The Wiltshire School

of
Beauty and Holistic Therapy

VTCT Level 2 Award in Thermal

Auricular Therapy

Practitioner’s Training Manual

W: www.wsbht.co.uk
E: [email protected]
T: 01793 73 77 33 M: 07824 337333
 CONTENTS

1. Aims & Objectives p3

2. Course Details p4

3. Thermal Auricular Therapy p5

4. Hygiene, Health & Safety p11

5. Professional Ethics & Standards of Practice p18

6. Related Anatomy & Physiology p21

7. Client Consultation p33

8. Contra-Indications p38

9. Contra-Actions p40

10. Aftercare p41

11. Equipment & Products p42

12. Storage & Insurance p43

13. Routine p44

14. What Happens Next? p46

15. Contact Details & Recommended Reading p47

16. Self Assessment p48

17. Notes p49

18. Accreditation p50

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 1. AIMS & OBJECTIVES

AIMS
The aim of this manual is to teach you the basics of health and safety, and
anatomy and physiology in relation to this course. This manual also covers the
background, benefits, treatments, consultation, contra-indications,
contra-actions, aftercare, equipment and products needed. You will also learn the
movements and techniques required to perform a professional treatment during
the practical sessions.

OBJECTIVES
The objectives of this course are that by the end it, you will be able to perform a
professional treatment in a safe and hygienic manner in a commercially
acceptable time, along with experience of carrying out a consultation with the
knowledge of the background, benefits, consultation, contra-indications, contra-
actions, aftercare, equipment and products needed.

WSHBT advise you to read this training manual thoroughly

along with other research before you take part in your practical
session.

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 2. COURSE DETAILS

During this course you will learn how to perform a professional Thermal Auricular
treatment.

You will learn how to:

prepare the treatment area
prepare the client for treatment
carry out a client consultation
carry out a thermal auricular treatment
provide aftercare advice.

You will also study:

related hygiene, health and safety
related anatomy and physiology
the history behind thermal auricular therapy
benefits of thermal auricular therapy
ear symptoms and treatments
client consultation
contra-indications
contra-actions
aftercare.

Studying the VTCT Level 2 Award, requires you to attend a 4 hour practical
training session, and a 4 hour assessment session, to include sitting a multiple
choice assessment paper

Once you have successfully completed the course and training, you will receive
The VTCT Level 2 Award in Thermal Auricular Therapy.

Good luck and enjoy!

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 3. THERMAL AURICULAR THERAPY

The History of Thermal Auricular Therapy

Thermal Auricular Therapy, also known as Hopi ear candling, is an ancient form
of therapy practiced by many people on a worldwide basis. Its name is taken from
the Hopi Indians of North Arizona, USA, and means 'peaceful people'.

Hopi candling is a very safe therapy and its popularity is growing as more people
become aware of its positive benefits.

Ear candles are an ancient and natural therapy handed down by many
civilisations. They were used as far afield as Asia, the Siberian prairies and, most
notably, native America.

It is believed that the Ancient Greeks used ear candles, initially probably for
cleansing, purifying and healing on a spiritual basis, but then, much later, on a
purely physical basis. However, the practice reached the modern world via the
native North American Hopi Indians.

Ear candles were used traditionally by Shaman healers. Ancient wall paintings
(such as those found within the caves of the Grand Canyon) show the importance
of ear candling in initiation rituals and healing ceremonies of the tribe.

How Thermal Auricular Therapy Works

The candles and cones used are special spiral shaped, and made from natural
ingredients such as beeswax, honey extracts, St Johns Wort, sage and chamomile.

Ear candling looks to remove blockages within the ear canal without the need for
syringes or solutions, but does work better as a preventative so it is a good idea to
have treatments before the ears become too impacted with wax.

The spiral shape of the cone causes air to be pulled down into the ear.
As it burns, the cone's ingredients turn to vapour and the airflow creates a
vibrational effect. Warmth, vibration and vapour massage the ear-canal, breaking
down any blockages. Wax, toxins and impurities are then loosened to be able to
come out of the ear naturally.

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Benefits of Thermal Auricular Therapy
Many conditions can be helped, including:

Glue ear
Sinusitis
Migraine
Tinnitus
Excessive wax
Vertigo
Blocked tear ducts
Cold and flu symptoms
Loss of sense of smell
Lymphatic circulation (can be increased)
Stress
Ear pain
Lack of hearing, or even taste and smell (can be enhanced)
Loss of pressure in the ear (caused by, for example, frequent flying/sports
such as driving).

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Ear, Nose and Throat
Although the ears may appear to be isolated structures, they are directly linked to
the nose and throat. The visible part of the ear, the pinna, is connected to the ear
canal, which ends at the eardrum. Beyond this membrane lies the middle ear, an
air-filled space connected to the back of the nasal cavity and to the throat by a
channel called the Eustachian tube. This tube ensures that the air pressure is the
same on both sides of the eardrum.

Our ears provide us with two vital but very different senses: hearing and balance.
Sound detected by the ears provides essential information about our external
surroundings and allows us to communicate in highly sophisticated ways, such as
through speech and music. In addition, our ears contribute to our sense of
balance, the largely unconscious understanding of the body’s orientation in space
that allows us to maintain an upright posture and move without falling over. Ear
problems and infections can upset this delicate balance.

Ear Symptoms and Treatment

Hopi Ear Candles have been effective at treating a number of conditions that are
associated with the ear, nose and throat.

These are listed below for your information.

Colds
Colds can occur at any time of the year, although infections are more frequent
in the autumn and winter. The initial symptoms of a cold usually develop
between 12 hours and 3 days after infection.

Symptoms include:

frequent sneezing
runny nose
sore throat
cough.

Bacterial ear infections are a common complication of colds.

Hopi Care - We recommend that, whilst suffering from a cold, Hopi ear
candles are used every other day for a week, Whilst these treatments will not
cure a cold, they may help to clear congestion and ease discomfort.

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Sinusitis
The sinuses are air-filled cavities around the nose and eyes. Within the lining
of the sinuses are many mucus-secreting glands. Mucus passes continuously
through narrow channels that lead from the sinuses to the back of the nose.

