^{The Electrologists Diagnostic Case History Course & Examination© Page}

^{PART THREE}

^{Hair and Skin Condition}  

^{Evaluation of the hair and skin condition is of paramount importance. Today's electrologist must record all information and perform a visual observation. We live in an age when all professional clinician’s must legally protect her or his own interests, health, and professional standing by careful scrutiny of each patient's skin condition.}

 

^{Previous treatment. This can tell the electrologist a lot about the quality of prior of a patient’s electrolysis or self-administered treatments. Plucking, waxing and shaving can result in ingrown hairs, pustules and other abnormalities. It is important to record these carefully. If there is any damage, which resulted from tampering with the hairs, document it. The patient should then initial this. By doing this, electrologists protect themselves by making the patient aware of pre-existing skin damage.}

^{Skin Damage. The electrologist should always record skin damage such as scars, burns, birthmarks, and pitted area. Carefully record any anomalies.}

 

^{Doing this saves future disputes and protects the electrologist from false malpractice claims.}

^{Pitting from previous electrologist. Like all questions in this case history, documentation is most important. An electrologist should not assume the blame for another practitioner's poor treatment.}

 

^{Hairs: Recording fine, medium, course, heavy and endocrine. The electrologist should document the actual condition of the hairs to be treated. Endocrine hair problems grow in particular hair patterns and one should be most observant. This particular type hair problem is most resistant to treatment. The electrologist in charge of treatment should record every detail.}

 

^{Condition of skin and areas to be treated. Overall skin condition must be recorded before treatments start. The electrologist should look for scarring from acne, injuries, surgery, home electrolysis units, or other problems.}

^{The electrologist should ascertain whether there has been damage to the skin from other conditions. Shaving, plucking, waxing, and using depilatories over a period of time cause damage.  The electrologist should always document these pre-existing facial flaws.} 

 

^{Have the patient ever had a serious form of acne or other skin condition? Acne leaves permanent scars, from light to serious lesions. The electrologist should document all skin conditions.}

 

^{Moles and warts and skin tags. Suspicious moles with hair (nevus peli) have a tendency to be precancerous, especially if they have a very dark shiny blue-black appearance. The electrologist should never work on a mole unless the patient has a note or letter from a physician indicating it is safe to do so.  A physician should only remove skin tags and warts.}

 

^{Skin reaction to previous electrolysis treatment? This is important and enables the practicing electrologist to evaluation intensity, timing, and programming with computerized equipment.}

^{Electrologist’s comments. Electrologist’s comments are an excellent way of recording a patient's overall reaction to treatments as well as documenting emotional and nervous disorders and characteristics. Electrologists that work in a cooperative endeavor can be informed about a patient's personal preferences and likes and dislikes prior to beginning treatment.}

 

^{Diet and stress. Often patients do not consider diet and its relationship to a hair problem. With the exception of organic beef and poultry and some organic pork and raw animal flesh, all meats contain hormones, antibiotics, and steroids. When people who have a low tolerance for them ingest these chemicals, it may cause imbalances in their bodies, which will create noticeable deposits on the skin and hair follicles.}

 

^{These hormones, steroids, antibiotics and preservatives such as red dye can cause side effects such as unwanted hair growth through the stimulation of the human endocrine system. Patients who have a borderline endocrine disorder are most prone to react adversely to these substances. Over a period of time, these chemicals accumulate in the body and can trigger hormonal imbalance and other side effects, causing unwanted hair growth, a male secondary sex characteristic of hormones and steroids.}

 

^{The electrologist can see how important diet is. It is most important to realize that these chemicals can make an already diagnosed endocrine disorder much worse. If the intake of certain foods is reduced it can improve the endocrine condition. The most noticeable positive effects will be improved well-being and improved electrolysis results with the reduction of the amount of hair. The result is finer instead of coarser hair, and increased skin softness and suppleness is noticeable. Also, self-confidence is boosted, which creates an improved social life.}

 

^{Weight loss and weight gain is evident in cases of hypothyroidism. Diet plays a key role in our lives. It is difficult to believe that most doctors overlook the dietary habits of their patients, and how much of a factor they can be in the patient's health care. Medications would not improve their condition, and many do not believe in a follow-up on these types of tests when the results are in the normal range.}

