Are you familiar with what to look for, if improvements are not being seen? You don't want to accuse the client if you suspect some illegal use, but you can be aware of some tell-tale signs. Some medications can cause tearing, bruising, and irritation, which the aesthetician will want to be aware of for waxing and chemical peel treatments. Clients who dabble with illegal drugs may not be aware that some can cause irritation and acne. For body treatments or detoxification, it is also important to know that various medications may cause loose stools and/or diarrhea. Keep that in mind if a client complains of similar symptoms following a spa service. Did you wax a long time client and the skin tear? The clue may all come down to the medication that they have been prescribed.
With the woes of the economy, clients may currently be on anti-depressants. Some of the symptoms of depression they can experience are feeling hopeless and worthlessness. Depression sometimes can be triggered by severe stress, such as being out of work, illness, divorce, flunking out of school, or the loss of a loved one. As aestheticians we are not required to diagnose such clinical conditions; however, we should be aware of the medications that they are on because of the added risks involved. Furthermore, they may give us a clue as to why they want a particular treatment. Extra listening skills will always be helpful to you and the client. Some clients see the treatment rooms as a safe haven and want to discuss their current situations. Be empathetic, but refrain from offering solutions or making specific recommendations. It might be wise to have the address of a licensed psychiatrist or psychologist on file, in case you feel it necessary to recommend someone
more qualified.
Retired psychiatrist Dr. William Fleming states, "Stepping into the shoes of a therapist can be a very exciting and challenging experience. Unfortunately, it may also be potentially harmful to the client, if you get carried away with your desire to help and offer simple solutions to very complex problems. For most people, talking about your burdens is frequently very helpful and results in finding some relief. From the emotional point of view, you should offer what is within your area of expertise, which should include being a good, non-critical listener. You may be surprised at how helpful that can be."
Brittany Ricci, aesthetician from West Palm Beach, Fla., knows the importance of having a history sheet filled out by all her clients, especially when she is waxing. She has seen problems develop and not handled properly due to lack of a proper medical history. Brittany developed the following
pre-waxing form:

Medication to be Considered Prior to Waxing
The medication listed below MAY or may not affect the results of body waxing. Some of these medications may cause tearing, bruising, or irritation of the skin:
Dermalogical – Retina-A®, Accutane®, Renova™, Tazorac®, Differin®, Azelex®, and recent injectables such as Botox®
Anti depressants – (not limited to) Celexa®, Cymbalta®, Effexor®, Lexapro, Paxil®, Prozac®, Wellbutrin, Zoloft®
Anti psychotics – (not limited to) Zyprexa®, Risperda®, Haldol®
Benzodiazepines – (not limited to) Xanax®, Ativan®, Valium®, Klonopin®

Common skin side effects may include:
Dryness (tearing/irritation)
Anemia (bruising)
Dermatitis (no treatment)
Folliculitis (no treatment)
Toxic Epidermal Necrolyis (no treatment, causes severe peeling of the skin)

I have read the above information and am aware that, if I am on any of these medications, I may experience one or more of the listed adverse effects from any body or facial waxing.
Signature _____________________________
Date _________________________________

With so many medications on the market, it is recommended that you have in your treatment room a Physicians Desk Reference (PDR). You can also go online where you can review a consumer website for drugs (such as: http://www.drugs.com/pdr). If memory escapes as to the contraindications of a specific medication, the PDR is an excellent source of information which you can use as a guideline on drug indications, side effects, and interactions.
I was working with a mother and daughter and the mother's skin was improving. Her hyperpigmentation was fading and her fine lines were diminishing. She was very pleased with her results. However, I was also working with her daughter whose results were not as great as with her mother. I was a little frustrated. Her daughter was 22 years old and in law school and under a lot of stress. She had Grade 3 acne and very asphyxiated skin. The treatment would seem to start working, another breakout would take us back to the beginning. I thought it might be due to her being under a lot of stress. She had final exams and couldn't keep up with the treatments and took a month off. One evening her mother called me and said that her daughter's skin had cleared up completely. I thought she was calling to say thank you but that isn't quite how the conversation went. Cindy went on to relay how she had found out her daughter had been smoking marijuana and she had a huge fight with her and threatened to cut off all assistance with college if she didn't stop! The daughter complied and they decided to have her go on a detoxification cleanse. During that time the skin cleared up entirely. No more pimples! Her mother was convinced that this was the cause of her daughter's broken out complexion. Three months later, her daughter started to smoke marijuana again and, again, she started to break out. Her mom immediately knew the signs and confronted her daughter, managing to get her to stop once more. Her complexion cleared up once again. Six months later she is still acne free. This got me to thinking: is this a coincidence or is there something really to marijuana causing pimples?
"Everyone's skin is a little bit different and sometimes it takes more than one type of treatment to get good results," states Charles E. Crutchfield III, MD, clinical associate professor of dermatology, University of Minnesota Medical School and medical director of Crutchfield Dermatology. A client with acne may have many causes for the papules, pustules,
and comedones.
However, for this article we are focusing on prescribed and illegal drugs. People differ on how they are affected by smoking marijuana. With regard to skin reactions, some you may see breakouts around the mouth, where they might have shared a joint or a bong. One study stated that women were usually affected much more often than their male counterparts. One of the possible reasons for this is that the use of marijuana affects testosterone levels. Marijuana has been shown to lower the levels of testosterone, sometimes markedly so. This is followed by a rebound increase to higher than normal levels. The increase of testosterone is achieved by the increased production of androgens, which is the precursor of testosterone. In the process, sometimes the body ends up producing too much testosterone. As is well known, the overproduction of androgens is a known cause of acne. Hence, smoking marijuana can lead to acne. In females, this effect is more profound because the female body normally has less testosterone, and so the acne breakouts are a result of the new hormonal imbalance. Skin irritants are also known to cause acne. In some cases, this means that the smoke from marijuana will cause a break out. If your skin is ultra sensitive, the smoke may cause breakouts, or even being in a room heavily laden with smoke could be enough to cause a new flare up. In this case, cigarette and cigar smoke may do the same.
Cocaine has been known to cause frequent nose bleeds and even boils. Skin sores or boils can appear in persons who are heavy users. Cocaine use is extremely dangerous after rhinoplasty. Cocaine constricts the blood vessels, restricting blood and oxygen supply to vulnerable areas of your nose, especially the septum, causing tissue loss due to vasoconstriction, eventually affecting the normal
sinus passages.

