8

Chapter

Chapter Outline
Why Study Skin Disorders
Skin Disorders
and Diseases
and Diseases?

Disorders and Diseases

of the Skin

Disorders of the Sebaceous

(Oil) Glands

Disorders of the Sudoriferous

(Sweat) Glands

Inflammations and Common

Infections of the Skin

Pigment Disorders of the Skin

Hypertrophies of the Skin

Skin Cancer

Acne and Problem Skin

© Grafica, 2010; used under license from Shutterstock.com.

Aging Skin Issues

The Sun and Its Effects

Contact Dermatitis

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 Learning Objectives
After completing this chapter, you will be able to:

LO1 Recognize common skin lesions.

LO2 Describe the disorders of the sebaceous glands.
LO3 Name and describe changes in skin pigmentation.
LO4 Identify the forms of skin cancer.
LO5 Understand the two major causes of acne and how to treat them.
LO6 List the factors that contribute to the aging of the skin.
LO7 Explain the effects of overexposure to the sun on the skin.
LO8 Understand what contact dermatitis is and know how it can be prevented.

Key Terms
Page number indicates where in the chapter the term is used.
albinism closed comedo excoriation hypopigmentation
pg. 183 (whitehead) pg. 180 pg. 183
pg. 180
allergic contact extrinsic factors impetigo
dermatitis (ACD) conjunctivitis pg. 187 pg. 182
pg. 190 (pinkeye)
pg. 182 fissure intrinsic factors
anaerobic pg. 180 pg. 187
pg. 186 contact dermatitis
pg. 190 free radicals irritant contact
anhidrosis pg. 188 dermatitis (ICD)
pg. 181 crust pg. 191
pg. 179 herpes simplex
basal cell carcinoma pg. 182 keloid
pg. 184 cyst pg. 180
pg. 178 hyperhidrosis
bromhidrosis pg. 181 keratoma
pg. 181 dermatitis pg. 184
pg. 182 hyperpigmentation
bulla pg. 183 lentigines
pg. 178 dyschromias pg. 183
pg. 183 hypertrophy
chloasma (liver pg. 184
spots) eczema
pg. 183 pg. 182

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8
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 Key Terms
Page number indicates where in the chapter the term is used.
lesion nodule seborrheic tubercle
pg. 178 pg. 178 dermatitis pg. 179
pg. 181
leukoderma noncomedogenic tumor
pg. 183 pg. 187 secondary skin pg. 179
lesions
macule primary lesions pg. 179 ulcer
pg. 178 pg. 178 pg. 180
sensitization
malignant psoriasis pg. 190 verruca (wart)
melanoma pg. 182 pg. 184
pg. 184 skin tag
retention pg. 184 vesicle
milia hyperkeratosis pg. 179
pg. 180 pg. 186 squamous cell
carcinoma vitiligo
miliaria rubra rosacea pg. 184 pg. 183
(prickly heat) pg. 181
pg. 181 stain wheal
scale pg. 183 pg. 179
mole pg. 180
pg. 184 tan
scar (cicatrix) pg. 183
nevus (birthmark) pg. 180
pg. 183 telangiectasis
sebaceous cyst pg. 181
pg. 181

8 176 Chapter 8 Skin Disorders and Diseases Part 2: General Sciences

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 A re you interested in skin care? Have you always thought that
it would be interesting to understand the way that the skin
functions and how it can be improved and beautified? If so,
then skin care is a possible area of specialty for you!
Skin care specialists are in high demand in many salons and spas and
earn excellent salaries. Some stylists find caring for the skin less arduous
and physically demanding than styling hair and choose to balance their
day by scheduling services in both areas. Whatever your reason, skin
care is an area of rapid change and growth and a topic on most clients’
minds. Knowing the basics of skin care and how the skin functions will
allow you to advise clients on their skin care regimens when they seek
your professional opinion.

WHY STUDY SKIN

DISORDERS AND DISEASES?
Cosmetologists should study and have a thorough understanding
of skin disorders and diseases for the following reasons:
■■ In order to provide even the most basic of skin care services, you
must understand the underlying structure of the skin and common
skin problems.
■■ You must be able to recognize adverse conditions, including inflamed
skin conditions, skin diseases, and infectious skin disorders, and
you must know which of these conditions are treatable by the
cosmetologist and which need to be referred to a medical doctor.
■■ Knowing about and being able to offer skin care treatments adds
another dimension of service for your clients.

Disorders and Diseases

of the Skin
Like any other organ of the body, the skin is susceptible to a
variety of diseases, disorders, and ailments. In your work as a
practitioner, you will often see skin and scalp disorders, so
you must be prepared to recognize certain common skin
© Kurhan, 2010; used under license from Shutterstock.com.

conditions and know which you can help to treat and

which must be referred to a physician. Occasionally,
you may be asked to apply or use on a client a scalp
treatment prescribed by a physician. These must be
applied in accordance with a physician’s directions.
A dermatologist is a physician who specializes in
diseases and disorders of the skin, hair, and nails.
Dermatologists attend four years of college, four
years of medical school, and then about four

Part 2: General Sciences Chapter 8 Skin Disorders and Diseases 177

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8
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nodosum,

