Is your electrologist using proper sanitation and sterilization?

Hair Removal Methods Professional Electrolysis
#1

Editorial Note: When I posted this, I was thinking in terms of what I look for and not necessarily thinking about how this post would be received by the average consumer. I am a trained and licensed electrologist, and somewhat partial to my own methods of treatment and sanitation. However, the electrologist that I use differs quite a bit in the ways that she does things. This does not mean that she is unsafe or uncaring, just that she uses what is practical for her practice.

Other professionals on this thread have expressed differences in practices that I do not use, or have even considered as they are not practical for my practice space and the availability of certain features at reasonable costs. Still, I have both seen and used other electrologists that do not have the equipment that I use and still gave good results without infection. I have also experienced some things a few years back that I could have done without. Fortunately, this type of thing is the exception rather than the rule as far as infection goes.

The most likely outcome from poor electrology is higher levels of discomfort and a lower rate of permanancy in hair removal. These things are fairly apparent to a consumer who takes the time to research the process and can often be rectified by giving their electrologist some feedback on what you are experiencing. If the treatments do not improve, you might want to consider another practitioner.

I Have gone back through this post and have inserted qualifications in itlaics as necessary. Even so, please remember that there will be acceptable alternatives to many of the things that I list and just because I do not mention it, does not mean that the alternatives are invalid or pose a higher risk.

Joanie 9/26/2006

I have seen quite a few electrologists over the years and I have come to a point where I feel the need to relate some of the things that I’ve learned and seen with regards to proper sanitation and sterilization.

When I first enter the office I notice things like is the reception area clean? Does the practice smell musty or dirty or does the area smell clean?

  1. When you are taken into the treatment area, does the treatment table have clean paper over it? Note: disposable towels, clean cotton towels and other coverings may be used as well. These do not indicate imporper sanitation, just different methodology.

  2. Are the instruments and supplies stored in covered containers?

  3. Does the electrologist wash their hands prior to and after working on you?

  4. Does the electrologist use a new disposible probe for each client?

  5. Are things like tweezers and cataphoresis probes sterilized and stored in containers with each instrument in a sealed package with a heat indicator that has turned black? Note: read as changed color. Some heat indicators go from one color to brown depending on brand and whether they are intended for use with dry heat sterilizers or autoclaves (steam heat)

  6. Does the electrologist use a new pair of disposable gloves prior to handling equipment and beginning work on you? Note that all states do not require the use of gloves. California, where I practice, does not. The only requirement is that I wash my hands prior to and after each client. I do use gloves to protect myself more than the client as I come in contact with a lot more people per week than the average client does.

  7. Does the electrologist thoroughly remove any makeup you have in the treatment area and completely disinfect the area prior to beginning threament? This should be standard practice, however one should never wear makeup, even foundation, on an area to be treated. I will remove any makeup from a treatment area prior to disinfecting the site, but I do count this time against the time my client has booked. I expect my clients to come to me clean and ready to be treated and will not give them the time to correct anything that they should be doing prior to coming to me.

  8. Does the electrologist clean and disinfect the area treated prior to the application of post treatment products?

  9. Does the electrologist promptly and properly dispose of all matterials such as used probes, sterilization packages, used cotton and gauzes after your treatment? Is the trash container covered or open?

  10. Does the electrologist wash their hands after treating you and then immediately disinfect and sanitize all equipment before treating the next client? This is another area with a large range of alternative acceptable practices. No acceptable method is really better than another, some are just quicker than others.

  11. Are soiled instruments immediately placed in marked, sealed containers after use? This is another area where there are many legal and and alternative standards. The AEA standards are some of the highest but are not mandated in most states. If the practice is using these standards with a high degree of complience, cross infection will be very unlikely. However, lower standards are used by many practices with very good success and no discernable history of problems. Again, proper disinfection and a rational sterilization standards, combined with general good overall cleanliness of environmental surfaces will generally provide a safe environment for treatment.

  12. Does the practice use either an autoclave or dry heat sterilizer for the sterilization of instruments? Some practices do not sterilize on site, or in their treatment rooms. This does not indicate that their practices are improper or substandard.

These are all things that a client should be aware of when consulting with a new electrologist. After all, if the electrologist does not take the time and effort to maintain the facilities in a clean and sanitary condition, you are the one who will experience post treatment problems. If you have questions ask them. If you get reasonable answers and your treatments are producing good results, you can be reasonably certain that they are taking proper care of you.

