UNDIAGNOSED LUMPS AND BUMPS
If the client has any undiagnosed lumps and bumps you must refer them to their GP for written consent prior to offering treatment.
POSITIVE REACTIONS TO A PATCH TEST
If the client shows signs of a positive reaction to a patch test of your products, then treatments should not go ahead unless you test them again on another part of the body or request their GP’s written consent prior to offering the treatment.
HIV AND AIDS
If the client informs you that they suffer from HIV or AIDS, they should seek advice from their GP as their medication may be a contra-indication. If you have any doubts about treating the client, refer them to their GP for written permission to carry out the treatment but do consult your insurance company as to whether your policy covers you to perform treatments on this occasion.
HEPATITIS B AND C
If you are advised that your client has been diagnosed with Hepatitis B or C (inflammation of the liver) you should not treat them as it is very infectious, and you could pass the infection onto other clients or even contract it yourself. Hepatitis B can last outside the human body for up to 10 Days.
It is strongly recommended that Therapists seek advice from GP about getting vaccinated against Hepatitis B. Please note that there is currently no vaccination available for Hepatitis C.
If your client has a heart condition, they may be taking medication to thin their blood. During some treatments bleeding can occur, this may cause a problem if the blood is thin as it would take longer to coagulate and stop bleeding. It is therefore advisable to refer them to their GP for written consent prior to treating.
Your client needs to obtain written consent from their GP before any treatment can be offered. This is because the medicine the client has to take may have an adverse effect on the treatment.
If your client has been diagnosed with any form of cancer and has or is receiving chemotherapy or radiotherapy you must not treat without obtaining written consent from their GP prior to offering treatment.
LYMPHOEDEMA AND HAEMOPHILIA
Lymphoedema is the accumulation of lymph in the tissues. It mostly affects the legs and causes swelling.
Haemophilia is a disorder in which the blood clots very slowly. If a client has haemophilia, they will bleed more and so this makes most treatments dangerous.
Clients who have been diagnosed with these conditions are not able to have wax treatments.
If a client indicates they have had a previous reaction to any treatment, then treatment must not go ahead. Some clients may have allergies to the ingredients found in products, such as rosin, PPD, Cryanacalyte or essentials oils. If this is the case, you should not treat the client.
Restrictive Contra Indications
The following are contra-indications that will prevent treatment going ahead until the infection or problem has cleared up following treatment by a medical practitioner.
Pregnancy is not an illness, however, if the client advises you that they have a history of problems then you should not offer the treatment without GP’s written consent. Also, if the pregnant client has advised you that they have developed certain medical condition during the pregnancy that are contra-indications to the treatment, they must obtain a letter from their GP prior to offering treatment. You must also check the guild lines of your insurance company.
Prickly heat is common in warm climates and is caused by trapped sweat. It appears as an itchy rash of tiny blisters or large reddened areas of the skin. Do not offer treatments until the irritation goes completely. If the condition is severe, refer the client to their GP or pharmacist.
This is recognisable by the reddening of skin and soon becomes a cluster of blisters or pustules. It is highly contagious, and treatment would cause cross infection. The therapist should recommend that the client goes to see their GP for medication. The treatment can be carried out once the condition has cleared completely.
This is the inflammation of the eyelid, often the upper eyelid. This is caused by an infection in the hair follicle. There is swelling and redness, and pain is felt in the eyelid. Scratching or rubbing the infected area could cause the infection to spread. You should recommend that the client goes to the doctors for medication. Treatment can then be carried out once the condition has been treated and cleared completely.
A boil is a painful, red bump on the skin usually caused by an infected hair follicle. As white blood cells fight the infection, pus forms inside and the boil grows larger. Eventually it will rupture, and the pus will drain away. Boils usually occur on the neck, face, thighs, armpits, and buttocks. You should recommend that the client goes to see their GP for medication. The treatment can be carried out once the condition has cleared completely.
