CE INSTITUTE LLC BLOG

Providing massage, facial, bodywork, cosmetology appointments and more direct hands-on contact over tissues that have cosmetic fillers is CONTRAINDICATED. 

One of the reasons why manual services over cosmetic or dermal fillers is contraindicated is because of something known as shifting or migration.  

While there are few published articles that have been written about cosmetic injectable shifting, our anecdotal experience has seen a significant increase of clients who are suffering from shifting and migration of cosmetic injectables, which can cause pain, swelling, physical disfigurement, obstruction of circulation and even death.

When a practitioner manipulates soft tissue over an injectable, the practitioner could be blamed for shifting the filler away from its original placement site. While the chance of this happening might depend on the technique and force used with hands-on application, it is an incalculable risk for the potential of client injury or lawsuit. Any injectable failure due to shifting could be blamed on a practitioner who has physically manipulated the affected area, which is one of the reasons why we label cosmetic fillers as a service contraindication for any hands-on manipulation in the affected area.

Some practitioners have chosen to work over a filler with the physician's written direction and consent; however, the practitioner provides their work at their own risk knowing that working over cosmetic fillers is a general  service contraindication.  If you do chose to work with cosmetic fillers with these written approvals, know that it is additionally contraindicated to provide massage, facial, bodywork, cosmetology appointments and other services that have direct contact over the broken skin where any filler has been applied with needles on the same day as application. Skin must be whole and intact prior to working over the direct area to prevent infection and infection causing disease.

Please also keep in mind that there could be blood exposure on the skin on the same day as injectable application.  Blood exposure is another service contraindication, especially on the day of service with cosmetic fillers.

There are many different types of cosmetic fillers on the market today.  The FDA has recently approved some dermal fillers that have a temporary effect, because some of these fillers contain materials that are absorbed by the body over time.

Silicone injectables are an example of fillers used that are not approved by the FDA because they are permanent and remain within the body. The FDA warns: “It can move throughout the body and cause serious health consequences, including death. In fact, when injected into areas with many blood vessels, such as the buttocks (butt), silicone can travel through those vessels to other parts of the body and block blood vessels in the lungs, heart, or brain. This can cause a stroke or even death.”[i]

To learn more, please register training with us at:  https://ceinstitute.com/

[i] Commissioner. “Caution: Injectable Silicone and Dermal Fillers for Body Enhancement.” 19 Nov. 2021, U.S. Food and Drug Administration, FDA, https://www.fda.gov/consumers/consumer-updates/fda-warns-against-injectable-silicone-and-dermal-fillers-large-scale-body-contouring-and-enhancement. 

#lymphaticfacial #mld #filler #cosmeticfiller #injections #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #facial #cosmetology #cosmetologist #spa #salon #makeupapplication #esthetics #esthetician

by Selena Belisle, Founder/Instructor, CE Institute LLC

Providing massage, facial, bodywork, cosmetology appointments and other non-invasive services is usually acceptable depending on WHEN this service is provided. Massage, facial, bodywork, cosmetology appointments and other hands-on services immediately AFTER Botox application is contraindicated.

It is contraindicated in most massage, facial, bodywork, cosmetology appointments to work directly on broken skin.  According to WebMD:  "Getting Botox takes only a few minutes. You won’t need anesthesia. The provider uses a small needle to inject Botox into specific muscles with only minor discomfort."

According to Medline:
Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including:

• Temporary smoothing of facial wrinkles and improving your appearance
• Severe underarm sweating
• Cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions
• Blepharospasm - uncontrollable blinking
• Strabismus - misaligned eyes
• Chronic migraine
• Overactive bladder

Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to twelve months, depending on what you are treating. The most common side effects are pain, swelling, or bruising at the injection site. You could also have flu-like symptoms, headache, and upset stomach. Injections in the face may also cause temporary drooping eyelids. You should not use Botox if you are pregnant or breastfeeding.

The Broken Skin Contraindication with Botox or Dysport Application
The majority of botox service is not provided with a singular needle application. Botox providers may insert needles in a dozen different placements and more based on the areas where a client wishes for treatment. This could create multiple areas of broken skin with these needle injections.