Sinusitis is an inflammation of any of the sinuses. Sinusitis may be acute

(developing and clearing up rapidly) or chronic (long term).

The most common cause of sinusitis is a viral infection such as the common
cold. If the channels connecting the nose to the sinuses become blocked due to
the viral infection, mucus collects in the sinuses.

Symptoms depend on which sinuses are affected and may include headache,
pain, and tenderness in the face that tends to worsen when bending down.

If symptoms do not improve within 3 days, you should consult your doctor.

Hopi Care - In the first few days of acute sinusitis we recommend daily
treatment. Monthly treatments may then help to prevent the severity and
frequency of attacks. Chronic sinusitis will probably require a weekly
treatment for the first month, then once or twice per month for a further 2-3
months.

Ear Blockage
Blockage of the ear canal by earwax often causes a feeling of fullness and
irritation in the ear.

Earwax, produced by glands in the ear canal, cleans and moistens the canal.
Usually, wax is produced in small quantities and emerges naturally from the
ear. However, if the canal becomes blocked with wax, it causes a feeling of
fullness and discomfort, and sometimes hearing loss.

Hopi Care - To help clear wax blockage, one treatment may be sufficient,
however 2-3 may be needed depending on the extent of build-up. Regular
treatments every 6-8 weeks may help to relieve and prevent excess build-up.

Chronic Secretory Otitis Media (glue ear)

This is a persistent collection of fluid in the middle ear, common in children
under 8 years old. Sometimes referred to as glue ear the middle ear becomes
filled with a thick, sticky, glue-like fluid. It is the most common cause of
impaired hearing in children under the age of 8.

The middle ear is normally ventilated by the Eustachian tube. However, if this
tube becomes blocked, possibly as a result of infection, the middle-ear may fill
with fluid. Often, the blockage persists, causing chronic (long term) Secretory
Otitis Media.

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The symptoms may develop gradually and may initially go unnoticed. The
symptoms tend to fluctuate and tend to be worse in the winter months. They
may include: partial deafness, immature speech for the child’s age, and ear
infections.

If symptoms persist for several months, grommets will probably be inserted

under general anesthetic to allow air to circulate around the middle ear.

Hopi Care - An initial treatment of once per week for 1 month may be
sufficient. Regular monthly treatments thereafter may be beneficial.

Allergic Rhinitis
Allergic rhinitis is the inflammation of the membrane lining the nose and
throat due to an allergic reaction. It affects people who experience an allergic
reaction after they inhale specific allergens.

Allergic rhinitis may occur only in the spring and summer, in which case it is
known as seasonal allergic rhinitis or hay fever, or it may even be perennial,
which would mean it would occur all year round.

The symptoms of allergic rhinitis can include:

itchy sensation in the nose

frequent sneezing
blocked, runny nose
itchy, red, watery eyes.

Allergic rhinitis is more common in people who also have other allergic
conditions such as asthma.

Hopi Care - Dependent upon the severity of the condition, 2-3 Hopi ear
candle treatments may be needed in the first week, then 1-2 times in the next
2-3 weeks. A monthly treatment may help to reduce the frequency or severity
of attacks.

Tension Headaches
Moderate or severe pain affecting one or more areas around the head, often as
a result of stress.

Hopi Care - The pressure relief and relaxation brought about by a Hopi ear
candle treatment can really help this condition. The frequency of treatment
will depend upon the severity of the condition.

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Tinnitus
Tinnitus is sounds heard in one or both ears in the absence of any external
noise. People with tinnitus hear sounds that originate within the ear itself.
These sounds may include ringing, buzzing or whistling.

Hopi Care - Hopi ear candle treatment can help to reduce the symptoms of
Tinnitus by aiding relaxation, however there is no known cure for Tinnitus
and whilst some sufferers may find Hopi beneficial, others may not.

Ménière’s Disease
Ménière’s Disease (pronounced min-years) is a disorder of the inner ear that
can affect hearing and balance. It is characterised by episodes of dizziness and
tinnitus, and progressive hearing loss, usually in one ear. It is caused by an
increase in volume and pressure of the endolymph of the inner ear.

Hopi Care - Hopi ear candle treatment can help to reduce the symptoms of
Ménière’s by aiding relaxation, however there is no known cure for Ménière’s
and whilst some sufferers may find Hopi beneficial, others may not.

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 4. HYGIENE, HEALTH & SAFETY

Maintaining a high standard of hygiene is essential. Whether you intend to work

for yourself as a self employed therapist or as part of a salon, clients will not
return if the salon, treatment area, or equipment is not clean. Your hands should
always be washed after you have carried out the consultation, before you
commence the treatment, and then again once treatment has been completed.

Spillages should be cleaned up immediately, with a floor sign if the floor is still
damp. The therapist should have a good access to their trolley and any product
they are using. Dirty towels should always be placed in a covered bin after use on
each client.

If you are working in a salon, it is a legal requirement for employers to display an

approved health and safety poster or to supply employees with an equivalent
leaflet or information. If you employ 5 or more members of staff, it is law that you
provide a health and safety policy.

It is recommended that you get copies of the following from your local council:

Health and Safety in the Workplace

Trade Descriptions Act
Data Protection Act
Sales of Goods Act
COSSH Regulations and Risk Assessment (Control of Substances
Hazardous to Health)
Local Government (Miscellaneous Provisions) Act 1982
The Management of Health and Safety at Work Regulations 1992
The Workplace Regulations 1992
The Manual Handling Regulations 1992
The Personal Protective Equipment at Work Regulations 1992
The Health and Safety (Display Screen Equipment) Regulations 1992
The Electricity at Work Regulations 1992
Health and Safety (First Aid) Regulations 1981
RIDDOR – The Reporting of Injuries, Diseases & Dangerous Occurrences
Regulations 1995
Fire Precautions (Workplace) Regulations 1997
Consumer Protection Act 1987.

All businesses are required by law to comply with the following health and safety
acts, which are monitored and managed by The Health & Safety Executive (HSE)
www.hse.gov.uk

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Health and Safety at Work Act 1974
This protects your rights either as an employer or employee. The law states
that the employer must provide a safe working environment, provide
health and safety training for staff, produce a written policy of the
company’s health and safety policy, and ensure that anyone on their
premises is not exposed to any health or safety risks.