hat
pus,
Vesicle: years of specialty training in dermatology. Many have
Accumulation of fluid between
s less the upper layers of the skin; additional training in internal medicine, because some
meter elevated mass containing
serous fluid; less than 0.5 cm skin symptoms may be reflective of internal disease.
uncles,
tis
Example: Cosmetologists refer clients with medical issues to
Herpes simplex, herpes
zoster, chickenpox dermatologists more than any other type of physician.
nly Bulla (plural:
Macule bullae):
(plural: maculae): It is very important that a salon not serve a client who is
Same as a changes
Localized vesicle only in skin
Wheal: greater
color ofthanless0.5 than cm1 cm suffering from anMacule
inflamed skinmaculae):
(plural: disorder, infectious or not,
large
ule only Localized changes in skin
rns,
Localized
Example:in diameter
BullaContact
Example: (plural:
epidermis
edema in the
bullae):
causing irregular
dermatitis, large
without a physician’s note permitting
color of the client to receive
less than 1 cm
emphigus in diameter
advanced
Same
Freckleas athat
elevation
second-degree vesiclemay only
burns,be red services. The cosmetologist
Macule should
Example:(plural: be able to recognize these
maculae):
greater
or(plural:than
pale impetigo,
Bullabulbous 0.5 cm
bullae):pemphigus Localized changes in skin
not basal cell Example:
Example:
Same as abullae):
vesicle only
conditions and sensitively
color
suggest
Freckle that
of lessmaculae):
than 1 cm
proper measures be
the skin BullaContact
(plural:
Insect bite dermatitis,
or0.5a hive large Macule (plural:
greater
Same asthan
second-degree a vesicle cm only
burns,
taken to prevent more inserious
diameter
Localized
Macule
consequences.
(plural:changes in skin
maculae):
Example:
Papule: greater than 0.5 cm Example:
color of less than 1incm
bulbous dermatitis,
Contact impetigo, pemphigus large Freckle Localized changes skin
however, Example:
Solid,
Tubercle:
elevated lesion
second-degree burns,
less Numerous important terms
in of relating
less than 1to
diameter
color
Papule: cmskin, scalp, and hair
han Contact
than 0.5 cmdermatitis,
in diameter large Example:
in diameter
rmis or bulbous
Solid
Example: andimpetigo,
second-degree elevated; pemphigus
burns,however, disorders that youExample:
should
Solid, be
Freckle familiar
elevated lesionwith
less are described in
es, 0.5-2 cm itbulbous
extends
Warts, deeper
impetigo,
elevated nevithan
pemphigus than 0.5 cm in diameter
papules into the dermis or subsequent sections. Freckle
Example:
Tubercle:
subcutaneous tissues, 0.5-2 cm Papule:
Warts, elevated nevi
nodosum, Solid, elevated lesion less
Solid and elevated; however,
Example:
it extends
Lipoma,
Tubercle:
papules
deeper than
erythema, nodosum, Lesions ofExample:
the
thanSkin
Papule: 0.5 cm in diameter
cyst andinto
Solid the dermis
elevated; or
however, Solid, elevated lesion less
Papule:
Tubercle:
subcutaneous
it extends deeper tissues,
than 0.5-2 cm A lesion (LEE-zhun) is a mark
Warts,
than
Solid,0.5 cm inon
elevated
elevated
the skin that may indicate
nevi
diameter
lesion less
Solid and elevated; however,
Example:
hat
papules
it extends
Lipoma,
into the dermis
deeper
erythema, than
nodosum,
or an injury or damage Warts,
that0.5
Example:
than changes the structure of tissues or
cm in diameter
Vesicle:
subcutaneous tissues, 0.5-2
or cm elevated nevi
pus,
papules
Pustule:
cyst
Example:
into
Accumulation of
subcutaneous
the dermis
fluid between
tissues, 0.5-2 cm organs. A lesion Example:
can be
Warts, elevated nevia freckle or as dangerous
as simple as
as less Vesicles
the upper
Lipoma, orlayers
bullaeofthat
erythema, the skin;
nodosum, Vesicle:
meter Example:
become
elevated filled with
mass containing pus, as a skin cancer. Lesions can indicate
Accumulation of fluidskin
betweendisorders or
y Maculecyst
Lipoma,
(plural:
usually erythema,
maculae):
described nodosum,
as less
uncles,
serous
cyst
Pustule:
Localized
than
Example: 0.5
fluid;
changes
cm
less than
in in
diameter
0.5 cm
skin diseases and sometimes themay
upperindicate
layers of the
elevated mass containing
other
skin; internal diseases.

itis Vesicles
color
Example: of or
less bullae
than
Herpes simplex, herpes 1 that
cm Being familiar with the
Vesicle: principal
serous fluid; lessskin
thanlesions
0.5 cm will help you
rge inAcne,
diameter
become filled with pus,
s, Pustule: zoster,impetigo,
chickenpox furuncles, Accumulation
Example: of fluid between
mphigus
Example:usually
carbuncles,
Vesicles
Pustule:
described
or as less
folliculitis
bullae that be able to distinguish between
the upper conditions
layers of
Herpes simplex, herpes
Vesicle: the skin;that may and may
Freckle
than 0.5 cm inwith
diameter elevated mass containing
become
Vesicles
Example:
usually
filled
or bullae
described
pus,
that
as less
not be treated in Vesicle:
a salon or spa (Figure 8–1).
zoster, chickenpox
Accumulation of fluid between
serous fluid; less than 0.5 cm
become
Acne, filled with
impetigo, pus,
furuncles, the upper layers
Accumulation of the
of fluid skin;
between
than 0.5described
cm in diameter Example:
elevated mass containing
Wheal:carbuncles, folliculitisless
usually as the upper layers of the skin;
ule only Herpesfluid;
simplex, herpes
Example:
Tumor:
Papule:
Localized
than
Acne,
Example:
0.5 cm edema
impetigo,
epidermis causing
in the
in diameter
furuncles,
irregular
Primary Lesions of the Skin
serous
elevated
zoster,
Example:
Wheal:
masslesscontaining
chickenpox
than 0.5 cm
serous fluid; less than 0.5 cm
owever, carbuncles,
The
Solid, same
elevated
elevation
Acne, as folliculitis
that
impetigo, a nodule
lesion
may be only
less
furuncles,red The terms for different lesions
Herpes
Localized
Example: listed
simplex,
edema below often indicate
herpes
in the
nadvanced greater
than or0.5 cm
pale
carbuncles, than 2 cm
in diameter
folliculitis zoster,
Herpeschickenpox
epidermis causingherpes
simplex, irregular
notor
mis basal cell Example:
Example:
Example: differences in the areaelevation
of the skin
that may
zoster, chickenpox
layers affected and the
be red
,the skin Tumor: Carcinoma bite (such as advanced
0.5-2 cm Warts,
The
breast
elevated
Insect
same
ornevi
a hive
as a nodule
carcinoma); not only
basal cell size of the lesion.Wheal:
or pale
Localized edema in the
greater than 2cell cmof the skin Example:
dosum, Tumor: or squamous epidermis
Insect bitecausing
or a hive irregular
Wheal:
Primary lesions are lesions that
Example:
Tumor:The same as a nodule only elevation
Localized that are
edema mayin
athe
bedifferent
red color than
Carcinoma
greater than (such cmas advanced
2 nodule Wheal:
or pale
The
breast
Example:
same as a
carcinoma); not only
basal cell the color of the skin and/or
epidermis
Localized
Example:
lesions
causing
edema inthat
the are raised above
irregular
greater
or squamousthan 2 cmof the skin
cell elevation
epidermis that mayirregular
causing be red
Carcinoma
Example: (such as advanced the surface of the skin.Insect
Requires
bite or medical
a hive
or pale that may be red
elevation
referral.
breast
Carcinoma carcinoma);
(such asnot basal cell
advanced Example:
t Vesicle: or squamous cell ofnotthebasal
skin cell or pale
us, breast carcinoma);
Accumulation of fluid between Bulla (BULL-uh), (plural: bullae,
Insect bite
Example: BULL-ay), is a large
or a hive
ess or squamous cell of the skin Insect bite or a hive
y
ter Macule
the upper layers of the skin;
(plural:
elevated mass maculae):
containing
blister containing a watery fluid; similar to a vesicle but
Localized
serous fluid;changes
less than
color of less than 1 cm
in skin
0.5 cm larger (Figure 8–2). Requires medical referral.
ncles, Example:
rge in diameter
s Herpes simplex, herpes
s, Example:
zoster, chickenpox
Cyst (SIST) is a closed, abnormally developed sac that
mphigus Freckle
contains fluid, pus, semifluid, or morbid matter, above
or below the skin. Cysts are frequently seen in severe
only
Wheal: acne cases. Requires medical referral.
Localized edema in the
Papule:
epidermis
Solid, causing
elevated irregular
lesion less
owever,
n elevation
than 0.5 cmthat may be red
in diameter
Macule (MAK-yool), (plural: maculae, MAK-yuh-ly),
© Milady, a part of Cengage Learning.

