September 2010

Lisa Kind - Editor

Esthetic Endeavors | by Judith Culp


Infection Control for Estheticians

By now, most of us have heard of community-acquired Methicillin-resistant Staphylococcus Aureus, also known as Ca-MRSA, a form of staph infection on the skin that is resistant to common antibiotics.

I wonder how many estheticians are aware that their work brings them close to its favorite places on the body to hide.

The highest concentrations of staph on the body are found in the nose, underarms and groin. Even an eye infection can be considered suspicious.

Most commonly, staph presents itself as a skin infection, rash, boils or pimples. Technicians with a suspicious rash should have it checked by a medical professional. If it is staph, it is contagious and they must follow their state guidelines about when they can return to work, and what special safety measures they must follow.

Transmission may be direct – person-to-person, or indirect – person to inanimate object and then to another person. To prevent introducing staph to the treatment room, clients with a suspicious rash should have it checked by a medical professional before any treatments are performed. Even if they want the treatment in a different area of the body from where the rash is, there is a risk they could touch or scratch the rash, and then touch a surface in the treatment room, depositing microorganisms.

If you get the client to the treatment room and then discover a suspicious rash, you need to use your best diplomatic skills and refer them to a physician for diagnosis. Then, thoroughly disinfect the room and any areas the client may have touched.

As a technician, your best protection is hand-washing. Always wash hands between clients and as frequently as necessary to prevent cross-contamination. While some people feel it is always best to use an antibacterial cleanser, the reality is that this is not true. The guidelines for these products recommend they not be used more frequently than once every 4-6 hours. If used more frequently, they destroy the skin’s natural protection and leave the hands more subject to dryness, irritation or infection.

We tried them in the clinic bathrooms, but within three days, everyone noticed their hands were becoming more irritated. We immediately replaced them with standard liquid hand cleanser. This is adequate for most uses outside the medical community. If you wash your hands frequently, it also makes sense to be applying a good lotion to help maintain / restore the natural barrier.

Wearing gloves is another key protective method, but it does not take the place of hand-washing following standard hand washing protocols.

If the facial client has a little bit of a runny nose – even if they think it is just their allergies, wearing gloves helps protect the technician from picking up any potential staph microorganisms onto their skin. Our skin may look intact, but over-washing, cuticle irritation, nicks and cuts from working in our home, kitchen or garden all leave portals of entry for microorganisms. Wear non-latex gloves and change them as frequently as needed to ensure infection control.

Some of the more popular areas to have waxed are also high staph zones. Wearing gloves can protect in the same way as just described. Some people think that wax cannot harbor germs, or that its warmth will kill those germs. Today’s waxes are applied in a temperature range between 99°F to about 120°F. This makes them more of a potential incubator. As we move to more botanical based products, the risk does not decrease. All botanicals have a natural decay potential because they are plant based. Decay is intrinsically linked to microorganisms.

There have been claims that waxing has no more risk of germ transmission than applying nail polish. However, there are inherent differences. Polish is applied to intact nails, not to exfoliated skin. When we wax, we remove layers of the stratum corneum along with the hair. Even if there is no apparent injury, we have stripped off the skin’s protective barrier and created a non-intact skin. It is what we cannot see that can be the problem. Wearing gloves for waxing just makes good sense.

The makeup counter is also an area where we need to be pro-active to prevent cross contamination. Cosmetics should never be directly applied to the client. The product should be decanted onto a work pallet that can be disinfected, or is disposable, and then applied to the client’s skin from the pallet. If you work with loose powders, use a small spatula to scoop some onto the pallet. If you work with pressed powders, use the spatula to gently scrape some of the product onto the pallet. For lipsticks, use the scrape technique and a gentle touch so you do not break the lipstick.

No products should be applied directly from their container, except mascara. For mascara or liquid liner, the wand that comes in the tube should be cut off. Instead, use disposable applicators and never re-insert them into the tube after touching the client. Sharpening pencils between clients is necessary to completely remove anything that may have come in contact with the client.

Many professional makeup schools are now teaching their students to do makeup wearing clear vinyl gloves. This allows them to use the warmth of a finger to blend things like concealer, without putting the technician’s oils onto the client’s face. The back of a gloved hand can make a lovely pallet to blend stiff camouflage creams or lipstick tones. It works extremely well and enhances infection control. If the bride has developed a last minute acne lesion but needs her makeup applied, wearing gloves reduces the risk of spreading microorganisms.

In addition to protecting our health and the health of our clients, infection control has the added bonus of showing our clients an extra level of caring. They like to see the steps we are taking to prevent problems from occurring, so do not hide what you are doing to ensure infection control. Instead, make it part of your marketing, showing you go the extra mile to care for your clients.

Judith Culp, a CIDESCO Diplomat has been in the esthetics industry since 1980. A CPCP permanent makeup technician for over 18 years she served a 4-year term as a Director for the Society of Permanent Cosmetic Professionals, two years as their president. She is president of Culp Enterprises Inc. and CEO of NW Institute of Esthetics. Judy Culp is available for consulting. For more information visit