This concoction should be used in a local focal treatment area, as it could be extremely cooling to the skin, and overstimulating for some if it was used in a full body treatment.

Ingredients can vary based on the client and their individual needs.  Here are some suggestions to create a Sport Massage Blend with Gels, Oils, Lotions & Creams:

• Unscented massage medium (you can use gels, oils, lotions or creams
• Peppermint essential oil (stimulating, refreshing and restorative)
• Spearmint essential oil (uplifting, calming and relaxing)

Some may substitute a menthol essential oil for it's cooling effects, especially for athletes who are competing to exhaustion or in extreme heat.  The amount of essential oil used will depend on the amount of massage medium being blended.  Remember to only blend in tinted glass just prior to using, to retain the greatest amount of essential oil therapeutic properties.

Be sure to train in aromatherapy applications and contraindications plus sports massage and heat exhaustion or heat stroke symptoms prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

This soak can either be provided as a spot treatment, such as for the feet - or as a full body immersion soak in a tub as well.

Ingredients can vary - here are some suggestions:

• Himalayan Salt (detoxifies, revitalizes, rejuvenates and relievers tired aching muscles).
• 5% Rose Absolute Essential Oil (Uplifting, comforting and soothing).
• Honey Powder (natural humectant which will counterbalance the salt).
• Pink Rose Petals (visually soothing with all the rose essential oil benefits, plus it is visually pleasing and soothing).

Be sure to train in hydrotherapy and aromatherapy applications and contraindications prior to administering any type of service to a client.

For full directions on how to create this treatment, or to learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Massage Magazine has updated their free client intake form to include questions and special client service agreement during COVID-19.   You can click HERE to download Massage Magazine's free client intake form!  Below is a screen shot of a small portion of their intake form:

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Author: Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL

Did you know that one of our largest national massage and spa chains just lost a class action lawsuit for how they advertised and sold their one-hour appointments in the State of Missouri?  Well, according to multiple new sources, they did!  The class action lawsuit asserts that clients purchased an advertised "One-Hour" appointment, but, only received 50 minutes of hands-on service time with 10-minutes being provided for consultation and clothes dressing, instead of the full 60-minute service as advertised. The chain had to pay a $1.6 million award to the plaintiffs and their attorneys for customers that received these shortened services for an 8+ year period, from January 31, 2012 to April 13, 2020.  Other states, spas and establishments may now be at risk for similar legal action due to this new legal precedence.

I believe as a spa, salon or massage establishment or practitioner, that we can all learn from this example.  It is important to be clear and exact in our appointment advertisements.  When advertising a one-hour service, it should be precisely detailed if the one-hour service includes anything other than the advertised service itself.  In this case, if a one-hour appointment only provided a 50-minute serwith 10 minutes of consultation and dressing time, then that detail of dressing and consultation time should be included in the advertisement.

It is essential to properly advertise time with a massage appointment today, because most busy clients must plan childcare, work absence, or other time-sensitivities to attend appointments.  Advertising a 50-minute massage but then keeping your client occupied in a treatment room for 60 minutes or more with dressing and consultation would not good practice today either, due to our whole new busy world of time-management pressures.

Let's look back on the massage industry's appointment scheduling practices:

In the “old-days” (early-to-mid 1990s and before), we used to advertise one-hour massages and then leave 15-minute "breaks" in-between our 60-minute hands-on service for the clients to dress, undress and consult with the therapist prior to, or after their appointment. We didn't have cellphones where we could check emails, texts and so forth, every second of every day, so it was a whole different era, lifestyle and work standard.  Back then, we were less accountable for time if the appointment went longer than advertised which is important to note.  That is because our "old" standard did not leave a client feeling “cheated” for their time and money, which appears to be a new legal liability and complaint today with this successful lawsuit against Massage Envy. 

So why the change in appointment scheduling?  From the late 1990s to today, as the massage industry became more popular and the demand for appointments increased, these new 50-minute “hours” were commonly adopted by many establishments, all the way from Massage Envy to the Ritz Carlton. This 50-minute hour practice allowed most establishments and therapists to often:

• see more clients;
• earn more income;
• provide easier view of an appointment book;
• provide less of a hardship if a client was a no-show and there was no way to charge the client for the lost time;
• there is a long list of other reasons why a 50-minute hour appointment practice is a preferred method of appointment scheduling.  