dvanced
mis or cell
t basal
or pale
Example:
Example:
is any flat spot or discoloration on the skin, such as a
, 0.5-2 Warts, elevated nevi
he skin cm Insect bite or a hive freckle or a red spot, left after a pimple has healed.
dosum,
Figure 8–1 Nodule (NOD-yool) is a solid bump larger than
Primary skin lesions. These illustrations show
the size, elevation or depression, and layers of
.4 inches (1 centimeter) that can be easily felt.
the skin that are affected in each type of lesion. Requires medical referral.
t Vesicle:
us, Accumulation of fluid between
ess the upper layers of the skin;

8
ter elevated mass containing

ncles, 178
Example:
serous fluid; less than 0.5 cm
Chapter 8 Skin Disorders and Diseases Part 2: General Sciences
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Herpes simplex, herpes
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
zoster, chickenpox
 Papule is a small elevation on the

Academy of Dermatology. All rights reserved.

Reprinted with permission from the American
skin that contains no fluid but may
develop pus. Papules are frequently

Reprinted with permission from the American Academy of

seen in acne.
Pustule is a raised, inflamed, papule
with a white or yellow center

Dermatology. All rights reserved.

containing pus in the top of the
lesion referred to as the head of the
pimple (Figure 8–3). Figure 8–2
Bullae.
Tubercle (TOO-bur-kul) is an
abnormal, rounded, solid lump above, within, or under the skin; larger
than a papule. Requires medical referral. Figure 8–3
Papules and pustules.
Tumor (TOO-mur) is an abnormal mass varying in size, shape, and
color. Tumors are sometimes associated with cancer, but the term tumor
can mean any sort of abnormal mass. Requires medical referral.
Vesicle (VES-ih-kel) is a small blister or sac containing clear fluid, lying
within or just beneath the epidermis. Poison ivy and poison oak, for

Timothy Berger, MD, Associate Clinical Professor, University of

example, produce vesicles (Figure 8–4). Requires medical referral.
Wheal (WHEEL) is an itchy, swollen lesion that lasts only a few hours;
caused by a blow or scratch, the bite of an insect, urticaria (skin allergy),
or the sting of a nettle. Examples include hives and mosquito bites.

Secondary Lesions

California, San Francisco.

Secondary skin lesions are characterized by piles of material on the
skin surface, such as a crust or scab, or by depressions in the skin
surface, such as an ulcer (Figure 8–5).
Crust is dead cells that form over a wound or blemish while it is healing;
Figure 8–4
an accumulation of sebum and pus, sometimes mixed with epidermal Poison oak vesicles.
material. An example is the scab on a sore.

Scar Crust Ulcer

© Milady, a part of Cengage Learning.

Figure 8–5
Secondary skin lesions.

Scale Fissure Éxcoriation

Part 2: General Sciences Chapter 8 Skin Disorders and Diseases

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179 8
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 Excoriation (ek-skor-ee-AY-shun) is a skin sore or abrasion produced
by scratching or scraping.
Fissure (FISH-ur) is a crack in the skin that penetrates the dermis.
Examples are severely cracked and/or chapped hands or lips.
Keloid (KEE-loyd) is a thick scar resulting from excessive growth
of fibrous tissue (Figure 8–6).
Scale is any thin dry or oily plate of epidermal flakes. An example
is abnormal or excessive dandruff.
Scar, also known as cicatrix (SIK-uh-triks), is a lightly raised mark
Figure 8–6 on the skin formed after an injury or lesion of the skin has healed.
Keloids.
Ulcer (UL-sur) is an open lesion on the skin or mucous membrane
of the body, accompanied by loss of skin depth and possibly weeping
of fluids or pus. Requires medical referral. LO1

Disorders of the Sebaceous

(Oil) Glands
There are several common disorders of the sebaceous (oil) glands that
the cosmetologist should be able to understand and identify.
An open comedo, also known as a blackhead, is a hair follicle filled
with keratin and sebum. Comedones appear most frequently on the
face, especially in the T-zone, the center of the face (Figure 8–7). When
the sebum of the comedo is exposed to the environment, it oxidizes
and turns black. When the follicle is closed and not exposed to the
environment, the sebum remains a white or cream color and is a closed
comedo, also known as whitehead, and appears as a small bump just
under the skin surface.

Reprinted with permission from the American Academy of Dermatology. All rights reserved.
Figure 8–7 Comedones can be removed by trained beauty professionals as long
Comedones. as proper procedures are employed and the procedure is performed in
a sanitary environment using extraction implements that have been
properly cleaned and disinfected.
Milia (MIL-ee-uh) are benign, keratin-filled cysts that appear just
under the epidermis and have no visible opening. They resemble small
sesame seeds and are almost always perfectly round. They are commonly
associated with newborn babies but can appear on the skin of people of
all ages. They are usually found around the eyes, cheeks, and forehead,
and they appear as small, whitish masses (Figure 8–8). Depending on
the state, milia can be treated in the salon or spa.
Figure 8–8
Milia.
Acne, also known as acne vulgaris, is a skin disorder characterized by
chronic inflammation of the sebaceous glands from retained secretions
and bacteria known as propionibacterium acnes (P. acnes), the scientific
term for acne bacteria. Acne will be discussed in further detail later in
this chapter (Figure 8–9).