 

^{Stress. Everyone experiences stress and is adversely impacted in different ways. Symptoms include: high blood pressure, migraine headaches, muscle pains and spasms, ulcers, but most relevant, the obvious hair problem.  If the electrologist have done the electrologist case history correctly and questioned the patient regarding diet, endocrine, heredity, and medications, the electrologist can deduce the reasons. Look for obvious signs of stress such as impatience, nervousness, fidgeting, headaches, family and work pressures, and so on.}

 

^{PART FOUR – Comprehensive History, Diet and Stress, Previous Electrolysis Treatments, Temporary Methods, Addenda Laser Treatments Cause Chronic}

 

^{Pain Syndrome, AIDS Questionnaire}

 

^{Diet and Stress}

 

^{On a one to ten scale how would the electrologist rate the electrologist stress level?}

 

^{Is the patient aware that stress can cause an unwanted hair problem? 
For example people who are constantly stressed put excessive demands    on their adrenal system. The adrenal glands produce adrenaline for emergency body functions. The adrenal cortex produces aldostorone and cortisone two steroids that have male secondary sex characteristics such as unwanted facial and body hair. (The electrologist should be aware of this. If not brush up on the electrologist endocrinology.)}

 

^{Does the patient eat a balanced diet?}   

^{Some patients who are overweight or underweight could have hypothyroidism or hyperthyroidism. Either of these conditions can result in unwanted hair problems. The diagnostic case history can assist the electrologist in treating endocrine-induced hair problems.}

 

^{Does the patient exercise regularly or meditate? 
People who exercise and practice some type of meditation regularly are healthier and tend to handle and cope with stress much easier. People who do not exercise or meditate tend to have stress-related hair problems.}

^{Previous Electrolysis Treatments}

 

^{Be sure to record previous treatment and the kind of equipment and treatments that the previous electrologist used. Some patients will have had treatments that provide valuable information for the electrologist. The difference in equipment and types of treatments helps the electrologist evaluate each patient on an individual basis. Take advantage of this information.}

 

^{Listed below are the categories. Taking time to do a thorough case history demonstrates to the patient that the electrologist listens, and gains the electrologist patient's confidence and loyalty.}   

^{Addenda Laser treatments cause Chronic Pain Syndrome}

^{Addenda article seven. Nine out ten patients who walk into my office that have been to a Laser Parlor have suffered permanent skin damage caused by first, second and third degree burns. These burns have resulted in permanent skin damage just like any other burn victim that would be seen in hospital emergency room. In addition to that they have permanent loss of pigmentation where the skin has absolutely no color. These burns can be quite disfiguring and cannot be repaired a plastic surgeon or any other medical procedure.}

 

^{Additionally patients who have had laser treatment at the local parlor have had their skin traumatized and burned. Electrologists should never work on sunburn, which in my professional opinion completely understates the trauma that has been inflicted upon their skin. In addition, laser parlors inflict a much more from of severe sunburn that damages the skin and makes it over sensitive. The end result is the patient who has recently laser treatment will be complaining and blaming the electrologist and claim electrolysis procedure is too much to bear. If this be the case inform the patient that the electrologist evaluated their skin and in the electrologist opinion is safe to work on.  On the other hand the electrologist nerve endings are presently inflamed and that’s why the patient is so sensitive. However the electrologist must take into consideration that laser treatment has been known to permanently leave nerve tissue presently damaged and that patient subject to permanent pain syndrome from moderate to severe.}

 

^{Fact - it takes three to four months for a patient who had Laser treatments of which I consider the minimum damage to their skin classified as severe sunburn. So when a patient who has had laser treatment presents himself or herself for electrolysis treatment the electrologist must point the sensitivity they have is due to being burned by the laser.  The electrologist the electrologist must record this information and help the patient to understand that the laser parlor traumatized the nerve endings of their skin. This must be recorded on the case history card. Additionally a digital camera is requisite to record this type of skin condition.}

 

^{PART FIVE -Temporary Methods and Approximate Use, AIDS Questionnaire,}

 

