By Michelle D'Allaird

This article is excerpted from Les Nouvelles Esthétiques Magazine - American Edition.

Ahhhhhchoo! How many times has that happened to you when you’ve gotten a strong whiff of an essential oil during a facial or body service? Did you wash your hands before going back to your client? Did you wash your hands at all? Did you touch your table, counter, implements or jars? Or even worse, your client’s face?

So you didn’t use a tissue, so what? Well, let me tell you what: You’ve not only spread your germs, you may very well have lost a client. Now what about the floor—what’s lurking in the shadows? Dripping down the walls, piling up on the counter or brewing in the wax pot? (I’m sure you don’t double dip!) Not to mention the last time those sheets were changed!

Infection control
Here’s a news flash: Cleanliness is next to godliness in this industry. It is shocking that most spa professionals don’t know the difference between sanitation, disinfection and sterilization, but it’s true. I know you all learned about it, studied it and had to pass an exam on it, but what have you done with the information now that you are a tried-and-true “professional” and out in the real, unsanitary world?

Let’s begin with a simple review of infection control, levels of sanitation and universal precautions. Infection control refers to efforts that are used to prevent the spread of diseases and to kill microbes. It is truly amazing how easy it is to spread and breed bacteria in the esthetics environment. Bacteria grow in warm, damp, dark areas; they spread from hands, utensils, coughing, sneezing and touching skin. Take this simple scenario: you sneeze, cover your mouth, pick up your tweezers (contamination), scoop a product out of a jar (contamination, which will continue to grow) and mush it around your client’s face (more contamination). Simple infection control procedures include washing your hands, using hand sanitizer, wearing gloves and even wearing safety glasses or masks.

There are three levels of infection control that are expected practices in our business, but each one is different and must be adhered to. The first level of infection control is sanitation,the physical removal of debris and microbes. This includes washing with an antibacterial soap or detergent. It also pertains to washing your hands and pre-washing any reusable implements.

The second level of infection control is disinfection. This is the most frequently used level in our industry and involves destroying all bacteria and a wide spectrum of viruses, but it does not eliminate bacterial spores. In order to be effective, a disinfectant must be registered with the Environmental Protection Agency (EPA) as a disinfectant that is effective against HIV, HBV and tuberculosis. The use of an EPA-registered disinfectant is required for all surface areas, instruments and tools that may be exposed to blood.

The third and highest level of infection control is sterilization, which destroys all small organisms including bacterial spores. This is applied to any implement that is used for invasive procedures or to puncture the skin, including electrolysis needles and non-disposable lancets.

Taking universal precautions means following the same infection control guidelines with each client and every service. Doing so guarantees that you will always disinfect your treatment area, beds, countertops, implements and room in a particular manner, as well as consistently wear gloves and use disposable implements for extractions or any other potentially hazardous procedures.

Infection control considerations
There are many things to consider with infection control. Microbes, small, microscopic bacteria that live everywhere, in and around our bodies, can be harmless or harmful, depending on the type. Nonpathogenic bacteria are actually harmless and are found in medicine and even yogurt! Pathogenic bacteria, on the other hand, are disease-producing bacteria that are harmful and cause such things as papules and pustules and diseases such as strep throat, pneumonia, tetanus, tuberculosis and syphilis. They are most frequently spread through contaminated implements, dirty hands and fingernails.

Another issue to consider is whether or not to wear a glove when performing procedures on clients. What does your state say? Some states actually have specific guidelines pertaining to wearing gloves during esthetics procedures. Gloves must be worn during extractions, when working on acneic skin or whenever there is a chance of coming in contact with blood or bodily fluids.

Here’s a question for you: Should you sanitize, disinfect or sterilize? The answer? All of the above! Sanitation is a no-brainer—wash your hands, wash your implements and wash your linens. Disinfect everything that comes in contact with a client’s skin. Sterilize anything used to puncture the skin. This is one area in which we, as professional estheticians, can absolutely not cut corners. It is our responsibility to our clients and to ourselves to practice the prevention of the spread of disease. I once had a student make a comment that I thought was quite silly, until it sank in. She said, “Do you know how much bacteria enters the air when you flush the toilet with the seat up?” Ugh!

The easiest way to ensure that diseases are not being spread is by using as many disposable implements as possible. Cotton, sponges, lancets, tongue depressors, hair nets and QTips should be properly disposed of after each use.

