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Professional Skin Analysis: What is Your Skincare Professional Looking For?

Professional Skin Analysis: What is Your Skincare Professional Looking For?
Have you ever wondered what your skincare professional is looking for during a skin analysis consultation or why they do it? What are they doing when they touch your skin or use lamps, lights or cameras? How do they know what treatment or home care you need?  If you answered yes to any of these questions, this post is for you as we enter the mind of a skincare professional!

 

Skin analysis forms the first crucial step of every professional skin procedure.  It ensures that your skincare professional can determine what your individual skin needs are to select the procedure and home care regime which has the best opportunity to achieve safe and effective results1,7,8.

 

Safety must be at the forefront of every aesthetic procedure. During a skin analysis, your skincare professional will check for ‘red flags’ which may indicate that you should not be having a procedure at the present time. Some of these ‘red flags’, or contraindications, may include undiagnosed spots or lesions, irritated and reactive skin, inflammation and injured skin, sunburn or extensive sun exposure or active eczema, dermatitis or psoriasis to name but a few 6,7,8. (Image by Avenue Aesthetics).

 

The skincare professional will ask lots of questions including what medications you may be taking, the skin products you are using, sun exposure levels, health history or any current medical conditions you may have, plans for pregnancy or breastfeeding, and lifestyle factors such as smoking, alcohol consumption, recreational drug use and diet.  Without asking these questions, vital information is missed which may put you at risk of side effects 7,8.

 

Once safety has been determined, the skincare professional will look for indicators to determine your individual skin needs.  They may ask questions such as ‘what are your main skin concerns’ or ‘what would you like to address with your skin?’.  Although you may have a clear idea what you want to achieve with your skin, don’t be surprised if your therapist gives you advice that extends beyond this, as a thorough skin analysis often identifies more about your skin than you realise!

 

Basic skin analysis aims to determine levels of skin hydration, pigmentation, vascularisation, thickness, texture, inflammation, elasticity, barrier function, reactivity/sensitivity and oil flow 1,2,3. Skin hydration refers to the amount of water in your skin which can be easily determined through use of a Wood’s lamp, skin imaging device, the naked eye and by gently pinching the skin 2,17.  Dehydrated skin looks deep violet under a Wood’s lamp or skin imaging device and can appear as fine lines to the naked eye, or when the skin is lightly pinched. The image to the left indicates dehydration on the eyelids as it is a deep violet colour, which is a very common area for this to appear (Image by Avenue Aesthetics).

 

Pigmentation appears as dark brown or black spots/patches when in the upper layer of the skin, and light grey or brown when in the lower layers. Although we can usually see skin pigmentation with the naked eye, the use of a Wood’s Lamp or skin imaging device allows the therapist to determine more accurately where the pigment is positioned in the skin, which is crucial to select the most effective treatment 2,3. The images to the left (Wood's Lamp) and below (natural light) indicate that the client has pigmentation in both upper and lower layers of the skin, with most being in the upper layers as it is darker in colour. (Images by Avenue Aesthetics). 

 

Assessment of the level of pigmentation in the skin, alongside how likely you are to tan following sun exposure is also crucial, as the therapist needs to determine how at risk you are for developing skin pigment. This is called Fitzpatrick phototyping, and if you are a darker Fitzpatrick skin type you will need to be on a special home care regime prior to treatment to ensure that you do not over develop pigment in the skin after your procedure 7,8.

Skin inflammation, vascularisation (blood vessels), sensitivity and reactivity go hand in hand.  Often people who have very vascular skin with lots of dilated capillaries can be quite sensitive or acutely reactive to certain skincare products, the environment or even the weather.  People who have reactive and sensitive skin are often inflamed and have a tendency to flush when reacting to something, and may experience stinging, itching, dryness and irritation on a regular basis 12,13. This is easily detected with the naked eye, however using a skin imaging machine can tell the therapist a lot more by using various filters which highlight the blood vessels, as shown by the image to the right which highlights the blood vessels in the cheek area. The skin analysis procedure also helps the therapist to see how sensitive or reactive you are in the cleansing phase. If your skin flushes and feels reactive when products are applied, a tendency toward sensitivity may be detected. (Image by Avenue Aesthetics).

 

Skin thickness, texture and elasticity are often assessed by the naked eye and through touch.  Thickened skin often appears alongside sun damaged or oily skin, and very thin skin often appears pale, more fragile and sensitive. Texture refers to the roughness of the skin, with sun damaged, dry, dehydrated and flaky skin often feeling rougher than a finer, smoother texture skin. Elasticity refers to the ability of the skin to rebound when stretched.  This can be assessed by looking at the level of wrinkling and fine lines on the skin, or if there is any sagging/drooping 14,15,16,17.

