Remove or reduce skin imperfections using cryocautery

This standard coexists alongside, SKANSC1: Implement and maintain safe, hygienic and effective working practices during elective non-surgical cosmetic procedures,SKANSC2: Consult, assess, plan and prepare for elective non surgical cosmetic procedures, SKANSC14 Carry out a thorough skin analysis using technologies and SKANSC15 Complication management of non-surgical cosmetic procedures. This standard is for aesthetic practitioners carrying out the removal or reduction of a diverse range of blemishes and skin imperfections using cryocautery techniques. You will also be required to do a post procedure evaluation and reflection for continuous improvement. It is best practice for the aesthetic practitioner to have a first aid at work qualification or equivalent and be able to carry out the functions within SFHCHS36: Provide basic life support and have access to life support equipment as identified in the complication management plan. Users of this standard will need to ensure that their practices reflect up-to-date information, policies, procedures and best practice guidance.

1. carry out a concise and comprehensive consultation face to face with the individual
2. maintain your responsibilities for health and safety pre, during and post the cryocautery procedure
3. discuss, refer and request the individual seek and obtain a written medical diagnosis for a suspected contraindication when necessary
4. discuss to establish the individual's objectives, concerns, expectations and desired outcomes to inform the cryocautery procedure plan to include:

• 4.1 preparatory skin priming programme
• 4.2 skin classification and skin characteristics
• 4.3 skin imperfections
• 4.4 alternative treatment options
5. discuss and agree the skin priming programme or recommendations required, prior to the cryocautery treatment
6. develop an emergency plan with the identified healthcare professional trained to deal with adverse reactions to cryocautery
7. reiterate, confirm and agree with the individual, they have understood the proposed cryocautery procedure to include:
• 7.1 contra-actions
• 7.2 adverse reactions
8. obtain the individual's signed informed consent for the cryocautery procedure and pain management, allowing an adequate time scale for the individual to make an informed choice
9. illuminate, magnify and prepare the individual's treatment area
10. select an effective hygiene preparation product to meet the individual's needs in accordance with the manufacturer's instructions
11. prepare the individual's treatment area in accordance with the cryocautery procedure protocol
12. select equipment, modality, intensity and duration according to the cryocautery procedure protocol and manufacturer's instructions
13. follow the cryocautery procedure and protocol to remove or reduce skin imperfections to include:
• 13.1 manually supporting the skin
• 13.2 adapting techniques for the individual's treatment area
14. monitor the individual's health, wellbeing and skin reaction throughout the cryoocautery procedure
15. implement the correct course of action in the event of an adverse reaction
16. conclude the procedure in accordance with the cryocautery procedure protocol, legislative requirements and organisational policies and procedures
17. take and store consensual visual media of the individual's treatment area in accordance with insurance requirements, organisational policies and procedures
18. complete the individual's non-surgical cosmetic procedure records and store in accordance with data legislation
19. use reflective practice to evaluate the cryocautery procedure and take appropriate action
20. provide and obtain confirmation of receipt of the instructions and advice given to the individual pre and post procedure
21. record the outcome and evaluation of the cryocautery procedure to agree and inform future procedures
22. discuss and agree future procedures with the individual

1. the importance of collaboration with competent professionals to support effective and safe working practices
2. your role and responsibilities in performing non-surgical cosmetic procedures and the importance of working within your competence

3. why you must comply with ethical practice and work within the legislative requirements to include:

   • 3.1 the responsibilities under local authority licensing regulations for yourself and your premises

4. the importance to engage in, and document continuous professional development to include, up-to-date information policies, procedures and best practice guidance

5. the anatomy and physiology relevant to this standard

6. the relative and absolute contraindications relevant to cryocautery procedures, to include:

   • 6.1 the legislative and insurance requirements for obtaining medical diagnosis and referral

7. the importance of recognising suspicious skin irregularities and lesions, and referring to a relevant healthcare professional

8. how a skin priming programme and pre-treatment recommendations can benefit the cryocautery treatment outcomes
9. the chronological skin ageing process and the relationship to intrinsic and extrinsic factors

10. the purpose, use and limitations of cryocautery procedures in relation to:

