Semi-Permanent Make Up - Brow Training 

Module Two

ALLERGIC REACTIONS & PIGMENT TESTING

Pigment skin testing is a procedure that consists of implanting a small amount of pigment into the skin to determine whether the client is allergic to the pigmentation selected for this procedure. Generally people do not have any reactions to the pigmentation however it can be possible. This is not a mandatory procedure. Technicians may want to consider a patch test if a client typically has reactions to the following:

  • Bacitracin 

  • Novocain, Lidocaine and Epinephrine 

  • Latex protein

  • Pigment

  • Needles

Bacitracin: A component of antibiotic ointments. Ask if they have any allergies to antibiotic ointments used at home. Novocain, Lidocaine and Epinephrine: Anesthetics that may cause reactions when used topically or given by injection. Ask if they have had any problems with aesthetics during any previous medical visits.

 

Latex protein: Found in latex gloves. It can cause immediate hives or a more delayed contact dermatitis. (we recommend using Nitrile gloves)

Pigment: The pigment may cause reactions because it is being embedded under the dermal layer of the skin.

Needles: Needles are made of metal. Needles that are made of Nickel and can cause an allergic reaction in clients who are allergic to this metal. Our main concern would be an allergic reaction to the implanted pigment. True signs of an allergic reaction to the pigment: Cracking, bleeding, swelling, bumps, dry skin, oozing pain, Itching skin, raised blisters, scabbing, burning, won't heal properly, tender to touch. 

 

ANESTHETICS

There are only a few topical anaesthetics available over the counter for our clients, these include, EMLA, LMX-4 and Ametop. These products are 'P' medicines, which mean Pharmacy Only Medicine, and should be given under direction of the pharmacist direct to the user (client). It was always believed that professionals could purchase topical anaesthetic for application on their clients prior to any invasive procedure. Over the last year, acquiring such products have proved more difficult as pharmacists refuse to sell to aesthetic practitioners.

 

Every council also have their own stance on the use of topical anaesthetics. Some are ok with us purchasing and using the product on our clients after a patch test, whilst others prefer the client to purchase and apply the product themselves. The MHRA also state that it is down to individual councils and our insurers to use the product safely and legally. However, the issue of using 'P' products only becomes an issue, when a client has a reaction or subsequently dies from the use of such.

 

So, what happens when a client presents with a reaction to a medical professional? The client is usually asked what they have had done or what they may have used recently on their skin. If they are directed to hospital, blood, urine and stool samples may also be taken. Local councils and MHRA do prosecute individuals where they have not complied with the law with devastating consequences to the therapist’s business. As an independent witness for local councils, I have witnessed first-hand the wrath of the councils when it comes to prosecution. Using illegal anaesthetics will land you horrendous fines (up to £20,000) and that’s before you are charged with negligence or grievous bodily harm. Using legal anaesthetics pose lesser risks but can still land you in hot water although following specific protocols can protect you and your business.

 

Can we use OTC (over the counter) topical anaesthetics legally? The law around this is simple, no we cannot. 'P' medicines should only be sold to the intended user. Whilst some councils and the MHRA turn a blind eye, it is a risk not worth taking. The best and safest solution is to speak to your client about pain tolerance and discomfort that may be associated with your treatment. If you have a prescriber, then they can prescribe cream specifically for them to use or the client can go and purchase this direct at their local pharmacy. The client should apply this to themselves 20-30 minutes prior to their appointment. The client should also sign to state that they purchased and applied the anaesthetic themselves and/or are happy for you to apply it, if it is for use on eyelids or other areas where they may struggle with the application.

