Impetigo will often be sore and have signs or erythema. There will be small blisters present and found classically around the nose and mouth (Werner 2009). The blisters on the skin can be very sensitive to touch and are prone to bursting leaving a yellow/brown crust. The area of infection will be itchy however it is very important not to touch as the infection will spread (NHS Direct 2008). Impetigo can also show effects of fever, diarrhoea and generally feeling down and weak.
A client with Impetigo would not be able to have any treatments in a beauty or spa environment due the severity of the infection. If a client did not know that they had the condition the therapist would refer the client to a GP for medical advice. Impetigo can be treated with a tropical antibiotic cream that can be applied straight to the skin. If the Impetigo is serious oral antibiotics can be taken.
Acne Vulgaris
“It has been said, for example that over 80% of people develop ‘spots’ at some point in their lives. Perhaps 20-30% of the population seek medical attention from health professionals for acne.”
This quote taken from Graham Brown, Bourke (2007) suggests that a high percent of people all over the world are self conscious about the appearance of the skin and the way they look to others. Acne is a chronic skin condition and on average starts at the time of puberty. The main areas of infection are the nose cheeks and eyelids. Other common areas on the body are the back and chest which can often scar. These areas are generally parts of the body which produce more sedum.
Werner (2009) states that when a person starts puberty the body secretes additional hormones called oestrogen and testosterone. These hormones are normally the reason behind mood swings and teenage rebellion. These powerful hormones can also send the sebaceous glands into overload, making them produce excess sebum. Sebaceous glands are located in the dermis and make up part of the hair follicle (see fig.6). The sebum produced in the gland is an important oil that protects the epidermis, keeping the skin supple and moisturised. However if there is an over production of sebum the follicle can become infected. This infection normally occurs by dead skin cells or flaking of the sebaceous duct covering the end of the follicle (Werner 2009). The Immune systems will then recognise there is an unwanted substance and attend to the area where the white blood cells will fight the infection, resulting in the white puss like material in a pustule. Werner (2009) also states that another cause for acne lesions such as pustules, pimples, papules and Nodules is a bacterial infection. The over production of sebum in the skin surface attracts the bacteria which clumps together producing an infection of the hair follicle. There are many other causes that have been researched relating to stress, leading to hormonal imbalances and even liver congestion that can stop the normalisation of testosterone in the body.
The skin of an acne patient will often have signs of erythema and will look swollen and painful. The area will feel very uneven and rough to touch. Acne consists of many different lesions depending on how severe the acne is, and what stage the infection is at. These include: papules (a spot with no white head this will have signs of erythema and be tender to touch), pustules (the next step from a papule and will be very inflamed with signs of erythema and a yellow puss will be apparent in the centre), comedone (also know as a blackhead, this is a blocked pore which can often turn into a papule or pustule if left unattended). Scaring can arise if the sufferer is squeezing or picking the lesions (Acne.org 1997).
There are many different treatments for acne, however the most common is just a straightforward skin care routine of cleansing the skin twice daily with a suitable cleanser for the skin type. Oral medication can be taken to level out the hormones along with the contraception pill which has this effect. Tropical antibiotics can also be applied to the skin to help with the direct lesions. If a client if suffering from severe acne, laser surgery is recommended to improve skin texture. Most importantly it is vital that touching of the skin is kept to a minimum to prevent scarring and spreading of bacteria (Werner 2009). In a beauty or spa environment, a client with acne would not be advised to have a massage on the severe areas such as higher back and chest; this would be painful and help spread the infection, however the therapist could adapt the treatment. Other treatments such as facials can help by gentle cleansing and exfoliation.
Skin cancer
“Around 7,000 people are diagnosed with melanoma each year in the UK” (Bupa 1996).
This quote from Bupa shows that this type of skin cancer alone is a huge killer in the UK and more commonly recognized in mature individuals, however is coming more familiar in younger people due to the increased popularity of tanning studios and sun worshippers. Cancer is the effect of an extensive procedure that begins when in the cell are damaged, these cells are then replicated and divided, this process is known as . The speed of mitosis increases when the organelles are infected with the cancer disease. (Cancer Quest 19/04/2007).