Trade Descriptions Act 1972

This act is particularly relevant to therapists as it relates to how the goods
or services are described in any kind of advertising or promotional
material. The act makes it illegal to mislead the public in any way or make
any false claims about what you are able to do.

Data Protection Act 1984

This is only relevant if you are storing information about your clients on a
computer. If so, you must register your business on the Data Protection
register.

Sale of Goods Act 1994

This act protects your clients’ rights by insisting that any goods or services
sold must be of a satisfactory standard, be suitable for the purpose
described, accurately described, and provided in a reasonable time and for
a reasonable price.

Control of Substances Hazardous to Health Act (COSHH) 1989

This act provides guidance on dealing with chemical substances that could
enter the body and cause skin irritations, allergies, burns etc.

Local Government (Miscellaneous Provisions) Act 1982

The local authority is responsible for registering and licensing any
businesses where invasive treatments, i.e. body piercing, epilation,
acupuncture take place on the premises. This is to ensure that all
equipment is sterilised, only fully qualified therapists are carrying out the
treatments, waste products (especially needles) are disposed of correctly.

The Management of Health & Safety at Work Regulations 1992

This act outlines the responsibilities of the owner/manager of the business
to protect the well-being of all who visit the premises, to keep a record of
all checks they have made and also of any first aid treatments carried out
on their premises.

The Workplace Regulations 1992

These regulations govern the appearance of all parts of the workplace, not
just the treatment rooms. This would include suitable toilet facilities which
are kept clean and tidy with adequate soap, towels, hot & cold running
water etc. Proper ventilation, the areas are well lit, the area is at a
comfortable temperature, is clear of all waste material (keep the walk ways

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 clear of clutter), has up to date fire fighting equipment, has drinking water
available.

The Manual Handling Regulations 1992

This relates to the appropriate posture when lifting to reduce the risk of
injury and to safely carry out manual tasks required in the workplace.

The Personal Protective Equipment at Work Regulations 1992

This act requires you to provide the correct safety/protective equipment to
carry out a particular task.

The Health & Safety (Display Screen Equipment) Regulations 1992

These regulations are relevant to anyone using a computer and require you
to get regular eye tests, take regular breaks, and use the correct height
adjusted chair.

The Electricity at Work Regulations 1992

This governs the use of electrical equipment in the workplace and ensures
that any equipment is checked at least once a year by a qualified
electrician. Any faulty equipment is removed from service, and written
records are kept should an inspector wish to see them.

Health and Safety (First Aid) Regulations 1981

No matter how small your business is there must be first aid treatment
available should an injury take place.

RIDDOR – The Reporting of Injuries, Diseases & Dangerous

Occurrences Regulations 1995
This outlines the correct procedure to adopt if a workplace accident
occurs. An accident book is a must.

Fire Precautions (Workplace) Regulations 1997

This ensures that the safety of all those present is considered and planned
for should a fire take place.

Consumer Protection Act 1987

This is designed to look after your clients’ interests and protect them from
any product deemed unsafe.

Reporting Accidents
The reporting of all accidents and near misses should be recorded in the Accident
Book, which should be kept with a first aid kit on the work premises.

The following information should be recorded:

Full name and address of the person(s) involved in the accident.

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Circumstances of the accident.
Date and time of the accident.
All details of what may have contributed to the accident.

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Salon/Treatment Area Hygiene

Clean the salon thoroughly, daily.

Clean the treatment area before and after every client.
Use clean fresh smelling towels for each client, (dirty linen must be
laundered at a minimum of 60◦C).
Creams, lotion and sprays should be dispensed from purpose-specific
pump or spray bottles where possible, otherwise use a clean disposable
spatula to remove products from bottles/jars.
Replace all lids after removing products from the bottles/jars.
Sterilise all tools.
Empty bins and dispose of contents accordingly.
Check all the plugs and wires on electrical equipment and make sure they
conform to British Standards, and are professionally checked annually.
Make sure all fire exits are clear and accessible.
Make sure your client’s personal belongings are safe.
Protect client’s clothing by using towels. The towels may also be used to
preserve the client’s modesty during the treatment.
Read all labels and follow all manufacturer’s instructions.
Know the hazardous warning signs.
Store products safely and in accordance with safety data sheets.
Report any faulty equipment/goods to your supervisor or supplier.
Have a first aid kit that complies with the Health and Safety (First Aid)
Regulations 1981.

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Sterilising Equipment

Micro-organisms that may cause disease must be controlled through cleaning,

disinfection or sterilisation.

Sanitation
This greatly reduces the number of pathogenic bacteria. It is the lowest form of
decontamination and is safe to use on the skin. This process will remove soil,
dust, dirt and organic matter along with a large proportion of micro-organisms
from an object.

Sanitation/cleaning is essential before disinfection or sterilisation of instruments

and equipment. This process can be carried out by applying sanitising sprays,
soaps and gels directly onto the skin and equipment.

Disinfection
This greatly reduces the pathogenic bacteria on work surfaces. This method is
not suitable for the skin, hair or nails.

Disinfection is used on floors, any work surfaces/station, walls and bowls etc.
This process does not remove bacteria spores.

Sterilisation
This process kills all living organisms; sterile, in this context, means free living
disease-causing micro-organisms and their spores. This is a difficult process to
maintain but should be carried out on all tools, especially if they have been in
contact with blood.

Several ways to sterilise the equipment:

UV light
An enclosed steel cabinet that emits UV light when closed to kill off any
bacteria

Autoclave
This works in a similar way to a pressure cooker by heating the water
under pressure to a temperature of 100°C, which kills all germs, and is one
of the most efficient methods.

Barbicide
This is a liquid used to soak instruments; ammonia can be used as the
liquid within the barbicide.

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 Carrying out a Risk Assessment

There is a legal requirement to provide a safe environment for staff and clients
who may be using your premises. Carrying out a risk assessment will identify any
hazards that could potentially cause harm. It is important that risks (hazards
that are likely to cause harm) are minimised and that all staff are trained in the
event of an accident. There are some potential salon hazards that will require a
regular risk assessment, such as the space, any equipment and the security of
people and money. This should be carried out by a nominated person/team, who
will determine the severity of risk and put measures in place to reduce or prevent
risks. Any chemicals that are being used should follow a procedure where they
are stored, handled, and disposed of correctly, with accurate up to date records of
which chemicals are being used.

