Stress

Stress is shown in the face as tension lines where the facial muscles are tight.  Because blood and lymph cannot circulate properly, this causes a 'sluggish' skin condition and poor facial nutrition.  That could cause pre-mature ageing.  A person suffering from stress usually experiences disturbed sleep, sometimes sleeplessness (insomnia).  Lack of sleep causes the skin to become dull and puffy, especially the tissue beneath the eyes, where dark circles also appear.  Too much sleep also can cause the facial tissue to become puffy - because the circulation is less active; body fluids collect in the tissue.
Individuals suffering from stress may drink more tea, coffee or alcohol, or smoke more cigarettes; this too damages the skin.
Stress and anxiety are often the underlying cause of certain skin disorders.  Some skin conditions, such as boils and styes, appear at times of stress; others, such as psoriasis and eczema, may become much worse.  Stress also influences and aggravates acne breakouts.

Smoking

Smoking interferes with cell respiration and slows down the circulation.  This makes it harder for nutrients to reach the skin cells and for waste products to be eliminated.  Cigarette smoking also releases a chemical that destroys vitamin C.  This interferes with the production of collagen, and thereby contributes to premature wrinkling.  Excessive nicotine in the system can cause a yellow cast to the skin.

Alcohol

Heavy intake of alcohol dilates the blood vessels.  If these conditions continue over a long period of time, this can weaken the capillary walls.  Alcohol also draws water out of the tissues and leaves the skin dull and dehydrated.

Weight loss

To keep the body healthy an individual should maintain his or her normal weight.  When weight is lost too rapidly, as in the case of crash diets, the skin does not have time to adjust to the changes in the underlying facial muscle.  This cause premature wrinkling and sagging of the skin.

Medications

Medications can affect the skin and need to be considered.

High blood pressure tablets can cause rashes and bruising.

Birth Control Pills may affect the skin by causing hyperpigmentation and clients may see a change in the amount of acne breakouts they experience.

Antihistamines, which are so often taken by those clients suffering from allergic reactions and sinus congestion, may cause excessive dehydration on the skin surface, and some are reactive with ultra-violet light.

Antibiotics, and in particular the tetracycline so often given for acne, cause increased sensitivity to ultra-violet light.  Antibiotics can also cause skin rashes.

Steroids, especially cortisone, can in some cases cause a certain type of "acne", which is in fact an inflammation of the follicles.

Medicines containing bromides and diodides, as found in many cold remedies, can cause acne breakouts.

Excessive use of diuretics and laxatives will cause the skin to become dehydrated.

Caffeine, antihistamine and cold remedies are all very dehydrating to the body.

Medical condition

1. Arthritis
   High aspirin intake used in the treatment of arthritis thins the capillary walls, resulting in increased skin sensitivity, and couperose. Take care when performing certain massage movements on the affected areas.
    
2. Diabetes
   The client may have a skin with poor healing ability, bruise easily and have a hypersensitive skin.  Diabetics may suffer from extreme redness of the face and increased skin infections.
    
3. Sinus conditions
   The client may have hypersensitive skin couperose across cheeks which may also be red and inflamed.  Treat the skin as hypersensitive skin - less heat.  Less pressure.  Less product.  Less time.
    
4. Bridge work or dentures
   The client may have sensitive skin or couperose.
    
5. Epilepsy
   The client may experience convulsions or may be taking medication which can affect the skin. In this case, use of any electrical machines should be avoided due to the possibiility they may trigger a fit.
    
6. Thyroid Issues
   Thyroid conditions affect the skin, and thyroid hormones are responsible for the production of connective tissue in the lower layers of the skin, and the secretion of skin sebum.
   An overactive thyroid causes the skin to become thin, moist and covered with fine, sweaty hair.  An underactive thyroid gland shows up as rough, dry skin with decreased sweat and hair growth.
    
7. Liver Disease
   Liver diseases such as yellow jaundice increase the skins bruisability, and the amount of spider naevi.
    
8. Pregnancy and menstruation predisposes the skin to reactions due to an abnormal state of hormonal balance.
   The therapist must remember that menstruation will predispose the client to allergies, and reactions to pressure, pain, and heat.
   Clients may also be more susceptible to oiliness and breakouts during this time.
    
9. X-rays inhibit sebaceous gland activity. 
   The client may notice a marked decrease in the amount of oil production, and breakouts of the skin after dental X-rays.

Diet
The skin is an organ of elimination.  If the body is on a detoxification diet or a fast, the skin may breakout.  If the client has a restricted fat intake, the skin may become very dry.
Good nutrition helps the skin to function in a normal way.  Allergies, rashes and other skin disorders are often the result of a poorly balanced diet.