by Corinne Asch
CONSENT FOR PIGMENT LIGHTENING
Name (Please Print) _______________________________________________________________
The nature and method of the proposed pigment lightening procedure has been explained to me, including risks or possibility of complications during or following its performance. I understand there may be a certain amount of discomfort or pain associated with the procedure and that the other adverse side effects may include: minor and temporary bleeding, bruising, redness or other discoloration and swelling. Secondary infection in the area of the procedure may occur. However, if properly cared for, this is rare. _________ (initials)
I understand that several treatments may be needed in order to attempt to achieve my desired results. _______(initials)
I understand that the previous unwanted pigment may not be successfully lightened to the point that it can no longer be seen. Scarring as hyper-pigmentation or hypo-pigmentation, or other damage to the skin may occur during this process and may be permanent. I will not hold my technician and /or the distributor of tattoo removal products used in this attempted pigment removal liable for any damages that may occur to my person. _______(initials)
Which of the following best describes your skin type? (please circle one number)
I. Always burns, never tans
II. Always burns, sometimes tans
III. Sometimes burns, always tans
IV. Rarely burns, always tans
V. Brown, moderately pigmented skin
VI. Black skin
For skin types V and VI and saline removals only:
I understand that I am at a higher risk for hyper-pigmentation and hypo-pigmentation than other skin types. I agree to the risks involved. _______(initials)
I understand that lightening tattoo pigment is difficult, if even possible, and that there are no guarantees with this procedure. As a result, I will not hold my technician or this establishment responsible for any resultant failure to lighten the unwanted pigment _______(initials)
I agree to submit to before and after photographs, and give my permission to use such photographs for publication and/or teaching purposes. _______(initials)
I agree to follow all after-care instructions provided by my technician. _______(initials)
I have been duly informed of the risks, possible complications and consequences as listed above. _______(initials)
I understand all information listed above, have had my questions answered, and agree to all conditions and provisions of this document as evidenced by my signature below. I accept the risks for having this procedure done. _______(initials)
_______________________________________________________________
Client Name (please print)
______________________________________________Date____________
Client Signature
______________________________________________Date____________
Technician/Tattoo Artist
MODEL PHOTO RELEASE FORM
(Your company name)
I hereby give permission to
_______________________________________________________________(tattoo artist) to use my photographic likeness in all forms and media for advertising, exposition displays, trade, teaching materials and any other lawful purposes.
Print Name: ___________________________________________________
Signature: _________________________________ Date _____________
After Care Instructions
1. Clean the treatment area on the night of procedure and daily thereafter. Apply a thin layer of after-care balm, grapeseed or coconut oil to the treatment area twice daily (once if you have oily skin), being careful not to over saturate. A thin layer is all you need.
2. Besides gently cleansing the procedure area daily, keep water off of your brows for the next 5 days. That includes sweating, saunas and hot showers.
3. Do not use any face creams, exfoliators, or harsh cleansers on your brows during the healing process.
4. Normal activity can be resumed immediately, but no heavy exercise such as aerobic dancing, weight lifting, swimming, etc. for the next 10 days.
5. Your procedure will begin to oxidize immediately. This causes the pigment to become darker. Do not be alarmed, this dark color will fade during the next few days.
6. Do not pick any scabs or dry areas that may form during the healing process. This may cause you to lose color or damage your skin. Instead, apply some of the after-care your technician gave you after the procedure.
7. Other fading or loss of pigment may occur. Some flaking off of the pigment is normal on some skin types; the pigment may sometimes, disappear only to reappear a few days or weeks later. Any pigment loss will be recovered at touch up.
Lightening/Removal Client After-Care
It is critical to follow all aftercare instructions to prevent complications, scarring and to achieve optimum results. Please read the following carefully.
1. KEEP THE AREA CLEAN and open to the air. Do not cover with a Band-Aid or anything else, leave open to air. Air/oxygen provides good and faster healing. You should not be touching the area at all, but if you find yourself needing to, please make sure your hands are exceptionally clean.
2. DO NOT SOAK the treated area in water. You can shower as normal but keep the area out of the shower spray the best you can and do not let the area stay wet for more than a few minutes.
3. NO BATHING, SWIMMING, SAUNAS, HOT TOBS, TANNING, OR INTENSE EXERCISE.
4. DO NOT disrupt the scabbing process (i.e. no picking, scratching, etc.) All scabbing needs to fall off naturally. If you force or pick a scab off you will disrupt the process and possibly cause scarring.