Weigh in on This!
When you think of steroid abuse, typically body builders and athletes come to mind. Corticosteroid is a generic name for the group of hormones that have a cortisone-like action. They are man-made steroids that have the same activity of cortisone. Cortisone is produced naturally in the body and is involved, among many effects, in regulating inflammation, thus dealing with injury. Corticosteroids are not the same as anabolic steroids. Corticosteroids are used in the treatment of many diseases like asthma, eczema, allergies, arthritis, colitis, and kidney disease. The steroids that become a problem and lead to abuse are anabolic steroids. The term 'anabolic' is derived from a Greek word that means to 'build up.'
However, corticosteroids are used as medication for specific diseases, such as AIDS. They help prevent muscle loss. Steroids have a characteristic effect of boosting androgens in the body. Androgens are the male hormones that are also present in small quantities in females. Testosterone is the most important androgen and with an increase in testosterone, the sebaceous glands are stimulated. This results in more sebum being secreted in the skin and ultimately it breaks out as acne. The effect is such that pimples spring out not only on the face but also the chest, back, and neck.
Adolescents or adults who have been taking moderate or high doses of oral steroids, such as Prednisone, over a period of time may develop small skin bumps, which sometimes itch. They commonly first appear on the chest. They are sometimes pustular, or large firm lumps, that seem buried under the skin. Unlike the propionium acne, most of the lesions are the same size and tend to be small. Pronounced nodules are rare.
Side effects of steroids: skin atrophy, myopathy, impaired wound healing, suppression of immune response, skin infections, excessive facial hair growth, ingrown hairs contact dermatitis, acne, eczema, cysts, rashes, lesions, blisters, water retention, or easy bruising.

Huffing
Huffing is the voluntary inhaling of chemical vapor, such as the contents of aerosol spray cans. They may be sprayed on a rag and inserted in a bag to inhale the fumes with the purpose of obtaining an altered mental state or "high." It can be deadly. Many teenagers are doing this right in their parents' garage. Parents of teens need to be especially vigilant about signs of huffing, since the abused substances are simple household items are not readily identifiable as drugs of abuse. These substances are also easily purchased and inexpensive, making them attractive to curious teens. In addition to signs of intoxication, parents should be warned of potential inhalant abuse by sores and scratches around the mouth and nose along with the presence of unusual odors.

Alcohol
Alcohol can irritate and dry the skin, especially for clients who have rosacea. This disorder is believed to affect well over 14 million Americans. Rosacea is becoming increasingly widespread as the populous babyboom generation enters the most susceptible ages. A Gallup survey found that 78 percent of Americans have no knowledge of this condition, including how to recognize it and what to do about it. Typically, clients who suffer from rosacea will have these visible signs of redness on the cheeks, nose, chin, or forehead; with small, visible blood vessels on the face and acne. If it is left untreated, it will get worse. Rosacea often flares when something causes the blood vessels in the face to expand, which causes redness. Rosacea is not caused by alcohol abuse, as people thought in the past. However, drinking alcohol may aggravate the condition.
Dr. Richard P. Rand, MD states that drinking alcohol has a diuretic effect and will dry out your skin. Alcohol intake can also reduce the level of vitamin A within the body. This leads to two problems: lower skin cell turnover and a decreased ability to fight free radicals. Lower skin cell turnover causes the skin to begin appearing sallow as dead cells accumulate on the surface. The decreased ability to fight free radicals allows the free radicals to spread, thereby accelerating the deterioration of collagen and elastin. This process eventually leads to fine lines and wrinkles. No one is saying not to the key.
As professionals, we need to know what drugs our clients are taking and understand their side effects. It is the only way we can effectively design the best treatments for them. When a client comes in and is concerned with a new or unusual case of ingrown hairs, we can review the client's history form and ask a few questions. Learning that they are on a steroid medication may clarify the reason of a new case of folliculitis. Most professionals are very vigilant about asking if the client is pregnant and will routinely alter the treatment as necessary. We must be just as vigilant in asking about drug use and understanding medications. Remember that with recreational drug use, clients are less likely to be forthcoming; just look for any tell-tale signs that may guide you to a better treatment and understanding of why their skin is not improving. If there are questions about medications or concerns about the results or reactions from a procedure or product, it is always in the best interest of the client to contact their doctor and ask for a release.

Denise R. Fuller is a licensed aesthetician and a certified body wrapping instructor in the state of Florida. Fuller is a trained Australian beauty therapist, a published author, and an AIA Ambassador.
www.denisefuller.biz, This email address is being protected from spambots. You need JavaScript enabled to view it.