15.1 Skin Types, Conditions, Consultation, and Contraindications
Key Takeaways
- NIC New Jersey Domain 3.A tests whether you evaluate skin type and condition, recognize contraindications from disorders and diseases, choose services and products, and keep client records — without diagnosing and without performing the facial steps taught in Chapter 16.
- Oily, dry, combination, and normal describe sebum balance; sensitive is a reactive overlay that can sit on any type; dehydrated skin lacks water and can appear on oily skin, which is not the same as dry (alipidic) skin that lacks oil.
- N.J.A.C. 13:28-3.3(d) is a refuse rule for a patron you know or have reasonable grounds to believe has a communicable, contagious, or infectious disease that could reasonably spread during the service; sunburn and isotretinoin history are manufacturer-and-barrier stops, not Board-published wait clocks.
- N.J.A.C. 13:28-1.1(a)1iv–vi is the cosmetologist-hairstylist skin slice: cosmetic preparations on hair, scalp, face, or neck; massage, cleanse, or stimulate the face, neck, or upper chest and upper back; superfluous hair by depilatory, wax, or tweezers, not electrolysis.
- N.J.A.C. 13:28-2.15(b)6 forbids cure-or-remedy claims; 13:28-2.15(b)1–2 forbid lancets, credo blades, skin scrapers, and work below the stratum corneum; consultation language stays observational and medical questions are referred.
Why this is Domain 3.A, not a facial recipe
Quick Answer: On the NIC New Jersey Cosmetologist-Hair Stylist theory exam, Domain 3.A asks you to evaluate the client's skin (type and condition), identify contraindications from disorders and diseases, determine services and products, and establish or maintain client records. Skin Care and Services is 15 of 110 weighted items. This section is the consultation. Cleansing, steaming, exfoliation, extraction, massage, and masks are Chapter 16. N.J.A.C. 13:28-1.1(a)1iv–vi is the cosmetologist-hairstylist skin slice. N.J.A.C. 13:28-2.15 keeps lancets, work below the stratum corneum, medical devices other than Class I FDA, and disease-cure claims out of the room. N.J.A.C. 13:28-3.3(d) is the refuse rule when a condition could reasonably spread during the service.
A New Jersey cosmetologist-hairstylist holds a cosmetology and hairstyling license. For skin, that license authorizes applying cosmetic preparations, antiseptics, tonics, lotions, creams, or makeup to the hair, scalp, face, or neck; massaging, cleansing, or stimulating the face, neck, or upper chest and upper back, with or without cosmetic preparations, by hand, mechanical, or electrical appliances; and removing superfluous hair from the face, neck, arms, legs, or abdomen by depilatories, waxing, or tweezers, not electrolysis. Hair-removal technique is Chapter 17. Here you decide whether the face in front of you is even a lawful, safe cosmetic service.
Chapter 5 taught you to recognize signs. This chapter uses those signs as service decisions: proceed, modify, postpone, or refuse and refer. You do not name a medical diagnosis, prescribe isotretinoin, or sell a mask as a remedy for illness. 13:28-2.15(b)6 already closed that sentence.
Consultation happens before steam, brushes, or product leave the dispensary. You drape, you look in good light (a magnifying lamp is lighting equipment, not a medical scanner), you ask, and you record. If the client wants a deep-clean extraction facial and you see honey-colored crusts, grouped vesicles on the lip, or a peeling sunburn, the analysis is finished: stop. The procedure chapter cannot rescue a contraindicated start.
Skin type: oily, dry, combination, normal
Skin type in theory teaching is sebum balance — how much oil the sebaceous glands are producing — not a mood and not a race. You read it on clean, makeup-free skin after the client has not just stepped out of a hot car, and you confirm what the client reports at home (shine by noon, tightness after washing, flakes on the cheeks).
Normal skin is the teaching baseline: balanced oil and moisture, even texture, pores that are not obviously enlarged or paper-fine, few comedones. It still needs sunscreen talk as cosmetics, not as a disease protocol. It is not a license to skip consultation.
Dry (often called alipidic in textbooks) is a lack of oil. The barrier looks tight, may feel rough, and can show fine flakes. Pores often look smaller because there is less sebum stretching the follicle opening. Dry type wants emollient, lipid-supporting cosmetic products and less stripping surfactant. It does not automatically mean the client needs a heavy oil if the real problem is water loss — that is the dehydrated trap below.
