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As we make a gradual return to normal life, beauty salons, spas and clinics will need to maintain COVID-19 safety
measures in the foreseeable future to protect their clients/ patients, staff and business reputation.

 Here are some tips to ensure staff, client and patient safety in the COVID-19 era.

Patients/ clients

Start with appropriate screening that begins with the pre-visit interaction and on the day of attendance. Enquire about risk factors such as overseas travel or contact with known COVID-19 patients in the last 14 days. Also ask about respiratory symptoms on the day of attendance. Sanitisers should be placed on counters and patient/client should attend alone or minimise accompanying persons.

Reception/rooms

The screening process is repeated when the patient/client arrives for the appointment. A printed sign placed on the reception desk can facilitate the screening process. Consider taking patient/client temperature on arrival. Social distancing applies in the waiting room with chairs spaced 1.5m apart separated by a 4msq space. Staff should consider wearing surgical masks and these can also be offered to patients/clients. Declutter the waiting room by removing magazines, toys, water coolers and any unnecessary fabric items that cannot be easily wiped down. Staff should practice frequent hand washing or use of alcohol gel rubs. Regular wipe down of contact surface areas such as counter-tops, door handles, seats and examination couch with disinfectant eg 70% alcohol or 0.1% sodium hypochlorite. Note: sodium hypochlorite is a bleaching agent that may not be suitable for device care.

Procedures

A good policy is to assume that all clients/ patients may carry the virus and to adopt universal precaution. Antiseptic skin wash such as 70% alcohol or 0.05-0.1% chlorhexidine will inactivate the coronavirus so this is recommended prior to cosmetic procedures such as injectables and non-ablative devices such as lasers and IPL. Other non-ablative devices such as cryolipolysis (CLATUU, Cooltech), needling procedures (SECRET), microfocused ultrasound (ULTRAFORMER) fall into this category. Practitioners should wear surgical mask and gloves and patients needing eye protection should use either disposables or reusable goggles that is cleaned after each patient (70% isopropyl- or ethyl-alcohol or 0.05-0.1% chlorhexidine). Hair caps are useful to minimise contact of hair with reusable goggle straps. Nitrous oxide when offered should be with a disposable single-use mouth piece. After the procedure, wipe down the device, probes, bed, eye shields and other contact surfaces with disinfectant (eg 70% alcohol or 0.05-0.1% chlorhexidine). Do not forget to regularly wipe down the keyboard for entering notes. 

Ablative procedures such as fractional CO2, fractional erbium carry a greater risk of aerosol generation especially with procedures around the nose and mouth. Dispersion of aerosol is increased with use of chilled air and nitrous oxide inhalers. Practitioners should wear N95/P2 masks and face shield. Plume extractor with HEPA (high-efficiency particulate absorbing) filter is best and placement of suction tip should be 5cm or less from the treatment site to efficiently capture plume. Once again use of chilled air may increase aerosol and plume dispersal. Ablative procedures introduce blood and body-fluid contact with device tip/probe which generally require higher level disinfection such as autoclaving or use of chemical disinfectant such as 2.4–3.2% glutaraldehyde. After the procedure, wipe down the device, probes, bed, eye shields and other contact surfaces (eg keyboards) with disinfectant (eg 70% alcohol or 0.05 – 0.1% chlorhexidine). 

 Disinfectants

70% alcohol is available in the form of commercial wipes or as solution spray for surfaces. 70% alcohol and 0.05% chlorhexidine medical grade solution is available for skin and wound antisepsis. Be aware that Iodine based antiseptics is coloured and therefore can interfere with visible light devices. Chlorhexidine can cause corneal irritation so avoid splashes into the eye. Bleach-based disinfectant such as sodium hypochlorite can potentially damage devices. Device probes and tips in contact with blood and body fluids are either sterilised with autoclave or chemically disinfected with 2.4–3.2% glutaraldehyde or non-glutaraldehyde alternatives such as ortho-phthalaldehyde.  

 Device care

Please refer to the manufacturer’s recommendation for specific care and cleaning of each particular device. Generally, alcohol-based disinfectants are recommended over bleach-based agents such as sodium hypochlorite. 70% isopropyl- or ethyl-alcohol is commercially available as disposable wipes or sprays. After each procedure, clean the device contact areas such as touch screen, handpiece and device cable. Googling the disinfectant ingredient will bring up a list of commercially available brands. 

 Acknowledgements:

  • Australasian College of Dermatologists
  • Australasian Society of Cosmetic Dermatologists
  • Department of Health

 Useful links:

 

 

DISCLAIMER: This sample checklist is for general information purposes only and not intended as legal or government advice. Cryomed does not accept liability for its contents as it is essential that each clinic customise the form according to industry, treatment procedures, state law requirements, specific local requirements, government and insurance compliance. Cryomed does not make any representation, guarantee, express or implied or assume any liability or responsibility for the accuracy or completeness of the contents of this checklist. In these unprecedented times you should seek your own legal advice independently or through your insurance policy provider along with industry associations and latest WHO recommendations.

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