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Recognize mechanisms behind skin problems

When you work in the medical beauty field, you are often seeing clients with severe blemishes that appear to be treatment-resistant. Customers with "nervous" skin, which repeatedly gets out of balance and reacts with redness, scaling and inflammation can be very challenging. Only when you identify the cause of a skin problem can you treat it appropriately.

In order to provide competent advice and, if possible, to treat effectively, a thorough skin assessment is the most important cornerstone. Therefore, it is not advisable to ever recommend a treatment to an unknown customer over the phone. Customers sometimes say a lot about their skin on the phone, but this is always a subjective impression. Some customers also call with a specific diagnosis from the dermatologist, for example rosacea. Here, too, you should always carry out your own skin assessment in advance. As a result, the first appointment with a customer always takes a little longer. However, this time is well invested, it forms the foundation for a trusting customer relationship.

Questionnaire and interview

A detailed questionnaire, which you can also tick off, provides information about some basic things. In any case, you should ask:

  • Contact details (do not forget the information on data protection)

  • Grooming habits (Have you had regular cosmetic appointments so far? Are products used regularly and correctly at home?)

  • medication

  • intolerances and allergies (allergy pass, if available)

  • nutrition

  • diseases (especially chronic)

  • stimulants

  • sun exposure

  • profession

  • dermatologist treatment

  • interventions -e.g. surgeries, filler or botox treatments

  • laser or deep peel

Then, in a conversation, it is determined what is particularly important to the customer, what bothers him personally about his skin and where problems arise. Also ask what has already been done to solve the problem. Preferences for cosmetic treatments should also be addressed.


Then the skin is assessed by the skin therapist. If the customer comes with cleansed skin, that makes things easier, if not, it is cleaned with a product that is as neutral as possible.

The skin is observed and also "touched". This gives you an impression of the roughness of the skin and possibly also conclusions about the degree of keratinization. A magnifying lamp is essential for skin assessment. All areas of the face should be gone through. These give a conclusion about the current skin condition and can also help to get on the right track with skin problems:

  • Creases: They are caused by a lack of moisture, so ask how much you drink and recommend moisturizing products

  • Comedones: Does the client have a seborrheic skin type, seborrhea sicca (dry) or oleosa ( oily)? Have peels been done?

  • Broken veins: They can be caused by sun, sauna, spicy food. Is there a family predisposition?

  • Flaky areas: is it more dry or oily? Ask about excessive keratinization, frequency of peeling, or use of AHAs.

In general, when dealing with a skin problem, you should proceed logically and consider all eventualities.

Four examples

1. The customer complains of pimples, but the skin assessment shows dry skin without comedones:

Small red spots can be seen, which the customer mistakes for pimples. Here you have to ask exactly what care habits the customer has and how long the problem has been occurring. Ask customers about hormonal changes (e.g. due to the pill, pregnancy or menopause). Perhaps a specific event can be associated with the time it occurred.

Sometimes such “pimples” turn out to be more like micro-inflammations in the case of a barrier disorder in the skin. It would therefore be absolutely counterproductive to work with products for blemishes.

2. A customer comes from the dermatologist with a diagnosis of rosacea, but the prescribed preparations do not help. The skin is generally scaly, reddened and nervous:

It is important that we as beauticians do not make a medical diagnosis, but we can very well "check" the diagnosis of the dermatologist in our deliberations. It is quite often noticed that "rosacea" skin is actually perioral dermatitis. In that case , treatment for rosacea will not help, so we need to use different strategy. The customer can also be sent to another dermatologist for a differential diagnosis.

3. Customers with scratch acne are also very tedious and problematic:

Actually, the skin is not impure at all, rather the smallest comedones and (supposed) pimples are manipulated. It is pressed and ripped. Sometimes this causes a real inflammation and a scab.

The spot does not heal, but the customer continues to abuse the skin. If these areas heal at some point, a dark spot, the so-called post-inflammatory hyperpigmentation, often remains. Therefore, the skin of these customers always looks very uneven and restless at first glance. This is where you need to look very carefully. Are there really, objectively speaking, many comedones? In most cases, it takes a lot of educational work and patience to get the problem under control.

4. The customer complains about dry skin:

We all know that - a customer complains about dry skin, but doesn't get along with the rich products customer is already using.

What is the basic type of skin? In the case of actual sebostasis, the skin is fat and lacking in moisture, with a tendency to early wrinkle formation, and may be sensitive and thin. Often, however, one finds a rather normal skin with a tendency to combination skin. Excessive calluses that lead to scaling on the nose or chin are misinterpreted as dryness. Now it is important to see where the feeling of dryness comes from, and this is usually a pronounced lack of moisture - this can then be easily treated cosmetically.


Always question why a particular product is being used. It often happens that customers with oily and impure skin use oils for their skin care. That just doesn't fit and can be easily explained to the customer. If medication has been prescribed by the dermatologist, the beautician must not simply say that it should be discontinued. But she can certainly recommend getting a second opinion.

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