A massage therapist normally sees more of their client’s skin than the client does. As a massage therapist, you should have a basic knowledge of skin conditions but you don’t need to be able to diagnose them. You simply need to be safe — for both you AND your client. You don’t want to catch an infectious skin disease and you don’t want a client’s skin condition to progress because you failed to bring it to their attention.
There are over 3,000 different types of skin conditions, from acne to warts. While most skin conditions do not pose a risk to you, there are some that are contagious.
Skin conditions can be tricky and should be approached with caution! Now, if you see a zit on someone’s back keep your mouth shut and massage away. If you spot an open wound that has green pus draining out of it – hands off! This type of skin condition falls into the category of tactfully asking your client if they are aware it is there and inquiring about what it is and still NOT touching it, just to be on the safe side.
As a general rule if you notice an unusual spot, mole, lump, or anything that should not be on your client’s skin (keep in mind birthmarks are common), after the treatment is completed you should ask your client if they were aware of the (fill in the blanks with what you saw). If they have bad acne or a huge zit, you don’t need to mention it. Enough said.
If the skin condition is small in area or in a location that’s difficult to see, there is always a good chance your client is not aware it is even there. While most skin conditions are harmless, some can be life-threatening, such as skin cancer. Therefore, anything unusual is worth mentioning. But be considerate, and don’t freak your client out by saying something like, “Hey, my Aunt Sally had a such and such just like that and it was cancer and she was dead in two months!”
Be cautious of massaging any area of skin that is cracked or appears to be fragile. And above all, if your client is in the process of undergoing radiation or chemotherapy and has open wounds, be wary that any oils or lotions you apply could work their way into your client’s blood stream and make them extremely ill. A simple rule to follow: do not massage skin that appears to have any type of lesion or infection.
Psoriasis is a common skin condition. The affected skin becomes dry and itchy and produces white flaky pieces of dead skin that easily falls off the body. Psoriasis is an autoimmune system disease (the body produces too many skin cells) and there is no known cure.
Typically a massage therapist should avoid areas of the skin that appear to have psoriasis. Psoriasis is not contagious but massaging the area may increase blood flow to the area and increase cell production thus worsening the condition.
According to the National Psoriasis Foundation, more than 5 million people in the United States have psoriasis. There is a good chance as a massage therapist you will bump into more than one client that is suffering from psoriasis. While it may appear to be a contagious lesion it is harmless to the therapist.
Eczema (also known as Atopic Dermatitis) is the most common type of skin condition you will see as a massage therapist. Your client’s skin may look red and inflamed. In some cases, it can be very severe–so much so you may shirk when you see it. However, for the sake of embarrassing your client and yourself always be prepared to see something you’re not expecting to see. Eczema is not contagious and moisturizing the effected skin can will help sooth the itching. Ask the client if applying oil and massaging their atopic dermatitis is beneficial or if they’d prefer that you avoid the area. The answer you get from your client will determine how you continue care and you’ll at least impress your client with your use of medical terminology.
Since psoriasis and eczema are often stress related, a massage might be an appropriate treatment for a client suffering from either skin condition.
You can relax, there is no actual worm crawling around under the skin, looking for a way out. It’s called ringworm because it is identified by the red circular spot on the skin. Ringworm is a fungal infection. You should avoid touching it because it is contagious. The same rule applies to shingles, impetigo, and warts.
If you suspect ringworm, you should inform your client that they have a lesion that you think they should have they’re doctor look at. Try not to identify the lesion by name. Instead say “I noticed a small lesion on your back that you should probably have your doctor look at.” Stay away from diagnosing skin conditions or any other potential ailment. But do refer your client.
If a client has MRSA, the last place they should be is on your massage table. One look at the infection and you should know that this client needs to be referred to a hospital ASAP. The client will most likely also present with a fever and be unwell. The skin infection (methicillin resistant staphylococcus aureus) is caused by staph bacteria and may be resistant to many antibiotics. MRSA is not only one of the most unsightly types of skin infections you may encounter, it is also highly contagious and can be deadly. MRSA generally starts out as small red bumps and can quickly turn into deep, painful abscesses.
Do not massage a client that you suspect has MRSA, and immediately refer this client to the emergency room. Massage may spread this contagious staph infection in the blood stream.
There are many types of skin cancer, and the condition is not contagious. In fact, you may have massaged a skin cancer lesion and not even have realized it. While it may freak you out that you touched cancer and leave you a little unsettled, just take a deep breathe and continue with the massage. Often you may find that your client wants to talk about their skin cancer. If you can just listen and be empathetic, it can be therapeutic for your client.
If you notice any type of skin lesion that you supsect could be cancerous it is your duty as a massage therapist to inform your client of the lesion. You don’t need to be able to diagnosis skin cancer but you should know what is suspicious, just remember your ABCDEs.
A lesion is more likely to be cancerous if:
A – Asymetry: the lesion doesn’t have a symetrical shape.
B – Border: the border is rough or uneven.
C – Color: inconsistent or varied colors should also get your attention.
D – Diameter: larger lesions are also more likely to be cancerous. A mole that is larger in diameter than a pencil eraser should get your attention.
E – Evolving: If you’ve seen a client before and it appears a lesion is getting larger or changing you should also refer them to a doctor.
There are many skin conditions, and as massage therapists we aren’t expected to know what they all are. However, we are expected to look out for the best interests of our clients and be a member of their health care team. A mantra that I’ve used for years is “if in doubt, refer them out.” I’d much rather have a client see their doctor and find out the lesion was just a mole than find out later it was skin cancer.