8.3 Contagious Diseases and Inflammations

This section is NIC contagious diseases of the skin plus inflammations of the skin, tied to Illinois refuse-service rules. High-yield contagious names: bacterial conjunctivitis, herpes simplex, and tinea. High-yield inflammations: dermatitis, eczema, and rosacea, including telangiectasia — a frequent NIC sample item. You still do not diagnose. You document and decline. 225 ILCS 410/3A-1 forbids medical-treatment advice for diseases of the skin.

Contagious Conditions: Recognize, Stop, Refer

Contagious (communicable) means the condition can transfer person to person or via fomites — towels, tweezers, eye pads, a headrest that was not covered. NIC wants the name and the stop. Illinois wants 1175.115(b)(33)–(35).

Herpes simplex virus 1 (HSV-1) is the classic facial-room vesicle. A prodrome (tingling) followed by a cluster of clear-fluid blisters, then a crust, is a stop at every stage that is still an eruption. Steam, waxing the lip, extractions, and peels spread virus across that face and onto your hands. Do not “work around it with extra concealer.” Microbiology already covered herpetic whitlow as an occupational finger infection. This chapter’s job is the vesicle-as-lesion stop: clear fluid, lip or nostril, refuse.

Conjunctivitis can be bacterial or viral. NIC lists bacterial conjunctivitis. Either way, you do not perform lash extensions, lash lifts, brow waxing, or a facial that requires you at the eye. Send the client to a physician. Do not recommend antibiotic drops — that is medical-treatment advice under 3A-1.

Tinea corporis is ring-shaped scale. Tinea pedis is athlete’s foot. Tinea capitis is scalp. A circular plaque is not a “dry patch” for a glycolic peel or a wax strip. If the stem says tinea as a contagious fungal disease, treat it as a refuse on the affected surface. Do not tell the client which antifungal cream to buy.

Other contagious presentations you should still refuse even if the stem does not use the three headline names:

• Impetigo — honey-colored crusts; bacterial; highly contagious
• Warts / verruca — HPV; do not tweeze, extract, or “cut off”
• Pediculosis and scabies — parasites from the microbiology chapter; no service

Illinois 1175.115(b)(33)–(35)

Learn the three subsections as three jobs:

• (b)(33) — No owner or manager of a salon or shop shall knowingly permit any person suffering from a serious communicable disease, as defined in 77 Ill. Adm. Code 690, to work on the premises.
• (b)(34) — No licensee shall be required or permitted to massage any surface of the skin or scalp where the skin is inflamed or where a skin infection or eruption is present.
• (b)(35) — No licensee shall be required or permitted to work upon a person suffering from a serious communicable disease as defined in Part 690.

Two layers matter on the exam. Part 690 is the Illinois Department of Public Health Control of Communicable Diseases Code — the “serious communicable disease” list for (b)(33) and (b)(35). You are not required to recite that entire table. (b)(34) is broader for daily esthetics: you do not need a Part 690 diagnosis to stop. An HSV vesicle, impetigo crust, inflamed tinea plaque, or weeping dermatitis is infection, inflammation, or eruption. Massage is forbidden on that surface. Steam, waxing, and exfoliation are not safer substitutes for massage on the same eruption.

A coworker with a known serious communicable disease is a (b)(33) management problem, not a “keep them on the books until the rash dries.” A client with such a disease is a (b)(35) problem. An ordinary cold sore may or may not be the Part 690 item the writer has in mind; it is still an eruption under (b)(34). Answer with the subsection that matches the stem.

Inflammations: Dermatitis, Eczema, Rosacea

Dermatitis means inflammation of the skin. It is a category, not a single disease. Two exam splits:

Contact dermatitis happens because something touched the skin.

• Irritant contact dermatitis is damage from a harsh substance — leftover disinfectant on an implement, an over-processed peel, wax that was too hot. Anyone can get it if the exposure is strong enough.
• Allergic contact dermatitis is an immune response after sensitization — fragrance, a preservative, latex, certain adhesives, a new mascara. It can appear as redness, itching, and sometimes vesicles.

Atopic dermatitis is endogenous — excess inflammation tied to an atopic picture (often eczema, hay fever, asthma). It is not “the client touched the steamer.” The barrier is reactive. Products that are fine on oily, resilient skin sting here.

Eczema is a painful, itching inflammatory disease that may be acute or chronic, dry or moist. Seborrheic dermatitis is often taught as a form of eczema with oily or dry scale. Open, weeping, or inflamed eczema is a stop. You do not “heal eczema” with a facial. You may, on intact, non-erupting skin, use very gentle cosmetic care. The exam answer on a flare is refer, not a peel.

Psoriasis is a related inflammatory, scaly condition (silvery scale on plaques). It is not contagious, but inflamed or open plaques are still not waxing or extraction sites. Do not tell a psoriasis client that a salon acid is their medical treatment.

Rosacea and telangiectasia

Rosacea is a chronic inflammatory congestion, usually on the cheeks and nose: flushing, persistent redness, papules and pustules in some clients, and telangiectasia. Triggers include heat, sun, spicy food, alcohol, caffeine, extreme temperatures, and stress. It is not comedonal acne. Do not extract “rosacea pimples.”

Telangiectasia (couperose) is distended, dilated capillaries visible at the surface. NIC sample items often ask what telangiectasia is — not what laser treats it. Distended capillaries are not comedones. Do not extract them. Do not use heavy tapotement, hot steam, or aggressive vacuum on highly vascular or rosacea skin. Illinois laser and radio-frequency devices intended to affect living tissue are out of scope on the IDFPR prohibited-practices list. Cosmetic camouflage and trigger-avoidance talk is appearance advice. “You need a vascular laser and metronidazole” is medical-treatment advice, which 3A-1 forbids.

When Steam, Massage, Waxing, and Exfoliation Are Contraindicated

Use this as a service-planning table. If more than one column is a “stop,” the whole appointment usually is.

A client with conjunctivitis is a no for eye-area services even if the cheeks look fine. A client with a cold sore is a no for a full-face service that involves steam and massage — the virus sheds, and (b)(34) already blocked massage of the eruption. “I’ll skip the upper lip” is the trap answer when the rest of the protocol still heats, massages, and exfoliates a contagious face.

Do Not Diagnose; Document and Decline

The professional sequence:

1. Observe — lesion type (vesicle, crust, scale, pustule), location, open versus closed, client-reported duration.
2. Decide — treatable surface congestion versus inflamed, infected, erupting, or contagious.
3. Decline or modify — whole service or the affected area, matching 1175.115 and NIC contraindications.
4. Document — what you saw, what you did not do, and that you suggested the client see a licensed medical professional.
5. Do not name a diagnosis as fact and do not prescribe.

3A-1 is explicit: estheticians may not render advice on appropriate medical treatment for diseases of the skin. “Please see a physician or dermatologist” is a referral. “Apply this steroid” or “that is definitely ringworm, buy this cream” is medical advice. Abnormal skin growth education (P.A. 103-0851 / 1175.1225) in the next chapter covers when a pigmented lesion is a refer. This section’s contagious and inflammatory findings are already enough to stop today’s facial.

Failure to follow 1175.115 is unprofessional conduct and may be a Section 4-7 violation. Working on a serious communicable disease, or massaging an eruption because the appointment was prepaid, is not a customer-service decision. It is a license decision. Recognize. Refuse or modify. Document. Refer. Do not diagnose.