Systems should be reviewed regularly and updated if necessary and all staff, new
and existing should be provided with up-to-date training on emergency
procedures.

Health and safety should not be the responsibility of “someone else”. Everyone
has an obligation to support and protect each other. Records should be kept up-
to-date, and spot checks should be carried out regularly. Staff should be
supported and encouraged to give feedback to management and provide
suggestions on improvements. By having an “open door” policy, suggestions can
be made on ways to continually improve the safety for everyone.

If there is ever a security breach, then the salon manager/owner must be

informed, and then the salon procedure should be followed, which could involve
witness statements, calling the police, notifying the data protection registry if
applicable and also clients of the security breach.

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 5. PROFESSIONAL ETHICS & STANDARDS
OF PRACTICE

A Therapist should:

maintain the highest standard of professional conduct.

provide services in an ethical and professional manner in relation to
clientele, business associates, health care professionals and the public.
practice within the professional boundaries of the practitioners training.
ensure client comfort and safety.
protect client privacy.
respect client confidentiality.
maintain anonymity of the client when discussing the client’s case with
other professionals, unless written consent is obtained.
have adequate professional insurance.
never claim to cure a condition.
never treat a client with a condition that is contra-indicated to the
treatment.
keep all records of treatments complete and up to date.
explain the treatment and answer any questions and queries prior to
carrying out the treatment on the client.
never treat a minor or disabled person without prior consent from a parent
or carer.
treat all clients in a professional manner at all times regardless of their
colour, sex or religion.
refer clients to other professionals/GP where required.

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Standards of Practice

The practice of good ethics is essential to the reputation of the field of beauty
therapists and the welfare of the clients and practitioners of the therapies. The
following is a statement of standards and ethics for therapists, including
standards of ethical and proper behaviour.

A Therapist should:

conduct herself/himself in a professional, honest, and ethical manner.

promote professionalism.
establish goals with each client and evaluate the outcome at the end of
each session.
promote the therapies within the community.
promote therapies with healthcare professionals and other practitioners.
truthfully and accurately represent their credentials, qualifications,
education, experience, training and competence relevant to the practice.
maintain confidentiality of the client.
undertake continual professional development to enhance their skills.

A Therapist will:

take a full medical history on the client's first visit.

discuss and record any health problems, contra-indications, symptoms or
diagnosis from a conventional medical practitioner.
use this information to decide whether treatment is suitable for the client.
explain the treatment to the client.
give a full and professional treatment.
give full and correct aftercare advice.
write up full details of the treatment on the client's record card.
on the client's next visit, discuss and record any changes that they may
have noticed in their symptoms.
refer the client to their GP if necessary.

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Skills and Personal Qualities

A Therapist should:

be comfortable touching people.

be a good communicator, able to explain treatments to clients and ask
appropriate questions.
have good listening skills.
be able to make clients feel relaxed and comfortable.
have empathy with clients.
be able to respect professional boundaries.
know when to advise clients to seek conventional medical advice.
keep accurate written records.
respect confidentiality.
have business skills if they are self-employed.

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 6. RELATED ANATOMY & PHYSIOLOGY

THE EAR AND ITS FUNCTION

Our ears do more than just allow us to hear. They also help us to keep our
balance, and it’s not until we have an ear infection or blocked ears that we
appreciate this.

The ear is made up of three main sections; the outer-ear, middle-ear and inner-
ear. Each part has its own function.

The outer-ear is made up of the pinna, which basically acts as antennae for
collecting and trapping soundwaves. This is the part of the ear we can see, and is
made up of cartilage and soft tissue.

From here, soundwaves travel along the auditory canal, which is about an inch in
length and diameter, into the middle-ear. Here, the soundwaves strike the ear
drum (tympanic membrane), which causes the eardrum to vibrate and pass the
vibrations onto the three smallest bones in the body; the ear ossicles. These
ossicles then allow the sound to be changed to a mechanical vibration, which is
amplified and sent into the inner-ear, where the cochlea is found.

Alongside the cochlea are the semi-circular canals which control our balance.
The cochlea is a fluid-filled organ which contains sensory hearing cells that
changes the sound from mechanical vibration into electrical impulses.

Travelling along the auditory nerve, the impulses are then sent to the brain,
which then allows the brain to make sense of what it is we have heard.

The Eustachian tube is an important part of the ear when it comes to carrying out
this treatment. The tube runs from the front wall of the middle ear down to the
back of the nose and throat. Its main function is to provide ventilation and access
to the air outside, as well as to equalise the air pressure on both sides of the
eardrum. Children are more prone to ear infections, and also a condition called
glue ear, because their Eustachian tube is shorter and narrower than an adults.

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THE SKIN

The Skin Structure

Skin makes up around 12% of an adult’s body weight. It’s very adaptable and able
to mould into different shapes, covering bones and muscles to perform various
functions of the body’s make up.

The functions of skin (Shapes) are:

Sensation - Main sensory organ for temperature, pressure, touch and pain.
Heat Regulation - Regulates the body temperature by sweating to cool the
body down when it overheats, and shivering when the body is cold.
Absorption – Some creams, essential oils and some medication can be
absorbed through the skin.
Protection – Too much UV light may harm the skin, so the skin protects
itself by producing a pigment, seen in a tan, called melanin. Bacteria and
germs are prevented from entering the skin by a protective barrier called
the Acid Mantle. This barrier also helps protect against moisture loss.
Excretion – Waste products and toxins are eliminated from the body
through the sweat glands.
Secretion – Sebum and sweat are secreted onto the skin’s surface. The
sebum keeps the skin lubricated and soft and the sweat combines with the
sebum to form the acid mantle.
Vitamin D production - Absorption of UV rays from the sun helps
formation of vitamin D, which the body needs for the formation of strong
bones and good eyesight.

There are 3 major layers of the skin, the Epidermis, Dermis and the
Subcutaneous.