Joanie

#2

Good list, however, many of these things would not be in evidence to the client even if they are done, as they may be out of the client’s contact with the practice. Just one example being that many practices don’t have their sterilization systems anywhere near areas the clients would frequent, as the sterilization process itself would tend to make the place smell unpleasant. We all know what happens when you offend a lady’s nose, now don’t we? <img src="/ubbthreads/images/graemlins/blush.gif" alt="" />

#3

One of the things that I should have mentioned is that a consultation works both ways. One of the things I do during a consultation is to ask the electrologist specific questions about the subjects of sterilization and sanitation and the types of things that they do to protect my health. I can also look at their work station when I walk into the treatment area and see how things are organized and stored.

So far everyone I’ve consulted with has been more than happy to show me their facilities and explain their procedures to me.

As far as the smell of sterilization goes, that may smell a bit like roasted paper or plastic, but will not resemble the aroma of old trash or an unclean lavatory or dirty sinks. The last three items are what “offends” my sense of smell! These also indicate how well the facility as a whole are being maintained.

Just like many people can walk into a restaurant and tell whether or not they wish to dine there by the smell eminating out of the kitchen, a clean electrology practice will smell somewhat of disinfectants and cleansers, not of dirty carpets and inadequately cleaned plumbing fixtures.
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#4

While people probably won’t copy this list to take in, I would like to point out a few things that are not totally accurate in the list above. I would agree wholeheartedly that electrologists should be looking for “coffee stains” in their practice. What I mean by that is that sometimes we overlook a little thing that might mean a great deal to a client - such as a little stain on the carpet, or even dust on the frames of pictures.

My concern with the list is that items like number 5 states the heat indicator has turned black - my brand turns brown, so will a client leave because someone stated it must be black. In number 10, if a barrier is used, the equipment does not need to be disinfected or even cleaned before the next client. Also, in 11, soiled instruments are not placed in marked, sealed containers after use - they are to be placed in a covered soaking container of some sort…

The American Electrology Association has Infection Control Standards that are available on the internet for all electrologists to read and use - they were written specifically for electrologists. Consumers who are interested can also read them.

James makes a great point also - some electrologists have a private room for sterilizing. I have to tell a story now. When my son was about 6, I took him to a local medical emergency office. We were in this room alone, but nurses kept coming in the main door and going into a small room attached. Chris finally asked them why they were going in there. The nurse replied that the room was used for sterilizing instruments. Chris, being the little joker that he was replied, “What kind of instruments, violins?”

#5

Thanks for expanding on what I was pointing out.

I know people who don’t even sterilize anything on the site where they work, and therefore could not even show a client their equipment.

One of the reasons we have a hard time making any blanket statements about what we do is there are so many valid variations on what we do.

In the end, the results are what have to speak for themselves.

#6

While both of you have given excellent contradictions to the list I gave, what I’ve stated is fairly basic what California requires. I will agree that some of the strilization indicators do turn brown rather than black, I suppose that a better statement would have been “with a sterilization indicator that has changed color.”

California does not require that instruments be placed into a covered container container with a soaking solution. The only requirement is that the used instruments be placed in a covered (stated sealed) container that is clearly marked. California does require that all instruments be scrubbed with soap and water and then disinfected in an protein dissolving solution (such as quats) and then in 70% isopropyl alcohol prior to sterilization.

While an individual practice may not have their sterilization equipment on premises, properly packaged and sterilized instruments should be in evidence.

As far as a “barrier” being used to negate the disinfection of equipment, does the electrologist touch the equipment barrier, even with gloved hands, during the treatment? If so, is the barrier material replaced after each client? Are the probe holders and cords disinfected prior to each client? Is a sanitized probe clamp used for each client? Was the epilator adjusted during the treatment? If so, was it disinfected? What about the lamp being used? Was it manipulated from the time that treatment started to when the treatment ended? All of these things are potential sources of cross infection. Disinfecting the equipment could be achieved by replacement of barriers. The point here is that if the operator adjusts the equipment after making contact with the client, even with gloved hands, some type of preventative measures must be taken to prevent cross infection prior to the next client.

I agree that some of the things that I stated in the original post could be misconstrued, but I also feel, from some of my own past experiences, that a client needs to adopt an “I’m from Missouri” attitude before deciding that an electrologist is maintaining a safe environment for them.

I’m sorry if I have upset anyone, but I have had some very bad experiences over the last few years. One required three courses of antibiotics to get rid of. This was also one of my motivating factors for becoming an electrologist. Since I have started participating in this forum, I have heard of electrologists working without gloves, people working in what had to be unlicensed facilities under California laws, operators working with a cold which a mask, or even two, will not will prevent the spread of the virus. If you have better suggestions as to a kind of generic check list for a client reviewing an electrology practice for their work, I would appreciate comments as to how a client can make the determination if minimum standards are being met. Remember that the AEA standards, which I fully support, are not manditory in all areas. And from what I’ve seen, not even all CPE’s adhere to them.