 

Skin oiliness is assessed by sight, touch, a Wood’s Lamp and skin imaging machines.  Oiliness can be detected by sight through the appearance of shine, with dryness (lack of oil) being detected by skin flaking and tightness without the ‘healthy glow’.  Oily skin is often thickened with dilated pores, and clients will often comment that they feel oily during the day.  Detecting areas of high oil flow with a Wood’s Lamp or skin imaging device occurs with a UV light filter to make the oil fluoresce a bright yellow-orange colour, with some people showing pink or red when acne bacterium are present 2,3,4,5,16. The image to the far left indicates oil flow with the presence of acne bacterium due to an orange-red fluorescence, and the second image displays less red and therefore oil flow is dominant 5. (Image by: Dobrev, 2010, p. 286).

 

The capacity of your skin barrier function is also assessed.  What is barrier function you might ask?  It refers to how well your skin acts as a barrier to the outside world depending on how strong and well-structured it is.  The first hint to how your barrier function is working is when your therapist cleanses your skin. If you are reactive and flush, this may indicate that you need to strengthen your barrier function. If you skin is dehydrated or dry this may also indicate a lowered barrier function.  This is because your skin is not acting as a barrier to hold water inside itself and therefore the water loss through your skin barrier leads to dehydration. Skin irritation, itchiness, flaking, breakouts, sun damage and presence of skin conditions such as eczema and dermatitis also indicate a poor barrier function 9,10,11,13.

 

The use of a skin imaging machine makes this process straight forward and have the unique ability to photograph your analysis using different filters. This is beneficial as following a course of treatments your skincare professional can compare the ‘before and after’ photos to assess the effect of the treatments and home care regime 1. Some devices also have email capacity so if you want a copy of your 'happy snaps' ask your therapist!

 

As you can see, a thorough skin analysis consultation is complex and takes time.  There are multiple aspects for the skin professional to consider to develop a safe and effective treatment regime, and it involves intricate interconnection between a detailed health and lifestyle history, physical touch and light or imagery analysis. This post only present the very basics of skin analysis - it is only the tip of the iceberg! In conclusion, if your skincare professional requests for you to have a skin analysis consultation do not hesitate as it is for your own safety, and of course, optimal results.

 

If you have any questions regarding skin analysis or this post please leave us a message in the comments below.

 

References:

  1. Linming, F., Wei, H., Anqi, L., Yuanyu, C., Heng, X., Sushmita, P., . . . Li, L. (2018). Comparison of two skin imaging analysis instruments: The VISIA® from canfield vs the ANTERA 3D®CS from miravex.Skin Research and Technology, 24(1), 3-8. doi:10.1111/srt.12381
  • 2. Gupta Lalit Kumar , Singhi MK. (2004). Wood's lamp. Indian Journal of Dermatology, Venereology, and Leprology, 70(2), 131-135.
  • 3. Ponka, D., & Baddar, F. (2012). Wood lamp examination. Canadian Family Physician, 58(9), 976-976.
  • 4. Richter, C., Trojahn, C., Dobos, G., Blume‐Peytavi, U., & Kottner, J. (2016). Follicular fluorescence quantity to characterize acne severity: A validation study. Skin Research and Technology, 22(4), 451-459. doi:10.1111/srt.12286
  • 5. Dobrev, H. (2010). Fluorescence diagnostic imaging in patients with acne. Photodermatology, Photoimmunology & Photomedicine, 26(6), 285-289. doi:10.1111/j.1600-0781.2010.00541.x
  • 6. Lee, K. C., Korgavkar, K., Dufresne, R. G., & Higgins, H. W. (2013). Safety of cosmetic dermatologic procedures during pregnancy. Dermatologic Surgery, 39(11), 1573-1586. doi:10.1111/dsu.12322
  • 7. O'Connor, A. A., Lowe, P. M., Shumack, S., & Lim, A. C. (2018). Chemical peels: A review of current practice. Australasian Journal of Dermatology, 59(3), 171-181. doi:10.1111/ajd.12715
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  • 10. Jungersted, J. M., Hellgren, L. I., Jemec, G. B. E., & Agner, T. (2008). Lipids and skin barrier function – a clinical perspective. Contact Dermatitis, 58(5), 255-262. doi:10.1111/j.1600-0536.2008.01320.x
  • 11. Zhang, Z., Lukic, M., Savic, S., & Lunter, D. J. (2018). Reinforcement of barrier function – skin repair formulations to deliver physiological lipids into skin. International Journal of Cosmetic Science, 40(5), 494-501. doi:10.1111/ics.12491
  • 12. Wang, X., Su, Y., Zheng, B., Wen, S., Liu, D., Ye, L., . . . Man, M. (2020). Gender‐related characterization of sensitive skin in normal young chinese. Journal of Cosmetic Dermatology, 19(5), 1137-1142. doi:10.1111/jocd.13123
  • 13. Farage, M. A., Katsarou, A., & Maibach, H. I. (2006). Sensory, clinical and physiological factors in sensitive skin: A review. Contact Dermatitis, 55(1), 1-14. doi:10.1111/j.0105-1873.2006.00886.x
  • 14. Moon, C. ‐., & Lee, O. (2018). Age‐dependent skin texture analysis and evaluation using mobile camera image. Skin Research and Technology, 24(3), 490-498. doi:10.1111/srt.12459
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