Client Health

Self-Esteem Is a Beautiful Gift to Give

Paramedical makeup artists use special techniques and cosmetics to help clients camouflage hair loss, skin flaws, and nail deformities.

From the football hero with a small scar on his chin to the woman whose face has been disfigured by a burn, the paramedical makeup artist can help both achieve a “normal” appearance. Since self-esteem and a positive self-image are influenced by personal and social acceptance, paramedical makeup allows the victim-turned-survivor to be in control.

According to Marvin Westmore, president of the MG Westmore Academy of Cosmetics Arts in Sherman Oaks, Calif., “paramedical makeup” is the use of specially formulated cosmetic products and techniques to normalize the outward appearance of clients who have been referred by a medical professional. The recommendation and the proper use of skin care products for the purpose of cleansing, conditioning, and protecting the skin are included in the broad use of the term.

Paramedical makeup clients include post-cosmetic surgery patient who may have temporary skin discoloration as the normal result of such surgical procedures; persons with birth anomalies, such as a birthmark or cleft lip; clients with facial disfigurements from skin disorders, hyperpigmentation, lupus, scleroderma, and cancer. While women are the primary users of traditional cosmetics, paramedical makeup is for anyone who needs it – children, young adults, mature adults, and the elderly.

Practitioners of paramedical makeup use certain techniques to camouflage hair loss, skin problems, and nail deformities. “These techniques are not beauty treatments in any sense of the word,” emphasizes Westmore. “First, beautification is not what is needed, wanted, or intended [for these clients]. Normalization is the goal. Second, we are not treating any facial condition. Treatment belongs to the medical field. We only work with the outer layer of the epidermis by applying the cosmetics topically, thus creating the topical illusion of normalcy.”

Aside from facial conditions, paramedical makeup covers hair care, hairstyling, and the use of wigs and other false head and facial hair. As far as concealing nail deformities or nail loss, Westmore says that any technique devised to assist the afflicted individual is based on the same used on any client, plus a large degree of creativity and ingenuity.


Education and training in the paramedical field is limited. Westmore’s own education in “creating an illusion,” as he calls it, has evolved over 35 years. His first endeavor in this field began with learning the art and science of motion picture and television makeup and creating a character by transforming an actor with makeup. He turned beautiful women into ugly ducklings and average-looking women into beauties; he created monsters from men and transformed ordinary-looking guys into handsome men. He also created historical characters and space aliens, and made gaping wounds and burns that looked painfully real.

“Throughout the years,” Westmore reflects, “I have obtained a vast knowledge of available makeup products, colors, and application techniques. Even today, I find that experimentation is a major part of my continuous education.”

Westmore started teaching paramedical makeup artistry 15 years ago. Today, he feels that his 160-hour course teaches what is necessary to be a minimally competent paramedical makeup artist. “This degree of competency coupled with extensive post-graduate hands-on experience, plus continuous education in a number of fields, is the beginning of the making of a qualified paramedical makeup artist,” he says.

Training in the paramedical field can be found in motion picture and television makeup courses, art courses, art and science of color classes, the nursing field, communication courses (especially learning how to listen), and psychology courses on how to deal with people.

Specialty makeup schools that offer paramedical makeup techniques, like the Westmore Academy, are also an option. Just as a motion picture makeup artist can make a healthy person look disfigured, she can make a disfigured person look normal.


Job opportunities for a paramedical specialist are numerous, says Westmore, provided the individual who chooses this career path is willing to do research and then promote herself to the medical field in her community. Employment opportunities can be found in hospitals, in doctors’ offices, by opening one’s own office, and by working for a number of physicians.

Establishing a paramedical makeup center in a hospital is probably the most convenient arrangement, but the most difficult to accomplish. A client base can be developed by asking medical specialists in the hospital to refer you to plastic surgeons, dermatologists, cancer specialists, head and neck surgeons, pediatricians, and many others. You can also establish a traveling practice where you go home from home to visit clients who have been referred by a number of physicians. Says Westmore, how well you promote yourself, your education, and your services will determine how successful your business will be.

Paramedical makeup is a rewarding field in many ways. “Conducting this as a dollar-earning business is only one of the many rewards you receive for your time, knowledge, education, and dedication. A sense of increased worth and the knowledge that you are providing a much needed service for those seeking your assistance is the best payoff of all,” says Westmore.


Sharing one’s knowledge of, and talent in, hair, skin, and makeup artistry also is the principle behind the Look Good… Feel Better program, established in 1989 by the Cosmetic, Toiletry, and Fragrance Association (CTFA) Foundation, the National Cosmetology Association (NCA), and the American Cancer Society (ACS). The program was designed to show women who are undergoing chemotherapy or radiation treatment how to improve their appearance and enhance their self-image with creative beauty tips. Look God…Feel Better recently launched a public service announcement campaign, using as its slogan: “No woman with cancer should have to look it.”

People with cancer suffer not only from the physical effects of the disease – hair loss and skin changes – but also from diminished self-esteem due to their altered appearances. Cancer treatment can cause the loss of hair (including eyebrows and eyelashes), changes in skin pigmentation and texture, and fingernail and toenail problems.

The multifaceted program provides patient education through group or individual sessions by NCA volunteer cosmetologists and beauty advisors. Program participants receive complimentary makeup kits, donated by cosmetics manufacturers, and free program materials and patient pamphlets.

In group programs, patients are taught how to apply makeup on themselves and are versed in wig prosthesis, which covers not only the mechanics of wearing and caring for a wig, but how to feel comfortable in one. There also is a demonstration on how to wear turbans, wiglets (wispy bangs), and scarf tying. The highlight of the workshop is a complete makeover on one of the attendees. In an individual program, a new cancer client will go to a participating salon for a free consultation, which includes information on wig styling or hairstyling, and skin, nail, and makeup tips. There are more than 3,000 salons in the United States involved in the program.

