The aesthetician in 2021 is faced with many challenges, but there is nothing that cannot be overcome and mastered moving forward in professionalism and aesthetics excellence. Sanitation is the foundation upon which skin care professionals have always stood in the industry and is a paramount ideal that aestheticians must harness with sincere importance. The trust that clients have in the technical aspect of our work is only one important avenue to long-term success and is rooted now, more than ever before, in the unspoken showcasing of sanitary standards and infection control ethics. Practitioners must understand what has changed due to COVID-19, proper handwashing techniques, laundry and linen requirements, personal protective equipment, and the importance of disposable smocks or changing of scrubs, sanitation and safety protocols for social distancing, and spa rules are all new territory during and after the 2020 pandemic. There is absolutely nothing spas cannot handle with grace and certainly, with the proper rules and internal controls in hand.

GUIDELINES

COVID-19 Safety Guidelines

Spas and business owners must institute safety guidelines for their employees and clients to follow during the pandemic and beyond. General safety guidelines must always be followed, as a licensed spa through the state governing agency in which one is overseen.

Employee Guidelines

Employees should be required to have their temperatures tested daily prior to entering the facilities. A binder should be stored at the employee entryway, and all daily recording of temperatures should be logged for compliance and liability standards. Employees should be required to wear masks when performing services on each other and members of the public. Employees should be required to always wear gloves when performing services and change when appropriate. Employees in a spa or medical spa setting should also showcase the appropriate spacing in areas where consumers congregate. The sitting or standing of six feet apart should be industry standard, and where spacing six feet apart is not possible, the wearing of the face masks should be an absolute requirement. Setting the standards in the workplace internally is the best place to begin the tightening of sanitation rules and should be followed whether clients are currently in the facility or not.

Client Guidelines

Facilities should prioritize a set standard for employees and then extend specific guidelines for clients as well. These guidelines should be posted on the business website in its own page link and additionally located on the reception desk at check-in for all clients to view. Employers can also choose to ensure guidelines are within the intake forms and consent forms being signed by clients at the beginning of each service, whether on paper or digitally signed.

Aestheticians want their clients to feel comfortable when choosing to receive services in their facility while still taking serious precautions to ensure client safety.

If a client has any symptoms, encourage them to stay home and contact a doctor or local health department. The spa will take the client’s temperature upon arrival to all appointments and log the client’s temperature within their client chart or HIPPA compliant booking system. The spa should maintain separate waiting areas where social distancing can be easily maintained, or can ensure the client is directed to their designated treatment area as soon as they arrive at the spa. The spa will require all clients to wash their hands upon arrival. The spa will also ask that clients arrive alone for their appointment and not to bring any children or guests into the spa with them.

Service Guidelines

Aesthetics practitioners must follow specific guidelines regarding the rendering of services. It is encouraged for the employer to go the extra mile and have their staff sign-off on certain documents for their human resources employee file. For example, if the provider has any symptoms, the employer should encourage the provider to stay home and contact a doctor or local health department for COVID-19 testing. Employers should also encourage the avoidance of touching their own face, even with gloves on. Be sure to communicate with clients about the cancellation notice, as well as what the spa’s disinfection procedures are. Have multiple sets of tools, supplies, and linens available to speed up the treatment room turn around. If the provider has access to an autoclave, use it for all metal implements and tools. Prior to the service, businesses should encourage the following step-by-step procedures when providing treatments to the public.

Staff should clean the treatment room. Make sure that all surfaces, devices, linens, and tools are cleaned and disinfected through the proper steps of cleaning – decontamination, disinfection, and sterilization when applicable. Have and remind all staff to wash their hands. Utilize disposable towels to dry hands and discard them in closed trash cans. Hand-washing should be a

minimum of 20 seconds. Keep hands moisturized as excessive dryness will impact the skin’s barrier, which can cause infection. When using alcohol-based hand sanitizers, allow them to dry for a minimum of 20 seconds. Set up. The treatment room can be set up at this time after the previous steps have been followed. Remember to not shake hands or touch the client when initially greeting them.

