Treatment, Consultation and Contraindications

Preparing client for treatment.

Complete the medical and treatment plan.

Take before photos of the client from several angles. Wash and dry hands.

Prepare the pigment.

Draw the template on the clients head, get them to check and adjust until you are both happy. Photograph the client from several angles to clearly show the template.

Washing and dry hands and put on clean gloves. Put on apron and facemask if used.

Open the needle cartridge, check and insert into the handpiece. Switch on machine and adjust needle to correct length.

Switch off machine and wrap barrier film to cover the joint between needle and handpiece. Check if client is comfortable and ready.

Check that the items on the top shelf are covered in plastic and disposable.

You’re now ready to begin treatment.

If you need anything from second shelf or anywhere else during the treatment, remove the gloves and place in the waste bag on the trolley. Fetch whatever you need, put on clean gloves and continue.

At the end of the treatment, get the client to check. Remove gloves to hand client the mirror.

Put on fresh gloves to make any adjustment to the treatment.

When you both agree that the treatment is over remove gloves and take the after photographs from several angles.

Get the client to sign the treatment plan and give them aftercare advice. Take payment and rebook for the next session if required.

Cleaning down.

Put on clean gloves.

Remove several medical grade wipes and leave them close to hand. Remove the needle from handpiece and put it into the sharps box.

Remove all the plastic cling film/barrier film from the machine, lead, trolley, light and put them in the waste bag.

Put the waste bag into a yellow bin bag.

Wipe down all surfaces including the floor area with a clinical grade wipes and put it in the yellow bin bags.

Spray down all surfaces including the floor area with medical grade solution. Air dry.

Remove gloves and apron and put into the yellow bin bag. Tie up the yellow bin bag and place in a large yellow outdoor bin.

Wash hands and dry with single use paper towel.

Metal allergies/Nickel/Iron oxide. Patch test before treatment

Mitral valve prolapse. A heart condition which increases risk of infection. Dentists prescribe antibiotics before dental treatment. For the same procedure for the two treatments. Refer to GP.

Pregnancy no treatment no line retinal detachment. Written consent from ophthalmic surgeon required for eye treatments.

STD. Use double gloves and show your cleaning starters are high.

Scars. Scar tissue can vary enormously. Some scar tissue can be very delicate and absorb high intensity pigments however that scar tissue can also be tough and very difficult to tattoo. Proceed with caution and ensure client is aware the more sessions may be required.

Keloid scars. Scar tissue grows excessively. Ask about healing with small cuts and proceed with caution. Hypertrophic scars. Raised, becoming more white with time. Allow to heal for 6 months before treatment and proceed with caution.

Atrophic scars. Indented scars. Wait 6 months before treatment.

Shingles. Immune system virus. Wait until six months after an outbreak.

Skin disorders (psoriasis, eczema, dermatitis) The skin can be sensitive, dry. Pigment may not implant or retain well. Do not treat if it’s in the area of the treatment.

Styes and eye infections. Allowed to heal for 6 weeks. Eyeliner treatment may cause further outbreak.

Surgery. Allow 3 months before PMU treatment.

Thyroid problems. May cause slower healing and colour fading.

Trichotillomania. Hair/scab pulling. Increased risk of infection, patchy healed results, scarring.

Visual impairments. Client will need to be accompanied by someone who can co-sign consent forms.

Vitiligo. Treatment may trigger further outbreaks.

Medications and skin preparation.

Antabuse. Stop taking and leave for 6 months before giving treatment. Allow 4 to 6 weeks to heal before taking Antabuse

Anti-Coagulants. Blood thinners. It’s best to obtain medical consent.

Anti-Inflammatories. Such as ibuprofen, Nurofen. Thin the blood, may bleed bruise easily. May require additional treatments.

Blood thinners aspirin, may bleed bruise easily. May require additional treatments.

Insulin. See diabetes

Roaccutane & Accutaane. Skin medication, causes thin skin prone to scarring. Do not tattoo within 6 months of treatment and leave 4 to 6 weeks to heal before resuming medication.

Steroids & Cortisone. Skin medication, causes thin skin prone to scarring. be cautious and don’t over work the skin.

Thyroxine. See thyroid problems.

Warfarin. Blood thinner. It’s best to obtain medical consent.

Retin A, Retinol, Retinoid, Tretinoid, Tretinoin, Vitamin A skin treatments. Thin skin, delay in healing and risk of scarring.

Mild – discontinue for 2 weeks before treatment. Wait 4 weeks before using again

Medium/strong – discontinue for 4 weeks and weight 4 week before using again.

Skin peels.

Mild – discontinue for 2 weeks before treatment. Wait 4 weeks before using again.

Medium/strong – discontinue for 4 weeks and wait 4 weeks before using again.