I have seen electrologists in California, over the last year, that are still using the old-style probes in a plastic envelope attached to each client’s chart folder. Are they being sterilized prior to each use? I doubt it as the probes were in the small zip-loc bags that people buy small items in.

I also have seen an electrologist that has one pair of tweezers that she sticks back into an open container of alcohol of the same type that my childhood doctor used to put his oral thermometers in after use. When the next client was on the table, she would pull them out and go right to work. This obviously does not meet any existing standards that I am aware of. BTW…This was in another state, not California.

I can accept criticism of my post, but there is still the question of what are the minimum safe conditions for an electrology office to provide a safe environment? Remember that many states do not require anywhere near the standards of infection control that the AEA has adopted.

I do not want to scare off any potential clients, but there has to be some baseline that the average consumer can use to determine if a potential electrologist is operating within acceptable standards. Not all electrologists are AEA members but still give good safe treatments. Not all electrologists adhere to AEA Standards of infection control, but still maintain adequate sterilization where they do not have post-treatment problems. Like James said, it’s the final results that count. But there is still truth to the old saw that an ounce of prevention is worth a pound of cure.

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#7

Please don’t misunderstand, I did not mean to chastise you for your contribution, I was just pointing out that your list could be misconstrued in such a way as to cause a client to walk out on a perfectly good practitioner based on something that doesn’t matter, or is simply misunderstood.

Trust me, I know how you feel. I have to deal with people getting mad at me because I said that high end lighted magnification equipment coupled with newer digital epilators minimize the learning curve for new electrologists while increasing the possibilities for experienced practitioners to expand on their arsenal of weapons for hair removal, all while giving more comfortable treatments and making faster treatment possible. This somehow got mutated to “James says that if you don’t have a brand new computerized machine and a halogen fiber optic lighted binocular style visual aid, you suck!”

Now come here and let me give you a hug.

#8

Hi James,

I appreciate your response and I know from experience that people will misconstrue anything they can. I spent several years as a programmer and learned exactly how hard it is to work around people’s inate ability to apply things the wrong way.

I guess though I’d better cool off before I make another post with that type of absolutes in it again and offer garments to a more generic cut.

What brought this on was a friend of mine who had her first electrology treatment and wound up with a massive skin infection on her face. She will have some scarring from this and will require extensive work to bring her appearance back to anywhere near where it was before. What was really heartbreaking is that my friend is one of the most attractive women I’ve ever seen and is an absolute cleanliness freak. It’s too bad that she only had one electrologist close to her and it turned out to be this individual.

Fortunatley, the “electrologist” who did the work has been removed from practice but the damage has been done. My friend was not the first to file complaints.

My best retraction of the original post and restatement of this would be to recommend that a client take a good look at the practice and treatment areas before going with an electrologist. Do things appear to be well maintained, clean, and properly organized? Are disposable gloves and and disposable probes on the menu? In other words, does the place look like somewhere that you would want to have work done in?

BTW James…Cyber-hugs are perfectly acceptable!
Joanie <img src="/ubbthreads/images/graemlins/wink.gif" alt="" />

#9

This whole thread has me somewhat worried because I have had 4 consultations at different electrolysis offices over the past week and 2 out of the 4 didn’t wear any gloves! This shocked me at the time and I am even more surprised now after reading more and more about important gloves are. I questioned both the “non-gloved” electrolysis about there lack of gloves and both gave me surprisingly similar answers. Both clamed they had been in business so long (since the 70’s) that when they started they didn’t use gloves and they have found that using gloves now lessens there perception of the probe and therefore the quality of there work is better without gloves. One even told me that since electrolysis is a sterile procedure with no blood or bodily fluids released all over the place, the need for gloves was non existent.

The general opinion on this forum seems to be the exact opposite though. Plus I live in California and I was under the impression that California has rather stringent rules governing the practice of electrolysis. When I asked one of the electrolysis about the law she said no, that she is not required to wear gloves in Cali. Is this true?

My other problem is that I am now faced with making the decision of where I want to go to have my electrolysis completed, because aside from the whole glove issue the two “non-gloved” electrolysis were the ones I liked best based on technique, cleanness of the office, skill at not zapping me, and a couple other factors (ie: price)

Basically my question boils down to… is wearing gloves really that important if you know what your doing and you make sure everything else has been sterilized?