Oily skin shows shine, especially through the day, enlarged pores, and a tendency toward open and closed comedones. The T-zone (forehead, nose, chin) is the usual spotlight. Oily type often does well with lighter, water-based cosmetics and clay or absorbing masks used as cosmetics. It is not a diagnosis of acne, and a clay mask is not a cure for acne under 13:28-2.15(b)6. Inflamed papules, pustules, or cysts still follow the Chapter 5 caution-or-refer map.
Combination skin is oily in the T-zone and drier on the cheeks (or the reverse pattern). You zone the products: a lighter finish where it shines, more emollient where it pulls. One jar forced over the whole face is how combination clients leave greasy in the center and tight at the sides.
You feel sebum with a tissue test or simply by looking after cleanse in the consult — you do not need a laboratory. You still do not punch a hole in the skin to “see the oil.”
Sensitive is a condition overlay, not a fifth oil type
Domain 3.A splits type from condition. Sensitive skin in salon language is reactive: redness, stinging, flushing, or intolerance to fragrance, acids, or heat. It can sit on oily, dry, combination, or normal type. Treat it as a condition that changes product choice and intensity: skip aggressive heat, skip harsh exfoliants, skip extraction on angry, intact-but-reactive skin. Do not relabel every pink cheek as a medical disease you will treat.
Other conditions you describe without diagnosing: comedones, papules, visible capillaries, hyperpigmentation or hypopigmentation patches, dehydrated surface, sun damage appearance, intact versus open barrier. Chapter 5 already mapped contagious vesicles, honey crusts, plaques, and changing moles. Here you only need the decision.
Dehydrated versus dry: water versus oil
Dry type is not enough sebum. Dehydrated skin is not enough water in the tissue. Dehydration can appear on oily skin: the T-zone still shines, pores still look large, and the surface still feels tight or finely flaky. Stripping that face with a harsh “oil-control” wash because you only saw shine makes dehydration worse. The product answer is often water-binding humectant cosmetics and a gentler cleanse, not more degreaser.
A Cherry Hill client who says her skin is dry and you see a glossy nose plus cheek flakes is not a contradiction. You record oily or combination type with a dehydrated condition. You do not write a medical diagnosis of a barrier disease. You do not sell a tonic as a cure for “dehydrated illness.”
Fitzpatrick as textbook sun-reactivity — not a Board scale
Some textbooks teach the Fitzpatrick scale (I–VI) as a way to talk about how skin tends to burn or tan. The New Jersey State Board of Cosmetology and Hairstyling does not print Fitzpatrick types in N.J.A.C. 13:28. If your school uses it, use it carefully: it is a sun-reactivity teaching aid, not a racial classification, not a cancer diagnosis, and not a substitute for looking at this client today. A person who tans easily can still arrive sunburned. A person who burns easily still may have oily T-zone skin. Do not let a Roman numeral replace the consult.
Contraindications: contagious, barrier, history — without diagnosing
A contraindication is a reason not to perform the planned facial service, or to modify it. You recognize signs. You do not tell the client you have diagnosed herpes, impetigo, or cancer.
Contagious or infectious findings that could reasonably spread on hands, towels, steam, brushes, or extractors are refuse under N.J.A.C. 13:28-3.3(d). 13:28-3.3(c) is the mirror for you. Reasonable grounds are enough. You do not wait for a culture. Active grouped vesicles on the lip, honey-colored crusts, infectious-looking red, discharging eyes, or a scaly ring of broken hairs at the hairline are stop examples you already met in Chapter 5. Cover-with-concealer is not a proceed. Picking a vesicle with an extractor is both infection control and 13:28-2.15(b)1–2.
Sunburn is inflamed, heat-loaded skin. Steam, massage, extraction, and exfoliation on a burn are how you turn a cosmetic service into more injury. Postpone. You are not treating a medical burn. You are not applying a “healing” peel as a remedy.
Isotretinoin (oral acne medication; clients may say a brand name) is a manufacturer-and-refer history, not a Board-published calendar. Product labels and standard esthetics teaching treat recent or current isotretinoin as a contraindication for waxing, aggressive extraction, and aggressive exfoliation because the skin can be fragile. The Board has not printed a mandatory six-month or twelve-month wait in 13:28. You ask, you follow the manufacturer of any product or hair-removal system you would use, you do not lance or work below the stratum corneum, and you refer medical timing questions to the prescribing physician. A signed salon release does not override the label or 13:28-2.15.
