8.2 Other and Advanced Facial Services: Aromatherapy, Medical-Setting Care, Ultrasonic, Dermaplaning, and Nano Infusion

Why these services are on the exam

Modern spa menus go beyond the basic facial. The NIC outline asks for basic knowledge here, meaning enough to recognize what a service does, choose suitable clients, protect them, and know where the professional boundary is. Missouri's statute frames that boundary. A Class E esthetician may use "mechanical, electrical apparatuses or appliances" and cosmetic preparations not exceeding 10% phenol for beautifying work, but Class E practice does not include medical treatment (RSMo 329.010(5)(d)). Missouri's statute and Board rules do not mention dermaplaning, nano infusion, or microneedling by name. Before offering any service that uses a blade or creates channels in the skin, confirm with the Board and make sure you have documented training.

Aromatherapy

Aromatherapy is the use of essential oils, which are concentrated, volatile aromatic extracts from flowers, leaves, bark, roots, and peels, for their scent and their effects on mood and skin.

• How they are used: diffused into the room, added to steam, or diluted in a carrier oil (such as jojoba or sweet almond) for massage. Undiluted essential oils can irritate or sensitize the skin.
• Common examples: lavender (calming), chamomile (soothing), tea tree (antibacterial, for oily skin), peppermint and eucalyptus (cooling and invigorating).
• Safety:
  • Ask about allergies and patch test new blends.
  • Phototoxic oils, especially cold-pressed citrus oils such as bergamot, can cause burns or dark patches when the skin is exposed to UV afterward. Avoid them before sun exposure and in daytime leave-on products.
  • Use extra caution, or skip essential oils, for pregnant clients, clients with asthma, epilepsy, or fragrance sensitivity, and children.
  • Store them in tightly closed, dark glass bottles away from heat. Many are flammable.
• Scope: you may offer aromatherapy as part of a relaxing service, but not claim that it treats disease.

Pre- and post-surgical (medical-setting) treatments

Estheticians increasingly work alongside dermatologists and plastic surgeons, preparing skin before procedures and supporting comfort and hygiene afterward.

Remember the Board's Medical Esthetician Disclaimer: working in a medical office does not create a separate license. You remain a Class E esthetician and must advertise that way.

Ultrasonic services

Ultrasound is sound at frequencies above about 20,000 Hz (20 kHz), beyond human hearing. Two uses appear in esthetics:

1. Ultrasonic skin scrubber (spatula): a flat metal blade vibrating at ultrasonic frequency. Held at a shallow angle on damp skin, it loosens dead cells, sebum, and debris, a gentle form of exfoliation and pore cleansing. Turned so the flat side faces the skin, it is used to help water-based products penetrate.
2. Ultrasonic product delivery: ultrasound passed through a conductive gel or serum to help it penetrate.

Contraindications are like those for other electrical devices: pacemakers and other implanted electronic devices, metal implants in the treatment area, pregnancy, active inflammation or broken skin, and recent procedures without clearance. Clean and disinfect the spatula after each client according to Missouri's implement rule.

Dermaplaning

Dermaplaning is a manual exfoliation that uses a sterile, single-use surgical-style blade to shave off dead surface cells and fine vellus hair.

Technique overview

1. Cleanse and thoroughly dry the skin, and degrease it if your training calls for that. A blade glides poorly on damp or oily skin.
2. Hold the skin taut with your non-dominant hand.
3. Hold the blade at a shallow angle to the skin, roughly 10 to 45 degrees depending on the training protocol, and use short, light, feathering strokes, usually in the direction of hair growth.
4. Avoid the eyelids and lips, and skip any lesion, mole, or raised area.
5. Follow with soothing hydration and sunscreen.
6. Discard the blade immediately in a rigid sharps container. Never recap a blade by hand or reuse it.

Contraindications

Active acne pustules, rosacea flares, sunburn, open lesions, active herpes simplex, very thin or fragile skin, recent isotretinoin use, topical retinoid use near the service date, and anticoagulant therapy, which raises the bleeding risk from any nick. If the skin is cut, stop and follow the blood-exposure procedure (Section 2.3).

Nano infusion

Nano infusion (sometimes marketed as nanoneedling) uses a pen-style device with a tip covered in nano-sized silicone cones or pyramids. Manufacturers describe the tips as creating temporary micro-channels in the stratum corneum to improve how serums are absorbed, without penetrating the living epidermis or dermis.

• Use single-use, sterile tips, and disinfect the device body between clients.
• Apply the serum or ampoule, then glide or stamp lightly as the manufacturer directs.
• Contraindications: like dermaplaning. Avoid active acne, inflammation, infection, broken skin, and recent procedures.

Nano infusion versus microneedling

Treat any device that punctures living tissue as outside a beautifying service. If you are unsure where a specific device falls, ask the Board before you offer it.

Microdermabrasion (in brief)

Microdermabrasion, covered in Section 7.4, mechanically exfoliates the stratum corneum with a crystal stream or a diamond tip combined with vacuum. It belongs in the same advanced-topics group on the outline: superficial only, contraindicated over inflammation, rosacea, and fragile skin.

Scenario: choosing the right advanced service

A client with dull, dry skin, no active acne, and fine facial vellus hair wants "something advanced" before a wedding. She takes no retinoids or blood thinners and has no history of keloids. A dermaplaning service, if you are trained and it is offered at your establishment, would remove the vellus hair and surface cells so makeup sits more smoothly. Follow it with a hydrating alginate mask and broad-spectrum sunscreen. If she also had an active cold sore or a rosacea flare, the dermaplaning would wait. A calming facial and a reschedule would be the professional choice.