Sunbeds. Discontinue for 2 weeks. Wait 2 weeks before using again.

Eyelash growth serums. Discontinue for 4 week before eyeliner treatment. Wait two weeks.

Tinting lashes and eyebrows. Treatment one week after tinting or 4 weeks after tattoo treatment.

Health and safety. Setup and clean down.

Common sense

A new client is anyone who may be making enquiries or using the services of the workplace. Our responsibility is to offer treatment which does not put the client or others at risk.

Medical forms and treatment plans, accurate and kept secure
Knowledge of contraindications
Treatment photos, kept secure, electronic storage
Further training
Legislation, procedures for handling waste
Sanitizing in cleaning
Professional appearance, hair, jewellery
Smoking eating certain foods, strong perfume not advise when doing treatments
Cleanse hands before and after contact
Practice and procedures should be non-discriminatory
Recognise actual and potential hazards to self and others.
Know how to deal with accidents and emergencies.
Have a fire evacuation procedure.
Security procedures for stock, equipment, money and records of clients information.
Risk assessment treatments.
COSHH – control of substances hazardous to health, require the substances to be assessed before any work is exposed so that precautions can be taken.

The Health and Safety at Work Act 1974 requires all employers to provide safe systems of work, including the safe use, handling, transport and storage of substances.
RIDDOR – reporting of Injuries, Diseases and Dangerous occurrences regulations.
Accident book – under the health and safety act all accidents are to be recorded.
Risk assessment – to the level of risk and put in place procedures to minimise the risk.

Setting up procedures

Prepare treatment area, couch, chair, trolley.

Cover with plastic film anywhere which you make touch during treatment. This is to prevent blood borne pathogens and pigments from contaminated surfaces.

There should be no pillows, blankets and towels in the treatment area.

Consultation.

Complete forms and check for contraindications.

Client’s comfort.

Check that the client is comfortable full stop Offer water and breaks as required.

If a cushion is needed in must be covered in plastic film.

Technician’s comfort

Treatment may take several hours so be sure is not causing you strain. Be especially careful with your back and neck.

Preparation.

Trolley setup.

The trolley should be made of non absorbent surfaces, and wiped down and sprayed with a medical grade solution after each treatment.

Wrap with cling film or plastic any part of the trolley you will touch during the treatment.

Top shelf.

Should be covered with plastic waterproof roll paper.

The only item on this shelf should be disposable, or also covered with plastic wrap. Machine wrapped in plastic.

Wound care pack, sterile gauze, plastic pot with a sterile water. Pigment/Inc stand, covered in plastic and small pigment/ink pot.

Second shelf/close by.

Cotton buds, micro brushes, hauze, clippers, pencil, sharpener, barrier film, pigment pots, dilutant, mirror, wipes, box gloves, sterilant wipes and spray, spare needles.

Also needed.

Plastic pre-cut lead covers, cling film, hand mirror, spare wound packs, sharps box, pigments, light with daylight bulb, aprons, masks, height adjustment stool, indoor waste foot pedal bin lined with yellow clinical waste bag.

Preparing for treatment.

Wash hands, palm to palm, palm over backs, between fingers, along each finger and thumb. Dry with single use paper towel.

Cover the couch, chair, trolley top with plastic film. Cover the couch with paper roll if required.

Cover the light with plastic film.

Attached a small waste bag to the trolley.

Place a disposable apron and face mask on the second shelf. Put a needle cartridge on the shelf.

Put on gloves.

Cover the top of the trolley with waterproof paper.

Wrap the tattooing motor with plastic film and place on a trolley’s top shelf. Cover the handpiece and lead with pre-cut lead cover. Fix with a barrier film. Wrap the pigment stand with a barrier film.

Push a pigment pot into pigment stand.

Attach a small waste bag to the side of the trolley (for tidying used gauze wipes when working). Feel the small plastic pot with sterile water/normasol and dampen the gauze

Health and Safety; Contraindications and Cautions for PMU, SPMU, SMP tattoo treatments

Tattoo treatments are not to be done on anyone who is under the age of 18
Do not provide treatment to anyone under the influence of alcohol or drugs
Do not treat anyone who has not signed a consent form
Medical conditions often need longer healing time and clients may require further treatment session. This list is basic. Discuss any issues and if in any doubt ask client to get clearance from GP

Allergies – Patch test prior to treatment

Alopecia – Work gently, may be more sensitive, thinner skin. Colours may heal warmer.

Anaemia – May bleed more and take longer to heal

Asthma – Use of inhaler may cause skin to be thinner, more sensitive with more bleeding and bruising.

Birthmarks – Cannot be tattooed over

Blepharoplasty (eye surgery) – Wait 3 months before giving treatment close to the eyes.

Botox – Best to do PMU prior to botox. Or must leave 21 days after botox was given.