The Epidermis Layer

The outermost layer of the skin is called the epidermis layer. There are no blood
vessels in the epidermis but it’s the deepest layer and is supplied with lymph
fluid. It is thickest in the palms and on the bottom of the feet.

There are various layers of cells within the epidermis, the outermost of which is
called the stratum corneum (or horny layer). The layers can be seen clearly in
the diagram of the skin. The surface layer is composed of twenty-five to thirty
sub-layers of flattened scale-like cells, which are continually being cast off by
friction and replaced by the cells of the deeper epidermal layers.

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The surface layer is considered the real protective layer of the skin. The cells are
commonly called keratinised cells because the living matter within the cell
(termed protoplasm) is changed to a protein (keratin) which helps to give the
skin its protective properties.

New skin cells are formed in the deepest layer within the epidermis. This area is
called the stratum basale (or basal/germinative layer). The new cells will
gradually move towards the outer layers of the skin as the stratum corneum is
shed. The new cells gradually change in form as they move upward to the outer
layers, becoming keratinized in the process.

Names of the Layers of the Epidermis

English Name Latin Name

Horny Layer Stratum Corneum
Clear Layer Stratum Lucidum
Granular Layer Stratum Granulosum
Prickle Cell Layer Stratum Spinosum
Basal/Germinative Layer Stratum Basale

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The Dermis Layer
The dermis is a tough and elastic layer containing white fibrous tissue interlaced
with yellow elastic fibres.

Many structures are embedded in the dermis including:

blood vessels
lymphatic capillaries and vessels
sweat glands and their ducts
sebaceous glands
sensory nerve endings
the erector pili - involuntary muscles are sometimes activated in cold
weather to give 'goose bumps’
hair follicles, hair bulbs and hair roots.

The Subcutaneous Layer

This is the deepest of the layers of skin and is located on the bottom of the skin
diagram. It connects or binds the dermis above it to the underlying organs. The
subcutaneous layer is mainly composed of loose fibrous connective tissue and fat
(adipose) cells interlaced with blood vessels. The hypodermis (subcutaneous
layer) is generally about 8% thicker in females than in males. The main functions
of the hypodermis are insulation, storage of lipids, cushioning of the body and
temperature regulation.

Diagram of the Skin

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FACIAL MUSCLES
The face has several relevant muscles. Below is a chart of their names, position
and action.

Name Position Action

Frontalis Upper part of the Elevates eyebrows; draws the scalp
cranium forwards
Corrugator Inner corner of Draws eyebrows together (frowning)
eyebrows
Procerus Top of nose between Depresses the eyebrows (forms
eyebrows wrinkles over bridge of nose)
Orbicularis Surrounds the eye Closes the eye (blinking)
Oculi
Nasalis Over the front of nose Compresses nose (causing wrinkles)
Temporalis Runs downs the side of Aids chewing; closes mouth
face towards jaw
Masseter Runs down and back to Lifts the jaw; gives strength for
the angle of the jaw biting (clenches the teeth)
Buccinator Forms most of the Puffs out cheeks when blowing;
cheek and gives it keeps food in mouth when chewing
shape
Risorius Lower cheek Pulls back angles of the mouth
(smiling)
Zygomaticus Runs down the cheek Pulls corner of the month upwards
towards the corner of and sideways
the mouth
Quadratus labii Runs upward from the Lifts the upper lip; helps open the
superiorus upper lip mouth
Orbicularis Surrounds the lip and Closes the mouth; pushes lips
Oris forms the mouth forwards
Mentalis Forms the chin Lifts the chin; moves the lower lip
outwards
Triangularis Corner of the lower lip, Pulls the corner of the chin down
extends over the chin
Platysma Front of throat Pulls down the lower jaw; angles the
mouth
Sterno – Either side of the neck Pulls head down to shoulders;
mastoid rotates head to side; pulls chin onto
chest

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Diagram of some of the Facial Muscles

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SINUS CAVITIES

There are four pairs of sinus cavities that are in the facial part of the skull, and it
is possible for them to become blocked or infected.

One of the main functions of the sinus cavity is to trap dust from the air, but they
also add resonance to the voice. The mucus that the sinuses produce is required
for cleaning the membranes of the nose and throat. When the cavities become
blocked the area is very painful, producing tightness behind the eyes and ears.

The cavities are found below the eyes (maxillary), above the eyes (frontal),
between the eyes (ethmoid) and further above the eyes (sphenoid).

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BONES OF THE SKULL & FACE
The adult skull is usually made up of 22 bones. Many of them are small bones
that make up larger ones. The most significant to you are:

Name Position
Frontal Makes up your forehead and also the roof of your eye sockets;
joins with the parietal and temporal bones
Parietal Forms the roof and sides of the cranium
Occipital Situated at the back of the cranium
Temporal Situated on both sides of the cranium
Sphenoid Located at the front of the temples; contains a sinus cavity and
houses the pituitary gland
Ethmoid Forms the roof of the nasal passage
Nasal Forms the bridge of the nose
Lacrimal The most fragile bone of the face and is part of the eye socket
Maxilla Forms the upper jaw and is the largest facial bone
Mandible Forms the lower jaw and is the strongest of the skull
Zygomatic Forms the angle of the cheeks

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THE CIRCULATORY SYSTEM

The circulatory system is the system that is involved with passing vital substances
around the body in order for cells to survive. Blood is pumped by the heart; a
fist-sized muscular structure, to every cell in the body via a complex network of
vessels. These vessels consist of arteries, veins and capillaries and carry blood
around the body delivering nutrients, oxygen, heat, hormones and removing
carbon dioxide and waste.

The heart consists of four chambers, i.e. a right and left atrium, and a right and
left ventricle. It is separated by a septum, which prevents oxygenated and
deoxygenated blood from meeting. Deoxygenated blood enters the right side of
the heart and is pumped to the lungs where the deoxygenated blood is removed
and replaced with oxygen. Here the richly oxygenated blood is returned to the
heart in order for it to be pumped around the body.

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THE RESPIRATORY SYSTEM
The respiratory system is the system that deals with breathing and supplying
blood with oxygen, but also has many other functions, including:

filtering and cleaning the air we breathe

adding resonance to our voice.

The respiratory system consists of many organs that work together to allow gas
exchange to take place. This system works in conjunction with the circulatory
system.