 

For more information on the legal OTC anaesthetics please follow the below links:

 

Emla https://www.emla.co.uk/wp-content/uploads/2018/12/Emla-Cream-Patient-Information.pdf

 

LMX-4 http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con2033763.pdf

 

Illegal Anaesthetics

 

Illegal anaesthetics are often imported in and have had no clearance within the UK for their safety. Their ingredients are often unknown and can contain various compounded anaesthetics such as higher than permitted levels of Lidocaine, Tetracaine, Benzocaine, Prilocaine and Epinephrine (an adrenaline). TKTX cream for example can contain 5% Lidocaine, 5% Prilocaine and 1% epinephrine, however some TKTX creams contain even higher concentrations. Compared to the likes of Emla which contains just 2.5% Lidocaine & 2.5% Prilocaine and LMX-4 which contains just 4% Lidocaine, these are seriously strong products that could cause long term side effects. Other illegal brand names include, Dr Numb, NumQuick, Tag45, Sustain and Blue Ice to name just a few.

 

Not only are these high doses of anaesthetic illegal, so is the use of epinephrine, an adrenaline that is often added to help block nerve sensors as well as control blood flow through vasoconstriction. Epinephrine can be highly dangerous and even a small amount can cause long term or life-threatening issues for a client. Here are some reactions caused by the topical use of epinephrine:

INFECTION, PREVENTION, & MORE

 

PURPOSE

This document has been developed for public health inspectors to educate personal service workers to reduce the risk of transmission of blood borne and other types of infection for both clients and PSWs during the delivery of personal services. Percutaneous exposure (through penetration of skin) or mucous membrane exposure to blood or body fluids can lead to infection with blood-borne pathogens including Hepatitis B (HBV), Hepatitis C (HCV), Human Immunodeficiency Virus (HIV), other human retroviruses, bacteria and other pathogens of concern, such as mycobacteria. For this reason, infection prevention and control precautions must be taken in every personal service setting. It is the responsibility of the owner/operator to ensure all PSWs are educated in regards to infection control requirements specified in this protocol; both the client and the operator may be at risk of infection. It is important to recognize that blood and body fluids do not have to be visible on instruments or other surfaces for an infection to be transmitted.

 

NOTE: IT IS MANDATORY TO COMPLETE THE ONLINE INFECTION CONTROL COURSE BEFORE PERFORMING A LIVE PROCEDURE

 

HYGIENE & EQUIPMENT

Guidelines for the control of infections are needed to assist in developing policies and procedures to ensure an optimal level of care is provided. These guidelines should be seen as directing principles and indications or outlines of the expected practice. The goal of infection prevention and control is to provide service in a manner that reduces the risk of transmission of microorganisms to the client and the personal service worker. Service should be provided in a manner that prevents disease transmission. Infection prevention practices must be tailored to the services being provided. Routine Practices describe prevention and control strategies to be used with all clients during all service delivery and include: 

  • Face Protection

  • Hand Hygiene

  • Equipment & Environment

FACE PROTECTION

Face protection should be worn to protect mucous membranes of the eyes, nose and mouth during procedures likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. 

 

HAND HYGIENE

Hand hygiene should be performed: Between clients, before performing invasive procedures, after contact with blood, body fluids, secretions and excretions, after contact with items known or considered likely to be contaminated with blood, body fluids, secretions, or excretions. Immediately prior to and after removing gloves between procedures on the same client in which soiling of hands is likely, to avoid cross-contamination of body sites.When hands are visibly soiled, hands must be washed with soap and water. Alcohol-based hand rubs are an acceptable method of hand hygiene especially when access to hand washing facilities is limited. Gloves are not required for routine procedures in which contact is limited to a client's intact skin. Gloves are not a substitute for hand hygiene, clean, non-sterile gloves should be worn. For contact with blood, body fluids, secrerions and excretions, mucous membranes, or non-intact skin. When handling items visibly soiled with blood, body fluids, secrerions and excretions. When the PSW has non-intact skin on the hands. Gloves should be changed between procedures with the same clients and between clients. Gloves should be removed immediately after completion of the procedure, at the point of use and before touching clean environmental surfaces. Hand hygiene should be performed immediately after removing gloves. Single-use disposable gloves should not be reused or washed.

 

HAND HYGIENE

Articles that touch the client's intact skin should be clean, equipment touching mucous membranes or non-intact skin, should be appropriately disinfected between clients. Chairs, cabinets, counters and charts should be cleaned on a regular basis. Soiled client care equipment should be handled in a manner. That prevents exposure of skin and mucous membranes and contamination of clothing and the environment. Used needles and other sharp instruments should be handled with care to avoid injuries during disposal. Used sharp items should be disposed of in an approved sharps container located in the area where the sharps item are used. All equipment that is being used by more than one client must be cleaned or cleaned and disinfected or sterilized as appropriate between client according to recommendations. 