Breast Feeding – Treatments must not be given until no longer breastfeeding

Bruise, bleed easily – Consider stopping if excessive during the treatment. Check you technique

Cancer – 5 weeks pre and post radiotherapy or chemotherapy Cataracts – visual impairment, obtain medical consent Chapped lips – Do not give lip treatment until healed.

Conjunctivitis – Do not give eye treatment until healed. Allow to heal for 6 weeks,

Contact lenses – to be removed before treatment

Contagious Skin Conditions – do not give treatments to anyone with highly contagious skin conditions, impetigo, ring worm, scabies until conditions have cleared up.

Corneal Abrasion – – protect with lubricant before doing eye treatments. Refer to GP

Cosmetic Surgery – Allow 3 months before PMU treatment

Diabetes – Skin may be thinner, more sensitive with more bleeding, bruising and more prone to infection. Leave longer for healing between treatment sessions. Consider getting medical consent.

Dry eye – During eye liner treatments, use more lubricant. Flush eye with saline/eye drops. Epilepsy – advised not to give treatment if client has experienced seizure within last two years. Eye laser surgery – Wait 3 months before giving treatment close to the eyes.

Glaucoma – I wouldn’t do eye liner treatments.

Haemophilia – Do not treat.

Heyfever – Find out when client is at their best and treat then.

Heart Conditions – discuss and treat at technicians discretion if condition is managed well.

Hepatitis – There are many causes for liver inflammation and usually you can give treatment. Consider using double gloves. Ensure to keep cleaning standards high.

HepB – Inoculation can help to protect you.

HepC – Do not give treatment.

Herpes Simplex – Lips can be more difficult to treat, and may trigger outbreak. Colours may not hold. Preventive medication from GP may help to prevent an outbreak.

HIV – Consent from GP required. Use double gloves. Ensure to keep cleaning standards high.

Hyper Pigmentation – Do not treat over these areas. Treatment may trigger further pigmentation.

Injectable Fillers – do lips before fillers, or 4 weeks after, Can make implantation/retention difficult.

Kidney Disease – requires written doctor’s consent

Latex allergy – use Nitrile or Vinyl gloves

Liver Disease – requires written doctor’s consent

Lupus – autoimmune, attacks body tissue. Treat during dormant phase, not during flare phase.

Discoit (cutaneous) Lupus – Skin condition, usually rash on the face, neck and scalp. Do not treat.

Makeup allergies – patch test before treatment. Use client’s pencil for template drawing.

The treatment environment is maintained appropriately

Overall appearance of environment area is clean, free of stains and dust, in good repair and uncluttered
All areas are light, to allow good visibility, and well ventilated
There is a documented, regular cleaning programme in operation/ cleaning schedule is adhered to (check cleaning record)
Cleaning clothes are single use and non-shedding
Designated areas & sufficient surface areas for different activities i.e. clear distinction between ‘clean’ and ‘dirty’ operating fields
Operating areas have intact surfaces and are clean and free from extraneous items
Operating/work surfaces are cleaned and disinfected between clients
All sterile products are stored above floor level
Surfaces are easy to clean and impervious to water
Walls, floors and ceilings should be smooth, impervious to water and kept in good repair as to enable easy and effective cleaning
Floor coverings are washable and impervious to moisture
The complete floor, including edges are visibly clean with no visible body substances, dust, dirt or debris
Furniture, fixtures and fittings are visibly clean with no body substances, dust, dirt or debris or adhesive tape
Dispensers, holders, paper tower/couch roll are visibly clean with no body substances, dust, dirt or debris or adhesive tape
Toilets are visibly clean with no body substances, dust, deposits or smears, including underneath the toilet seat
Hand wash basins are visibly clean with no body substances, dust, limescale stains, deposits or smears
Waste bins are clean, including lid and pedal
Foot pedals of waste bins are in good working order
All contact surfaces in client area (couches and chairs) are easy to clean and impervious to water
Chairs and couches are from rips and tears
Disposable paper couch/chair rolls are available for use as required and stored in a manner to avoid contamination (e.g wall mounted)
Where used, disposable paper couch/chair roll is changed between clients
Trolley/worktable surfaces are visibly clean and uncluttered to enable cleaning
In between use, mop heads should not be left standing in cleaning solution i.e should be left resting in drainage part of the bucket
Mop cleaning solution is changed or renewed when visibly dirty and on daily basis
Mop heads are renewed regularly
If not possible, mop heads to be removed, cleaned with detergents and warm water, rinsed with disinfectant , wrung out and left to dry
Mop buckets to be rinsed clean at the end of the day and left upside down to dry before reuse
There is a suitable sink for filling and emptying the mop buckets of water (i.e. not hand wash basin)
Treatment/operating room cleaning equipment is stored separately from kitchen cleaning equipment in a dedicated area.