Cosmetic
Hair removal - safety essentials
As members of the Association, we promise our clients they are in safe hands, especially when it comes to potentially harmful services such as waxing, laser and pulsed light. It is crucial that the beauty therapy industry maintain and follow best practice to make sure clients are protected against harm and to conform to new regulations that are aimed at helping to improve public health and safety. 
 
New laws to protect public health
Along with an increase in the popularity of services such as hot waxing, sugaring and laser hair removal, there have also been a number of reported cases involving client injury due to poor training or equipment misuse that has prompted a number of industry changes to help protect consumers. Based on a risk-based review of commercial health and hygiene services, the Auckland Council Health and Hygiene Bylaw and Code of Practice 2013 came into force on 1 July 2014 and is considered likely to be rolled out to other councils nationwide. 
 
The bylaw aims to protect consumers in several ways. Providers will need licenses for commercial services that risk breaking the skin, including hair removal, as well as those that risk burning the skin including pulsed light and laser treatment. The new regulations and code also insists upon minimum training standards to ensure that operators who are undertaking pulsed light and laser treatment conduct their operations in a safe and hygienic manner. Under the Local Government Act 2002 and the Health Act 1956, the council may enforce this bylaw and undertake inspections to determine whether or not this bylaw is being complied with. Any person failing to comply with this bylaw is liable to a penalty under the Local Government Act 2002 and the Health Act 1956.
 
Waxing
 
Best practice
Despite how commonplace it has become in the beauty industry and its consumer popularity, waxing still poses certain health and safety risks. Because depilatory waxing removes hair by the root, the papilla is ruptured and blood and body fluids can leak from the follicle onto the skin surface. It also removes the surface layer of skin cells, which very sensitive skin types may find irritating. 
 
The NZ Association of Registered Beauty Therapists Code of Practice for Depilatory Waxing also enforces their best practice health, hygiene and safety guidelines by terminating the membership of any salon or therapist found to not be following their Code of Practice. Of particular concern with waxing is the risk of cross contamination and the association recommends that for therapist and client protection, disposable gloves must be worn and hands must be washed before and after wearing the gloves. Prior to waxing, the skin should be sanitised and waxing areas should be kept scrupulously clean. The association recommends that hot wax is best placed into a disposable container from the main wax heater and then applied to the skin using a disposable spatula. Under no circumstances must hot wax be recycled and to prevent contamination of pot wax, each spatula should be used once only from pot to client. Open pots should be kept covered at all times to reduce the risk of airborne contamination.  Other client safety considerations are outlined by 
The NZ Association of Registered 
Beauty Therapists. 
 
Contraindications
Due to the risk of cross infection, waxing should not be performed on those with bacterial infections such as impetigo, stye, boil, furuncles, or viral infections including herpes simplex, conjunctivitis, warts, shingles or fungal infections such as ringworm, scabies, or lice. Fragile skin with bruising, cuts and abrasions, operations or recent scar tissue, recent haemorrhage, or skin disorders such as psoriasis, eczema, swelling, undiagnosed lumps and bumps, raised and hairy moles, or those on Retin A or Accutane medication should avoid waxing as it could tear the skin. If the client has sunburn or heat rash treatment should not occur until the condition subsides. A client with diabetes requires GP consent and should be carefully monitored throughout the treatment. Varicose veins also require GP consent due to the vein being so close to the surface – it could rupture and cause bleeding. Fragile skin is at risk of tearing, so is non-treatable. Broken bones, fractures or sprains require GP consent and should not be treated within six months of injury, as this would hinder the healing process. Although menstruation is not a contraindication, clients should be warned that a treatment at this time could cause undue pain. 
 
Aftercare – client recommendations
Ensuring that your clients are aware of their responsibilities with aftercare will reduce potential minor complications such as ingrown hairs, bacterial infections, scarring or itching. Clients should be advised to remove the dead skin cells from the top layer of the skin to help prevent ingrown hairs. A coarse dry body mitt may be used on dry skin after waxing and before showering and is recommended at least two to three times a week, beginning three days after a waxing treatment. Client should moisturise the area daily. For 48 hours after a wax treatment clients should avoid: exercise (sweat could cause bacterial infections); sunlight; touching the area; harsh soaps or acid based products, saunas, public pools, hot spas or hot showers to avoid cross infection. 
 