Two life-threatening viruses that can be spread without proper infection control are HIV and HBV. Human Immunodeficiency Virus (HIV), the cause of AIDS, is a highly infectious virus that is spread through blood or bodily fluids. The Hepatitis B Virus is also a highly infectious disease that is spread through bodily fluids and affects the liver. Although the risk of becoming infected with either of these diseases is very small, it is a possibility when working so closely with the public and concentrating on caring for their skin. Preventive measures are a matter of longevity—yours and your clients.

Regulatory issues: EPA, OSHA and state boards
Local, state and government agencies go to great lengths to provide protection for the public, including for estheticians and spa professionals. There are times that limitations and guidelines may seem a bit excessive or petty, but remember, they’re for your protection also.

The Environmental Protection Agency (EPA) was created in 1970 to protect human health and the environment. It is responsible for approving the efficacy of infection control products and the claims that are made on their labels. The EPA provides each disinfecting product with a registration number that verifies its efficacy against HIV, HBV and tuberculosis.

The Occupational Safety and Health Administration (OSHA) was created in 1971 by the U.S. Department of Labor. Its goal is to ensure safety in the workplace for employees. OSHA regulates every aspect of the work environment from equipment safety, electrical safety, storage of supplies and possible toxic substances.

Each state licensing department also has its own guidelines pertaining to the license in which you practice under, whether it’s esthetics or cosmetology. State regulations will outline the required levels of sanitation for your work environment, linens and implements, as well as guidelines pertaining to particular practices such as lancets, electrolysis and permanent makeup. Don’t get caught practicing outside the scope of your license—it can ruin your business.

It is up to each and every one of us as personal service workers and skin care providers to ensure the safety and health of our clientele, as well as ourselves.

It could happen to you
Now that we have the nitty-gritty out of the way, let’s talk about what might be lurking in the crooks and crevices when you neglect proper infection control guidelines, even just once! Here are some horror stories of what could happen if you’re not careful.

Just a little herpes! I, for one, am very prone to cold sores, technically known as Herpes Simplex- 1. Knowing what I do about cold sores, I would never receive or perform any facial service during any stage of a breakout, but not everyone is me! I have seen many instances in which clients still come in for their facials and suggest that the esthetician “just avoid” the area. I have even seen instances in which estheticians did not want to give up a commission and performed the service anyway.

Imagine the possibilities: While cleansing, you accidentally touch the infected area on your client’s face. You then work the cleanser into the remainder of the skin, pick up your toner, scratch your eyelid and then turn on the faucet. Your next client arrives. You turn on the faucet, apply her cleanser, pick up the toner bottle, obtain some massage cream and perform the massage. The next day, your second client calls to cancel her afternoon makeup application, for her big first date, because she has an enormous cold sore on her face! Thank you very much!!

A tiny prick! After performing a great deal of extractions on a client with acneic skin, you decide to toss your lancets into the garbage—after all, they are disposable. Your coworker is gracious enough to help take out your garbage and pricks her hand with a used lancet that has punctured the bag. Should she be worried? Who knows; do you have a blood work on that client, and do you know what bacteria was harboring on that pus-covered lancet? Even disposable lancets should be properly discarded in a sharps container and removed from the premises by a medical waste company.

A big old hanky! I was observing a seasoned esthetician perform a facial on a regular client. While the esthetician was preparing the treatment mask, the client coughed and wiped her nose on the bed sheet. I exited the room before the client got dressed and returned shortly after with clean linens, only to find the bed neatly made up and ready for the next client. When the esthetician saw my handful of linens, she stated, “Oh, we reuse them a few times, it saves on laundry!” Well, little does the next client know that she is about to climb into a bed of bacteria.

When was the last time you disinfected your door handle? What about the telephone, the staff room faucet, the on/off switch to the wax pot, each of your product containers, the armrest of your bed or the computer’s keyboard? I know what you’re thinking, and it’s not a pretty picture.

It is up to each and every one of us as personal service workers and skin care providers to ensure the safety and health of our clientele, as well as ourselves. One little slip up can affect a whole lot of people. Many times, we are not even aware of the multitude of germs that we spread, but why not take every precautionary measure to ensure that your work environment and your practices are within the strictest infection control guidelines and standards? After all, it really is your responsibility.