The respiratory system consists of the:

Nose
Larynx
Pharynx (throat)
Trachea
Lungs
Bronchi
Bronchioles
Alveoli
Diaphragm.

Air is sucked into the body via the nose or mouth where it is cleaned of unwanted
dust. It is then passed to the back of the pharynx and into the trachea where it
travels into the divided bronchi which lead to the alveoli via the bronchioles.
Here, in the alveoli, gas exchange takes place.

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THE LYMPHATIC SYSTEM

The lymphatic system consists of organs, ducts, and nodes. It transports a watery
clear fluid called lymph. This fluid distributes immune cells and other factors
throughout the body. It also interacts with the blood circulatory system to drain
fluid from cells and tissues. The lymphatic system contains immune cells called
lymphocytes, which protect the body against antigens (viruses, bacteria, etc.) that
invade the body.

Main functions are:

to collect and return interstitial fluid, including plasma protein, to the

blood, and thus help maintain fluid balance.
to defend the body against disease by producing lymphocytes.
to absorb lipids from the intestine and transport them to the blood.

Lymph organs include the bone marrow, lymph nodes, spleen, and thymus.
Precursor cells in the bone marrow produce lymphocytes. B-lymphocytes (B-
cells) mature in the bone marrow. T-lymphocytes (T-cells) mature in the thymus
gland.

Besides providing a home for lymphocytes (B-cells and T-cells), the ducts of the
lymphatic system provide transportation for proteins, fats, and other substances
in a medium called lymph.

Lymph nodes are bean-shaped and range in size from a few millimeters to about
1-2 cm in their normal state. They may become enlarged due to a tumor or
infection. White blood cells are located within honeycomb structures of the
lymph nodes. Lymph nodes are enlarged when the body is infected.

Lymph means clear water and it is basically the fluid and protein that has been
squeezed out of the blood (i.e. blood plasma). The lymph is drained from the
tissue in microscopic blind-ended vessels called lymph capillaries.

The diagram on the next page shows the lymph nodes in the head.

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 Lymph Nodes of the Head

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 7. CLIENT CONSULTATION

A consultation should always be carried out with your client on the first
treatment, and should be a working document, being added to when
circumstances change. The consultation will take many forms, one of which is a
written document in the style of a medical questionnaire that you can carry out
with your client. Here you will find out important and confidential information
that will help you and your client devise the best treatment plan.

Consultation will cover:-

Introduction
Personal details
Medication
Allergies
Contra-indication/contra-actions
Reasons for treatment
Products used
After care advice
Next appointment/recommendations

Verbal and written communication is not the only form to take place, but body
language will play an important role. The client may be fearful or not know what
to expect on a first treatment, so you will be able to pick up their true feelings by
paying careful attention to their body language.

First impressions count, as a therapist you must be:-

Friendly
Happy/smiley/approachable
Confident in yourself and your knowledge of the treatment
Give confidence to your client

As well as completing the consultation form, you will also carry out a visual and
manual consultation with your clients.

You must keep all your client records for future treatments. They must be
confidential and kept in a locked cabinet, to ensure you follow the Data
Protection Act, and for at least five years, after that they can be shredded safely.

It is essential clients feel secure with the confidential information that they
divulge to you as it could be of a sensitive nature. All clients have access to their
own records and can ask to see them at any time.

Treatment cards should be kept up-to-date, stating the treatment carried out,
date and any product that you have used.

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Always ensure you encourage your clients to give you feedback on your
treatments. This can be done in many ways, such as suggestion boxes,
anonymous questionnaires or on the consultation form. Make sure you act upon
feedback that has been given to you, which will improve the client satisfaction, as
well as repeat business.

If a client does feel the need to complain, always act in a professional and
courteous manner, and refer to the salon manager if applicable. If you are
working as a self employed therapist, you have the option to offer another
treatment at a reduced price. Ensure you record the complaint promptly and
how you resolved it.

By carrying out feedback, you can then reflect upon your own practice and learn
how to improve the service that you offer. You could carry out peer observations
on your colleagues (even if self employed) and learn assess your own strengths,
weaknesses and opportunities.

Record Keeping
Records must be maintained for a number of reasons:
They provide contact details in case you have to alter or cancel an
appointment.
So that you can monitor the client’s progression.
To track any aftercare advice that you have given the client.
As a backup in case the client has an adverse reaction to a treatment.
Another therapist should be aware of what treatments and products the
client has had.

Client records can be stored electronically or filed manually and should be

updated at every visit. If record cards are not updated and do not contain a
history of services and dates, you may find your insurance invalidated.

Records cards must be kept for three years, as medical claims can be made up for
up to that period. If a client is under 21 years of age, it is recommended that their
record card be kept until they are 21 years of age.

Client confidentiality must be protected at all times. If a salon holds

computerised records, they must register with the Data Protection Register. If a
salon only holds written records, this does not apply, but they must uphold the
principles of the Data Protection Act and comply with the following:

All info information must be accurate and necessary to the service or

treatment to be performed.
Individual client records must be available for the clients to view if
requested.

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 All information must be stored securely by password protected computer
file.

Any contra-indications and possible contra-actions must be identified and

discussed prior to the service. In the case of medical referral, the practitioner
should keep a copy of the GP’s letter with the client’s record card.

Always allow the client the opportunity to question and clarify any points before
signing the record card.

On the following pages are examples of consultation forms which you can adapt
to suit you.

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 Private & Confidential Client Consultation Form
Client Details
Client Ref: Telephone Number:
Address: Mobile Number:
Occupation:
Postcode: Date of Birth:
Email: Gender:

Medical History
Do you or have you ever suffered from:
High/Low BP yes/no Perforated eardrum yes/no
Headache/migraine yes/no Ear grommet(s) yes/no
Earache yes/no Cochlea implant(s) yes/no
Tinnitus yes/no Infectious condition yes/no
Glue ear yes/no Eczema/dermatitis yes/no
Excess/compacted wax yes/no High temperature yes/no
Catarrh yes/no Toothache yes/no
Hay fever yes/no Recent head/neck injury yes/no
Cold yes/no Under influence of drugs/alcohol yes/no
Sore throat yes/no Recent operation/scar tissue yes/no
Snoring yes/no Cysts/lumps yes/no
Pressure problems yes/no Are you pregnant? yes/no
Ménière’s disease yes/no yes/no
Allergies: Phobias:
What therapies have you experienced to date?