5. TREAT AREA WITH TLC. DO NOT DO ANYTHING AT ALL THAT COULD CAUSE ISSUE OR PROBLEMS TO THE TREATED AREA. IF YOU ARE NOT SURE OR HAVE ANY QUESTIONS, PLEASE CALL OR EMAIL
6. ONCE ALL SCABBING HAS NATURALLY FALLEN OFF, apply one drop of Vitamin E Oil 4 to 6 times throughout the day for a minimum of 4 weeks, or until next lightening session. DO NOT start applying the Vitamin E oil UNTIL all scabbing has completely fallen off. It is our goal to keep the area as dry as possible until all scabs have naturally fallen off.
It is important to the process and integrity of the skin that 8 full weeks of healing take place before another lightening session can be done. No exceptions
Lightening and/or removing unwanted pigment is a long process and patience is required. This is true whether you are choosing a lightening product service or laser treatement. Please be patient and give the process a fair chance to work. Expect visible and wanted results in 3 to 6 sessions. How many sessions needed will depend on how saturated the pigment is, how deep it was implanted and how much needs to be removed for the desired result. In many cases, only a percentage of the density needs to be lightened/removed and then we can continue the correction process by color correcting. In cases where we have pigment misplaced or in an unwanted area, color correcting will not be an option and removing as much of the pigment as possible will be our ultimate goal.
Results cannot be foreseen, predicted or guaranteed.
CHAPTER 4
The importance of proper sterilization
Sterilization is a big topic and varies from state to state and country to country. It is very important to get familiar with the laws in your area. Beyond that and for the protection of your client and yourself there are precautions you must take no matter what.
One teacher told me to handle each client as though they have HIV. I thought that was sage advice.
Following are the standard legal requirements. Be sure to check your local laws regarding tattooing and sterilization.
General Requirements:
Possess a current Infection Prevention Control Plan
Facility is clean, free of insects and rodents and has walls, floors and ceilings that are smooth, washable and free of holes.
All practitioners are registered with certificates posted.
A contract for removal of all shar
ps waste
Waste containers with liners in proceure area and decontamination area.
Properly labeled sharps containers that are within arms reach of the practioners in the procedure and decontamination areas.
Procedure Areas:
Equipped with adequate lighting
Equipped with hand washing sink with hot and cold running water, liquid soap, and single use towels in a touchless dispenser.
Decontamination Areas:
(Not required if only disposable, single-use, and pre-sterilized instruments are used)
Separated from procedure areas by at least 5 feet or by a cleanable barrier
Equipped with a sink with hot and cold running water for cleaning and disinfecting equipment
Only equipment manufactured for sterilization of medical instruments may be used
Upon initial installation, after repair, and at least monthly, the sterilization unit must be tested using a commercial biological indicator monitoring system.
An autoclave is a must for anything that you will reuse.
Instruments or other reusable items shall be washed, disinfected, packaged, and sterilized after each procedure. Packages shall contain either an integrator or process indicator and shall be labeled with name of instrument, date and initials.
Used, reusable instruments are to be stored in liquid until cleaned and sterilized. An instrument or reusable item that does not come into contact with non-intact skin shall be washed, scrubbed and decontaminated after each procedure.
Your autoclave will need to be spore tested once a month. Test results shall be recorded in a log.
The decontamination/sterilization area must be separate from the procedure area and supplied with a sink with hot and cold running water, containerized liquid soap, and paper towels in a wall-mounted dispenser that is readily accessible to the practitioner. You'll need a line waste container and sharps containers.
A body art facility lacking a cleaning room and sterilization equipment shall use only disposable, single-use, pre sterilized instruments and maintain records of purchase, use, procedures (include name of practitioner and client and procedure date). Keep records for at least 90 days.
Sharps containers must be within arm's reach, labeled and disposed of by the approved method. Documentation of proper disposal available and maintained for 3 years. Sharps waste includes, needles and needle bars, and hand tools if needle is part of unit.
No food, drink, tobacco product, or personal effects are permitted in the procedure area.
Practitioner shall wash hands in approved manner before procedure and when soiled.
Hand washing sink in the procedure area is supplied, has potable warm water and is accessible.
The practitioner shall use appropriate personal protective equipment including gloves, aprons, hair net, and mouth cover. Gloves shall be worn throughout and if removed, hand hygiene shall be performed.
