4.2.2. Common Skin Disorders, Diseases, and Abnormalities
💡 First Principle: Estheticians recognize skin conditions to make appropriate professional decisions — not to diagnose or treat them medically. Recognizing a condition that requires medical attention is just as important a skill as recognizing a condition you can work around.
The exam tests recognition and appropriate response — not medical diagnosis. For each condition, know: what it looks like, whether it is contagious, and what the professional response is.
Inflammatory conditions:
| Condition | Description | Esthetic Response |
|---|---|---|
| Acne vulgaris | Comedones, pustules, papules from clogged follicles | Can perform facials on mild/non-inflamed acne; avoid inflamed pustules/cysts |
| Rosacea | Chronic redness, visible capillaries, sensitivity | No heat, steam, or aggressive treatments; gentle approach only |
| Eczema (atopic dermatitis) | Dry, itchy, inflamed patches — often chronic | Avoid affected areas; consult physician before service |
| Psoriasis | Thick, silvery scales on red patches — autoimmune | Avoid affected areas; not contagious |
Infections (contraindications — no service on affected area):
| Condition | Description | Contagious? |
|---|---|---|
| Impetigo | Bacterial infection — crusty, oozing lesions | Yes |
| Herpes simplex (cold sores) | Viral — blistering around mouth | Yes |
| Ringworm (tinea) | Fungal — circular, red, scaly ring | Yes |
| Conjunctivitis (pink eye) | Bacterial/viral eye infection | Yes |
Non-contagious lesions:
- Milia — small white cysts from trapped keratin; can be removed by esthetician in some states
- Sebaceous hyperplasia — enlarged sebaceous glands; benign but may look like lesions
- Hyperpigmentation — excess melanin; can be addressed with certain treatments
- Skin tags (acrochordons) — soft flesh-colored growths; removal is a medical procedure
⚠️ Exam Trap: Psoriasis and eczema are not contagious — but active, inflamed lesions of either condition are still treated as contraindications for service in the affected area because the skin barrier is compromised. Not contagious ≠ safe to treat.
Reflection Question: A client has ringworm on their forearm but wants an eyebrow waxing. Can you perform the service? What factors affect your decision?