When the 50-minute hour first started, some professionals did not agree with the new rushed 50-minute service on the hour, every hour, as it became a “new normal” in our industry. And, as you can see from this class action lawsuit result, a “new normal” of practice doesn't necessarily make it right, or legal. 

Regardless of what a therapist or establishment owner prefers in massage appointment scheduling, it is perfectly acceptable to provide and charge for a 50-minute massage.  If you advertise a 50-minute massage, then you should simply provide a 50-minute massage of hands-on time. That's it.  What may no longer be acceptable, especially with this new court precedent and ruling, is to sell a one hour massage and then only provide 50-minutes of hands-on time.  In this court ruling, it appears that it did not matter that the other 10 minutes of the hour was spent on appointment-related needs such as consultation and dressing time.

With over two decades of watching industry scheduling practices, I do personally think that it might be possible to establish a different legal precedent where a 50-minute hour IS a normal standard because it is so commonly practiced, if we do not have that precedent already. However, I am not a lawyer, judge or jury - this type of legal precedent may only be determined in a court of law. If you have questions or concerns about this, you should consult your business attorney to discuss your individual exposure of your business appointment scheduling practices.

So, for those establishments and practitioners who provided as advertised and did not implement the new 50-minute hour without disclosure, a big-hats off, thumbs-up and kudos to you!  It looks like trying to provide a 50 minute hour without proper detail might be more trouble than whatever benefit you could gain from such a practice.

Please share this information with your peers, coworkers, employers and anyone else who could be affected by it.  This might be an important legal precedent that could affect your future (or past) practice of appointment advertisements and scheduling practices!

Please click HERE to review a summary of this class action lawsuit result on topclassactions.com

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

 ____________________

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL. She is a retired professional athlete and has been practicing massage therapy for over 30 years. Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage. She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] Español By Brigette Honaker June 1. “Missouri Massage Envy Class Action Settlement.” Top Class Actions, 19 June 2020, Found online July 12, 2020, topclassactions.com/lawsuit-settlements/open-lawsuit-settlements/consumer-products/health-fitness/miss-massage-envy-class-action-settlement/?fbclid=IwAR3CFdMWGoOm7fki5ydO26Q7Odqd58bx7PYTdAwHTY2ZoIxx0oVhe7FDrBQ.

Folliculitis

According to the Mayo Clinic, folliculitis is a common skin condition.  It occurs when hair follicles become inflamed. It is usually caused by a bacterial or fungal infection. First, tiny small red bumps or white-headed pimples may be visible around where the hair follicle protrudes the skin.   Each protruding infected hair follicle can turn into nonhealing, crusty sores.[i]

Sometimes the skin is “too thick” for new hair to break through the skin. When this happens, it is commonly referred to as an “ingrown hair”.  Ingrown hair (aka “folliculitis”, once it is infected) can often happen after shaving or waxing. 

Folliculitis is not life-threatening, but it can be itchy, sore and embarrassing. On first glance to an untrained eye, it could even look like a STD.  Severe folliculitis/infection can cause permanent hair loss and scarring.

Folliculitis signs and symptoms include:

• Clusters of small red bumps or white-headed pimples that develop around hair follicles and can develop into a large swollen bump or mass
• Pus-filled blisters that break open and crust over
• Itchy, burning, painful and/or tender skin

The 2 Main Types of Folliculitis: Superficial & Deep

According to Mayo Clinic, the superficial type involves “part” of the hair follicle, and the deep type involves the “entire” hair follicle and is usually more severe.

Forms of Superficial Folliculitis Examples Include:

Bacterial Folliculitis

This common type of folliculitis is marked by itchy, white, pus-filled bumps. It occurs when hair follicles become infected with bacteria, usually Staphylococcus aureus (staph). Staph bacteria live on the skin all the time, but they generally cause problems only when they enter the body through a cut or other wound.

Superficial Folliculitis (continued)

Hot Tub Folliculitis/Pseudomonas Folliculitis

With this type you may develop a rash of red, round, itchy bumps one to two days after exposure to the bacteria that causes it. Hot tub folliculitis is caused by pseudomonas bacteria, which is found in many places, including hot tubs and heated pools in which the chlorine and pH levels aren't well-regulated. 

Pityrosporum Folliculitis

This type produces chronic, red, itchy pustules on the back and chest and sometimes on the neck, shoulders, upper arms and face. This type is caused by a yeast infection.