It would be contraindicated to provide massage, facial, bodywork, cosmetology appointments and other services that have direct contact over the broken skin where botox has been applied with needles on the same day as application.  That is because the skin is broken, and it will take some time for the skin to heal and proliferate before hands-on services will no longer be contraindicated.  The skin is usually healed within a day or two from needle punctures; however, each client heals in different time frames.  Simply make sure the skin is intact prior to providing hands-on service to the affected area.

Massage Contraindication: Blood Exposure with Botox or Dysport Application
Please also keep in mind that there could be blood exposure on the skin on the same day as Botox application. Blood exposure is another service contraindication, which is why the skin must be healed and intact prior to massage and other appointment services.

The main concern of working with Botox is the broken skin that results with application.  However, if you're concerned that your bodywork or other service could interfere with the client's injections, you should contact the client's Botox provider to discuss more with them.

To learn more, please register training with us at:  https://ceinstitute.com/

#lymphaticfacial #mld #botox #injections #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #facial #cosmetology #cosmetologist #spa #salon #makeupapplication #esthetics #esthetician

Infestation is the presence of an unusually large number of insects, parasites, rodents, pests, etc. - in one place, typically so large that it could cause damage or disease.  An infestation could result in fines, bad press, unsanitary work and appointment service conditions plus it could close your massage or cosmetology establishment until the infestation has been eliminated - so it's best to try to prevent this from happening in the first place.

Some of the best ways to prevent against infestation is to eliminate food sources.  Empty trash regularly and use thick plastic or metal garbage cans (with tight lids).  Keep trash cans at least one foot off the floor. 

Helpful tips to prevent infestation are to seal any gaps or holes where pests could gain access in the workplace.  The CDC recommends[i] to seal gaps and holes with “steel wood” then caulk around the steel wood.  Just be sure that you do not block access to vital air supply, ventilation, water drainage or other important access areas for your practice. A licensed rodent control professional can help with this process.  Consider areas such as:

• Inside, under, and behind work stations, mirrors, hot towel cabis, furniture and appliances
• Inside closets near the floor corners
• Around windows or doors
• Around the pipes under sinks and washing machines (this includes around pedicure tubs)
• In laundry room floor drains
• Around the pipes going to hot water heaters and furnaces
• Around floor vents and dryer vents (check any fans used for manicure or pedicure drying)
• Inside the attic or basement
• Between the floor and wall juncture
• Around holes for electrical and other utility lines

Being clean and sealing up are some of the best ways to prevent infestation!

To learn more, please register for training with us at:  https://ceinstitute.com/

[i] “Rodents.” Centers for Disease Control and Prevention, 29 July 2010, www.cdc.gov/rodents/prevent_infestations/seal_up.html.

#cosmetology #nailtechnician  #salon #spa #business #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment 

Avoiding, eliminating and reducing the amount of germs at work or anywhere could help prevent illness and disease. Pictured above are protozoa.  Protozoa are one of the four common groups of germs that include:  Bacteria, Virus, Fungus and Protozoa.

The following are some of the most common methods of how germs are transmitted from one individual to another.

1. Direct Contact: when body fluids are directly transferred from one person to another. Examples of direct contact consist of providing massage, spa or cosmetology services with an infected individual. 

2. Droplets: when secretions fly out of noses and mouths (when we sneeze, cough, spit, drool, slobber, or vomit) into the air and then land on a hard surface or are inhaled by another person.

• Droplets can fly only a short distance (such as a sneeze). If these human droplets land on another’s eye, nose, or mouth they can spread disease.
• Germs can also be spread when we touch droplets (from another person) that land on a surface like a table and then touch our own eyes, mouth, or nose before washing their hands.
• Most of the germs that can be spread by direct contact can also be spread by droplets.
• Germs that can spread by droplets are more contagious than germs that require direct contact. When an infection can spread between people that are only near each other, the infection is more contagious. Diseases caused by viruses and bacteria can be spread this way.
• Fungi and parasites are not transmitted by droplets.
• Germs live longer on stainless steel, plastic, and similar hard surfaces than they do on fabric and other soft surfaces. Germs also live longer when the surface is wet and dirty. Food and water on a surface provide germs with all they need to survive and multiply! When droplets land on a hard surface like a table or a doorknob, the viruses in those droplets can live several hours or more. Bacteria can live for even longer.