^{Coagulation Disorders, Signature and Completion Waiver}

 

^{Temporary Methods and Approximate Use}  

 

^{Temporary methods of hair removal cause unseen damage to the skin such as distorted hair follicles, peli-incarnardi recurvis pseudo-folliculitus (inflamed, ingrown, and infected hairs which are most difficult to treat).}

 

^{Follicullitus and other diseases of the hair may be seen.}

 

^{Waxing is not only wholesale plucking but also pulls off the top layer of skin. Razor or shaving causes a callousness of the skin, which will encourage heavier hair growth and irritation with localized pustules and ingrown hairs.}

^{AIDS Questionnaire}

 

^{AIDS questions should be asked in all case histories. If the electrologist do not have, at a minimum, a basic AIDS screening test in the electrologist case history, the electrologist run a serious risk to all the electrologist patients' health and welfare, but the electrologist also endanger the electrologist’s self and loved ones. The most serious consequences can result if the electrologist is careless about treating without surgical gloves. Always use proper personal protective equipment!}  

^{Listed below are basic AIDS questions. Always use common sense and remember not to panic the electrologist patient by making rash judgments or statements.}  

^{Have the patient had a recent weight loss without dieting? 
Unexplained weight loss without diet or exercise is a symptom of AIDS. Use common sense, however, and rule out recent surgery or other medical or psychological condition that might cause weight loss.} 

^{Any long-term diarrhea? 
The cause of diarrhea should be ruled out, for example flu or food poisoning.}

^{Cold sweats?} 

^{Cold sweats, particularly night sweats, along with long-term diarrhea and unexplainable weight loss, are indicators of AIDS. As the electrologist go through the history have a calm approach and relaxed manner, especially when completing this part of the history.}

 

^{Loss of appetite? 
Another symptom of AIDS; however, remember to ask if they might have an ulcer or other problem.}

 

^{A feeling of malaise or tiredness all the time?}

^{These are classic symptoms, but the electrologist must eliminate work-related stress or depression, or chronic fatigue syndrome. Remember not to jump to conclusions.}

 

^{Blood transfusion in the last five years?}

^{Most patients who require a blood transfusion from loss of blood due to severe anemia, surgery and injury are screened for AIDS. If the patient does not appear healthy, then ask that they get a blood test or a letter from their physician stating they are free of AIDS and other contagious diseases.}

 

^{Wounds that do not heal well?}

^{This is a symptom of AIDS. Document and rule out other medical conditions such as diabetes.}

 

^{Drug abuse or I.V. drug use? Never work on a patient who the electrologist suspect is using drugs, whether inhaled, ingested or used intravenously. The risk of AIDS is very high in drug abusers due to their lack of personal hygiene and multiple sex partners. Take some simple precautions if the patient’s profile and symptoms are suspicious. Ask to look at the hair on their arms as part of the electrologist evaluation of their overall hair problem. Look for needle marks (tracks) or any unnatural appearing skin condition. Be discreet and make the electrologist’s inspection appear to be part of the overall examination. If a patient states he or she has used drugs in the past but no longer uses them, the electrologist can work on them after the electrologist receive a letter from their doctor documenting that their AIDS test is negative and which states that they have no contagious disease. (Remember, with AIDS, there is a "window period" during which patients may not test positive.)  The electrologist must use discretion when completing this part of the case history.  Do not state that the electrologist is completing an AIDS screening until done.  And do not forget that Hepatitis B and C is also commonly found among drug addicts}

 

^{Does the patient have AIDS or is the patient HIV positive? This may sound redundant, but I put this question at the end of the questionnaire for a reason.  Asking this question shows the electrologist care and interest in the electrologist patients' welfare.  Every patient I have asked felt good about the AIDS questionnaire and are pleased that I took precautions for their safety and mine. AIDS is an equal opportunity disease, which can strike any electrologist who does not properly screen his or her patients. AIDS is preventable and the electrologist is taking great risks with a disease that gives no second chance.}

 

^{COAGULATION DISORDERS}  

 

