4.3 Pigmentation Disorders, Growths, Contagious Disease, and Inflammatory Conditions

Color, growths, contagion, and inflammation on the same intake sheet

Skin analysis is not only Fitzpatrick typing (Chapter 5). It is also whether pigment is mottled, whether a growth sits in the wax path, whether a vesicle is a contagious warning, and whether a rash will worsen if you apply fragrance or heat. Domain 2.C groups these as diseases, disorders, contraindications, patch tests, and adverse signs. Georgia curriculum 240-16-.02 names conditions and disorders of the skin and advanced skin analysis/diseases in Sciences. Your license still stops at cosmetics on intact, healthy tissue.

Pigmentation disorders: too much melanin, too little, or leftover color

Hyperpigmentation is extra color. Hypopigmentation is reduced color. Depigmentation (as in vitiligo patches that lost melanin) is a related teaching term. None of these words authorizes you to prescribe hydroquinone as a physician or to promise to “erase” a medical pigment disease.

Melasma (often taught with chloasma, the “mask” pattern) is patchy brown hyperpigmentation on the face, commonly linked in textbooks to sun and hormonal change, including pregnancy. You will see it on cheeks, forehead, and upper lip. A Savannah bridal facial can still proceed on intact skin, but you avoid irritating peels the client did not patch-test, you do not pick the patches, and you educate on daily sun protection as home care beautifying advice, not as treatment of a dermatological diagnosis you just issued. Heat and inflammation can worsen PIH and melasma; aggressive extraction on a hyperpigmented lip is how a wax client leaves with a darker rectangle.

Post-inflammatory hyperpigmentation (PIH) is color left after acne, a burn, a rash, picking, or a too-hot wax. It is a condition of the skin, not a license to layer acids until it “evens.” If the original injury is still open, you wait. If the surface is intact, gentle cosmetics and strict sun-care talk are in scope; medical pigment procedures are not.

Lentigines are discrete brown spots from sun exposure (freckle-type or larger “liver spot” language in older texts). They are flat macules. Do not confuse a suddenly changing, irregular dark spot with an ordinary lentigo—that change belongs in Chapter 4.4 and a medical referral.

Vitiligo is patchy loss of pigment. It is not contagious. Do not refuse a client out of folklore. Do protect hypopigmented skin from unnecessary burn and irritation, because melanin is part of optical protection. Albinism is a congenital reduction or absence of melanin. Photoprotection education and gentle products are appropriate; staring, photographing “for the chart,” or claiming you will restore melanin with a salon serum as therapy is not.

Growths you recognize and leave alone

Verruca (wart) is a viral growth. Do not shave it, do not wax it off, do not share the same disposable on adjacent skin after you have already contacted it. Stop on that site and refer. Skin tags and ordinary moles (nevi) may be cosmetic concerns. You still do not snip tags or scoop moles in a Georgia salon. A mole that is inflamed, bleeding, or sitting under a wax strip is a skip-and-refer, not a “wax around it until it lifts.”

Contagious disease: herpes, tinea, conjunctivitis, impetigo

These four are high-frequency stop signs in facial and wax rooms. You are not the laboratory. You are the person who refuses to grind a virus or bacterium into the next client’s skin.

Herpes simplex on the face is classically a vesicle cluster on the lip or nose, often with tingling first (prodrome). Teach yourself to treat tingling plus a known cold-sore history as do not wax, do not extract, do not steam that field. “It is almost gone” still fails intact-healthy skin if a crust or vesicle remains. Viral particles do not care that the client has a flight. After an unexpected encounter, follow your blood-and-body-fluid and disinfection procedures; do not reuse the same wax applicator (Rule 240-4-.05 no double-dip).

Tinea is a fungal (dermatophyte) infection: ring-like, scaly, itchy patches on the body or face. Tinea corporis on an arm that was booked for waxing is a stop on that arm. Tinea faciei is a facial stop. You do not apply a salon “antifungal peel” as therapy. You refer. Some texts discuss tinea versicolor as yeast-related mottling on the trunk; you still do not diagnose it to prescribe medicine; scaly, patchy trunk skin that looks infected is not a healthy wax field.

Conjunctivitis (pink eye) is redness of the conjunctiva, often with discharge and crusting of lashes. It may be viral or bacterial and is readily spread on makeup brushes, lash combs, and finger-to-eye contact. A Marietta lash-tint or extension client with a red, sticky eye does not get a “careful one-eye service.” You stop eye services, you stop a facial that requires you to work the orbital area, you do not use the same mascara wand, and you refer. Domain 2.C adverse signs include this kind of presentation even when the client insists it is “allergies.” If you cannot tell, and the eye is inflamed with discharge, you still do not put product on the lash line.

Impetigo is a bacterial infection (classically staphylococcal or streptococcal in textbooks) that shows honey-colored crusts, often on the face in younger clients, but adults appear in salons too. It is highly contagious. A honey crust on the philtrum is not a “dry patch to exfoliate.” Stop the service, do not pick the crust, disinfect, and refer. The same crust in a student clinic in Athens shuts down that facial, not just one cheek.

Inflammatory conditions: dermatitis and eczema

Dermatitis is inflammation of the skin. Contact dermatitis may be irritant (too much surfactant, too much acid, too-hot wax) or allergic (true sensitization). Eczema is often used in client language for dry, itchy, inflamed patches (atopic-type stories in textbooks). Weeping, yellow crust, or open fissures are not intact healthy skin. Even on intact but highly reactive skin, you skip fragrance, skip essential-oil “cures,” skip occlusive dirty implements, and you patch-test new chemicals.

If a patch test for lash adhesive produces a wheal or vesicles on the inner arm, that is an adverse sign. Do not apply the adhesive to the lashes to “confirm.” If a client develops spreading hives during a facial, stop products, cleanse with a bland remover if appropriate, and escalate care if breathing or swelling of the mouth occurs.

Psoriasis is an inflammatory, scaly, plaque condition that is not contagious. Candidates miss this trap and refuse service out of infection folklore, or they wax plaques until they bleed. Silvery scale on the elbows is not tinea and not impetigo. If plaques on the face or a wax site are fissured or bleeding, you still stop because the barrier is broken. If plaques are intact and the client only wants a cleanse on uninvolved face, you may proceed on the intact field and you still do not scrape scale as dermatological therapy.

Georgia scenarios that mix pigment and contagion

A Midtown Atlanta client wants an upper-lip wax through melasma and a fresh herpes crust. Pigment is not the contraindication. The crust is. A Macon client wants camouflage makeup (curriculum includes camouflage make-up hours) over vitiligo on intact skin: that can be a beautifying service with sanitary makeup practice. An Augusta client wants you to “burn off” a wart on the chin with high frequency as disease therapy: refuse and refer.

Traps: bleaching melasma with a leftover medical peel; serving pink eye because only one eye looks bad; calling psoriasis contagious; waxing tinea “to lift the ring”; extracting impetigo crusts; ignoring a positive patch test.