    • 10.1 past and current medical history
    • 10.2 relevant lifestyle factors
    • 10.3 contraindicated medication and medical conditions
    • 10.4 the individual's physical and psychological suitability for the non-surgical cosmetic procedure
    • 10.5 individual's expectations •
    • 10.6 hyper-immune response management

11. the types of pain management and associated risks

12. the adverse reactions associated with a cryocautery procedure and how to respond
13. the health and safety responsibilities in line with legislation before, during and after the cryocautery procedure
14. the legal requirements for providing non surgical cosmetic procedures to minors and vulnerable adults
15. why it is important to discuss and establish the individual's objectives, concerns, expectations, desired outcomes and agree the non-surgical cosmetic procedure plan
16. the importance of using visual aids to inform the individual of the physical effects
17. the fee structures and treatment options
18. the legislative and indemnity requirements of gaining signed, informed consent for the cryocautery procedure
19. the storage, handling, usage and disposal of cryocautery equipment and single use sterile needles following manufacturer's instructions and legislative requirements
20. the importance of adhering to the cryocautery procedure protocol
21. the importance of magnification, illumination and preparation of the individual's treatment area
22. the types of hygiene products for the skin and the importance of following manufacturer's instructions
23. the range of techniques used to remove or reduce each skin imperfection
24. the types of equipment available
25. how to prepare the equipment in line with the cryocautery procedure protocol
26. the effects of the procedure on the skin
27. the reasons for working systematically with correct spacing across the individual's area to be treated
28. the importance of monitoring the health and wellbeing of the individual during and post procedure
29. the legislative, insurance and organisational requirements for taking and storing visual media of the individual's treatment area
30. the legislative and regulatory requirements of completing and storing the individual's non surgical procedure records
31. the expected outcomes of the removal or reduction of skin imperfections using cryocautery techniques
32. the purpose of reflective practice and evaluation and how it informs future procedures
33. how to collate, analyse, summarise and record evaluation feedback in a clear and concise way
34. the importance to record the outcome and evaluation of the cryocautery procedure
35. the instructions and advice pre and post the cryocautery procedure

Skin classification

1. Fitzpatrick scale
2. Phenotype and genotype
3. Lancer scale
4. Glogau scale
5. Monks Skin Tone Scale
6. Rubins Scale

Skin characteristics

1. skin sensitivity
2. skin condition
3. skin density

Skin imperfections

1. seborrheic keratosis
2. warts
3. verruca vulgaris
4. molluscum contagiosum
5. Skin tags
6. Campbell de morgans/cherry angiomas
7. solar lentigo/liver spots/hyperpigmentation
8. actinic keratosis

Anatomy and physiology

1. the structure and function of the body systems and their interdependence on each other
2. skin and systemic pathologies
3. severe adverse event pathologies
4. basic knowledge of pharmacology
5. effects of medications on the skin
6. the physiology of blood coagulation, cautery and tissue desiccation

Cryocautery procedure protocols

1. working environment
2. health and safety
3. risk management plan
4. infection prevention and control
5. complication management
6. procedure plan
7. informed consent
8. data management
9. audit and accountability
10. instructions and advice
11. waste management
12. evidence based and reflective practice

Instructions

1. the individual and aesthetic practitioner's legal rights and responsibilities
2. complication management
3. post procedure expectations and associated time frames
4. pre and post procedure instructions and care
5. restrictions and associated risks
6. future procedures
7. complaints procedure or concerns protocol

Skin classification
Skin classification scales can be referred to as the fitzpatrick scale, lancer scale,phenotype and genotypes, glogau scale, monks skin tone scale and rubins scale.
Treatment area
The indicative area to be treated, can also be referred to as treatment site or the anatomical name.
Universal precautions and standard precautions
Universal precautions are relevant if the practitioner is exposed to blood and/or some bodily fluid. It is the responsibility of the practitioner to implement infection prevention and control measures to prevent exposure to blood borne pathogens or Other Potentially Infectious Materials (OPIM). Standard precautions are the basic level of infection control that should be used at all times within the working environment, such as hand hygiene, personal protective equipment, risk assessment, respiratory hygiene and cough etiquette, environmental cleaning and waste disposal.
Visual media
Visual media is evidence generated through photography or video.

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