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sebaceous cyst is a large protruding pocket-like lesion filled with
sebum. Sebaceous cysts are frequently seen on the scalp and the back.
They should be removed surgically by a dermatologist.
Seborrheic dermatitis (seb-oh-REE-ick derm-ah-TIE-tus) is a skin
condition caused by an inflammation of the sebaceous glands. It is often
characterized by redness, dry or oily scaling, crusting, and/or itchiness
(Figure 8–10). The red, flaky skin often appears in the eyebrows and
beard, in the scalp and hairline, at the middle of the forehead, and along
the sides of the nose. Mild flares of seborrheic dermatitis are sometimes

Larry Hamill.
treated with cortisone creams. Seborrheic dermatitis is a medical
condition, but it can be helped in the salon with the application of
non-fatty skin care products designed for sensitive skin. Severe cases Figure 8–9
should be referred to a dermatologist, who will often prescribe topical Acne.
antifungal medications.
Rosacea (roh-ZAY-shuh), formerly called acne rosacea, is a chronic
condition that appears primarily on the cheeks and nose. It is
characterized by flushing (redness), telangiectasis (tee-lang-jek-tay-

Courtesy of www.dermnet.com.
shuhz) (distended or dilated surface blood vessels), and, in some cases,
the formation of papules and pustules. The cause of rosacea is unknown,
but the condition is thought to be genetic. Certain factors are known
to aggravate the condition in some individuals. These include exposure
to heat, sun, and very cold weather; ingestion of spicy foods, caffeine,
and alcohol; and stress. Rosacea can be treated and kept under control Figure 8–10
by using medication prescribed by a dermatologist, using proper skin Seborrheic dermatitis.
care products designed for especially sensitive skin, and avoiding the
aggravating flare factors listed above (Figure 8–11). LO2

Reprinted with permission from the American Academy of

Disorders of the
Sudoriferous (Sweat) Glands

Dermatology. All rights reserved.

Anhidrosis (an-hih-DROH-sis) is a deficiency in perspiration, often
a result of fever or certain skin diseases. Requires medical referral.
Bromhidrosis (broh-mih-DROH-sis) is foul-smelling perspiration,
usually noticeable in the armpits or on the feet, that is caused by Figure 8–11
Rosacea.
bacteria. Severe cases require medical referral.
Hyperhidrosis (hy-per-hy-DROH-sis) is excessive sweating, caused
by heat or general body weakness. Requires medical referral.
Miliaria rubra (mil-ee-AIR-ee-ah ROOB-rah), also known as
prickly heat, is an acute inflammatory disorder of the sweat glands,
characterized by the eruption of small red vesicles and accompanied
by burning, itching skin. It is caused by exposure to excessive heat and
usually clears in a short time without treatment.

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8
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Inflammations and Common
Infections of the Skin
Conjunctivitis (kuhn-juhngk-tuh-VAHY-tis), also known as pinkeye,
is a common bacterial infection of the eyes. It is extremely contagious,
and clients who have conjunctivitis or obviously irritated eyes should
be politely rescheduled and referred to a physician immediately. Any
product or implements touching infected eyes must be thrown away.
Dermatitis (dur-muh-TY-tis) is a term broadly used to describe any
inflammatory condition of the skin.
Courtesy of www.dermnet.com.

Eczema (EG-zuh-muh) is an inflammatory, uncomfortable, and

often chronic disease of the skin, characterized by moderate to severe
inflammation, scaling, and sometimes severe itching. There are several
different types of eczema. The most common type is atopic eczema,
which is an inherited genetic disorder. All cases of eczema should be
referred to a physician for treatment, which is often topical cortisone.
Figure 8–12
Eczema. Eczema is not contagious (Figure 8–12).
Herpes simplex (HER-peez SIM-pleks) is a recurring viral infection
that often presents as a fever blister or cold sore. It is characterized by
the eruption of a single vesicle or group of vesicles on a red swollen
base. The blisters usually appear on the lips, nostrils, or other part of
the face, and the sores can last up to three weeks. Herpes simplex is
contagious (Figure 8–13) and requires medical referral. Drugs are now
Academy of Dermatology. All rights reserved.
Reprinted with permission from the American

available to control the symptoms, but the virus always remains in the
body of infected persons.
Impetigo (im-pet-EYE-go) is a contagious bacterial skin infection
characterized by weeping lesions. Impetigo normally occurs on the
face (especially the chin area) and is most frequently seen in children.
Clients with any type of weeping open facial lesions should be politely
Figure 8–13 rescheduled and referred to a physician immediately.
Herpes simplex.
Psoriasis (suh-RY-uh-sis) is a skin disease characterized by red
patches covered with silver-white scales and is usually found on the
scalp, elbows, knees, chest, and lower back. Psoriasis is caused by the
skin cells turning over faster than normal. It rarely occurs on the face.
Academy of Dermatology. All rights reserved.
Reprinted with permission from the American

When the condition is irritated, bleeding points can occur. Psoriasis

is not contagious (Figure 8–14), but it requires medical referral. It is
treatable, but it is not curable.

Figure 8–14
Pigment Disorders of the Skin
Psoriasis. Pigment can be affected by internal factors such as heredity or
hormonal fluctuations, or by outside factors such as prolonged exposure

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to the sun. Abnormal colorations, known as dyschromias (dis-chrome-
ee-uhs), accompany skin disorders and many systemic disorders. A
change in pigmentation can also be observed when certain drugs are
being taken internally. The following terms relate to changes in the
pigmentation of the skin:
Hyperpigmentation (hy-pur-pig-men-TAY-shun) means darker than
normal pigmentation, appearing as dark splotches. Hypopigmentation
(hy-poh-pig-men-TAY-shun) is the absence of pigment, resulting in
light or white splotches.
Albinism (AL-bi-niz-em) is congenital hypopigmentation, or absence
of melanin pigment in the body, including the skin, hair, and eyes. Hair

Reprinted with permission from the American Academy of Dermatology. All rights reserved.
is silky white. The skin is pinkish white and will not tan. The eyes are
pink, and the skin is sensitive to light and ages early.
Chloasma (kloh-AZ-mah), also known as liver spots, is a condition
characterized by hyperpigmentation on the skin in spots that are not
elevated. This is just a commonly-used term; the spots have nothing to
do with the liver. They are generally caused by cumulative sun exposure.
They can be helped by exfoliation treatments or can be treated by a
dermatologist.
Lentigines (len-TIJ-e-neez) (singular: lentigo, len-TY-goh) is the
technical term for freckles, small yellow-colored to brown-colored spots
on skin exposed to sunlight and air.
Leukoderma (loo-koh-DUR-muh) is a skin disorder characterized by
light abnormal patches (hypopigmentation); it is caused by a burn or
congenital disease that destroys the pigment-producing cells. Examples Figure 8–15
are vitiligo and albinism. Port wine stain.