#10

MaraJay: These days there are so many choices in glove wear that it is irresponsible not to wear them. Fortunately, to date, there is no record of contagious disease being transmitted by electrolysis but Barbara can verify this for us.

Joanie: Although my office is located in one of the unregulated electrology states, we happen to fall under strict regulations as we do skincare. I wanted to point out that fresh paper is not the only choice. Our regulations indicate that we can use fresh sheets, (properly laundered with fresh sheets for each client). We switched to sheets for our clients who have body work done. Its much more comfortable and quieter and clients can get up without bits of paper adhered to their bodies during the warm weather months.

#11

See, this is the type of thing I was talking about… <img src="/ubbthreads/images/graemlins/crazy.gif" alt="" />

I wear gloves. I have always worn gloves. It is possible to do good work, however, even if one doesn’t wear gloves. One must wash hands prior to and at the conclusion of work, (this is why some states DO mandate a sink be in the actual treatment room) but one doesn’t have to wear gloves. Unless they changed the laws recently, California doesn’t mandate the wearing of gloves. I don’t know a state that DOES mandate the wearing of gloves. This is because the chance of getting something from your electrologists hands is only a little more likely than getting something from your grandmother pinching your cheeks.

Can you get something from contact in the electrologist’s office? Yes, it is possible, AND it is possible that you would get the same thing shaking hands. The electrologist is more protected by the gloves than the client is. The electrologist is, after all, the person who comes in intimate contact with tens, to hundreds of people per week.

When using a barrier on an epilator in place of use of harsh chemicals frequently during the day (which get in the air you breath in the office, polluting both your client’s and your lungs leading to illness) one can cover the epilator with something as simple as syran wrap and peal the layers off client after client. Fast and easy, no cross contamination. The lamps and other vision equipment can also be treated thusly.

Think about it, many doctors don’t put on gloves to examine you, and you really don’t know where HIS/HER hands have been. I can’t speak for other states, but in New York DENTISTS are not mandated by law to use gloves, and they are putting their hands in your mouth!

If you are worried about infection, put Tea Tree Oil on your face immediately after your appointment, and deal with smelling like a Christmas Tree for the rest of the day after your appointments. It is more important to get good treatment with someone you can envision spending tens of hours and hundreds of dollars with, who you know won’t scar you, than to take substandard work just to increase your safety against a possible infection a slight amount.

Not to be controversial, but did you know that the reason why many, if not most states dropped laws against marriage of cousins is because the difference in one’s chance of birth defects only increases one percent. If you want to shock people, you say it is a 33 percent increase over normal, but one is only going from 2 percent to 3 percent in this example.

Relax. As long as no one is blowing their nose while treating you, one is most likely safe.

#12

Hi Marajay,

I guess that I’ve started a tempest in a teapot here and should clear up a few things. The wearing of gloves in not mandated in any state that I know of and really doesn’t pose much of a health risk where the client is concerned.

The primary concern for the wearing of gloves is for the protection of the electrologist. You will be on a treatment table for a minimum of time each week or every couple of weeks depending on how far your treatment has progressed. You electrologist will be in contact with clients for 40+ hours per week if their practice is busy. We are the ones that face the greater risk.

As far as your electrologist being a risk, if they come highly recommended and you are getting good results with a minimum of problems post treatment, then go with them.

Even with the older equipment, disposable probes are pretty much SOP in most practices. However, some states such as Ohio allow electrologists to practice certain things like spider vein treatment that some states, such as California do not allow. In these cases, reuseable sterilized probes may be used for some things. Tweezers and cataphoresis rollers, as far as electrology goes, are the other primary objects of concern, but if properly disinfected and sterilized, they really should not pose a problem.

I think that the main emphasis here should be the exercise of good sense. If you can see that the practice is clean and good hygene and sterilization are practiced, the skill of the electrologist becomes the primary focus as to whether or not you want to be treated there. If you are not sure of something, ask. Most electrologist are happy to tell you how they operate and what protections they provide.

Sorry for any unnecessary anxiety,
Joanie

#13

Joanie, just one little thing to advise on - Ohio does not allow electrologists to treat spider veins. I have an epilator that has a program for doing this and I know how to do this, but I am not allowed to perform this proceedure. Seems so very silly, but it is not permitted under my licensing. How I wish your comment was true though! It would be a great service for electrologists to offer for facial spider veins as well as hemangiomas.

As far as this discussion about sanitation and gloves goes, I have copied and pasted the link for the American Electrology Associations “Infection Control Standards For The Practice Of Electrology” that Chairwoman for the AEA Infection Control Committee, Barbara (Greathouse),CPE had mentioned here.