3. Airborne Transmission: when germs float suspended in the air attached to small droplets or dust particles and travel more than 3 feet.

• Airborne germs can travel across a room, down a hall, into a ventilation system, to another floor, or even from one building to another where another person can breathe in the germ.
• Germs that spread by airborne transmission are the most contagious of all. We can inhale them deep into our lungs where they can cause more serious illness. Disinfecting doesn’t help with the spread of these kinds of illness.
• Luckily, not very many germs can travel this way. Those that do are difficult to control. For example, the viruses that cause chicken pox and measles are spread by airborne routes. Nine out of ten unvaccinated people who breathe the air of a person infected with chicken pox or measles will get sick. Cleaning and disinfecting will not prevent air-borne illnesses. This is why vaccination is so important. It is the one of the few ways we have available today to protect ourselves from these extremely contagious diseases.

4. Fecal-oral Transmission: when germs in stool from one infected person make their way into the mouth of another person. These germs usually cause vomiting and diarrhea.

• This happens most commonly when infected people don’t wash their hands after using the bathroom.
  • When dirty hands touch food, the germs from that person’s stool are transferred to the food. When that food is eaten by someone else, the germs enter their body and they can get sick.
  • When dirty hands touch surfaces or objects, the germs are transferred there. When another person touches those same surfaces, he gets the germs on his hands. If he eats or puts his hands in his eyes, nose, or mouth without washing them, the germs get into his body and can make him sick.
• Infections from animals can also be spread this way. For example, reptiles and rodents have caused Salmonella outbreaks. They also carry germs on their skin which can cause illness through direct contact.
• Some common viruses, including Hepatitis A, Norovirus, and Rotavirus, are spread through fecal-oral routes. They may also be spread by droplets that are produced when a person vomits – this makes them very hard to prevent!
• Handwashing is our best defense against germs spread by the fecal-oral route!

5. Blood: when an infected person's blood enters another person's body through a break in the 2^nd person’s skin. Many of the germs that can be found in blood can cause life-threatening disease. However, most blood-borne infections come from infected needles, not from nonmedical workplace hazards.

6. Insect Bites: when an insect transmits bacteria and viruses to humans through their bites. West Nile virus is a disease that is transmitted by mosquitoes, which are insects.

To learn more, please register for training with us at:  https://ceinstitute.com/

#cosmetology #nailtechnician  #salon #spa #business #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment 

Some germs can be extremely harmful and contribute to life threatening illness when they are not properly treated. But not all microbes aka germs cause disease. Bacteria, viruses, and fungi are part of the ecosystems of our bodies. We’re made up of ten times as many microbial cells as human cells!

All of the microbes in our body together weigh three pounds – as much as our brains! This collection of microbes is called our biome. We need our biome to survive.

Microbes help maintain the health of our bodies. For example, they:

• make vitamins;
• break down tough plants so we can digest them;
• help to form our immune system and control inflammation. 

Exposure to germs in early childhood teaches our immune system how to tell the difference between what is harmful and what is not. Allergies occur when the body sees ordinary, harmless things like pollen as harmful. Some research even suggests that bacteria may help us maintain a healthy weight and protect us from asthma.

When we kill microbes with antibiotics, we kill the good with the bad, which is why we should only take antibiotics when we really need them. And we shouldn’t think of all microbes as bad germs that need to be wiped out. Some illnesses are even treated using microbes.

Probiotics or microbe-containing yogurt are sometimes used to replace some of our “good” microbes that are destroyed by antibiotics.

To learn more, please register for training with us at:  https://ceinstitute.com/

#cosmetology #nailtechnician  #salon #spa #business #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment 

A spill kit is used to clean and decontaminate areas where blood spills have occurred. Having a spill kit prepared makes it less stressful to clean up a spill.

