8.4 Skin Conditions, Disorders and Diseases
Key Takeaways
Disorders of the sebaceous glands include comedones, milia, acne, seborrhea, asteatosis, rosacea and sebaceous cysts; disorders of the sudoriferous glands include anhidrosis, bromhidrosis, hyperhidrosis and miliaria rubra.
Contact dermatitis, either irritant or allergic, is the most common occupational skin disorder for cosmetologists.
Herpes simplex (cold sores), impetigo and tinea are contagious, so services in the affected area are postponed and the client is referred to a physician.
Hyperpigmentation includes chloasma (melasma), lentigines and stains; hypopigmentation includes vitiligo, leukoderma and albinism.
Minnesota rules bar services on clients with open wounds or sores in the area to be serviced (Minn. R. 2105.0375, subp. 7, item G).
Why this section matters
Skin structure and lesions are covered in Section 8.1 and skin types in Section 8.2. This section covers the conditions and disorders that general theory topic 03.B.3 and written practical topic 08.A.2 test. Most questions ask you to identify a condition from its description or decide whether a service may proceed.
Disorders of the sebaceous (oil) glands
| Condition | Description | Salon response |
|---|---|---|
| Comedo (plural comedones) | Hair follicle filled with keratin and sebum; open comedo (blackhead) is dark at the surface from oxidation, closed comedo (whitehead) is covered by skin | Basic extraction with gloves and a comedone extractor or gloved fingers if within scope; avoid force |
| Milia | Small, hard, white keratin-filled cysts under the surface, common around the eyes and cheeks | Lancet removal is an advanced practice service in Minnesota; refer or leave alone |
| Acne (acne vulgaris) | Chronic inflammatory disorder of the follicles: comedones, papules, pustules, and in severe grades nodules and cysts | Gentle cleansing; no massage over inflamed areas; refer moderate to severe cases |
| Seborrhea | Excess sebum; oily, shiny skin or scalp | Balancing products; seborrheic dermatitis with redness and scaling is referred |
| Asteatosis | Dry, scaly skin from too little sebum, common with age or harsh soaps | Gentle cleansers, moisturizers |
| Rosacea | Chronic redness of the cheeks and nose, often with dilated capillaries and papules; triggered by heat, alcohol, spicy food and sun | Avoid heat, steam, stimulation and harsh exfoliation; refer for diagnosis |
| Sebaceous cyst (steatoma) | Large, protruding pocket of sebum, often on the scalp or back | Avoid; refer for removal |
Disorders of the sudoriferous (sweat) glands
| Condition | Meaning |
|---|---|
| Anhidrosis | Deficient or absent perspiration, often from fever or disease; needs medical attention |
| Bromhidrosis | Foul-smelling perspiration, usually in the armpits or on the feet |
| Hyperhidrosis | Excessive sweating from heat or general body weakness |
| Miliaria rubra (prickly heat) | Acute inflammatory eruption of small red vesicles with burning and itching, from exposure to heat |
Inflammations and contagious infections
| Condition | Description | Service decision |
|---|---|---|
| Contact dermatitis | Inflammation from contact with an irritant or allergen; the most common occupational skin disorder in cosmetology | Stop exposure; wear gloves; refer if severe (Section 3.4) |
| Eczema | Inflammatory, often itchy and dry or weeping patches; not contagious | Avoid irritating products; no services on weeping or broken skin; refer |
| Psoriasis | Chronic, noncontagious disease with red patches covered by silvery scales, often on the scalp, elbows and knees | Do not pick scales; avoid broken skin; refer |
| Herpes simplex (HSV-1, fever blisters or cold sores) | Recurring contagious viral infection with vesicles on the lips or nose | No services in the area while lesions are present; refer |
| Impetigo | Contagious bacterial infection with weeping, then honey-colored crusted lesions, often in children | No service; refer to a physician |
| Tinea (ringworm, including tinea corporis, capitis and pedis) | Contagious fungal infections with red, scaly, ring-shaped patches | No service in the affected area; refer |
| Conjunctivitis (pinkeye) | Contagious eye infection with redness and discharge | No eye-area services; refer |
Pigmentation disorders
| Hyperpigmentation (darker) | Hypopigmentation (lighter) |
|---|---|
| Chloasma (melasma): brown patches, often from hormones (pregnancy, birth control) and sun | Vitiligo: milky-white patches from loss of melanocytes; protect from sun |
| Lentigines (singular lentigo): freckle-like spots; "liver spots" or solar lentigines from sun | Leukoderma: general term for light, abnormal patches (includes vitiligo) |
| Ephelides (freckles) | Albinism: congenital absence of melanin pigment in the skin, hair and eyes; very sun-sensitive |
| Stain: brown or wine-colored mark, such as a port-wine birthmark | |
| Tan: a protective darkening from UV exposure | |
| Nevus (birthmark or mole): small or large malformation of the skin from pigmentation or dilated capillaries |
Post-inflammatory hyperpigmentation can follow acne, burns, waxing injury or over-exfoliation, particularly in darker skin tones, so gentle technique and sun protection matter.
Hypertrophies (growths)
| Growth | Description |
|---|---|
| Keratoma | Thickened patch of keratin from pressure or friction; a callus on hands or feet, a corn when it has a core |
| Mole | Small brownish spot or growth; watch for ABCDE changes (Section 8.1) |
| Skin tag | Small outgrowth of skin, often on the neck or underarms |
| Verruca (wart) | Hypertrophy of the papillae and epidermis caused by a virus; contagious |
Service decisions at a glance
- Contagious (herpes simplex, impetigo, tinea, conjunctivitis, warts in the area): do not service the area; refer.
- Open, weeping, crusted or broken skin in the service area: Minnesota prohibits services there (Minn. R. 2105.0375, subp. 7, item G).
- Inflamed but noncontagious (rosacea, active eczema or psoriasis, severe acne): modify or postpone; avoid heat, stimulation and irritants; refer for diagnosis.
- Noninflamed and noncontagious (mild comedones, asteatosis, pigmentation, skin tags): service may proceed with appropriate products and care; recommend sunscreen.
Cosmetologists describe what they see and suggest a physician; they do not diagnose or treat disease.
A client has small, hard, white bumps under the skin around the eyes. What are they most likely to be?
Open comedones
Miliaria rubra
Psoriasis
Milia
Which skin condition is contagious and calls for no service in the affected area?
Psoriasis
Impetigo
Rosacea
Chloasma
What is the most common occupational skin disorder among cosmetologists?
Contact dermatitis
Albinism
Vitiligo
Miliaria rubra (prickly heat)
Brown patches appear on a pregnant client's cheeks and forehead. Which pigmentation disorder fits this description?
Vitiligo (loss of melanocytes)
Leukoderma
Albinism
Chloasma (melasma)
Sections you finish are checked off in the contents.