Sugaring hair removal
An ancient temporary hair removal method, sugaring paste is a natural formulation usually made from a mix of sugar, lemon juice and water, which is warmed, rolled into a ball and pressed onto the hair. Strip sugaring is performed in the same way as hot waxing, using a muslin strip, so sugaring should be treated with the same code of practice and hygiene methods as waxing. As it is a natural, paraben-free formulation, clients that have concerns around chemical use may prefer this option. The gel washes off in warm water so there is less chemical use in clean up, which may also benefit those with sensitive skin types or concerns around chemical use.
 
Pulsed Light and laser hair removal
 
Safety concerns
Since its FDA approval in 1997, laser hair removal has become one of the most popular cosmetic treatments across the globe. However, therapists must appreciate that extreme care must be taken when utilising laser of pulsed light treatments to remove hair.  In unskilled hands the potential for the client to be dissatisfied with the results is a very minor concern when compared to the risk of painful burns, scarring or worse, the mistreatment of skin cancers, particularly misdiagnosing malignant skin lesions such as melanoma. And with the latest statistics showing that around 2200 New Zealanders are diagnosed with melanoma every year, all operators need to be gravely aware of the risks and observe all client skin carefully.
 
Best practice
In the hand of inadequately or untrained operators, laser and pulsed light devices can put patients at risk. The NZ Association of Registered Beauty Therapists offers best practice guidelines for both machine and operator and should be undertaken for the safety of the public at all times. An overview of the guidelines is below, to read the guidelines in full refer to the Association website.
 
It is crucial that the treatment abides by best practice for the device and its specific settings and is adjusted to suit the individual skin type and hair colour. Contraindications/medications that may make skin more sensitive to light therapies must be considered and fully disclosed by the client (including recent sun exposure) and all safety procedures followed such as the use of protective eyewear. Hospital-grade disinfectants much be utilised between each client and the area kept sterile. Clinics can increase therapist confidence and consumer safety by ensuring that ongoing training and workshops are attended on a regular basis and that equipment is closely monitored and regularly serviced.
 
Therapists can also consider undertaking formal training in the identification of skin cancer, such as the ABCD guide to melanoma. For this reason, written medical consent must be received before undertaking intense pulsed light or laser treatment for the removal of hair from moles and all clients must give a signed ‘informed consent’ prior to any treatment. If concerned about a skin pigmentation or lesion, your client should be referred to a doctor and a written consent must be obtained from the doctor prior to treatment. A patch test must be carried out prior to treatment to gauge the skin’s reaction. Any clients with a family history of melanoma must be exempt from all IPL / light/ laser / sunbed treatment.
 
Laser and IPL devices – buyer beware
While any machine is dangerous in the wrong hands, operator skill is not the only industry concern – the quality of the devices is imperative to customer safety. Initially all laser machines were European made and certified, however the industry is now rife with cheap, mass produced machines, which may put customers at risk of skin damage or leave clinics out of pocket when things go wrong.
 
One medical supplier has seen an increasing number of issues due to a lack of industry legislation and an influx of cheap Chinese-made machines. In one such case, a Palmerston North clinic had purchased an IPL device through a supposedly reputable medical doctor in Wellington. The HR handpiece failed and was returned to the doc for repair/replacement never to be seen again. The doctor had left the country and was unable to be contacted and the clinic was left with a machine that bore no markings or clue as to its origin. The clinic had no choice but to take a loss and purchase a new machine. The dud machine was replaced with a fully CE European-certified equivalent, complete with full product training for considerably less than what they had paid for their original machine. 
 
In another instance a therapist was having trouble with her IPL machine that she had recently purchased online from China. Nothing was able to be done without breaking the warranty seals. Of greater concern was the fact that the twin lamps in the hand piece were exposed directly onto the skin without any form of filtering or cooling, putting clients at risk of potentially suffering a burn injury to the skin. 
 