Nevus (NEE-vus), also known as birthmark, is a small or large

malformation of the skin due to abnormal pigmentation or dilated
capillaries.
Stain is an abnormal brown-colored or wine-colored skin discoloration
with a circular or irregular shape (Figure 8–15). Its permanent color is
due to the presence of darker pigment. Stains can be present at birth,
or they can appear during aging, after certain diseases, or after the
disappearance of moles, freckles, and liver spots. The cause is often
unknown.
Courtesy of www.dermnet.com.

Tan is the change in pigmentation of skin caused by exposure to the

sun or ultraviolet light.
Vitiligo (vi-til-EYE-goh) is a hereditary condition that causes
hypopigmented spots and splotches on the skin that may be related to
thyroid conditions (Figure 8–16). Skin with vitiligo must be protected Figure 8–16
from overexposure to the sun. LO3 Vitiligo.

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 caution Hypertrophies of the Skin
A hypertrophy (hy-PUR-truh-fee) of the skin is an abnormal growth
Do not treat moles or remove
of the skin. Many hypertrophies are benign, which means they are
hair from moles. Removing a
harmless.
hair from a mole could irritate
or cause a structural change A keratoma (kair-uh-TOH-muh) is an acquired, superficial, thickened
to it. Only a physician should patch of epidermis. A callus is a keratoma that is caused by continued,
remove a hair from a mole. repeated pressure or friction on any part of the skin, especially the hands
and feet. If the thickening grows inward, it is called a corn.
A mole is a small brownish spot or blemish on the skin, ranging in
Reprinted with permission from the American
Academy of Dermatology. All rights reserved.

color from pale tan to brown or bluish black. Some moles are small
and flat, resembling freckles; others are raised and darker in color.
Large dark hairs often occur in moles. Any change in a mole requires
medical attention.
A skin tag is a small brown-colored or flesh-colored outgrowth of the
skin (Figure 8–17). Skin tags occur most frequently on the neck of an
older person. They can be easily removed by a dermatologist.
Figure 8–17
Skin tags. A verruca (vuh-ROO-kuh), also known as wart, is a hypertrophy of the
papillae and epidermis. It is caused by a virus and is infectious. Verruca
can spread from one location to another, particularly along a scratch in
the skin. Requires medical referral.
Courtesy of www.dermnet.com.

Skin Cancer
Skin cancer—primarily caused from overexposure to the sun—comes
in three distinct forms that vary in severity. Each is named for the type
Figure 8–18 of cells that it affects.
Basal cell carcinoma.
Basal cell carcinoma (BAY-zul SEL kar-sin-OH-muh) is the
most common and the least severe type of skin cancer; it is often
characterized by light or pearly nodules (Figure 8–18). Squamous
(SKWAY-mus) cell carcinoma is more serious than basal cell
carcinoma, and often is characterized by scaly red papules or nodules
(Figure 8–19). The third and most serious form of skin cancer is
malignant melanoma (muh-LIG-nent mel-uh-NOH-muh), which
is often characterized by black or dark brown patches on the skin
that may appear uneven in texture, jagged, or raised (Figure 8–20).
Courtesy of www.dermnet.com.

Malignant melanoma is the least common—but also the most

dangerous—type of skin cancer.
Clients should be advised to regularly see a dermatologist for checkups
of the skin, especially if any changes in coloration, size, or shape of a
Figure 8–19 mole are detected, if the skin bleeds unexpectedly, or a lesion or scrape
Squamous cell carcinoma.
does not heal quickly.

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 Home self-examinations can also be an effective way to check for

American Academy of Dermatology.

Reprinted with permission from the
signs of potential skin cancer between scheduled doctor visits. When
performing a self-care exam, clients should be advised to check for any
changes in existing moles and pay attention to any new visible growths

All rights reserved.

on the skin.
If detected early, anyone with these three forms of skin cancer has a
good chance for survival. Cosmetologists serve a unique role by being Figure 8–20
able to recognize the appearance of serious skin disorders and referring Malignant melanoma.

the client to a dermatologist for diagnosis and treatment.

According to the American Cancer Society, professionals should use the ABCDE Cancer Checklist
to spot signs of change in existing moles (Figure 8–21 a-f):
• A is for ASYMMETRY: the two sides of the lesion are not identical.
• B is for BORDER: the border is irregular on these lesions.
• C is for COLOR: melanomas are usually dark and have more than one color or colors that
fade into one another.
• D is for DIAMETER: the lesion in a melanoma is usually at least the size of pencil eraser.
• E is for EVOLVING: melanoma as a lesion often changes appearance.
For more information, contact the American Cancer Society at http://www.cancer.org or (800) ACS-2345.
LO4

Figure 8–21a Figure 8–21b Figure 8–21c

Normal mole with normal symmetry. Both A is for asymmetry. Abnormal mole has Normal mole with regular even borders.
Courtesy of The Skin Cancer Foundation, http://www.skincancer.org

sides of the mole are the same. uneven symmetry. Two sides of the mole
are not the same.

Figure 8–21d Figure 8–21e Figure 8–21f

B is for border. Abnormal mole has uneven Normal mole with even color. C is for color. Abnormal mole, with more
or jagged borders. than one dark color.