In this photo of pityrosporum folliculitis below, a 25-year-old man presents with complaints of slightly pruritic (itchy), monomorphic follicular papules, pustules, and secondary keloid on the upper trunk and neck.  Shown are a large number of globular or orbicular-ovate yeasts of budding daughter cell, with collar structure around the budding.

Razor Bumps or Pseudofolliculitis Barbae

This is a skin irritation caused by ingrown hairs. It mainly affects men with curly hair who shave too close and is most noticeable on the face and neck. People who get bikini waxes may develop barber's itch in the groin area. This condition may leave dark raised scars (keloids).

This CDC Photo reports: patient presented to a clinical setting with what appeared to be a maculopapular rash on his face, primarily on his cheeks, chin, and neck. Diagnosed as pseudofolliculitis barbae (PFB), this condition occurs in areas of the body where hair is shaved. In the genital region, it is known as pseudofolliculitis pubis (PFP). Most often it occurs in cases where the hair is very curly, for after cutting, or plucking out the hair shaft, when the hair grows back, rather than growing out the normal route, it grows beneath the skin, which subsequently leads to inflammation of the hair follicle.

Forms of “Deep” Folliculitis Examples Include:

Eosinophilic Folliculitis

This type mainly affects people with HIV/AIDS. Signs and symptoms include intense itching and recurring patches of bumps and pimples that form near hair follicles of the face and upper body. Once healed, the affected skin may be darker than the skin was previously (hyperpigmented). The cause of eosinophilic folliculitis isn't known.

Boils/Furuncles and Carbuncles

These occur when hair follicles become deeply infected with staph bacteria. A boil usually appears suddenly as a painful pink or red bump. A carbuncle is a cluster of boils.

Gram-negative Folliculitis

This type sometimes develops if you're receiving long-term antibiotic therapy for acne.

Ingrown hairs, folliculitis or boils themselves are not contagious, though any germ causing agents that contributed to the condition (i.e. bacteria or yeast) could be “contagious”.  Most of this bacteria and yeast is naturally found on human skin; however, under the right conditions in broken skin, these germs can fester into uncomfortable, unsightly or even serious infection.

Do not work on or around broken skin or areas of infection.  Skin integrity is broken with folliculitis, and at extreme exposure for infection. As always, it is best to seek physician approval and/or direction for serious infections or medical conditions.

[i] Mayo Clinic Staff. “Symptoms and Causes.” Mayo Clinic, Mayo Foundation for Medical Education and Research, Retrieved on: 6 May 2018, www.mayoclinic.org/diseases-conditions/folliculitis/symptoms-causes/syc-20361634?p=1.

Hemophilia

Hemophilia is a rare inherited bleeding disorder in which the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery.  Hemophilia is caused by a mutation, or change, in one of the genes that provides instructions for making the clotting factor proteins needed to form a blood clot. This change or mutation can prevent the clotting protein from working properly or could be missing altogether.

Hemophilia can result in:

• Bleeding within joints that can lead to chronic joint disease and pain
• Bleeding in the head and sometimes in the brain which can cause long term problems, such as seizures and paralysis
• Death can occur if the bleeding cannot be stopped [i]

As personal care service workers, we have to be extra careful when working with a hemophiliac.  A simple bump or bruise could be a life-threatening situation for them. 

Hair braiders should avoid aggressive pulling on the scalp.  Nail technicians must use extra caution when working with “thin skin” such as cuticles.  Waxing, tweezing or facial extractions are all ill-advised.  Any personal service that could significant cause pressure on the skin (thus underlying blood vessels) should be avoided.  It is always best to seek approval and/or direction for services from a medical physician regarding medical conditions.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] National Center on Birth Defects and Developmental Disabilities. “Hemophilia.” Centers for Disease Control and Prevention, 2 Mar. 2017, www.cdc.gov/ncbddd/hemophilia/facts.html.

Hives (aka Urticaria)

Hives are red (and often itchy) bumps on the skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause the body to release chemicals that can make the skin swell up in hives. People who have other allergies are more likely to get hives than others. Other causes include infections and stress.  Hives are not contagious.

Hives are very common. They will usually go away on their own, but in a serious case, medicine, a shot or medical treatment may be required. When hives last longer than six weeks, it is called chronic hives. Usually no cause can be found. Most chronic hives resolve on their own in less than one year.  In rare cases, hives can cause a dangerous swelling in of the airways, making it hard to breathe—which is considered a grave medical emergency.[i]

It is important to use extreme caution when working on someone who has hives. 