Shingles is an infection of a nerve and the area of skin around it. It is caused by the herpes zoster virus which also causes chickenpox. Most people have chickenpox in childhood but after the illness has gone, the virus remains dormant (inactive) in the nervous system. The immune system keeps the virus in check, but later in life it can be reactivated and cause shingles. Shingles usually affects a specific area on either the left or right side of the body. The main symptoms are:
- A rash which develops into itchy blisters and then scabs over.
You should recommend that the client goes to see their GP for medication. Treatment can then be carried out once the condition has cleared completely.
This is a general term used to refer to a skin infection caused by a fungi called dermatophytes. The condition is known as ringworm because it can leave a ring-like red rash on the skin, it does not have anything to do with worms. It can affect different parts of the body.
Ringworm is highly contagious. It can be passed between people through skin contact and by sharing objects such as towels and bedding. It can also be passed on from pets such as cats and dogs. You should recommend that the client goes to see their GP for medication. The treatment can be carried out once the condition has cleared completely.
Scabies is a contagious skin condition where the main symptom is intense itching. It is caused by tiny mites that burrow into the skin. Scabies can be spread through.
- Skin-to-skin contact for long periods of time with someone who is infected.
- Sexual contact with someone who is infected.
Scabies can also be passed on through sharing clothing, towels, and bedding with someone who is infected. However, this is less likely than getting the infection through skin-to-skin contact. The incubation period for scabies is up to eight weeks.
Make sure you recommend that the client goes to see their GP for medication. The treatment can be carried out once the condition has cleared completely.
This is an infestation of the hair and body with wingless insects that cause intense irritation. As they cause itching, you can scratch your skin, leaving marks and maybe even causing a rash. They are spread by head-to-head contact and climb from the hair of an infected person to the hair of someone else. Recommend that the client goes to see their pharmacist for treatment. The treatment can be carried out once the condition has cleared completely.
The herpes simplex virus, or ‘cold sore virus’, is highly contagious and can be easily passed from person to person through direct contact. Once someone has been exposed to the virus it remains dormant most of the time. However, every so often the virus is activated by certain triggers, causing an outbreak of cold sores. The triggers that cause cold sores vary. Some people frequently suffer from recurring cold sores, two to three times a year for example, whilst others have one cold sore and never have another. Some people never get cold sores because the virus never becomes active. The client should be recommended to go to a local pharmacy for advice. The treatment can be carried out once the condition has cleared completely.
USE OF STERIOD MEDICATION
The use of steroid creams or medication can cause a thinning of the skin. Roaccutane (or Isotretinoin), Retin A, or Different medication for the treatment of severe acne can cause extreme dryness in the skin which often leads to thin or fragile skin. Wait at least six months from completing the course before any treatments, or longer if the skin is fragile. If in doubt, ask the client to obtain written permission from their GP prior to treating.
Dull red papules appear on the skin that are covered in silvery scales that can become infected. Psoriasis is contra-indicated if it is in the area to be treated. If the client has been prescribed any medication from their GP, they must seek advice as to whether the medication would prevent them from a particular treatment done.
If there is any sign of infection that is related to the Psoriasis the treatment must not go ahead until it has been treated by medical practitioner and their approval is given for the treatment to go ahead.
RAISED MOLES AND SKIN TAGS
Never work directly over these areas. Work around them and protect them in some treatments by applying a small amount of petroleum jelly over the area. If the moles are open or weeping refer the client to their GP for advice.
Warts are small, rough lumps on the skin that are non-cancerous. They are often found on the hands and feet. Warts are caused by a virus known as the human papilloma virus (HPV). HPV causes keratin, a hard protein in the top layer of the epidermis to grow too much. If someone comes into the salon with a verruca or a wart, ensure that it is completely covered with a plaster. If the client has not consulted their GP already, ask them to make an appointment for advice about treating warts.