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 Acne and Problem Skin
Common skin problems that affect clients’ appearance, such as acne,
can become a source of great concern. Most people have acne or another
skin issue at some time in their lives. Acne is both a skin disorder and
an esthetic problem, and it is a major concern to anyone who suffers
from it. Frequently misunderstood to be a teenage skin disorder, it
can affect people at almost any age. Women often do not have acne
problems until they reach their 20s or 30s or beyond. Because it affects
the appearance, it is of interest to cosmetologists and estheticians,
who are in a position to help their clients with treatment for minor
cases or to provide dermatological referral for more severe acne.
did you know? Acne is a disorder affected by two major factors: heredity and hormones.
People with acne inherit the tendency to retain cells that gather on the
Skin cancer is preventable and walls of the follicle, eventually clumping and obstructing the follicle.
early detection is possible, if you Retention hyperkeratosis (hy-pur-kair-uh-TOH-sis) is the hereditary
know what to look for. Be aware tendency for acne-prone skin to retain dead cells in the follicle, forming
of the following as you service an obstruction that clogs follicles and exacerbates inflammatory acne
your clients: lesions such as papules and pustules.
• Any unusual lesions on the skin The oiliness of the skin is also hereditary. Overproduction of sebum by the
or on the scalp or change in an sebaceous gland contributes to the development of acne by coating the dead
existing lesion or mole. cell buildup in the follicle with sebum, which hardens due to oxidation.
• Melanomas. These are This conglomeration of dead cells and solidified sebum obstruct the follicle.
sometimes found on the scalp
Propionibacterium acnes are anaerobic (ann-air-ROH-bic), which
and are often first detected by
means that these bacteria cannot survive in the presence of oxygen.
cosmetologists!
When the follicles are obstructed, oxygen is blocked from the bottom
• A new lesion or discoloration on of the follicles, allowing acne bacteria to multiply.
the skin or scalp.
The main food source for acne bacteria is fatty acids, which are easily
• Client complaints about sores
obtained from the abundance of sebum in the follicle. These bacteria
that do not heal or unexpected
flourish in this ideal environment, which is void of oxygen and with
skin bleeding.
plenty of food (sebum) for the bacteria. The bacteria multiply, causing
• Recurrent scaly areas that may inflammation and swelling in the follicle, and eventually rupture the
be rough to the touch, especially follicle wall. When the wall of the follicle ruptures, the immune system
in sun-exposed areas such as is alerted, causing blood to rush to the ruptured follicle, carrying white
the face, arms, or hands. blood cells to fight the bacteria. Blood will surround and engulf the
If you become aware of any of follicle, which is what causes the redness in pimples.
these conditions, suggest that
An acne papule is an inflammatory acne lesion resulting from this wall
your client consult a physician.
rupture and infusion of blood. A pustule forms from the papule when
enough white blood cells accumulate to form pus, which is primarily
composed of dead white blood cells.

Acne Treatment
Minor forms of acne can be treated without medical referral. The basics
of acne treatment involve:

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 • The use of cleansers formulated for oily skin. These foamy, rinse-off
products remove excess oil from the oily and acne-prone skin. Toners
designed for oily skin help to further remove excess sebum.
• Follicle exfoliants are leave-on products that help to remove cell
buildup from the follicles, allowing oxygen to penetrate the follicles,
killing bacteria. Commonly used ingredients in these products are
alpha hydroxy acid, salicylic acid, and benzoyl peroxide. Benzoyl
peroxide can be especially effective since it helps to shed cellular
debris and also kills the acne bacteria.
• Avoidance of fatty skin care and cosmetic products is important
because products that contain large amounts of fatty materials
and oils can cause follicles to clog from the outside. Make sure
all makeup and skin care products used on acne-prone skin are
noncomedogenic (non-com-EE-doh-JENN-ic), which means the
product has been designed and proven not to clog the follicles.
• Do not use harsh products or over clean acne-prone skin as this can
cause inflammation that can worsen the condition.
• Mild and moderate cases of acne are often treated by trained salon
and spa professionals who have received specialized education in acne
treatment. LO5

Aging Skin Issues

Aging of the skin is a concern of almost every client over thirty
years of age. There are two types of factors that influence aging
of the skin: intrinsic factors and extrinsic factors.
Intrinsic factors (in-TRIN-zic FAK-torz) are skin-aging factors
over which we have little control:
• Genetic aging is how our parents’ skin aged, their skin
coloring and resistance to sun damage.
• Gravity is the constant pulling downward on our skin
and bodies.
• Facial expressions are the repeated movements of the face
that result in the formation of expression lines, such as
crow’s-feet lines that form around the eyes, nasolabial folds
© Kurhan, 2010; used under license from Shutterstock.com.

that form from the corners of the nose to the corners of the
mouth, and scowl lines that form between the eyes.
Extrinsic factors (ex-TRIN-zic FAK-torz) are primarily environmental
factors that contribute to aging and the appearance of aging. Many
scientists and dermatologists believe that these extrinsic factors are
responsible for up to 85 percent of skin aging. Extrinsic factors include:
• Exposure to the sun. Tanning and sun bathing are no-nos, but
the cumulative sun that we get in little doses every day is the real

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 damage-causing sun for most people. Sun is by far the number one
cause of the appearance of premature aging. The key to preventing
this prominent skin-aging factor is to use a broad-spectrum sunscreen
every single day, and the easiest way to do this is to find a daily-use
moisturizer with built-in sunscreen. As a cosmetologist, you can help
your clients find the best sunscreen and moisturizer to use every day.
• Smoking is bad for the body and the skin. It produces tremendous
numbers of free radicals, unstable molecules that cause biochemical
aging. These molecules, over time, can have a devastating effect on
the body, especially wrinkling and sagging of the skin. Smoking
causes oxygen deprivation of the skin and body, and it affects blood

© Denise Kappa, 2010; used under license from Shutterstock.com.

flow so the skin does not get adequate blood nutrients. Lack of
blood flow also causes the accumulation of cellular waste, often
called toxins.
• Overuse of alcoholic beverages also has an overall effect on the
body and the skin. Alcohol abuse causes the body to repair itself
poorly and interferes with proper nutrition distribution for the skin
and body’s tissues. Alcohol can also dehydrate the skin by drawing
essential water out of the tissues, which causes the skin to appear
dull and dry.
 oth smoking and overuse of alcoholic beverages contribute to the
B
aging process on their own, but the combination of the two can be
devastating to the tissues. The constant dilation and contraction that
occur on the tiny capillaries and blood vessels, as well as the constant
deprivation of oxygen and water to the tissues, quickly make the skin
appear lifeless and dull. It is very difficult for the skin to adjust and
repair itself. The damage done by these lifestyle habits is typically
hard to reverse or diminish.
• The use of illegal drugs affects the skin as much as smoking does.
Some drugs have been shown to interfere with the body’s intake of
oxygen, thus affecting healthy cell growth. Certain drugs can even
aggravate serious skin conditions, such as acne. Others can cause
dryness and allergic reactions on the skin’s surface.
• Cumulative stress may significantly contribute to aging. Scientists are
now learning that stress causes biochemical changes that can lead to
the tissue damage that we call aging. Exercise, relaxation techniques,
and a healthy state of mind can reduce stress levels, as can relaxing
treatments like facials, aromatherapy, and massage.
• Poor nutrition deprives the skin of the proteins, fats, carbohydrates,
vitamins, and minerals that are required to maintain, protect, and
repair the skin, keeping it looking young and beautiful.
• Exposure to pollution produces free radicals and interferes with
proper oxygen consumption. This affects the lungs and other internal
organs, as well as the skin. The best defense against pollutants is
the simplest one: follow a good daily skin care routine. Routine

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 washing and mild exfoliating (removing dead surface skin cells) help
to remove the buildup of pollutants that have settled on the skin’s
surface throughout the day. The application of daily moisturizers,
protective lotions, and even foundation products all help to protect
the skin from airborne pollutants.
The appearance of aging skin can be greatly improved by practicing a
good skin care program, especially at home. A professionally designed
program for aging skin based on the client’s needs, skin type, and
condition severity involves a good hydrating sunscreen, an alpha or
beta hydroxy acid exfoliating product, and products using state-of-
the-art aging skin treatment ingredients such as peptides and topical
antioxidants. LO6

The Sun and Its Effects

The sun and its ultraviolet (UV) light have the greatest impact of all
extrinsic factors on how skin ages. Approximately 80 to 85 percent of
the symptoms of aging skin are caused by the rays of the sun. As we
age, the collagen and elastin fibers of the skin naturally weaken. This
weakening happens at a much faster rate when the skin is frequently
exposed to UV light without proper protection.
UVA rays, also known as aging rays, are deep-penetrating rays that
can even go through a glass window. These rays weaken the collagen
and elastin fibers, causing wrinkling and sagging of the tissues.
UVB rays, also known as burning rays, cause sunburns, tanning
of the skin, and the majority of skin cancers. These are shorter
rays that stop penetration at the base of the epidermis.
Here are some facts to pass on to your clients to educate
them about sun safety and aging sun damage prevention:
• The number one way to prevent premature
skin aging is to avoid deliberate sun exposure and to
use a broad spectrum sunscreen, which is one that
filters both UVA and UVB rays and has an SPF (Sun
Protection Factor) of at least 15, on a daily basis.
• Avoid prolonged exposure to the sun during
© Gina Smith, 2010; used under license from Shutterstock.com.

peak hours, when UV exposure is highest.

This is usually between ten am and three pm.
• Sunscreen should be applied at least thirty
minutes before sun exposure to allow time for
absorption. Many people make the mistake
of applying sunscreen after they have been
exposed to the heat and sun for thirty minutes
or more. The already inflamed skin is more

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 likely to react to the sunscreen chemicals when the sunscreen is
applied after sun exposure.
• Apply sunscreen liberally after swimming and after activities that
result in heavy perspiration. If the skin is exposed to hours of sun,
such as during a boat trip or day at the beach, sunscreen should
be applied periodically throughout the day as a precaution.
• Avoid exposing children younger than six months
of age to the sun.

© Audrey M. Vasey, 2010; used under license from Shutterstock.com.

• People who are prone to burning frequently and
easily should wear a hat and protective clothing
when participating in outdoor activities, in
addition to using sunscreen. Redheads and blue-
eyed blonds are particularly susceptible to sun
damage. LO7

Contact Dermatitis
Contact dermatitis is the most common work-related skin disorder for
all cosmetology professionals. Contact dermatitis is an inflammation of
the skin caused by having contact with certain chemicals or substances.
Many of these substances are commonly used in cosmetology. There are
two types of contact dermatitis: Allergic Contact Dermatitis and Irritant
Contact Dermatitis.

Allergic Contact Dermatitis

Allergic contact dermatitis, abbreviated ACD, occurs when the
person (cosmetologist or client) develops an allergy to an ingredient or
a chemical, usually caused by repeated skin contact with the chemical.
Sensitization is an allergic reaction created by repeated exposure to
a chemical or a substance. Monomer liquids, haircolor, and chemical
texture solutions are all capable of causing allergic reactions with
repeated exposures.
Once an allergy has been established, all services must be discontinued
until the allergic symptoms clear. The person affected by the allergy
(cosmetologist or client) must stop using that particular product. In
severe or chronic cases, affected people should see a dermatologist for
allergy testing.
Common places for allergic contact dermatitis are listed below and
include:
• On the fingers, palms, or on the back of the hand.
• On the face, especially the cheeks.
• On the scalp, hairline, forehead, or neckline.

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 If you examine the area where the problem occurs, you can usually
determine the cause. For example, haircolorists often strand test color
with their bare fingers and hands, so it is no surprise when they find
contact dermatitis on their fingers and hands.

Irritant Contact Dermatitis

Irritant contact dermatitis, abbreviated ICD, occurs when irritating
substances temporarily damage the epidermis. Unlike allergic contact
dermatitis, irritant contact dermatitis is not usually chronic if
precautions are taken.
Corrosive substances or exfoliating agents are examples of products with
irritant potential. Contact with irritant chemicals can cause damage to
the epidermis because the irritant can enter the skin surface and cause
possible inflammation, redness, swelling, itching, and burning. Repeated
exposure can worsen the condition.
The way to prevent both types of occupational contact dermatitis
is to use gloves or utensils when working with irritating chemicals.
Cosmetologists should use gloves or utensils when applying chemicals
such as haircolor, straighteners, or permanent wave solutions. Nail
technicians should use gloves or utensils when applying nail products
such as monomer liquids and polymer powders. Estheticians should use
gloves or utensils when applying exfoliants such as peeling products and
drying agents. All of these chemicals can irritate the skin of the hands
and arms if precautions are not taken to avoid contact.
Frequent hand washing can result in dry hands, with cracks in the skin
that can cause more irritation and that can allow penetration of irritant
chemicals. Hand washing is important to prevent the spread of disease,
but it should be followed by the frequent use of protective hand
creams to keep the hands in good condition. LO8

Protect Yourself
Taking the time to keep your implements, tools, equipment,
and surfaces clean and disinfected is an important step in
protecting yourself and avoiding a skin problem. Practice
these suggestions with great diligence:
• Take extreme care to keep brush handles, containers, and
© Liv Friis-Larsen, 2010; used under license from Shutterstock.com.

table tops clean and free from product, dust, and residue.
Repeatedly handling these items will cause overexposure
if the items are not kept clean.
• Wear protective gloves whenever using products known to
cause irritant or allergic contact dermatitis.
• Keep your hands clean and moisturized. Keeping the skin of the
hands in excellent condition will help prevent irritant reactions.

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 Review Questions
1. What is a skin lesion?
2. Name and describe at least five disorders of the sebaceous glands.
3. Name and describe at least five changes in skin pigmentation.
4. What are the three forms of skin cancer?
5. What are the two major causes of acne and how should they be effectively treated?
6. List the factors that contribute to the aging of the skin.
7. Explain the skin effects of overexposure to the sun.
8. What is contact dermatitis and how can it be prevented?

Chapter Glossary
albinism Congenital hypopigmentation, or absence of melanin pigment of the body, including
the skin, hair, and eyes.

allergic contact Abbreviated ACD; an allergy to an ingredient or a chemical, usually caused by repeated skin
dermatitis contact withthe chemical.

anaerobic Cannot survive in the presence of oxygen.

anhidrosis Deficiency in perspiration, often a result of fever or certain skin diseases.

basal cell Most common and least severe type of skin cancer; often characterized by light or
carcinoma pearly nodules.

bromhidrosis Foul-smelling perspiration, usually noticeable in the armpits or on the feet, that is caused
by bacteria.

bulla (plural: Large blister containing a watery fluid; similar to a vesicle but larger.
bullae)

chloasma Also known as liver spots; condition characterized by hyperpigmentation on the skin in spots
that are not elevated.

closed comedo Also known as whitehead; hair follicle is closed and not exposed to the environment;
sebum remains a white or cream color and comedone appears as small bump just under
the skin surface.

conjunctivitis Also known as pinkeye; common bacterial infection of the eyes; extremely contagious.

contact dermatitis An inflammation of the skin caused by having contact with certain chemicals or substances;
many of these substances are used in cosmetology.

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 Chapter Glossary
crust Dead cells that form over a wound or blemish while it is healing; an accumulation of sebum
and pus, sometimes mixed with epidermal material.

cyst Closed, abnormally developed sac that contains fluid, pus, semifluid, or morbid matter above
or below the skin.

dermatitis Inflammatory condition of the skin.

dyschromias Abnormal colorations of the skin that accompany many skin disorders and systemic disorders.

eczema An inflammatory, uncomfortable, and often chronic disease of the skin, characterized by
moderate to severe inflammation, scaling, and sometimes severe itching.

excoriation Skin sore or abrasion produced by scratching or scraping.

extrinsic factors Primarily environmental factors that contribute to aging and the appearance of aging.

fissure A crack in the skin that penetrates the dermis. Examples are severely cracked and/or
chapped hands or lips.

free radicals Unstable molecules that cause biochemical aging, especially wrinkling and sagging of the skin.

herpes simplex Recurring viral infection that often presents as a fever blister or cold sore.

hyperhidrosis Excessive sweating, caused by heat or general body weakness.

hyperpigmentation Darker than normal pigmentation, appearing as dark splotches.

hypertrophy Abnormal growth of the skin.

hypopigmentation Absence of pigment, resulting in light or white splotches.

impetigo Contagious bacterial skin infection characterized by weeping lesions.

intrinsic factors Skin-aging factors over which we have little control.

irritant contact Abbreviated ICD; occurs when irritating substances temporarily damage the epidermis.
dermatitis

keloid Thick scar resulting from excessive growth of fibrous tissue.

keratoma Acquired, superficial, thickened patch of epidermis. A callus is a keratoma caused by

continued, repeated pressure or friction on any part of the skin, especially the hands and feet.

lentigines Technical term for freckles; small yellow-colored to brown-colored spots on skin exposed to
(singular: lentigo) sunlight and air.

lesion Mark on the skin; may indicate an injury or damage that changes the structure of tissues
or organs.

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 Chapter Glossary
leukoderma Skin disorder characterized by light abnormal patches (hypopigmentation); caused by a burn
or congenital disease that destroys the pigment-producing cells.

macule (plural: Flat spot or discoloration on the skin, such as a freckle or a red spot left after a pimple
maculae) has healed.

malignant Most serious form of skin cancer; often characterized by black or dark brown patches on
melanoma the skin that may appear uneven in texture, jagged, or raised.

milia Benign, keratin-filled cysts that can appear just under the epidermis and have no
visible opening.

miliaria rubra Also known as prickly heat; an acute inflammatory disorder of the sweat glands, characterized
by the eruption of small red vesicles and accompanied by burning, itching skin.

mole Small, brownish spot or blemish on the skin, ranging in color from pale tan to brown or
bluish black.

nevus Also known as birthmark; small or large malformation of the skin due to abnormal pigmentation
or dilated capillaries.

nodule A solid bump larger than .4 inches (1 centimeter) that can be easily felt.

noncomedogenic Product that has been designed and proven not to clog the follicles.

primary lesions Lesions that are a different color than the color of the skin, and/or lesions that are raised above
the surface of the skin.

psoriasis Skin disease characterized by red patches covered with silver-white scales; usually found
on the scalp, elbows, knees, chest, and lower back.

retention The hereditary tendency for acne-prone skin to retain dead cells in the follicle, forming an
hyperkeratosis obstruction that clogs follicles and exacerbates inflammatory acne lesions such as papules
and pustules.

rosacea Chronic condition that appears primarily on the cheeks and nose, and is characterized by
flushing (redness), telangiectasis (distended or dialted surface blood vessels), and, in some
cases, the formation of papules and pustules.

scale Any thin dry or oily plate of epidermal flakes. An example is abnormal or excessive dandruff.

scar Also known as cicatrix; a lightly raised mark on the skin formed after an injury or lesion of the
skin has healed.

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 Chapter Glossary
sebaceous cyst A large protruding pocket-like lesion filled with sebum. Sebaceous cysts are frequently seen
on the scalp and the back. They should be removed surgically by a dermatologist.

seborrheic Skin condition caused by an inflammation of the sebaceous glands. It is often characterized
dermatitis by redness, dry or oily scaling, crusting, and/or itchiness.

secondary skin Characterized by piles of material on the skin surface, such as a crust or scab, or depressions
lesions in the skin surface, such as an ulcer.

sensitization Allergic reaction created by repeated exposure to a chemical or a substance.

skin tag A small brown-colored or flesh-colored outgrowth of the skin.

squamous cell Type of skin cancer more serious than basal cell carcinoma; often characterized by scaly red
carcinoma papules or nodules.

stain Abnormal brown-colored or wine-colored skin discoloration with a circular and/or

irregular shape.

tan Change in pigmentation of skin caused by exposure to the sun or ultraviolet light.

telangiectasis Distended or dilated surface blood vessels.

tubercle Abnormal, rounded, solid lump above, within, or under the skin; larger than a papule.

tumor An abnormal mass varying in size, shape, and color.

ulcer Open lesion on the skin or mucous membrane of the body, accompanied by pus and loss
of skin depth and possibly weeping fluids or pus.

verruca Also known as wart; hypertrophy of the papillae and epidermis.

vesicle Small blister or sac containing clear fluid, lying within or just beneath the epidermis.

vitiligo Hereditary condition that causes hypopigmented spots and splotches on the skin; may
be related to thyroid conditions.

wheal Itchy, swollen lesion that lasts only a few hours; caused by a blow or scratch, the bite
of an insect, urticaria (skin allergy), or the sting of a nettle. Examples include hives and
mosquito bites.

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