CLEANING STERILISING

Cleaning and sterilizing are crucial steps to preventing infection. There are 3 steps you need to know:

  • Cleaning

  • Disinfecting

  • Sterilizing

STEP 1

 

CLEANING SOLUTION

Any combination of soap (or detergent) and water, with or without a chemical disinfectant, used to wash or wipe down environmental surfaces such as floors, chairs, benches, walls and ceilings.

 

SANITIZER

Chemical the reduces the number of bacterial contaminants to safe levels on inanimate objects based on public health requirements. These are typically the anti-bacterial wipes . This is used on counter tops, sinks, doors and door knobs. 

 

DISINFECTANT

Chemical that destroys or inactivates microorganisms. Disinfectants are classified as low, intermediate, or high depending on their ability to kill or immobilize some, or all microorganisms. 

 

STERILANTS

Chemicals used to destroy all forms of microorganisms, including endospores. Most sterilants are also high level disinfectants when used for a shorter period of time. Sterilants are used only on inanimate objects that are used in semi critical and critical areas. Sterilants are not meant to be used for cleaning environmental surfaces.

STEP 2

The classification system first proposed by Dr. E. H. Spaulding divides medical devices into categories based on the risk of infection involved with their use. This classification system is widely accepted and is used by the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), epidemiologists, microbiologists, and professional medical organizations to help determine the degree of disinfection or sterilization required for various medical devices. Three categories of medical devices and their associated level of disinfection are recognized. Understanding what category your tools and or supplies far into, critical, semi-critical, and noncritical.

 

CRITICAL

A device that enters normally sterile tissue or comes in contact with blood body fluids. Such devices should be sterilized, which is defined as the destruction of all microbial life. Items such as implements, tattoo Needle , come-done extractors, surgical implements, etc.

 

SEMI-CRITICAL

A device that comes into contact with intact mucous membranes or non-contact skin. Tweezers, scissors, marking pens, electrodes 

 

NONCRITICAL

Devices that do not ordinarily touch the patient or touch only intact skin. These devices should be cleaned by low-level disinfection. Esthetic Beds, Counter tops, mag lamps, machinery.

STEP 3

When using cleaning, sanitizing, or disinfecting products ALWAYS Choose a product appropriate for the task. Keep a log book for Chemosterilants and MSDS safety sheets from the manufacturer. Follow the label instructions for mixing, using, and storing solutions. Read the warning labels. Clean soiled surfaces and items before using sanitizers or disinfectants Store these products safely out of reach of children. Choosing your method of cleaning, disinfecting and sterilizing and adhering strictly to the directions.

 

CLEANING & STERILISING WHEN IT COMES TO TATTOOING

Always use disposable drapery on bedding. Wipe your lights, bed, and counter tops down using a anti-bac wipe or Spray, to have a facial setup use disposable drapery at the head wipe or a Virucide, Bactericide, Fungicide, Tuberculocide, 30 of the bed Second Sanitiser Use a disposable head cap or head band as hair protection. Clean your microblading tool in warm, soapy water or an enzymatic implement wash. Let dry completely and have a pedal bin with a clean liner ready (or waste bag attached to your trolley), you will need easy access to throw away used items. If you are going to use an Auto Clav now would be the time not having to touch anything you insert your implement into a sterile pouch and follow the manufacturer guidelines. Use a sterile tray with a disposable paper on top to lay out. If you are using a chemical sterilant, follow the directions of your tools below. Keep your blade unopened until you are clean. Once you have washed and dried your tool, using clean gloves and ready to use it. With clean gloves to pick up your tool and insert it into a chemosterilant Keep your Microblading such as Virrox PreEmt CS20. Soak for the recommended tool in a sealed sterile amount of time (usually 20 mins) pouch until you are ready. Once completed again, using clean gloves rinse and dry to use it your tool free of any chemicals. Once you are ready to place tool into sterilant pouch and seal until you are ready microblade after you have measured and designed the brows, clean the skin one last time. To use it again, ALWAYS clean your tool immediately. Never leave your changed your gloves then prepare your tool and blade tools for hours unclean. Bacteria multiplies itself and will ruin your treatment. At the end fo the day, change your gloves again and dispose of all drapery. Dispose of your blade in a sharps container labeled biohazardous (These are usually available at your local pharmacy.)