Melanoma generally progresses from a simple mole (melanocytic naevus) that begins to change. These changes include the size and colour (lightens or darkens) some moles can start to bleed or become itchy around the edges depending on how much the mole is changing. Such moles and skin pigmentation for example freckles and seborrheic keratosis should be kept out of direct sunlight, however this is not the cause for all Melanoma cases. (Werner R 2009 p.71)
Cancer Quest (19/04/2007) suggests there are many causes that have an influence on the risk of developing skin cancer, one of which is ultraviolet radiation. Overexposure to ultraviolet radiation can have effects on the skin cells and result in melanoma. Such ultraviolet light can include tanning beds and direct sun exposure. Fair skin is much more susceptible to the radiation damage as this skin type can consist of more freckles, and moles. Immunosuppression meaning to weaken the immune system is another cause for skin cancer, the white blood cells in the body are unable to eliminate the beginning of cancerous cells. Cancer Quest (19/04/2007) also claims that family history can have an effect on whether people will get melanoma, along with smoking, injury and chemical exposure.
A method is used to diagnose the superficial spreading of malignant melanoma; this is called the ABCD(E) method (see fig.4). This helps to show the asymmetry, boldness, colour variation and diameter of the cancer mole. (Graham- Brown, Bourke 2007 p.149) By following this method it is easy to diagnose the changing mole that could become malignant in the near future. According to Cancer quest (19/04/2007) there are numerous types of melanoma categorized on symptoms and appearance. These include: Nodular lesions, superficial spreading, Acral lentiginous and Lentigo maligna melanoma for more details (see Appendix .5)
The treatment for melanoma is excruciating, a surgical excision can cure the cancer by removing the tumor or infected cells. The treatment is dependent of how far the cells have travelled, and whether they have infected deeper tissues than the epidermis. Chemotherapy drugs can also be injected to help the effected area (Werner 2009 p.72.). Skin cancer in most cases can be prevented by avoiding UV radiation and wearing a SPF 15 everyday even when the sun is not out. In a beauty or spa environment a client with melanoma skin cancer would not have any treatments unless he/she is in the later stages of cancer, this type of cancer can travel through the lymph system so any type of massage could help the cancerous cells travel to other parts of the body and organs. However if the client is in the later stages of cancer, and is dieing, massage and the spa environment can be comforting and help with the pains, along with the sense of wellbeing and relaxation.
It is very important as a therapist to not diagnose any skin diseases or disorders, the reason for this is simple, a beauty or spa therapist is not a GP, and does not have the qualifications to do so. Before any treatment a therapist should go through a thorough disclaimer form with the client to discuss any contra indications that could restrict or stop the client from the treatment for health and safety. At the end of the form the client will sign and date do declare that all the information is correct, this allows the therapist to carry on with the treatment. If a client does have any contra indications to a treatment, it will be put into two categories, to restrict the treatment or to stop the treatment. To restrict the treatment the condition is normally minor for example a wart or a verruca. The therapist can work around the area or should avoid the whole area in general, for example the leg. If a condition is severe or highly contagious the therapist has the right to stop the treatment, if the therapist is unsure about whether she/he can carry out the treatment it is important to refer the client to a doctor to ask for permission. It is important and professional that a therapist does not send the client away without a treatment if possible, for example, a client wanting a massage, however has thrombosis, should be told about alternative treatments in this case a manicure. The three diseases that have been discussed are only a few out of the thousands diagnosed. It is important as a therapist to have a clear understanding of conditions which they will come across in every day life working in a spa or salon.
Appendix
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References
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Emory University (19/04/2007) Cancer Quest. [Internet]. <> [24/10/08]
Graham-Brown Robin, Bourke Johnny (2007) Mosby’s color atlas and text of dermatology (second edition) London. Mosby Elsevie
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The Bohart Museum of Entomology. (2005) The Bohart Museum of Entomology. [Internet] Available from:<http://delusion.ucdavis.edu/mites.htm > [24/10/08]
The British United Provident Association Limited (1996) BUPA. [Internet]. Bupa <http://hcd2.bupa.co.uk/fact_sheets/html/fungal_skin_infections.html#1> [23/10/08]
Werner, Ruth. (2009) a massage Therapy guild to Pathology. (Edition 4) America, Lippincott Williams &Wilkins
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