The client is most likely experiencing an allergic reaction which could become life threatening. Hives could also be a symptom of a more serious disease that could be contagious or noncontagious.

Avoid working on any local area that is affected by hives. And if this skin condition is caused by something contagious - then hives would be a symptom of an overall bodywork or massage contraindication. If you're unsure of the cause of a client's hives, it may be best to refer the client to their physician for a formal diagnosis prior to treatment.

The skin integrity from hives is COMPROMISED. As such, the client is particularly prone to infection if a practitioner works directly over broken skin, which is contraindicated.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] U.S. National Library of Medicine. “Hives | Rash | Skin Rash | Itchy Skin.” MedlinePlus, U.S. National Library of Medicine, 23 Apr. 2018, medlineplus.gov/hives.html.

Impetigo

Impetigo is a contagious common bacterial skin infection that can produce blisters or sores anywhere on the body, but usually on the face (around the nose and mouth), neck, hands, and diaper area. It’s preventable and manageable with antibiotics, says pediatrician Thomas D. Smith, MD, of the FDA.

Two types of bacteria found on our skin cause impetigo: Staphylococcus aureus and Streptococcus pyogenes (which also causes strep throat). Most of us go about our lives carrying around these bacteria without a problem, Smith says, but then a minor cut, scrape or insect bite allows the bacteria to cause an infection, resulting in impetigo.

Anyone can get impetigo — and more than once, Smith says. Although impetigo is a year-round disease, it occurs most often during the warm weather months. There are more than 3 million cases of impetigo in the United States every year.

Untreated, impetigo often clears up on its own after a few days or weeks. The key is to keep the infected area clean with soap and water and not to scratch it. The downside of not treating impetigo is that some people might develop more lesions that spread to other areas of their body. This can infect others. Impetigo is contagious with fairly close contact, such as massage therapy or hands-on bodywork.

Because impetigo spreads by skin-to-skin contact, there often are small outbreaks within a family or a classroom, Smith says. Avoid touching objects that someone with impetigo has used, such as utensils, towels, sheets, clothing and toys. If you have impetigo, keep your fingernails short so the bacteria can’t live under your nails and spread. Also, don’t scratch the sores.[i]

The lesions shown below the person’s left forearm proved to be Streptococcal impetigo, a dermatologic condition quite often caused by Staphylococcus aureus bacteria.[ii]

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] Office of the Commissioner. “Consumer Updates - How to Treat Impetigo and Control This Common Skin Infection.” U S Food and Drug Administration Home Page, Office of the Commissioner, 12 Dec. 2017, www.fda.gov/ForConsumers/ConsumerUpdates/ucm048837.htm.

[ii] Miranda, Dr. Herman, Chambers, Peru A. “Public Health Image Library (PHIL).” Centers for Disease Control and Prevention, 20 Dec. 2017, phil.cdc.gov/Details.aspx?pid=14927.

Jaundice

Jaundice causes the skin and the whites of the eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. Bilirubin accumulates in the body and the skin may look yellow. if the liver is overwhelmed by the blood cells breaking down.

Here are some common causes of jaundice:

• Blood diseases
• Genetic syndromes
• Liver diseases, such as hepatitis or cirrhosis
• Blockage or cancer of bile ducts
• Infections
• Medicines[i]

If a client presents with jaundice, ask them about this observation and recommend they consult a physician if they were unaware of the condition.  Be clear that you are not making a medical diagnosis but a referral instead.  A client could have a serious medical condition with jaundice so use caution and be vigilant in their service, until there is a medical explanation as to why they have jaundice. Jaundice usually would not be a contraindication; however, it would be best to request a prescription for massage therapy service to ensure the client is not suffering from more severe medical disease that could be contraindicated.

The photo on this page is picture of a person with jaundice.  The picture is from Emory University in 1963 and published on the CDC website.  The photo caption states: the viral disease Hepatitis A is manifested here in this photo as icterus, or jaundice of the conjunctivae and facial skin.  HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A. Adults will have signs and symptoms more often than children.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] U.S. Department of Health and Human Services. “Jaundice | Icterus.” MedlinePlus, U.S. National Library of Medicine, 1 Mar. 2018, medlineplus.gov/jaundice.html.