During the service, aestheticians should follow the following guidelines and procedures for ensuring sanitation. These actions are mentally noted by the clients, whether the practitioner knows it or not. Sanitation and infection control during the entire transaction is paramount to continued success. Be sure to always wear gloves. Put gloves on before touching the client and change them as needed. Use close-fitting, nitrile gloves to avoid possible allergic reactions to latex. Wear a mask. Masks must be worn during services. The goal of this action is to protect the client from respiratory droplets that the aesthetician can spread regardless of one’s infection status. Consider wearing a face shield if a mask is unavailable, but be sure to fully disinfect after use. Discard porous items immediately after use in a closed trash container. For non-porous tools, place them immediately in a closed container labeled “to be disinfected.”

Never dispense products directly onto the client’s face from the container. Instead, place products into a small bowl or ramekin before placing them on the cart or task table.

After the completion of the service, the sanitation steps do not stop there. Showcasing infection control procedures, even when clients are not watching, is imperative to aesthetics excellence and ethics for long-term satisfaction and compliance. Remove all linens and place them into a closed hamper or directly into the washing machine. The provider can do this after they have escorted the client out of the room. Disinfect all work areas and follow the appropriate disinfection procedures for tools and devices. Clean non-porous items (brushes, spatulas, and metal tools) with antibacterial soap and water, dry, and then immerse in Environmental Protection Agency-approved disinfectant for the recommended time. Then, remove, rinse, dry, and place the items in a closed container. Discard porous items immediately into a closed trash container and finally, finish by washing hands. After the service has concluded, wash hands following the recommended guidelines previously stated, as this can be done after the checkout is completed.

Guidelines for Makeup Artists

Makeup artists in any facility must practice guidelines for maintaining the safety of clients. This has been a loose area in many department stores, retail boutiques, and similar businesses for many years and must come to an end. Sanitation regarding makeup and makeup tester units are extremely important in stopping the spread of infection – not only in the spa environment. Additionally, sales counter employees and brand representatives need to be in the loop on infection control guidelines if they are touching faces and makeup testers. Guidelines for makeup artists include the following:

• Use a spatula to dispense color onto a pallet
• Do not work directly from the tester
• Never use the back of the hand to mix color or test before applying
• Use disposable brushes whenever available
• For brushes that are non-disposable, do not reuse them on the next client. Completely decontaminate and disinfect after each use. Once dry, place in a dry, covered, and labeled container.

Environmental Guidelines

Aestheticians should be concerned with guest satisfaction regarding sanitation and safety but also must look at the overall sanitation and upkeep of the facility as a whole. Aesthetics professionals utilize various equipment items, machinery, and modalities when performing services. Having a written plan in the facility for the maintenance of equipment is extremely important, along with steps for cleaning the devices between clients and on a regular, routine basis. The facility itself, whether a treatment table or doorknob, must additionally have a written plan in place for general janitorial services. Whether the employer decides to hire out to a cleaning company to take on this task on a weekly or bi-weekly basis or institute it internally to the staff members, it is important to look at daily cleaning tasks overall and then, additionally, weekly and monthly cleaning guidelines. Lastly, the proper laundering of linens in the spa environment is more important than ever. Educate the aestheticians on staff but also any support staff, such as customer care specialists on the proper sanitation guidelines with spa laundry. It is suggested that a sanitation guideline for linens document be posted on a bulletin board in the laundry room, with all staff members signing on a semi-annual basis. There is zero excuse for someone to not know all sanitation guidelines in the spa environment.

CLEANING DEVICES

When wiping down devices, wipe down the device case, electrode handles, and wires with a disinfectant wipe. Electrodes, tips, and anything else that came in direct contact with the client should be disinfected using the non-porous tools instructions. Leave metal conductors out of the solution to avoid corrosion. These should never be in contact with the client. After fully cleaning the entire device (electrodes, tips, handles, and so forth), place it in a closed container marked “cleaned and disinfected implements.” Empty steamers at the end of every day and disinfect the interior of the hot cabinet and leave the door open to dry. Clean the water catch tray and turn it over to dry on top of the hot towel cabinet at the end of each day. Use a wax collar and dispose of it after each waxing service. Always use disposable applicators and discard immediately after use never double dip.

CLEANING SURFACES

While cleaning surfaces, spray with an Environmental Protection Agency-registered, hospital-grade disinfectant. Be sure to leave the surface wet for the full contact time listed on the label.

Use paper towels to wipe surfaces clean and then discard paper towels in a closed trash container. Wipe down product bottles with a disinfectant wipe following full contact time on the label. At the end of the day, mop the floor. A disposable floor cleaner can be used.

CLEANING LINENS

Use bleach or a different Environmental Protection Agency-registered disinfectant laundry additive. Follow the manufacturer's instructions for the correct water temperature. Place the linens in the dryer immediately after the wash cycle is done. Do not leave the linens in the washer overnight. Fold clean linens and place them in closed cabinets or another storage area. Wash uniforms nightly – multiple uniforms or smocks will be needed if laundry cannot be performed daily.

It is also encouraged, regarding the use of uniforms, that aestheticians change out of their spa uniforms prior to leaving the facility at the end of each day, especially if the use of disposable smocks was not an option. Understanding that multiple pairs of scrubs may be needed on site in the facility is an important factor for sanitation. Having a proper locker area or changing room near the laundry room is additionally suggested, where the use of a closed container and a locked cabinet for clean uniforms can be kept separately from the storage of uniforms to be laundered.

CLEANING OF IMPLEMENTS

One of the most important to do on a daily basis is cleaning pertaining to decontamination, disinfection, and sterilization. This can be applicable to a makeup brush, a set of tweezers, an extractor tool, or any other small implement that needs to be properly cleaned prior to new use on a client. Walking through these steps on a regular basis as a solo aesthetician or bringing steps into a staff meeting with other practitioners as an activity are great to review in regards to properly cleaning implements in a specific dispensary or environment. Put on a pair of gloves and prepare the implement for decontamination.

Place items into a wet sanitizer for approximately 10 to 20 minutes, or unless the manufacturer’s directions say otherwise for disinfection.

DISINFECTION

Disinfection means, “removing most but not all microbial life”. Wet sanitizers, by definition, are containers with closed lids that can hold disinfectant solution and completely immerse the item. As a reminder, disinfectant is typically a concentrate solution and must be diluted with water. The general rule of thumb with registered disinfectants is one fourth disinfectant solution to three-fourths water. Wet sanitizers must be cleaned out at the end of each day and not be utilized as a storage container for implements. Once the implements have been completely immersed for a maximum of 20 minutes, the practitioner may remove them with gloved hands, dry off the implement, and place them in a dry storage container that is labeled as “disinfected implements.”

STERILIZATION

An aesthetician may choose to sterilize the implement, meaning, “the removal of all microbial life inclusive of spores”. This is not a requirement of some state boards, as sterilization is more of a medical office requirement. It is, however, a great option that all owners should put into place through the use of an autoclave. Alongside the wet sanitizer on the dispensary counter should be an autoclave for the sterilization step. The implement would be pulled from the wet sanitizer after 10 to 20 minutes, dried completely, and placed into the autoclave for the designated amount of time, directed by the equipment manufacturer. Once the implement has completed the sterilization process in the autoclave and is cool to the touch, the implement may be removed from the autoclave utilizing gloved hands and placed in a dry storage container that is labeled appropriately or within a single-use pouch that is sealed on all sides.

Aestheticians in today’s marketplace must make sanitation education a regular requirement for not only themselves but other practitioners they may oversee in their spa environment. Ensuring that all employees, inclusive of support staff, understand sanitation procedures, and sign off on their understanding is paramount to the long-term success of any service industry business today. By understanding all state rules and regulations and how this has changed or tightened up due to COVID-19, practitioners everywhere can navigate their new territory with success and satisfaction for a job well done.

Courtney Sykes is the chief administrative officer of Southeastern Esthetics Institute and is a licensed aesthetics instructor in South Carolina. Sykes is also the creator of Courtney Sykes Molecular Anit-Aging, a clinical skin care line for consumers and professionals. Her passion lies in creating real change in the aesthetics industry, assisting her students to obtain gainful employment, and making a difference in the lives of their clients. Sykes specializes in a science-based approach to skin health and education. Her primary focus is chemical peels, laser treatments, eyelash extensions, micropigmentation, and cosmetic lasers. Her background in medical spa management has led her to nationally accredit the largest licensed aesthetics school in South Carolina – Southeastern Esthetics Institute.