Spill kits can be purchased or you can make one yourself. These are standard items included in a spill kit:

1. Personal protective clothing that is disposable, including gloves, goggles, and an N95 mask. A paper gown should be included to protect your clothing from cross-contamination when there is a large spill.
2. Paper towels and an absorbent material.
3. Commercially available absorbent material for spill kits can be purchased. Cat litter or vermiculite can also be used. They are relatively inexpensive and work well, although they are messy.
4. Tongs and a dustpan
5. An EPA-registered disinfectant
6. Plastic bags (red will help identify the contaminated contents)

Responding to Body Fluid Spills (BFSs) on Porous and Nonporous Surface

This is the OSHA standard for anywhere establishment workers or customers may be exposed to hazardous agents:

1. Secure area and notify coworkers and other required responders.
2. Prepare to clean up:

• Bring prepared spill kit to spill site if there is a BFS.
• Select a disinfectant that is registered by the U.S. EPA to disinfect blood spills. Look for this information on the label. Select a cleaner for carpets and a disinfectant for hard surfaces.
• Put on personal protective equipment (PPE) (gloves, eye protection, and mask).

3. Remove contaminated objects, spill, and spill waste

• Cover all spills with absorbent powder and/or disposable paper or cloth towels, use the kit dustpan to remove these materials.
• Soak up any liquid absorbed into porous surfaces (like carpeting) with disposable rags. Then wash surface thoroughly and rinse.
• Use nonporous equipment such as a dustpan or tongs (not hands or vacuum) to pick up contaminated sharp items such as needles and broken glass.

4. Disinfect hard, non-porous surfaces

• Apply disinfectant and leave the disinfectant visibly wet on the surface for the required dwell time.
• For horizontal surfaces, pour disinfectant directly on to spill area.
• For vertical surfaces, spray the disinfectant onto a cloth and wipe on surface.

5. Dispose of spill waste

• Place all materials used in the cleaning process, including PPE, sharp objects, etc., in the bucket with a double-lined plastic bag. Dispose of this waste in the dumpster.

6. Follow-up

• Remove your contaminated clothing, double-bag it in 2 milli-meter thick. bags, label, wash separately in a washing machine in hot water, and dry on high setting.
• Wash your hands and other areas of your body that come into contact with the disinfectant or body fluid spill immediately after spill clean-up for at least 20 seconds with liquid soap under hot running water.
• If soap and water are unavailable, use waterless hand sanitizer right away, and then wash hands as soon as possible. Keep in mind: hand sanitizer will not work effectively in the presence of blood.
• If you have had an unprotected exposure, immediately contact your doctor for medical treatment advice.

Allow re-entry to area of spill when:

• all materials are removed;
• area is clean, properly disinfected, and dry.

To learn more, please register for training with us at:  https://ceinstitute.com/

#spillkit #bodilyfluid #BFS #bodilyfluidspill #cosmetology #nailtechnician #manicure #pedicure #safety #safetyfirst #salon #spa #business #sanitation #disinfection #cleaning #mani #pedi #sds #sdssheet #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment #disinfection

It is important to keep your nail salone and cosmetology establishment clean when providing manicure and pedicure services to the public. Bacteria, fungi, and viruses can be transferred between customers through dirty nail implements and other supplies and equipment.  Follow some of these tips for shop cleanliness:

• Use a new towel for each customer.
• Wash your hands and your customer’s hands and/or feet before each service.
• Perform services only on healthy nails and intact skin. Refuse service to clients that show any signs of infection, unhealthy appearing conditions, or broken/irritated skin.
• Clean any residue from all reusable supplies and equipment after each use and before disinfection.
• Disinfect all reusable supplies and equipment with an appropriate disinfectant after each customer.
• It is best to use an EPA-registered, hospital disinfectant labeled as viricidal, bactericidal, and fungicidal or a disinfectant as prescribed by your state cosmetology board. Follow usage instructions exactly. You may also choose to sterilize these disinfected items in an autoclave, if desired, or if required by your state’s regulations.
• Do not put clients’ feet into water that contains an EPA-registered disinfectant and avoid skin contact with the disinfectant.
• Use disposable implements on only one customer.
• If gloves are worn, replace them after each customer.
• Do not use razor-type shavers to remove calluses. These devices can cause injuries requiring medical attention. Most states have licensing laws for nail salon workers and manicurists that do not allow the use of cutting tools to remove living or callused skin.
• Using nail implements owned by customers is not recommended. Problems can arise because clients may not properly clean and disinfect the implements. All implements must be properly cleaned and disinfected by the salon worker before use on a client.