“The workshop teaches cancer patients the art of illusion and helps them feel comfortable with their appearance and take back control of their lives,” says Rose Leskiw, coordinator of the Look Good…Feel Better program in New York and owner of RM’L Hair Fashions in Orchard Park, N.Y. “It’s a scary feeling to lose control of your personal ability to be healthy. Cancer patients are entering a realm of unknown, which is a frightening experience.”

In order to participate in the program, volunteers have to complete a four-hour certification seminar conducted by an NCA and ACS representative. Guest speakers may also include a dermatologist, who may give some insight on recognizing signs of skin cancer, or an oncology nurse, who may discuss emotional trauma on the patient and family and talk about ways to cope with the illness. The seminar familiarizes the cosmetologists with cancer terminology, sensitivity, and how to speak with a cancer patient.

The seminar also lays the groundwork for what cosmetologists should expect with cancer patients, especially the emotional side of the disease, which brings mood swings and irritability. Volunteers view a video from the CTFA, which reviews certification in the program and emphasizes natural and healthy-looking makeup. There also is a question and answer session. Volunteers learn how to style a wig prosthesis, and a makeup demonstration is done on a mannequin or cancer survivor model.

Since there are no financial rewards for cosmetologists who volunteer their time and services for the program, what is the payoff? There are three, says Leskiw. First, a lot of people get involved because family, friends, or clients have been diagnosed with cancer and they want to know how they can help. Second, it’s a way for cosmetologists to give back to their community in a helpful and productive manner. And last, it’s very satisfying and fulfilling for volunteers to share their knowledge, talent, and creativity by helping those in need.

Shelley Hill Grant, a model, actress, and head volunteer for the Look Good…Feel Better program’s Coastal Cities Unit in Culver City, Calif., is a former breast cancer patient herself. At the time she was diagnosed, she was a hand model and so had to keep her nails well tended. “I was able to continue doing hand modeling for the first year of chemotherapy, though my nails were pretty brittle,” recalls Grant.

Chemotherapy drugs sometimes cause mild, temporary changes in nails and nail beds such as brittleness, grooving, or discoloration; a change in growth rate; heightened sensitivity; and lifting of the nail bed. For these reasons, “It’s important to keep nails short during treatment,” she says. Grant also developed wide ridges on her nails. To combat this, she used ridge filler, two base coats, two coats of polish, and two top coats. Be sure to check with your doctor, though, before applying any nail product.

Although Grant chose to keep her nails natural, for breast cancer patient Janet Erceg, having artificial nails while undergoing chemotherapy is what she believes saved her nails. Erceg experienced total loss of all body hair, including her eyebrows, nose hair, and eyelashes, extreme nausea, fatigue, memory loss (because it was a mind-altering drug), infertility, weight gain (due to lack of energy), and her toenails turned yellow, loosened, and fell off.

“I always thought, ‘Cancer, chemo, skinny, die,’ and I wasn’t going to let that happen to me,” affirms Erceg. “Luckily, though, my fingernails grew normally and I still had a fill every two weeks. One of the nurses at the hospital told me my own nails probably stayed on because of the acrylics,” she says.

What helped Erceg overcome the cancer was meditation. “I accepted the treatment into my body to do what it had to do to get on with my life,” she reflects. “A lot of people fear it or reject it, which makes matters worse. I never lost control of my body.” When she first found out about cancer, Erceg prepared herself by cutting her long hair short. Then when it started falling out in chunks, she cut it shorter. She finally shaved it when it started coming out in clumps. “By doing so, I was in control,” she says.

For these special clients, keeping in control is the first step toward enhancing their outward appearance and self-esteem. Paramedical makeup artists and volunteers at the Look Good…Feel Better program play a valuable role in helping those in need feel good about themselves again.


The following list of Nail Care Dos and Don’ts has been provided by the Look Good…Feel Better program. Use it to remind clients about the special care their hands and nails require.

  • Most important: don’t cut your cuticles. Use cuticle remover instead.
  • Massage cuticle cream into the cuticle area to prevent dryness, splitting, and hangnails
  • Wear gloves while doing household chores, such as washing dishes. Prevent excessive exposure to water
  • Wearing nail polish can help keep nails strong and protect them from the environment.
  • Very dry nails can become weaker or more brittle during treatment. Use an oily remover to remove polish.
  • If you’re undergoing chemotherapy, avoid glue-on and artificial nails
  • Be sure to check with your doctor before applying any nail product. Alert your doctor to any signs of inflammation or infection


The Chicago Cosmetologists (CCA) is also getting involved in helping cancer patients enhance their appearance and self-image. They have developed a certification program called “Appearing Your Best” for cosmetologists already have been certified and are offering a free initial consultation to any patient.

The program is coordinated with the Illinois Division of the American Cancer Society. “It’s a way to share our skills and expertise with those in need,” says committee chair Josephine Zeppieri. She goes on to say that patients who believe they look good have a more optimistic outlook and are more cooperative in their own therapy and with their doctors.

The program certifies cosmetologists on natural looking wig styling to coping with chemotherapy side effects such as discolored fingernails, skin blotchiness, and loss of eyelashes and eyebrows. Makeup, hair, skin, and nail analysis and general appearance enhancement, as well as sensitivity to patient needs, are taught through the workshops. The CCA hopes to train 2,000 cosmetologists within two years. For further information about a program in your area, call the American Cancer Society at (800) ACS-0345.

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