Regular servicing of the laser and pulsed light devices will also ensure that they are performing to standards and reduce the risks of faults causing client harm, which is another reason purchasing a certified product that is backed by New Zealand customer support gives clinics better control. In addition, under the Health and Safety and Employment Act, along with the Electricity Act, it is necessary to have all electrical cabling, appliances and machines certified as electrically safe every year.
It’s easy to see why the New Zealand Association of Registered Beauty Therapists Inc does not recommend the use of unregulated IPL machines which have not been certified. To reduce the risks of purchasing an ineffective or dangerous machine, the association suggests that members purchase machines from reputable suppliers who provide postgraduate training, hold a current Safety Certificate and have comprehensive insurance coverage. 
 
Six considerations when purchasing a laser hair removal device 
• Make sure the device has a New Zealand-based customer support facility for repairs and maintenance, advice and product training. Support out of Australia only is not ideal – long-distance issues are difficult to resolve and New Zealand is generally not a priority.
• Avoid purchasing a product off the internet, particularly from websites such as Alibaba, TradeMe, Ebay or direct from Chinese companies where machines are mass-produced. If the price seems like too good a deal, it probably is. Remember, if the machine breaks down, it will need to be sent back to the supplier for repairs. This could equate to at least two to three weeks clinic downtime and lost income, plus chasing up the repairs and return of their device. Even with the best of intentions, you could face frustrating language barriers and time zone issues.
• Check the device comes with a product manual with an English translation. Many Eastern imports don’t come with an English manual and if it does it may only be a loose Google translation and not an accurate and safe guide to the machine’s proper use.
• Look for a laser device that comes with marketing brochures or advertising posters so that you can educate your staff on the product and easily answer client queries, and put the customer’s mind at ease that the device is 
a certified one. 
• Ask whether the device comes with training. Lasers come with different specs and usage recommendations so it is imperative that you and your staff know exactly how to operate 
your machine. 
• Check that the supplier can produce evidence of the manufacturer’s compliance for that product with either and preferably both CE (European Conformity) and FDA (American Food and Drug Administration) qualifications. 
 
Getting results – sticking to the schedule
Client disappointment is a risk with laser and pulsed light hair removal. To minimise this it is vital that a treatment schedule is booked and strictly followed.  The client should be advised upfront that they will need to expect four to eight sessions at least, potentially more on lighter and finer hairs. The treatment will have to be done every two months or whenever there is growth of new hair in the treated area till the growth stops. Due to hair cycle growth, active new growth will be seen which will have to undergo the same procedure. Business Consultant Margaret Walsh trains all her beauty therapy clients to schedule a series of customer bookings. “We have to empower the client as they walk out the door. They must rebook in the right hair growth cycle otherwise the treatment won’t work and they have to know to limit plucking, waxing, and electrolysis for six weeks before laser treatment to enable the laser to target the root,” 
she says.
 
Contraindications
Laser hair removal treatment is generally safe and effective but contraindications need to be considered. Clients should be asked to reveal their medical history and list any medications they are currently taking. Hirsutism (excessive body hair) can be a symptom of an underlying medical condition, so clients should be advised to consult their GP. Active or chronic herpes simplex viral infections should be treated with antiviral medication several days before starting treatment and continued for up to one week. Care should also be taken if clients suffer from hypertrophic scarring or keliod formation as the skin may not heal as well. Other conditions which should be approached with caution include psoriasis, bleeding disorders, vitiligo and severe histamine reactions. Laser hair removal treatment should not be carried out on skin which is sunburned, or had surgeries such as laser resurfacing and chemical peels.  Clients with tattoos should be made aware that laser can cause changes in the pigment.  Contraindications include acne medications such as Isotretinoin or Accutane, as well as photosensitising drugs, steroids, antibiotics such as tetracyclines and analgesics like ibuprofen. 
 
We believe the new regulations are good for the industry and will help to improve customer safety and strengthen the industry’s reputation. Operating to high health and safety standards not only delivers best treatment results, but will maintain client confidence and help protect the health of both the client and the therapist.
 
Publishing Information
Page Number:
97
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