When working in a nail salon or cosmetology establishment, be sure to protect yourself and others.  To learn more, please register for training with us at:  https://ceinstitute.com/

#cosmetology #nailtechnician #manicure #pedicure #safety #safetyfirst #salon #spa #business #sanitation #disinfection #cleaning #mani #pedi 

Sebaceous Glands

Sebaceous glands are located within the skin. They secrete an oily/waxy matter, called sebum.  The sebum helps lubricate and waterproof the skin and hair.  The sebum also helps contribute to the skin's low pH acid mantle.

The greatest number of sebaceous glands are on the face and scalp. There are no sebaceous glands on the palms of the hands or soles of the feet.

There are many different types of sebaceous glands in the human body.  The sebaceous glands which cosmetologists are most concerned with are connected to hair follicles. One or more sebaceous glands may surround each hair follicle, and the glands themselves are surrounded by arrector pili muscles. The glands deposit sebum on the hair shaft which travels to the skin’s surface.

Massage therapy, spa and salon staff service precaution:  do not press directly onto a sebaceous cyst.  Here are some images of sebaceous cysts that are clogged sebaceous gland pores:

Sebaceous glands can become “clogged” and cause oil/sebum to “back up”, creating infections plus unsightly bumps and cysts within the skin.  It is our job as cosmetologists and estheticians to clean the hair and skin (when the service is covered under your license), which can help prevent blockages of these sebaceous glands.  

Efficient cleansing and exfoliation should help prevent the formation of a sebaceous cyst, and exfoliation with a physical or chemical exfoliant could help eliminate a sebaceous cyst.  However, if the sebaceous cyst is not eliminated, is infected or bothersome, then the individual should seek immediate treatment from a licensed dermatologist.

To learn more, please register for training with us at:  https://ceinstitute.com/

#cosmetology #nailtechnician #manicure #pedicure #safety #safetyfirst #salon #spa #business #sanitation #disinfection #cleaning #mani #pedi #sds #sdssheet #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment 

The Following are Workplace Tips to Help Prevent Aches and Pains that can be Utilized for Massage Therapists, Estheticians, Cosmetologists and Personal Care Services Providers:

Industry workers can get aches and pains from long period of work, performing repetitive movements and resting hands, wrists, hips and forearms and/or elbows against hard surfaces or other undesirable body mechanics. 

Ergonomics is the science of “fitting the task to the worker” so that you are more comfortable and efficient when doing your job. Good ergonomic practices will reduce stress to your body and help you avoid aches and pains.

Steps You Can Take to Reduce Aches and Pains from Work (recommended by OSHA):

• Use an adjustable chair. Sit so that your feet are flat on the floor and your back is supported. Use a footrest if your feet do not touch the floor when sitting.
• Make sure there is enough space between the back of your knees and the front edge of your seat to improve blood flow to your legs.
• Adjust the lighting. Good lighting can help you see without having to bend over.
• Raise the client’s hand or foot. Use a cushion to raise the client’s hand or foot so you do not have to bend over as far.
• Use safety glasses with magnifying lenses. These glasses reduce the need for you to bend over to see the client’s hand or foot.
• Put a towel or foam pad on the table edge to soften it for hands, arms, wrists, and elbows.
• Put soft pads on tools to make handles larger and easier to hold.
• Take frequent breaks if possible; changing positions and doing a different task is also helpful.
• Pace your work. When you work too fast, your body can become tense, which could cause muscle pain.
• Do gentle stretching exercises, but check with your doctor before starting any exercise regimen.

To learn more, please register for training with us at:  https://ceinstitute.com/

#cosmetology #nailtechnician #manicure #pedicure #safety #safetyfirst #salon #spa #business #ergonomics #mani #pedi #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment