What is skin type? Many aestheticians fall into the trap of analytical skin evaluation based on general overview and render their clinical decisions using sketchy information at best. "Skin type" selection has become a science today and can no longer be judged on the antiquated oily, dry, normal, and acne condition of 1930's aesthetics. There are no two skins alike, even in identical twins. Any aesthetician relying on incomplete data concluded from common question and answers is taking a huge leap backwards, ultimately compromising results of the clinical treatment end point. Only progressive aestheticians can successfully acquire clinical end point outcome based on a systematic skin examination concluded from an in-depth information collection process. Putting this process into perspective, the aesthetician literally becomes a "skin detective" conducting CSI, or a "Corrective Skin Investigation".
How do you achieve this practice success? The answer is by performing the first therapeutic phase of CSI to arm yourself with valuable information of your client's skin for clinical solution. This integral detective process can uncover potential skin damaging culprits contributing to photo-aging, acne, pigmentation, and other problems including, but not limited to: sun damage, sensitivities, genetics, menopause, lifestyle imbalances, medications, ethnic blends, etc. Initial follow through of this set of rules is as important as a physical check-up conducted by a doctor prior to a medical procedure or Rx dispensing, and is no less significant.
What is Photo dermatology CSI assessment? Simply put, Photo-dermatology analysis is the backbone of your professional services and precedes all skin treatments and product dispensing; facilitating to pinpoint concealed histological manifestations of health related skin changes, not yet clinically evident, including the obvious signs of aging injury. Photo dermatology CSI assessment provides an itemized insight of the client's skin for the aesthetician to make an accurate verdict, and then select the suitable clinical skin treatments and professional products.
Photo-dermatology skin analysis evaluates this complicated immune organ to assist in establishing the "true age" of skin. "True age" of the skin does not necessarily mean chronological age. A 25-year-old can have skin that looks 50, and vice versa.
Evaluating the "true age" of the skin also includes fact finding conclusions of smoking, estrogen withdrawal, drugs, stress, excessive skin peeling, if client sleeps with their make-up on, poor nutrition, illness, radiation/chemotherapy, etc. in addition to UVR exposure. Add seven years to the age for each of these culprits. As an example, think of the President of the United States when he enters office to serve the country and how he looks after his term is up. The change is significant and gives pause to how stress and these other factors can speed up the aging process.
Although skin in itself is a protection barrier against radiation, this shield brings with it consequences of its own, leading to a "perceived age" that could be greater than one's actual age. Comprehending the basics of the aging process is important to understanding Photo-dermatology analysis. The primary extrinsic factor associated with the aging appearance and health of the skin is exposure to ultraviolet radiation, whether from natural sources (sunlight) or artificial causes (tanning salons, indoor lighting). Photo aging can be described as a continuum of assaults from the environment and lifestyle imbalances.
Reduced capacity of the antioxidant defense system of the cells results in age-associated oxidative stress and contributes to intrinsic aging. Increased matrix metalloproteinase (MMP), and decreased pro-collagen expressions involving mitogen-activated protein kinase signal-transduction pathways are central to the pathophysiology of intrinsic skin aging. Smoking and estrogen deficiency are interdependent risk factors that exacerbate intrinsic aging in skin directly affecting the cosmetic appearance. Like all other tissues, skin unavoidability ages, a process that influences the function and healthy look. Understanding manifesting causes intrinsically will help the aesthetician identify what is distressing the external skin and why Photo-dermatology CSI evaluation will make it easier for you decide the clinical end point of your treatments.
Check your client's forearm against their facial skin for comparison. This simple, quick visual check will provide biological distinction between the two skin's topography and help confirm the level of environmental damage to your client's skin. It can be a reality check.
Skin does not lie. In fact, it retains a memory of its complete injury history. Every "wrong" ever done to this immune organ will eventually show exterior clinical evidence and the aesthetician must learn how to recognize these conditions. Conclusive data compiled from the Photo-dermatology analysis allows the aesthetician to examine all of the signs from the skin's past to make a professional judgment call and eliminate a one-size-fits-all professional treatment and home skin care protocol.
It is easy for clients to forget how bad their skin was the day they walk in your door. But, pictures never lie. Therefore, begin by taking before and after photos and securing a consent form for both pictures and treatment. This is a fantastic way to maintain a visual record and reinforce to your client the reason they are committed to your exclusive program. It is also an amazing method to build a testimonial image archive you can share with new clients to relate how fantastic your professional products and skin treatments really are. These images act as a diplomat to your true skill as an aesthetician.
Finally, it is the important consideration of your client's current skin care program. Directing your questions with respect to all of the products they are currently using will assist the aesthetician in finding areas of their existing skin care that may need to be addressed. I always encouraged my new customers to "bring their face in a bag" so I could review the products along with the ingredients. This snooping also uncovers how they use their products, how much, if they are dipping their fingers in the jar, if the products have been exposed, etc. Finding out how they care for their products means this would be time to instruct them how to use skin care properly. I go so far by having them demonstrate to me how they apply it on their face. You would be amazed how one side gets 95 percent of the product and the other just dabs. Instruct the client to always to apply evenly, paying closer attention to the problem areas. Reviewing a customer's products also provides valuable insight to their dedication of a skin care program. Are they consistent? How much they spend? What kind of formula viscosity do they prefer? Never underestimate the power of what attracts a client to a product.
How does an aesthetician market a Photo-dermatology CSI analysis in their skin care clinic? By presenting it on your treatment menu and listing it as the most important service you offer. I recommend charging no less than $75 an hour. The information you gather during this session will always remain the central database of your client's records. No skin treatment should go forward without Photo-dermatology analysis.
In conclusion, how often should you conduct a CSI? Photo-dermatology analysis should be done once a year to keep your clients proactive with respect to their mature changing skin. The skin your client was in a year ago is not the skin they are in today. All yearly treatments and product updates should always be based on the new findings.

Christine Heathman, Master Aesthetician, CME, LMT is the Founder and CEO of Glymed Plus. With over 20 years of practicing clinical aesthetics, her experience with the medical profession is well established. As a licensed professional, she holds three licenses in aesthetics, one in California, a Master License in Utah, and one in Europe. As the Director of Education for the Gly-Med Institute of Skin Sciences in Spanish Fork, Utah, Heathman directs and provides the skin care professional with exceptional training. For more information, please contact her via e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it..