GP Referral Required? GP Name:

Practice Name: Telephone Number:
Address:

General Health / Lifestyle

General Health:
Energy Levels:
Stress Levels:
Sleeping Patterns: Hours per day:
General Diet:

Alcohol: …… units per week Water: …… litres per day Smoker: Yes/No …… per day
Hobbies, relaxation and exercise (type/frequency):

Additional Comments:

CLIENT STATEMENT & AGREEMENT

I acknowledge that all the information on this consultation sheet above my signature is accurate
and correct to the best of my knowledge. I accept full and complete responsibility for my own
emotional and/or physical well being both during and after this therapy and/or training session. I
agree to inform the therapist of any changes to my circumstances during any subsequent
treatments. I realise that any advice given to me to carry out between sessions is important and I
agree to make every effort to carry this out. I understand that no claim to cure has been made and
realize that treatments should not replace conventional treatments.

Signed: (Client) Date:

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 Private & Confidential Client Treatment Record
Client Ref: ………………………………………….

Date: Treatment:

Comments:

Have there been any changes to your circumstances, medication and general health since your last
treatment?

Client declaration: I declare that the information I have given is correct and to the best of my
knowledge I can undertake treatments without any adverse effect. I have been fully informed
about contra-indications and I am therefore willing to proceed with treatment.
Signed (Client): Date:

Date: Treatment:

Comments:

Have there been any changes to your circumstances, medication and general health since your last
treatment?

Client declaration: I declare that the information I have given is correct and to the best of my
knowledge I can undertake treatments without any adverse effect. I have been fully informed
about contra-indications and I am therefore willing to proceed with treatment.
Signed (Client): Date:

Date: Treatment:

Comments:

Have there been any changes to your circumstances, medication and general health since your last
treatment?

Client declaration: I declare that the information I have given is correct and to the best of my
knowledge I can undertake treatments without any adverse effect. I have been fully informed
about contra-indications and I am therefore willing to proceed with treatment.
Signed (Client): Date:

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 8. CONTRA-INDICATIONS

As with any therapy, it is essential that the therapist carries out an in-depth
consultation to be able to assess and determine if there are any contra –
indications. A contra-indication is the presence of a condition which may make
the client unsuitable for a treatment. The treatment may not be able to take place
or the treatment may need to be adapted.

When treating a client, if they show signs of any contra-indication prior to the
treatment taking place, then advise the client to get a letter from their GP,
granting permission for you to treat them. This way you are always protecting
yourself and the client.

There are certain conditions that will prevent treatment occurring, or require a
letter of approval from the clients GP. These are as follows:-

High/Low blood pressure – clients should have medical referral prior to

treatment, even if they are on medication. There is a risk of a thrombosis
(blood clot) which could travel to the brain.
Epilepsy – due to the complexity of the condition, medical advice should
always be sought before treating a client. There is a theoretical risk that
over stimulation or deep relaxation could provoke a convulsion (this has
never been proven in practice).
Undiagnosed lumps, bumps, swellings – the client should be referred to
their GP for a diagnosis. Treatments such as massage may increase the
susceptibility to damage in the area by the pressure and motion.
Intoxication – the increase in blood flow to the head can cause dizziness.
Allergies – ensure that any oils or products used do not contain substances
to which the client is allergic.
Perforated eardrum.
Grommets.
Cochlear implants – a type of hearing-aid implanted in the cochlea.
Infection of the outer/inner-ear.
High temperature/fever/heavy cold.
Auricular Cysts

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 Recent head or neck injury.
Pregnancy - it is advisable to avoid treatment during the first three
months. Some pregnant women may experience dizziness, so caution
should be taken after the treatment.
Children - Always have a parent present when treating, and you must have
a doctor’s referral letter.

The following conditions will require caution when treating:

Toothache
Serious medical conditions
Disorders of the nervous system
Recent operations/scar tissue
Bruising
Sunburn

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 9. CONTRA–ACTIONS

Contra-actions are adverse reactions a client may experience during or after a

treatment.

You must explain to your client what, if any, reactions to expect during/after a
treatment.

With all contra-actions tell your client that if they do not improve within 24 hours
to get in touch with their GP for advice.

Below is a list of what contra-actions that could occur during or after a Thermal
Auricular Therapy treatment:

crackling of excess wax

feeling of fullness in the ear
increased urination due to stimulation of circulation
increased thirst due to increased urination
increase or changes in bowel movement
headache due to the elimination of waste
increase in mucus from nasal passages as sinuses are draining following
facial massage
change in sleep pattern - usually better
increased appetite due to increase of metabolic rate
increased sensitivity in terms of emotions
feeling of tiredness, often leading to feeling revitalised
relief of stress and tension in muscles and joints
temporarily impaired hearing.

It is important to explain that these symptoms are part of the healing process,
sometimes called a “healing crisis”. The symptoms will pass and are an evident
sign that the treatment has been beneficial.

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 10. AFTERCARE

It is very important to give your client clear instructions about what to expect and
what to do at home in order to get the best from their treatments. This will help
prolong the effects of the treatment.

Explain to the client the following points:

drink plenty of water to aid flushing out toxins

avoid eating a large meal for several hours as the body needs energy for healing
avoid smoking
avoid alcohol, tea and coffee
rest
avoid swimming for two days
reduce dairy products, as they can cause excess mucus.

It is essential to emphasise the importance of aftercare.

Clients must be provided with clear written aftercare instructions to prevent

adverse reactions and know how to deal with them.

The client should sign to confirm that they will follow the aftercare regime and, if
they are unwilling to do so, the treatment should not be carried out.

It is always good practice to give your clients a leaflet explaining the advice, this
way you make sure they know and understand what to expect.

Finally, ask the clients for feedback on the treatment; fill in their record card on
your findings and ask when they would like to rebook.

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 11. EQUIPMENT & PRODUCTS

It is advisable to use a massage couch for both comfort to your client and
yourself. It is wise to get a couch that can be height adjusted for the sake of your
back and one that allows you to sit comfortably with your legs underneath it.