 

GENERAL GUIDELINES FOR EQUIPMENT, INSTRUMENTS, AND SUPPLIES FOR YOUR PHYSICAL SETTING REQUIREMENTS 

The work site must be appropriate to the personal service activity. Contact surfaces including: (counters, tables, trays, lamps, magnifers, etc) must have a smooth and non-absorbent finish. The work area: must be well lit to facilitate cleaning and prevention of injuries. The hand washing sink (must be accessible for use while personal services procedures are being performed (e. sink is free of cleaning equipment) and continuously supplied with potable hot and cold running water, dispensable liquid soap from a single-use disposable container and single-use (cloth or paper) hand towels in a dispenser. If the soap container is refilled, it must first be cleaned, disinfected with low-level disinfectant, rinsed and allowed to thoroughly air dry. Note: A washroom hand sink (s) within the PSS premises may be used for hand washing Hand washing sinks used by more than one premise are not acceptable (ie. hand washing sinks in a public washroom within a mal). All personal services settings must be equipped with a sink(s) for cleaning of equipment/instruments The cleaning sink (s) must be Conveniently located near the work area (s) Continuously supplied with potable hot and cold running water and of adequate size to accommodate thelargest instrument/ item of equipment to be cleaned. f one sink available within the PSS premis the same sink may be used for both hand washing and cleaning of there is only equipment/instruments providing that it satisfie the requirements of 3.1 (v) and (vii). The Pss water supply should be tested in accordance with local water regulations, unless the water is from a municipally controlled water source (e.g. water in a city or town) Note: In the event that a plumbing system cannot be installed in an existing personal service setting (eg premises is located in an older building) the Pss must seek approval from their local health department in order to use a portable sink. Such sinks must be inspected and approved by the health unit to ensure a health hazard does not exist.

 Health & Safety Guidelines 

Insurance

It is recommended that when working on any paying patron that you be fully insured for the procedures you are performing. Please check with your state for all important information pertaining to licensing and insurance. 

 

Scalpa Academy is an International Company training both licensed and non-licensed individuals, anywhere from home use to nurses. Because of the large variance in the students we educate, and the fact that laws and governing boards vary from country to country, state to state, and city to city, it is the sole responsibility of the student to research their governing boards and laws within their state and country if you are planning to perform any of the procedures we offer as a business. 

 

American Med Spa Association provides more information and insight regarding laws and licensing in the US. 

Click here to read more! 

 

 

Precaution & Protocols

We at the Scalpa Training Academy encourage all students to take extra precaution when performing any procedure where bloodborne pathogens may be present.

 

In the United States, the government agency responsible for worker safety is the Occupational Safety and Health Administration otherwise known as OSHA. 

 

We require that all students seeking certification through Scalpa to complete a Bloodborne Pathogen Training Course to meet and satisfy the training requirement under the federal OSHA Bloodborne Pathogens standard which prescribes safeguards to protect workers against the health hazards from exposure to blood and other potentially infectious materials and to reduce their risk from this exposure. Example health hazards include but are not limited to Hepatitis B, Hepatitis C, HIV, Malaria, Brucellosis, Syphilis, West Nile Virus, etc.   

 

Scalpa also requires that students must be certified in Infection Control and Prevention. One of the most common places for infections to occur is healthcare systems and they are also very prevalent within many aesthetic facilities. Because we are going to be penetrating the skin, it is extremely important to take every necessary step to ensure you and your client are safe from infection. Infections can live in the area, on materials, in your business, on your self and workers, and on the client, it is important to know how to control and prevent such infections from spreading.