Procedure shall not be performed while there is another client in the procedure room.
Client must be at least 18 years of age unless parent is present.
Skin shall be washed before being shaved. Immediately before performing the microblading procedure, the skin shall be prepared with an antiseptic solution, antimicrobial or microbicide.
Practitioner shall clean and decontaminate the area, solid surfaces and objects that have come in contact with client and the materials used during procedure, including chairs, armrests, table countertops and trays before and after procedure.
Barrier film is to be used on tattooing machine (body, clip, cord, etc.)
Products (stencils, marking agents, inks and soaps) applied to skin are single use, dispensed aseptically and/or disinfected for reuse.
Clean and/or sterilized instruments and equipment shall be protected during storage in appropriate, intact containers. If sterile packs become compromised, items shall be reprocessed before use.
Cross-contamination is avoided during all phases of procedure, including but not limited to set up, the procedure itself and tear down. Wastes generated are discarded immediately after use. The practitioner glove use limits potential cross contamination events.
Facility must be separate from any residential areas used for sleeping, bathing, or meal preparation and shall not share an entrance or toilet facility with residence. Procedure area is seperated from salon activities by a wall or a floor to ceiling partition and be separate from all business not related to body art. Mobile body art facilities shall be used only for the purposes of performing body art and body art procedures performed at a mobile facility shall be done only from an approved mobile facility. No body art procedure shall be performed outside of the enclosed mobile facility.
Facility shall have floors, walls and ceilings that are smooth, non-absorbent, free of open holes, washable, free of insect and rodent infestation and be equipped with adequate light and ventilation.
Procedure area, surfaces, chairs, armrests, etc. shall be in good condition and shall be disinfected.
Certificate of Registration and Health Permit shall be posted in a conspicuous place. Owner of the agency shall notify the LEA in writing within 30 days of practitioner changes and shall not allow a practitioner to work without being registered as a practitioner. The practitioner must be a registered body art practitioner and shall only perform body art from a permitted body art facility.
Operation and Employee Training Records shall be present and available upon inspection. Infection Prevention and Control Plan is maintained, followed and updated.
Practitioner has current hepatitis B vaccination/applicable booster, can demonstrate immunity or has complied with current federal OSHA hepatitis B vaccination declination requirements.
Practitioner shall provide evidence of completion of approved Blood borne Pathogen Training.
Toilet facilities must be adequate per state, local or other laws, codes or ordinances. Restroom shall be supplied with permanently plumbed sink, supplied with hot/cold running water, containerized liquid soap, and single use paper towels dispensed from a wall-mounted, touchless dispenser. Approved restroom facilities must be within 200 ft. of mobile art facilities.
A person shall not perform body art if he or she is not registered. Registration shall be renewed annually. A body art facility shall have a valid health permit or be subject to penalties and/or closure.
Instruments found to be unsafe, used in an unapproved manner or used in an unapproved location, may be impounded by enforcement officers.
If an imminent health hazard is found, the enforcement officer may order the practitioner to cease operation if the hazard is not corrected. If the hazard affects the entire body art facility, then the entire facility may be closed immediately. If a person who does not possess a valid practitioner registration is allowed to work, the LEA may suspend or revoke the facility's permit. A certificate of registration or a health permit may be suspended by a local enforcement agency for a violation of this chapter.
Blood Borne Pathogens
Blood borne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). Needle stick and other sharps-related injuries may expose workers to blood borne pathogens. Workers in many occupations, including first responders, housekeeping personnel in some industries, nurses and other healthcare personnel, may all be at risk for exposure to blood borne pathogens.
How are blood borne pathogens
and infections spread?
For disease to be spread, it requires that all of the following conditions be present:
An adequate number of pathogens, or disease-causing organisms.
A reservoir or source that allows the pathogen to survive and multiply (e.g. blood).
A mode of transmission from the source to the host.
An entrance through which the pathogen may enter the host.
A susceptible host (i.e., one
who is not immune).
Effective infection control strategies prevent disease transmission by interrupting one or more links in the chain of infection.
Bodily fluids, especially those visibly contaminated with blood, have the potential to transmit disease. When a contaminated sharp object cuts or punctures the skin. (Parenteral examples: needle stick, illegal drug usage, cut from broken glass, bite) When an infected body fluid gets into an open cut or mucous membrane (inside eyes, mouth, ears or nose) When a contaminated object touches inflamed skin, acne, or skin abrasion.