Fifteen years ago, I was diagnosed with Hashimoto's Disease, which is an autoimmune disorder that affects your thyroid function.  It affects every aspect of my body because your thyroid controls all body processes.  Early on the first few symptoms were severe weight gain and then weight loss and then weight gain again (up to 80lbs in a month), my hair would fall out, my skin would dry up, and I'd have pregnancy mask-like hormonal skin changes. 

The skin changes were the worst.  Not only was I affected

skin-wise with the disease but food allergies and contact allergies from skin care products and over-zealous Estheticians made my skin WORSE.

Pregnancy did not help.  Especially this last one which has made me have severe fluctuations in my skin.  16 months after having my daughter, I am still dealing with major fluctuations in my thyroid hormones.  This causes some of the following symptoms to my skin:

Excessive dryness

Irritation

inability to determine temperatures (be careful with those hot towels)

sensitivity to touch, inability to tell reactions

hypersensitive to certain products

gluten sensitive (yes, it affects my skin too!)

Puffiness especially around my face (in case you cant tell by the my picture).  What helps with this is facial MASSAGE!!!

During a facial I might: 

fall soundly and deeply asleep even while talking.

jerk reaction (which is my body's defense against falling asleep to dead ;-)

Restless leg

snore excessively loudly (sleep apnea is a huge sign)

have odd responses to touch stimuli

excessive dry eye which makes opening and closing my eyes difficult.

Have what may appear as panic attacks (heart palpitations, sweating etc)

Have no sense of hot or cold.  One minute I'm freezing, the next sweating and hot.

So, after writing this, here's what I recommend that you do with clients who have thyroid issues:

Ask them about body temperature (sometimes just leaving their feet open helps)

Remind them to tell you if something is too hot or cold.  And ask after the first couple of hot towels.

Ask them about irritants.  Don't beat yourself up if something is irritating when you are working on a client with this disorder.  One day it will burn, the next nothing. Keep an eye on them while masking to make sure they are not reacting.

Dryness is a huge problem along with pigmentation problems.

Spend more time on facial massage.  It feels so darn good when you have all this puffiness.  Move those fat rolls around to really get in there and massage.

Don't forget! They are coming to you because they are having all kinds of skin issues and just want to feel better.  I do recommend a good moisturizing facial for sensitive skin.