These standards are great and I personally adhere to them in my practice. These standards, I feel, should be adopted by all states,licensed and unlicensed, so that there is continuity and uniformity for all electrologists throughout the U.S. This would stop the confusion in the consumers mind about what goes with some electrologists wearing gloves and those who do not! This discussion is another reason why hairtell is such a jewel of a tool for communication in regard to hair removal.

You can read the whole AEA piece, but if it’s too much, skip to Section I “Standards for Hand Hygiene and Use of Gloves” under Infection Control Standards documentation page 21.

If I were a consumer, I would wish that I could see my practitioner wash her hands or rub her hands with a hand sanitizer prior to donning a fresh pair of gloves. I was ever so elated when my dentist and the hygienist started wearing gloves years ago. In the family practice office I work at, there are eight very,very busy family physicians. They are using the waterless hand sanitizers when they go from patient to patient. Saves on paper towels and is easier on the skin. In fact, the whole medical center at Ohio State has switched to this method, so I am told, but there are still sinks available for occassional handwashing and if bodily fluids come in contact with the skin or if the hands are physically soiled by something else.

Here is the link to the Infection Control Standards piece:

http://www.electrology.com/infectioncontrol.htm

Dee

#14

Hi Dee,
I am sorry for the mis-steak about the practice of spider vein removal in Ohio. One of my instructors at school mentioned something to this effect, but she may have been talking about elsewhere. I was listening to her lecture while I was doing work on a client at the time. Perhaps I missed something as I have this silly habit of paying attention to the person that I’m working on. lol

I appreciate the link, but I am actually working through the standard in the AEA’s Comprehensive Study Guide at the current time. I plan to take my CPE exam at the first available opportunity in 2007. I also use these standards in my practice as well, albeit I do have a couple of minor things that I stll need to tweak in this regards. Still though my standards are much higher than those required by my state and better than those practiced by the school I attended. The AEA standards are much more stringent than the California BBC requirements.

This link is a good thing for the consumer to read and I’m certain that your efforts will be appreciated by them as well.

All the best,
Joanie <img src="/ubbthreads/images/graemlins/smile.gif" alt="" />

#15

Yes, it would be good for hair consumers who choose electrolysis to take the time and read this. I am still dismayed to see comments from consumers who are being told that they need to pay for their own probes if they have concerns about the same probe being stored in an envelope, then re-used for the next tratment. An electrologist on another forum who responded to a poster about this same subject was also dismayed and said not only does she use a new pre-packaged sterile probe each time, but heck, she would even throw in a tissue at no extra cost if her eyes started to tear. I know it is better to save the frequent dime than to have seldom dollar, but re-using probes is ridiculous from a cost standpoint.They cost less than a DOLLAR!

Cost of supplies used, including gloves, are part of the treatment fee. Clients appreciate keeping things simple and hygenic. Many first time consults are too polite to say that they are grossed out and won’t be coming back. They just leave and look for other options. I wish consumers would question some practitioners when their gut feelings and common sense tell them a practitioner is doing something that seems inappropriate.

If the consumers expectations are too theorectical, then the electrologist can pull out a copy of the “Infection Control Standards” as provided by the AEA and back up why they do, what they do. That is why I feel a guideline followed by all electrologists uncomplicates the consumer experience and makes us all look professional. At the present time, these are voluntary guidelines that the AEA urges electrologists to follow in their offices. Most licensed states do not have the manpower to oversee who is doing what in their office, so it falls on the educated consumer to speak up or walk out. If this translates into less money for the electrologist, then just maybe their behavior would change. It’s kind of like “Freakonomics”.

Dee

#16

Hi Dee,

It is obvious that we are on exactly the same page in this regard.When a client comes to me for treatment, all they have to worry about is paying for whatever time they schedule and I include everything in the fee. The only time a client will be asked to pay anything additional is when they decide to buy one of the post-treatment or other skin care products I market.

Despite some of the electrologists that I’ve seen, I actually prefer that my clients have a good understanding of the process. This makes it much easier for me to work with them as well as work on them. I constantly strive to improve my skill and knowlege in order to provide the best possible service I can possibly offer.

When I get a client that takes their research to heart, we usually work very well together. They also tend to be very forward about things that they have a concern with and this will also allow me to make adjustments in how I treat them, giving them a better sense of appreciation and the security of knowing that I do take their concerns very seriously.

Joanie <img src="/ubbthreads/images/graemlins/smile.gif" alt="" />