^{Coagulation Disorders - The next question on the list is, "Do the electrologist have any blood disorders or hemophilia?"  If the answer is yes, the electrologist cannot work on these patients without the express written permission of a doctor. I would not work on a patient with hemophilia because the risk is just too great. Also, ask patients about their use of medication such as beta-blockers, which dilate the blood vessels.  These medications can result in bruising, excessive bleeding and abnormal blood disorders.}    

 

^{Other coagulation disorders can be brought under control by certain medications, for example beta-blockers, heart medications and anti-hypertensive medication that dilate the capillaries, veins and arteries. These medications can lead to extremely sensitive skin, which can result in bruising and bleeding. It is imperative that the electrologist thoroughly record medications taken by the electrologist patient and keep the electrologist patient information updated and current.  Professional electrologists do not take chances with their patients' health.}  

 

^{When recording unfamiliar medication on the case history, always refer to the electrologist Merck manual for medical conditions and a Physician's Desk Reference (PDR) for side effects of prescribed medications.}  

 

^{Coagulation Disorders below:}

 

^{Does the patient take anticoagulant/or coagulants? 
Write "yes" or "no"}

^{If "yes," what medical condition? 
State condition}

 

^{The physician(s) who prescribes these medications 
This information should be listed in the first page and here.}

 

^{What specific medications does the patient take? 
List medication and dosage.}

^{COAGULATION DISORDERS}  

 

^{Coagulation Disorders - The next question on the list is, "Do the electrologist have any blood disorders or hemophilia?"  If the answer is yes, the electrologist cannot work on these patients without the express written permission of a doctor. I would not work on a patient with hemophilia because the risk is just too great. Also, ask patients about their use of medication such as beta-blockers, which dilate the blood vessels.  These medications can result in bruising, excessive bleeding and abnormal blood disorders.}    

 

^{Other coagulation disorders can be brought under control by certain medications, for example beta-blockers, heart medications and anti-hypertensive medication that dilate the capillaries, veins and arteries. These medications can lead to extremely sensitive skin, which can result in bruising and bleeding. It is imperative that the electrologist thoroughly record medications taken by the electrologist patient and keep the electrologist patient information updated and current.  Professional electrologists do not take chances with their patients' health.}  

 

^{When recording unfamiliar medication on the case history, always refer to the electrologist Merck manual for medical conditions and a Physician's Desk Reference (PDR) for side effects of prescribed medications.}  

 

^{Coagulation Disorders below:}

 

<sup>Does the patient take anticoagulant/or coagulants? 

Write "yes" or "no"</sup>

^{If "yes," what medical condition? 
State condition}

 

^{The physician(s) who prescribes these medications 
This information should be listed in the first page and here.}

 

^{What specific medications does the patient take? 
List medication and dosage.}

 

^{Is the condition under control?} 

List as stated by patient.

 

^{Does the patient have an internally placed pacemaker?} 

^{Attention galvanic and blend operators: There is a possibility that that galvanic current could interfere with a pacemaker. It is safe to short-wave treatment with pacemakers if the electrologist one doubt always consult the patient’s physician before starting treatment.}

 

^{Does any medical condition handicap the patient in any way? 
If "yes," state how.}

 

^{Does the patient bruise easily?}

 

^{If answered "yes," there is a possibility that the level of medication taken by the patient requires readjustment. If the patient has any questions about starting treatment, the electrologist should not begin until the she or he receives a physician's clearance. Never jeopardize the patient's health or the electrologist practice! Always consult a patient's physician when in doubt!}

 

^{Signature and Completion}   

 

^{I acknowledge all information stated in this case history card is true to the best of my knowledge and understand electrolysis is a series of treatments.}

 

^{Signature ___________________________}

^{Parent or Guardian___________________________}

^{Case History by ___________________________}

 

^{This paragraph at the end of the history is very important and must be signed upon completion of the history. If the patient refuses, do not work on them. This case history has been designed for the electrologist to become aware of the electrologist patient's pertinent medical data. If a patient is dishonest and signs an inaccurate history and then later makes a malpractice claim, the electrologist is well protected. All case histories must be accurate and the electrologist must stress to the patient that all case histories are strictly confidential.}

 

^{The Boston Electrologists Diagnostic Case History Course & Examination©}

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