Open, weeping, or undiagnosed inflamed lesions: stop services that would stretch, steam, or extract them. Pustular or cystic presentations are refer-outs for medical care, not “advanced extraction day.” Changing moles, pearly nodules, or non-healing crusts: describe, do not diagnose, do not remove. 13:28-2.15(b)9 already bans skin-tag removal.
Client-reported allergies (fragrance, specific acids, latex, nickel) contraindicate those products or tools, not every facial forever.
| Finding or history | What you are actually seeing | Domain 3.A decision |
|---|---|---|
| Oily type, intact barrier, no contagious signs | Shine, enlarged pores, possible comedones | Proceed with lighter cosmetics; no acne-cure claim |
| Dry type, intact barrier | Tightness, lack of oil, fine flakes | Proceed with emollient cosmetics; do not confuse with dehydration |
| Combination | Oily T-zone, drier cheeks | Zone products |
| Dehydrated oily | Shine plus water-loss tightness or flakes | Modify: humectants, gentler cleanse, not more strip |
| Sensitive overlay | Stinging, redness, reactive | Caution: less heat, less aggression |
| Active vesicles, honey crusts, infectious eye signs | Possible contagious disease | Refuse under 13:28-3.3(d); refer; no cure products |
| Visible sunburn | Inflamed, heat-damaged barrier | Postpone steam, massage, extraction, exfoliation |
| Current or recent isotretinoin | Client-disclosed medication history | Follow manufacturer; refer medical timing; no lancet, no living-cell work |
| Open sores, cysts, changing lesions | Broken or undiagnosed tissue | Stop / refer; no skin-tag or mole removal |
Determine services and products inside New Jersey scope
After analysis you name a cosmetic service and a product that match type, condition, goal, and law.
If the barrier is intact and the type is oily, a cosmetic clay mask and a light moisturizer can be the product story. If the client wants that same mask sold as a cystic-acne cure, 13:28-2.15(b)6 says no — you may still offer ordinary cosmetics without the medical promise, or you refuse if the skin is not a proceed. If they want work below the stratum corneum, a lancet, a credo blade, laser hair removal, Botox or Restylane-type injections, or a non-Class I medical device, 13:28-2.15(b)1, 2, 7, and 8 already answered. 13:28-2.15(b)8 allows only Class I FDA-approved medical devices, used, cleaned, and maintained as the manufacturer instructs. The Board does not publish a facial-machine catalog.
13:28-1.1(a)1v includes upper chest and upper back for C-H massage, cleanse, or stimulate. That is wider than a barber’s face-neck-scalp skin slice. It is still cosmetic, still above living cells, and still not a medical back-acne clinic.
What you record
The Board does not publish a mandated skin-card template or a statutory retention period for salon notes. Shops still write cards because the next visit must be repeatable, allergies must be visible, and a refused service with a blank page helps no one.
Record identity and date; client goal; type and conditions observed in plain language; products and devices used; allergies; disclosed medications such as isotretinoin as the client stated them; photos with consent; services declined and why (contagious signs, sunburn, manufacturer contraindication). Do not write a physician’s diagnosis you are not licensed to make.
A Newark Saturday walk-in wants a “medical-grade peel that will cure my rosacea.” You observe intact but reactive redness, you refuse the cure claim, you offer only a cosmetic calm protocol if otherwise indicated, or you postpone and refer. That is Domain 3.A in a New Jersey shop: evaluate, choose, document, stay in scope.
Exam traps
- Trap: Dry and dehydrated are synonyms. Dry is oil; dehydrated is water; oily skin can be dehydrated.
- Trap: Sensitive is a sebum type like oily. It is a reactive condition that can overlay any type.
- Trap: Fitzpatrick is in 13:28. It is textbook sun-reactivity, not a Board table.
- Trap: A release lets you facial through vesicles or sunburn. 13:28-3.3(d) and barrier common sense say stop.
- Trap: Consultation is when you diagnose and treat acne as a disease. Recognition, cosmetic products, refer — 13:28-2.15(b)6.
A Hoboken client has a shiny T-zone and enlarged pores, but her cheeks feel tight and show fine surface flakes. Which analysis is correct for Domain 3.A?
During a Cherry Hill skin consultation a client asks you to sell a facial that will cure her psoriasis while you steam and extract. What does N.J.A.C. 13:28-2.15(b)6 require?
A Trenton client discloses she finished a course of oral isotretinoin and wants comedone extraction and hard wax on the face today. The Board has not published a wait interval. What is the correct consultation action?