Skin & Nail Services
Skin and nail services account for roughly one in twenty questions on the California cosmetology family of exams, and they are especially important for esthetician and manicurist candidates. This chapter walks through the anatomy you need to know before touching a client's face or hands, how to identify skin types, the standard facial sequence, waxing safety and contraindications, the basics of manicure and pedicure procedure, what makes nail enhancements legal in California (and what makes them illegal), and how to recognize medical conditions that require referral rather than service. The recurring theme is simple: stay within scope, stay sanitary, and do not service skin or nails that look diseased.
Facial Anatomy Basics
Estheticians do not need to know every facial muscle, but they should recognize the major ones and the nerves that supply them. The orbicularis oculi closes the eyelids, the orbicularis oris purses the lips, the frontalis raises the eyebrows and wrinkles the forehead, the zygomaticus muscles lift the corners of the mouth in a smile, and the masseter clenches the jaw. The two key cranial nerves are the trigeminal (cranial nerve V), which carries sensation from almost the entire face through its three branches V1, V2, and V3, and the facial nerve (cranial nerve VII), which provides motor control to the muscles of facial expression. Knowing this matters during massage: gentle, directional strokes along the muscles of expression, with awareness of nerve pathways, help the client relax and avoid pulling skin downward.
Identifying Skin Types
Before choosing products, an esthetician must classify the client's skin. Normal skin has balanced oil and moisture, fine pores, and even tone. Dry skin lacks oil, looks tight, can flake, and shows fine lines easily. Oily skin produces excess sebum, has visibly enlarged pores, and tends toward shine and breakouts. Combination skin shows oily characteristics in the T-zone (forehead, nose, chin) and drier conditions on the cheeks, which is the most common type. Sensitive skin reacts quickly with redness, stinging, or itching to new products, fragrance, or heat. Mature skin shows reduced elasticity, fine lines, and slower cell turnover. Treatment plans should respect the actual skin condition rather than treating every client with the same routine.
Basic Facial Procedure Flow
A standard facial follows a predictable sequence that gradually deepens treatment. Step one is cleansing: remove makeup, sunscreen, and surface dirt with a cleanser suited to the skin type. Step two is exfoliation: use a gentle chemical or physical exfoliant to lift dead surface cells so later steps can absorb. Step three, where appropriate, is extraction: only after the skin has been cleansed, warmed, and softened, with gentle even pressure using cotton-wrapped fingers or a sanitized extractor — never bare nails or sewing needles, and never on inflamed lesions. Step four is massage with effleurage (light strokes) to begin and end, petrissage (kneading) for circulation, and friction where appropriate; tapotement (percussion) is generally avoided on delicate facial skin. Step five is a treatment mask chosen for the skin condition. Step six is toner to rebalance pH. Step seven is moisturizer suited to skin type. Step eight, for daytime, is broad-spectrum SPF 30 or higher applied to the entire face, ears, and neckline.
Waxing Safety and Contraindications
Before any waxing service, conduct a thorough consultation. A small patch test is recommended for new clients, especially before sensitive-area waxing such as lip or brow. Always test wax temperature on the inside of your own wrist — not on the client and not just by looking. Several conditions absolutely contraindicate waxing on the area in question: oral isotretinoin (Accutane) use within the last six months, recent topical retinoid use (such as Retin-A or tretinoin) within at least two weeks, sunburned or otherwise damaged skin, recent chemical peel, open wounds, active herpes outbreak in the area, and known wax allergies. In each of these cases the skin barrier is compromised and wax can lift live skin, leaving wounds and scars. Document the consultation. For lip and brow waxing, California's sanitation rules require single-use applicator sticks: a stick that has touched skin must be discarded before any additional wax is taken — no double-dipping.
Manicure Procedure and Nail Anatomy
A safe manicure has a clear sequence. Start with hand sanitation for both you and the client, and confirm there is no contraindicating condition. Remove any old polish. Shape the free edge of each nail with a clean file, working in one direction toward the center to avoid splits. Soak briefly to soften the cuticle, then dry. Apply cuticle softener and gently push the cuticle back with an orangewood stick (single-use) or a metal pusher that has been cleaned and disinfected. Do not cut the living cuticle or the eponychium — only trim already-loose, dead hangnail tissue if necessary, using disinfected nippers. Massage the hand and lower arm. Cleanse the nail plate, then apply base coat, two thin coats of color polish, and top coat. Living tissue around the nail (eponychium, lateral nail folds) is never to be cut routinely. Cutting living tissue invites infection and is a major exam point.
Pedicure Procedure and Foot-Spa Disinfection
Pedicure procedure mirrors the manicure but adds extra sanitation steps because the feet share a basin and because foot tissue can hide infection. Before each client, the foot spa or basin must be drained, scrubbed free of debris, and disinfected with an EPA-registered, hospital-grade disinfectant left in contact for the full time stated on the product label. Many salons follow a daily deep-clean of the circulation system in addition to between-client cleaning. During service, soak the feet briefly, trim toenails straight across to reduce ingrown nails, file calluses with a metal foot file or pumice — never a credo blade (which can cut skin and is a frequent exam wrong-answer), gently push back cuticles without cutting living tissue, massage the lower leg and foot, and finish with moisturizer or polish. Document anything unusual you observe.
Nail Enhancements and the MMA Ban
California permits standard nail enhancement systems when used safely: acrylic systems built with ethyl methacrylate (EMA) liquid plus polymer powder, light-cured gel polish and hard gels (cured under UV or LED lamps), and dip-powder systems. What is NOT allowed is methyl methacrylate (MMA) liquid monomer, banned in California because of injuries linked to its hardness, difficulty of removal, and history of damaging the natural nail. Cheap, ultra-hard enhancements, products advertised as 'odorless liquid' at suspiciously low prices, and salons that refuse to identify their monomer are red flags. Gel polish cures only when exposed to the correct wavelength of UV or LED light for the time specified by the manufacturer; under-curing leaves uncured monomer that can cause allergic sensitization. All enhancement work should still respect natural nail health — never aggressively e-file into the natural nail plate, and remove products properly rather than peeling, which damages layers of the nail.
Nail Contraindications and Scope of Practice
Knowing when NOT to perform a service is as important as knowing how. Common nail-area conditions that contraindicate cosmetic service and require referral include: onychomycosis (fungal nail infection — thickened, yellow or green, crumbling nail), paronychia (bacterial infection of the nail fold — redness, swelling, pus), severely ingrown nails breaking the skin, untreated psoriatic nail changes with pitting and lifting, open wounds or active warts in the service area, and any unexplained skin lesion. The professional response is to refuse service on the affected nail or area and refer the client to a physician or podiatrist; never paint over or buff away a condition. Scope of practice is equally testable. A California manicurist is licensed to perform nail services on the hands and feet, including the skin of the hands and feet — but not facial waxing, facial treatments, hair services, or any other body-area work. An esthetician handles facial and body skin care, including waxing and superficial peels, but not injectables, lasers reserved for medical professionals, or services penetrating to the dermis. Cosmetic procedures that break the skin or reach the dermis are medical acts and require an appropriately licensed medical professional.