 P 1,020,000 S 206,000 Na 183,000 K 177,000 Cl 127,000 Mg 40,000 Si 38,600 Fe 2,680 Zn 2,110 Cu 76I14 Mn 13 F 13 Cr 7 Se 4 Mo 3 Co 1 While this is not an exact representation for any one individual, it gives an idea of the many different chemical components coexisting and interacting within the human body. Six elements, oxygen, carbon, hydrogen, nitrogen, calcium, and phosphorus account for over 99% of the human body. The most abundant chemical in every human body is water (H20), which composes between 65-90% of every living cell, closely followed by carbon (C). Because differentiated cells don’t vary hugely by chemical composition, the formula provided above should be reasonably accurate for human skin, hair, and nails with the exception of calcium and phosphorus, which would be significantly lower due to their concentration in bone.
CHEMICAL MAKEUP
To truly understand the chemical makeup of the skin, hair, and nails, it helps to understand the composition of each organ. Organs are made of tissues, which are groups of similar cells that work together to perform a certain function. Each of these cells is composed of organelles, or very tiny structures that perform certain tasks within the cells. Organelles are then made up of various materials including proteins. These proteins are made up of various amino acids. The chemical formula of an amino acid is easily definable, experimentally quantifiable, and tells with exactitude what the amino acid is and what it does. It is only at this miniscule level that we are able to cleanly identify the various different chemical components working within the human body. This shows the extreme complexity of the chemical makeup of the human body and highlights the uncertainty that remains when trying to determine the chemical formula for particular components (such as skin, hair, and nails) within the body. What we do know with certainty is that hydrogen, oxygen, nitrogen, carbon, sulfur, and phosphorus normally makeup more than 99% of the mass of living cells. Therefore, an understanding of how different chemical compounds interact with each of these elements can provide insight into how chemical compounds will
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Book Code: NTFL1024
EliteLearning.com/Cosmetology
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