Check the location of fire alarms as some candles may trigger them off

Have everything ready before you start the treatment. All items should be in easy
reach and on a clean trolley.

You will need:

one pair of filtered ear candles or cones

a lighter/matches to light the candle
a bowl of water in which to extinguish the ear candles after use
cotton buds to gently wipe away any powder residue
tissues
a cloth, such as flannel or muslin with a hole for the ear, to protect clothing
massage oil
a clock to time candle burning
a bolster to place between the client’s knees
a blanket to keep the client warm
consultation form and pen
drinking water and a glass.

Gentle music is not necessary as it can overload the senses and distract from the
pleasant sound of the candle burning, but lights should be dimmed if possible.

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 12. STORAGE & INSURANCE

STORAGE
Make sure you receive a copy of Material Safety Data Sheets (MSDS) from your
suppliers. All staff must be trained on the use of products and equipment.
Training manuals and information leaflets should be accessible to all staff.

Store your products correctly by following the guidance on the MSDS.

Carry out a risk assessment on each product or COSHH report if required.

Keep products in original containers where possible and ensure any decanted
products are fully labelled in smaller, purpose built containers.

Keep all flammable products out of direct sunlight and at room temperature or
below.

Mobile therapists must make suitable travel arrangements to avoid spillage and
ensure safe working practice, and be professional in appearance.

INSURANCE
There are several types of insurance that are potentially relevant to you as a
therapist. The most important are the ‘Professional Indemnity Insurance’ and
‘Public Liability Insurance’. Both of these are necessary in the unlikely event that
a client decided to sue you.

Public Liability Insurance - This covers you if a member of the public, i.e. a
client or passerby is injured on your premises or if their personal property
is damaged in any way.

Professional Indemnity Insurance - This protects you should a client

decide to sue you claiming personal injury or damage as a result of
treatments carried out by you.

Employer’s Liability Insurance - This is only necessary if you hire others to

work for you. This type of insurance would cover you should a member of
your staff have an injury on your premises.

Product Liability Insurance - This insurance is important if you plan to

use, manufacture or sell products as part of your business. This will
protect you in the event that a client is dissatisfied with the product or
experiences a reaction to using the product.

Car Insurance - If a car is used for business purposes, ensure that this is
covered by the policy and that theft of equipment is included.

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 13. THE ROUTINE

The full procedure should take around 40 -45 minutes

The room should already have been prepared in advance with all
equipment to hand.
Carry out a full consultation.
Ask the client to lie on their back, with a pillow if necessary for comfort.

Step One - Initial Grounding (approx 6 minutes)

1. Place both hands lightly on the client’s crown chakra (top of head). Take a
few deep breaths, and ask your client to take a few deep breaths.
2. Move your hands down and place lightly over the client’s ear, and hold for
a few moments.
3. Move your hands back to the crown chakra and leave for a few more
moments, breathing deeply and slowly.

Step Two – Stimulation of Face Pressure Points (approx 10 minutes)

Ear candling treatments can be enhanced by the pressure points.

Please follow the points on the separate diagram.

Step Three – Ear Candle Application (approx 20 minutes)

1. Look inside the ear for any obstructions, and place the cloth over the ear.
2. Light the candle away from the client and place gently into auditory canal,
with the candle seam facing towards the client’s face.
3. Holding the candle gently between your fingers, keep it as upright as
possible. The client will experience a warmth, but also crackling
sensation.
4. Keep the candle in place until it has burnt down to about 1cm above the
label, which is about 2/3rds down.
5. Remove the candle and extinguish it in a glass of water.
6. Very gently, clean around the outside of the canal using a bud. Never push
the bud into the ear.
7. Ask the client to turn over and repeat the procedure with the other ear.
8. Allow the client to lie back, and then massage up the back of the ear. Pull
and stretch the ear, massage down the front of the ear towards the neck
with the oil.

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Step Four –Stimulation of Face, Cranium & Neck (optional) (approx 10 minutes)

Ear candling treatments can be enhanced by massage of the face, neck, scalp and
ears, together with pressure points.

Please follow the points of the separate diagram which you will be issued with on
your practical training.

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 14. WHAT HAPPENS NEXT?

Once you have completed the course satisfactorily, you will be awarded The VTCT
Level 2 Award in Thermal Auricular Therapy.

The school is available for support and guidance during and after your training.
Further training or refresher sessions are available if required.

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 15. CONTACT DETAILS & RECOMMENDED
READING

CONTACT DETAILS
Principal : Tia Dowman

Address : 706 Delta Office Park

Welton Road
Swindon
Wiltshire
SN5 7XS

Telephone : 01793 73 77 33

Mobile : 07824 337333

email : [email protected]

Website : www.wsbht.co.uk

ESSENTIAL READING
Ear Candling in Essence
Lesley Hart & Mary Dalgleish
Hodder Arnold
ISBN 9780340926949
iro £14.99

Like us on Facebook or follow @wsbht on twitter

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 16. SELF ASSESSMENT

Do I have a good understanding of:

 Hygiene, health & safety □

 Basic anatomy and physiology □
 Contra-indications □
 Contra-actions □
 Equipment & products □
 Aftercare □
 Routine □

Can I:

 Set up my area □
 Complete a thorough consultation □
 Complete a thermal auricular therapy □
 Give aftercare advice □

Well done!

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 17. NOTES

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 19. ACCREDITATION

This course is accredited by:

VTCT
The Guild of Beauty Therapists
The Guild of Holistic Therapists
Professional Beauty Direct
Associated Beauty Therapists

WSBHT is registered with UKRPL

UK Register of Learning Providers No: 10027055

Medical Disclaimer
It is advised that you take medical advice if you or any of your clients have a
health problem. Any qualification from WSBHT will not qualify you to advise on
any medical condition or to diagnose a condition.

Liability
WSBHT will accept NO liability for any person for any type of loss or damage
whatsoever resulting from the use of materials within any course held by
WSBHT.

Copyright
All copyright and other intellectual property rights in these materials are owned
by or licensed by WSBHT. Copyright, adapting or other use of all or part of these
materials without written permission of WSBHT is strictly prohibited.

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