8.4 Consultation, Protocol Development, Facial Fundamentals & Makeup Application

Protocol Development (Advanced Practice Outline)

The first service item in the Advanced Practice outline is "apply knowledge for protocol development": identify the procedure environment (clinical, spa, home), determine contraindications for the protocol, and document the protocol.

A written protocol states the purpose, products and settings, step order, timing, contraindications, expected reactions, and what to do if something goes wrong. Section 7.4 shows how to chart a treatment in SOAP format.

Consultation and Documentation

The Combined Practice outline lists "performing a client consultation and documentation (e.g., health history, intake form, consultation chart, physician release)." A consultation should cover:

• Health history: medical conditions, medications (especially retinoids, isotretinoin, blood thinners, and photosensitizers), allergies, pregnancy, recent procedures, and implants such as pacemakers.
• Skin history and goals: concerns, home care, sun exposure, and previous reactions.
• Skin analysis: Fitzpatrick type, skin type and conditions, and lesions, using magnification and a Wood's lamp when helpful (section 3.4).
• Physician release: written medical clearance when a condition, medication, or recent surgery could make a service unsafe.
• Consent and records: signed consent for the planned service, and treatment notes after every visit.

The Core Facial, Step by Step

1. Hand hygiene and set-up. Disinfect surfaces, drape the client, and secure the hair.
2. Cleansing. Remove eye and lip makeup first, then cleanse the whole face; a second cleanse removes remaining residue. The NIC practical cleansing section scores cleansing the eye area and lips, distributing cleanser over the whole face, removing residue, and applying toner.
3. Skin analysis under a magnifying lamp.
4. Exfoliation: enzyme, AHA, or mechanical, matched to the skin (Chapters 4 and 5).
5. Steaming: warm vapor softens sebum and debris and warms the tissue. Follow the manufacturer's distance and time limits, and reduce or skip steam for sensitive skin, rosacea, visible capillaries, and active inflammation.
6. Extraction if indicated (section 5.5).
7. Massage.
8. Mask: clay for oily skin, cream for dry skin, gel for soothing and hydration, sheet masks, and thermal or setting masks (paraffin, modelage) for warmth or cooling.
9. Toner, serum, moisturizer, and broad-spectrum sunscreen.

Massage Movements

Massage contraindications: severe acne or inflamed skin, rosacea flares, contagious conditions, uncontrolled high blood pressure, recent injections or surgery in the area, and any condition the client's physician restricts. The Dr. Jacquet movement, a light pinching of the skin, is traditionally used for oily skin to help move sebum out of follicles.

Makeup Application

Color theory:

• Primary colors: red, yellow, and blue. Secondary colors mix two primaries: orange, green, and violet. Tertiary colors mix a primary with a neighboring secondary.
• Complementary colors sit opposite each other on the color wheel and neutralize each other: green corrects redness, peach or orange corrects blue-purple under-eye shadows, and lavender brightens sallow (yellowish) skin.
• Undertones are warm, cool, or neutral. Match foundation along the jawline in natural light.

Face shapes and corrective work: the oval face is considered the ideal proportion. Round, square, oblong, heart, diamond, and pear (triangle) shapes are balanced with contouring: darker shades make areas recede and lighter shades bring areas forward.

Brow mapping: the brow begins in line with the side of the nose, arches above the outer edge of the iris (looking straight ahead), and ends where a line from the nostril through the outer corner of the eye meets the brow.

Makeup after advanced services: avoid makeup on freshly resurfaced, peeled, or needled skin for the time set in the post-care protocol, then begin with clean tools and simple mineral formulas.

Washington Cosmetic Sanitation Rules

WAC 308-20-110 applies directly to makeup and facial products:

• Liquids, creams, and other preparations are kept in clean, closed containers.
• Products are dispensed so the remaining supply is not contaminated: use a disposable or a cleaned and disinfected applicator, never re-dip an applicator, and dispense liquids with a squeeze bottle, pump, or spray.
• Pencil cosmetics must be sharpened before each use, and the sharpener cleaned and disinfected or discarded after each client.
• Any product that touches the client and cannot be disinfected is discarded after that client.
• The client's skin is washed with soap and warm water, or wiped or sprayed with an antiseptic or waterless cleanser approved for skin, before the service.