ABRASIONS, INSECT BITES, BROKEN SKIN, BRUISES AND SUNBURN
Do not offer any treatment over affected area until it is completely healed. Do not treat areas that show signs of infection.
In some cases, you would not work over these areas, if in doubt get client to consult with their GP.
This appears on the skin as a red rash that sometimes is raised or itchy and there may be blisters. The skin can weep and crack and scaling of skin occur. Do not treat over any area of the body that is affected by eczema. If the client has very severe eczema it is best to obtain GP’s consent prior to treating as certain products may irritate the condition further.
Oedema is the medical term for fluid retention on the body. It occurs when there is a build-up of fluid (mainly water) in the body’s tissues, causing swelling to occur in the affected area. Do not perform treatments over any area of the body that shows signs of Oedema. If the client has not consulted their GP already about the problem, ask them to make an appointment for advice about treating this.
RECENT PIERCINGS OR TATTOOS
You should wait until the area has completely healed before treating. You can treat areas that are not in the area of the piercing or the tattoo.
RECENT SCAR TISSUE
Do not perform treatments over scar tissue that is less than six months old and only then if there is no sign or redness and the scar looks healed. If in doubt, refer the client to their GP for advice before treating. This also applies to fractures, sprains, and broken bones.
When discussing this illness with your client you have to be very careful not to offend and be accused of discrimination on the grounds of disability. Ask the client if they know what causes a seizure and how often they experience them. If they advise you that stress may cause a seizure, then you should advise them that some treatments can be uncomfortable and cause them stress and they may wish to consider the impact the treatment may have on their health. Offer them a patch test or treatment tester so that they can experience it for themselves before commencing the full treatment.
Ensure that you have a contact number for their next of kin on record on their record consultation card and discuss with the client what action you would be required to take if they have a seizure whilst you are with them. All therapists should undertake a first aid course so that they know how to help someone that may have an epileptic seizure, or any other medical emergency, whilst visiting the salon.
If the client has any concerns about whether they should go ahead with the treatment, you should recommend that they seek advice from their GP.
As well as taking care of the client, you should also make sure that you think about yourself. You should be aware that as a therapist you may be vulnerable to contact dermatitis or allergies. If this is the case, follow the procedure as you would with a client, and take precautions during further treatments. Disposable gloves worn during treatments can cause contact dermatitis in some therapists.
We have consulted with the industries insurers and they have confirmed that it is acceptable to offer some treatments to diabetic clients whose condition is controlled by diet or medication, thus removing the need for the therapist having to obtain written consent from the client’s medical practitioner. However, therapists must ensure that there are NOT on any other medication or have any medical complications related to diabetes present in the area and not treat, such as neuropathy, as this can restrict the client’s ability to feel heat or pain in a specific area. If any loss of sensation is present in the area to be treated, then refer the client to their medical practitioner for advice and consent prior to heat treatments.
SPRAY AND MANUAL TANNING TREATMENTS
If a client has recently had a tanning treatment you must advise them that performing treatments over an area that has been recently spray tanned, may cause their tan to appear patchy or streaky. If they wish you to procced, always make sure that they sign the client record card to say that they have discussed this with you and that they understand what may happen but wish to go ahead.
GPS WRITTEN CONSENT
Some GPs refuse to write letters for their patients and others will write a letter but charge a fee for it. If you cannot get a GP’s letter, then you will not be insured to carry out the treatment and this must be made clear to the client. Some salons ask their clients to sign a disclaimer to say they are willing to go ahead with the treatment without the GP’s letter or without having a patch test. However, disclaimers are not guaranteed to stand up in court if a personal injury claim is pursued. If you are not certain whether to treat a client, then you should refer them to their GP for a letter prior to offering them treatment. You are not qualified to diagnose medical conditions or understand medication. If you explain to the client that you require a letter as you do not want to offer them a treatment that could have an impact on their health, they are usually happy to go to their GP.