Ep 304 – Keep it Clinical and Handle Delicately

Summary

ASCP Esty Talk: Episode 304 – Keep it Clinical and Handle Delicately

Release Date: February 12, 2025
Host/Author: Associated Skin Care Professionals (ASCP)
Description: ASCP Esty Talk and The Rogue Pharmacist podcast are tailored for estheticians, delving into diverse topics from skincare science and business strategies to beauty diversity. Episode 304, titled "Keep it Clinical and Handle Delicately," focuses on the critical subject of managing herpes viruses in esthetic practice.

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1. Introduction to Herpes Viruses in Esthetic Practice

In this episode, co-hosts Maggie Stasicken, ASCP's Program Director, and Alec Cressman, a licensed esthetician and ingredient enthusiast, delve into the complexities of managing herpes viruses within the skincare industry. They emphasize the importance of estheticians being well-informed to prevent the spread of infections and handle sensitive client situations with professionalism and empathy.

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2. Understanding Herpes Viruses Relevant to Estheticians

a. Herpes Simplex Virus Type 1 (HSV1)

• Definition & Common Presentation: HSV1, commonly known as oral herpes, manifests as cold sores on the lips or inside the mouth.
• Prevalence: "Globally, it's estimated that 64% of people under 50 have HSV1." (Cressman, 04:22)
• Contagiousness & Management: Highly contagious; essential to avoid treating affected areas during active outbreaks. Proper sanitization and, when necessary, rescheduling appointments are crucial to prevent transmission.

“HSV1 is a party crasher. No fun, not invited.” — Alec Cressman (03:25)

b. Herpes Simplex Virus Type 2 (HSV2)

• Definition & Common Presentation: HSV2 is typically associated with genital herpes but can appear in other areas.
• Interchangeability: "Both types can swap locations. Think of them as interchangeable characters of a soap opera." — Maggie Stasicken (07:07)
• Contagiousness & Management: Similar precautions as HSV1 apply. Treatments like Brazilian waxes or intimate brightening should be avoided during outbreaks and rescheduled if necessary.

c. Other Herpes Viruses

• Herpes Zoster (Shingles):

  • Relation to Chickenpox: Shingles is a reactivation of the chickenpox virus, presenting as a painful rash often in strip patterns.
  • Management: Avoid treating areas affected by shingles until fully healed to prevent contagion. Stress and weakened immune systems can trigger outbreaks.

• Epstein-Barr Virus (EBV):

  • Association: Linked to mononucleosis (mono), fatigue, sore throats, and unexpected skin rashes.
  • Prevalence: "Almost everyone gets the Epstein Barr virus at some point in their life." — Maggie Stasicken (15:04)

• Herpes Simplex Virus Type 7 (HSV7):

  • Association: Often related to eczema herpeticum, presenting as painful, fluid-filled blisters on eczema-affected skin.
  • Population at Risk: More common in immunocompromised individuals.

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3. Importance of Thorough Consultations

Both hosts stress the necessity of comprehensive client consultations to identify any herpes virus presence or susceptibility. This involves:

• Asking Targeted Questions: Inquiring about past herpes outbreaks, current symptoms, and any preemptive treatments clients might be undergoing.
• Documentation: Keeping detailed records as clients' conditions can change between visits. "The consultation and that paperwork is being done every time your client comes in, because things change." — Maggie Stasicken (18:02)

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4. Handling Clients with Herpes Outbreaks: Real-Life Stories

Case Study 1: Chemical Peel and HSV1 Spread

• Scenario: A client with an active cold sore underwent a chemical peel.
• Outcome: Within 24 hours, the cold sore spread extensively to her chin.

“It was a horrible outbreak... every time that she has an outbreak, it could potentially spread to her entire chin.” — Maggie Stasicken (06:02)

Case Study 2: Misidentifying a Cold Sore as a Pimple

• Scenario: A client attempted to extract a cold sore, mistaking it for a pimple, and sought professional help.
• Outcome: The esthetician had to rebook her to prevent further spread.

“She was attempting to extract it on her own... we had to rebook her.” — Maggie Stasicken (10:34)

Personal Anecdote: Instructor's Delicate Approach

• Scenario: An esthetician's instructor questions a client's potential cold sore presence, leading to client embarrassment.

“We can't treat you. We can't even touch her face.” — Maggie Stasicken (08:00)

This highlights the delicate balance between clinical necessity and empathetic communication to avoid client discomfort and maintain professional relationships.

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5. Clinical and Empathetic Communication

Effective communication is paramount when addressing herpes-related concerns:

• Use of Gentle Language: Avoid medical jargon that might alienate or embarrass clients.

  “Handle it super delicately with empathy and everything.” — Alec Cressman (08:00)

• Maintain Professionalism: Keep discussions clinical to reassure clients and emphasize safety.

  “Keep it clinical.” — Alec Cressman (08:00)

• Educate Clients: Explain the reasons behind consultations and any necessary appointment changes to foster understanding and trust.

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6. Prevention and Management Strategies

Estheticians can adopt several strategies to manage herpes risks effectively:

• Sanitization: Rigorous cleaning of tools and surfaces to prevent virus transmission.
• Avoiding Triggering Treatments: Reschedule treatments that may exacerbate outbreaks, such as chemical peels, micro-needling, and dermaplaning.
• Preemptive Treatments: Collaborate with clients' healthcare providers to manage herpes outbreaks proactively.
• Holistic Client Care: Address clients' overall well-being to minimize stress-related triggers for virus reactivation.

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7. Conclusion & Key Takeaways

Episode 304 of ASCP Esty Talk underscores the significance of maintaining a clinical yet compassionate approach when dealing with herpes viruses in esthetic practice. Key takeaways include:

• Awareness: Estheticians must be knowledgeable about various herpes viruses and their implications in skincare treatments.
• Effective Communication: Balancing clinical professionalism with empathetic client interactions is essential to prevent embarrassment and ensure client safety.
• Proactive Management: Comprehensive consultations and diligent sanitization practices are critical in mitigating the spread of herpes viruses.
• Continuous Education: Ongoing learning and sharing of real-life experiences enhance estheticians' ability to handle sensitive situations adeptly.

By adhering to these principles, estheticians can safeguard their clients' health, uphold professional standards, and foster a trustworthy practice environment.

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Notable Quotes:

• “HSV1 is a party crasher. No fun, not invited.” — Alec Cressman (03:25)
• “Both types can swap locations. Think of them as interchangeable characters of a soap opera.” — Maggie Stasicken (07:07)
• “Globally, it's estimated that 64% of people under 50 have HSV1.” — Alec Cressman (04:22)
• “The consultation and that paperwork is being done every time your client comes in, because things change.” — Maggie Stasicken (18:02)

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For more insights and to connect with Maggie and Alec, visit the ASCP Esty Talk show notes. Share your thoughts and experiences on social media platforms like Instagram and Facebook, or email getconnectedcpskincare.com.

Transcript

[A]

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[B]

Hello and welcome to ASCP's Bestie Talk. I'm your co host Maggie Stasicken, ASCP's program director.

[C]

I'm Alec Cressman, licensed esthetician, ingredient junkie and content contributor for Associated Skincare Professionals.

[B]

Ella, I want to talk with you about something a little less glamorous but just as important and that is the herpes virus. Herpes is super common and as estheticians it's something we really need to be aware of.

[C]

Absolutely, yeah.

[B]

As estheticians we're constantly around clients faces, necks, sometimes other body parts. So knowing how herpes shows up and how to manage it is huge. And we don't want to be the one spreading cold sores or dealing with that. Awkward. Is that a cold sore moment when we're working on someone's skin?

[C]

It is very interesting. I cannot wait to dive into this topic because it is not just something we have to be aware of. Hyper aware of goes back to the consultation, but it's also like an incredibly awkward conversation.

[B]

It really is. And when people hear the word herpes, at least in my mind, you automatically are going to either cold sore or std. But there's actually a lot of viruses that are classified as herpes that people are maybe not even aware of.

[C]

Like what?

[B]

We're going to dive into it, but I know you have some statistics for us that we're going to get to. Let's just talk in general first. What is herpes anyway?

[C]

That is a great question because it's a lot of things.

[B]

Yeah, it's a virus. There's a lot of variations. Like I said, we're usually thinking of it like the cold sore or the std. Let's start first with HSV1.

[C]

Yes, HSV1. This is the one that we're going to most likely come into contact with as a professionals. It's what we usually call oral herpes. This is the classic cold sore that you will see on lips or in the inside of mouth. Basically, it's a party crasher. No fun, not invited. It's highly contagious. And avoiding treating the skin when there's an active outbreak is key. But also being aware of it in your consultation so that you're not sparking an outbreak. One key thing is, of course, always sanitize your tools and avoid touching any affected area. I like to just completely avoid the treatment at all and reschedule the appointment, which is not an easy conversation.

[B]

It's not. No. It can be embarrassing for the individual and you want to approach it in such a way that they aren't feeling awkward. It's not embarrassing. It happens to a lot of people.

[C]

It does happen to a lot of people. In fact, let me tell you, I just kind of took a peek to see and here's the thing. Globally, as estimated that 64% of people under 50 have HSV1.

[B]

That's huge. And the thing too is that some of the treatments that we're doing in our, in our treatment room can stimulate an outbreak, it can aggravate an outbreak and spread it further. And so really important, if someone is experiencing that, you don't want to have this mindset that, well, just avoid the area and carry on. You really should be rescheduling that appointment.

[C]

And there is treatment that you can take preemptively. Your clients that goes right back into consultation is key.

[B]

Yeah.

[C]

So if you're a practitioner, it doesn't mean you have to, it doesn't mean you have to cancel that appointment that day. You can perform something preparatory for the next treatment, but then have them start their medication that they usually are prescribed by their doctor and then reschedule, or not reschedule, but schedule the treatment that may instigate it, like chemical peels, micro needling, microdermabrasions and sometimes even dermaplaning Even dermaplane can start that cascade, though. It's like, peekaboo. I heard there's a party.

[B]

Yeah. Let me share this story with you. I knew this girl back in the day when I was an instructor, and she had a little cold sore outbreak on her lip. And it was right around the time that we were learning chemical peeling and we are educating. Reschedule. Don't do it. It could stimulate that outbreak. And she went and had a chemical peel. Anyway, she got with her partner, did a chemical peel, and literally within 24 hours, that cold sore outbreak had spread to her entire chin.

[C]

Oh, my God.

[B]

I mean, we're talking like full blown. It was a horrible outbreak. I mean, I really felt for her and the thing for estheticians to know and for the client to know now, every time that she has an outbreak, it could potentially spread to her entire chin.

[C]

That is so unfortunate. Like, I feel empathy for her on another side. What an amazing learning experience for those students, though.

[B]

Yeah.

[C]

Not only her, but those students who got to see that. Because I don't feel, feel like there's a little touch on it in school. Like we, we go through the checklist and all these things, but they got to all have this firsthand experience with just how bad it can be.

[B]

Yeah.

[C]

So I feel so bad for her. But it's a great cautionary tale.

[B]

Yeah. HSV2 is the other type of herpes virus that is very commonly or mostly known that is genital herpes. But honestly, both types can swap locations. So I like to think they're like the interchangeable characters of a soap opera.

[C]

Soap opera or horror story. Yeah. Oh, my God.

[B]

It's scary. Exactly. So it can spread even when there's no visible sores. You want to avoid treating the area if the client has an active outbreak. So same like HSV1, HSV2. If your client has an outbreak, you do not want to move forward with the treatment. So thinking like Brazilian wax or bikini wax, if somebody has an active outbreak, you want to reschedule them.

[C]

Even intimate brightening.

[B]

Yes.

[C]

Something that's growing in popularity. And I would think also this would be something very important to have in your consultation. I know when I used to do a lot more waxing, I didn't really have a consultation.

[B]

You know what, I didn't either. I mean, there was maybe a quick conversation about, you know, let's talk about what you're here for today or what is the shape we're giving you today?

[C]

Landing strip are all gone.

[B]

Right, Right.

[C]

Yeah.

[B]

And Certainly, I'm not examining the area. We're just going to get this thing done and get you out.

[C]

Yeah, Seven minutes or less, right? Yeah, that. So consider that. Make that part of. And consider it delicately. Let me tell you a story that happened to me. It's also a school story, but this is one that stuck with me. So in the case that the story that you shared, that client, if you will, or that student, that professional, she's always gonna have something that sticks with her. But in mind, this was my experience. So I had an instructor in school and I had a client come in and, you know, we had to have them evaluate our plan of action. And I didn't really know what was going on, but this. She had, like, a little tiny red dot on her bottom lip by the outer corner. The instructor came over and she's looking at her face. She goes, is that. Is that a cold sore? Are you prone to cold? She goes, is that a cold sore? And the client was like, I don't think so. I'm not quite sure. Are you prone to cold sores? Have you had cold sores, like, in this tone of fright and assertiveness? And the client was stammering and, like, felt. I was, like, so embarrassed for the client. She was, we can't treat you. You can't be treated. We can't even touch her face. We can't even cleanse, like, going in on it, in my opinion. And I was mortified for all parties, and especially us. So one thing that I always do is I try to handle it super delicately with empathy and everything. So it's definitely a part of my facial consultation. Are you prone to this? Do you need medication? I do. Very gentle. But also try to keep it clinical.

[B]

Yeah.

[C]

So this is something I would think that you would want to consider also, because it's all probably even more embarrassing for the belly button down is keeping it gentle and clinical. And it is a clinical reason why we don't proceed. But it's not like something's wrong with you, because that's how I. I felt that that client felt who came into the school day and she rebooked, she didn't show up. And she would have. I don't think she would have ever gone back because she was, in my version, completely mortified, or perhaps it was that I was mortified for her. So you don't want that to happen. You don't want people to not come back to you because of the language you use?

[B]

Yeah. Having tact is really important in these situations. And There's a lot of things that can happen in the treatment space that you have to handle delicately. This is just another one of those. And I think for the esthetician as well, you know, they get worried about what is contagious. There are so many things that are contagious. So don't freak out about this situation in particular.

[C]

Right. Your pimples are contagious.

[B]

That brings me to another story. I had a client that had a cold sore that thought it was a pimple. Oh, yeah. Oh, poor thing. She was attempting to extract it on her own and came in to say, this pimple won't go away. It keeps coming back. You know, this was kind of, you know, a one off situation, but making sure they understand that I'm doing this for your best interest because we don't want to spread it, we don't want to exacerbate it.

[C]

Right, yeah. So did she. Did it resolve it resolved?

[B]

Yeah. Okay. Yeah, we had to rebook her.

[C]

Good. I'm glad she got relief at least. Hold that thought. We'll be right back.

[A]

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[C]

Okay, here we go. Let's get back to the podcast.

[B]

So there are a few more members of this herpes virus family that show up in unexpected ways, like shingles, chickenpox, and even a couple other more rare strains. So herpes zoster is one of those things that also very contagious. If your client is coming in with herpes zoster, you probably want to reschedule and book. So let's talk about the big one that can appear later in life, more commonly known as shingles. So this is related to the chickenpox virus and it shows up as a painful rash. It's often in a band or a strip pattern on the body. It doesn't cross the spinal column. And make sure to avoid this affected area until it is completely healed, because touching that rash, which is basically a herpes outbreak on the body, is very contagious. And if you've had chickenpox, you're at risk for shingles or this herpes zoster virus down the line. And the virus, it actually can hang out dormant in your body and then surprise. It can be activated or reactivated later on, usually when you're stressed or immune system is weakened.

[C]

One of my trainers got this.

[B]

Really? Okay.

[C]

And it's like maybe mid, maybe young, 30s, maybe late 20s. And he was like, can you look at this on the side? Do you see anything? He felt it before he saw it, by the way. Just being aware, he's like, it really hurts and you don't see anything. I was like, I don't see anything. I don't see anything. And he then later told me it was shingles. But painful is from what I can understand. So it can happen later, later in life, it's more common, but it can happen at any time. If he had chicken pox, you might want to check it out.

[B]

Yeah, for sure.

[C]

So let's talk about chickenpox. Guess what? This is the OG of the herpes viruses. And this makes a mess and then leaves only to come back as shingles. It's adulthood. Yay. Thanks. As a kid, if you had it, you are probably still carrying it and it's just waiting to peekaboo itself out. Uh, did you get it as a kid?

[B]

I did, yeah.

[C]

Did you? And was it bad?

[B]

Um, from what I recall, yeah. It wasn't fun.

[C]

Yeah. I think most people get it. The earlier you get it, the less severe it is. The older you get it, the more severe it is. And I remember all. Both my brothers and I got it at the same time. Older brothers was worse and my younger brother's was not as bad.

[B]

Yeah. Back in the day, I think the parents had like the chickenpox party, you know, when one kid got infected, then you brought all the kids together, so everyone got infected. Like you wanted to have it.

[C]

Yeah.

[B]

And then done and then you're done with it. Yeah.

[C]

So you're later in life.

[B]

Yeah.

[C]

I don't think they used to talk about herpes, zoster or shingles. I didn't ever heard. I never heard about it as a kid. So it did feel as a kid, like a rite of passage.

[B]

Yeah.

[C]

Like, ah, I got it. Did you get it? Anyways, it starts with these itchy red spots that then turn into fluid. Fills, blisters.

[B]

Ugh.

[C]

Like a rash on steroids, covering the body and waiting. Super contagious. So something to consider. If you've gotten it before, you should be okay. But if you haven't and you're client has a kid who has it and usually then it's not going to happen, but just be careful.

[B]

Yeah, for sure. Another herpes virus that people are maybe not aware of is Epstein Barr. Have you heard of this?

[C]

I have, yeah.

[B]

This is actually a herpes virus. So some people may not realize they have this, but it's linked to mono and it can cause fatigue, sore throat, and also surprise skin rashes. Yeah. So typically it's actually not contagious. But. But fun fact, almost everyone gets the Epstein Barr virus at some point in their life. And it's one of the most common viruses around, but most of us don't even know we've had it. And it's just like having a bad cold or a flu. For others, it can be much more severe. And then this is when they get that rash outbreak. So the rash related to Epstein Barr virus can appear as red, bumpy. It often shows up on the body, and clients may come in with a rash that looks like an allergic reaction or it could also look like acne. But you want to take note if they have recently had a bad flu, a cold, mono. So Epstein Barr also can be linked to certain skin conditions like chronic fatigue syndrome, rosacea, and even some types of psoriasis.

[C]

You know what's so funny? Not funny ha ha. But interesting is I had, you know, just my blood drawn, I think, in August of last year, and it had tested for this or it came back EBV on the test, you know. Yeah, I think I'm a medical professional. So it's reading the test before I talk to my doctor about it. And it said like positive or negative. And so I was trying to analyze myself and I got to this one. I was like, what, what is this? But that's when I found out that I had had it at some point in my life between now and when I was born. So we heard of HSV1, we heard of HSV2, but did you know there's HSV7?

[B]

Tell me.

[C]

Herpes simplex virus 7. It's less commonly discussed, but it's generally associated with other skin conditions like Eczema herpeticum, which. There's your sign. Right. Which what this is is it's an infection that occurs in people with eczema when exposed to the herpes virus. And what it looks like is pain. It's these fluid filled blisters on the skin. It's crazy painful. And it's often present where the eczema is. So what kind of cards did you draw that you got Eczema. And on top of that, there's Itchy, ouchy, eczema.

[B]

So double whammy.

[C]

If you're healthy, shouldn't be a problem. But it's most likely to appear in immunocompromised individuals. So I'm gonna go back again to consultation. Understanding the clinical side of somebody is super important, even when we're offering facials, because it's not like we're just asking these questions because we're nosy. We're asking these questions because we want to make sure we're treating or addressing our clients in a holistic way, meaning their whole selves and not causing, you know, a problem.

[B]

Yeah, you said it. And I think the important thing to note, too, is that the consultation and that paperwork is being done every time your client comes in, because things change. And if we're talking about herpes here specifically, one day they could have an outbreak and the next day they could not. So documenting this and educating our clients and making sure they're understanding, like you said, why we're doing these consultations, why we're documenting, why we're asking these questions, and if we have to turn them away, it's simply just for their safety. Just like with any other virus or skin condition, the best thing we can do as estheticians is to show empathy, use gentle care and recognize when a client may need medical advice. Now, listeners, we want to hear from you. Share with us on social media, through Instagram, Facebook or by emailing getconnectedcpskincare.com thank you for listening to ASCPSDtalk. And as always, for more information on this episode or for ways to connect with Ella and myself, or to learn more about ascp, check out the show notes.