Cosmetologist's first aid kit: what is important to know

Although the topic of this article is compiling a “cosmetologist’s first aid kit,” the author’s main goal was to once again remind beauty industry specialists of the legal aspects of providing assistance to patients in a cosmetology office, and to increase alertness regarding the risks that accompany many cosmetic procedures.

So, the drugs used in a cosmetologist’s office can be divided into several groups:

• disinfectants for treating work surfaces, instruments, specialist hands, and patient skin;
• medications used directly for cosmetic procedures;
• medications necessary to eliminate complications from cosmetic procedures;
• pharmacological preparations necessary for the prevention of infection of personnel with viral diseases (HIV, viral hepatitis B, C);
• medications to assist with emergency conditions that may or may not be directly related to cosmetic procedures.

Cosmetology salons and clinics that have a medical license are equated, according to the legislation of Ukraine, to medical institutions providing primary health care. Unified protocols for providing emergency medical care in a cosmetology clinic (office), according to the order of the Ministry of Health No. 34, provide, first of all, for calling an emergency medical team.

I would like to note that any prescription of pharmacopoeial drugs for conditions that do not threaten the patient’s life should be carried out by a doctor or paramedic after collecting an anamnesis and assessing the general condition of the patient.

I. Medications used directly for cosmetic procedures

Preparations for mesotherapy and contouring, threads of various compositions. As mentioned earlier, the range of these products is very wide. However, very few manufacturers can boast of European and Ukrainian certification.

Anesthetics:

• Emla cream 5%, 10% is so far the only pharmacopoeial (officially registered) topical anesthetic in the form of a cream;
• Lidocaine hydrochloride 10% (solution, spray) - used for topical anesthesia of mucous membranes;
• Lidocaine hydrochloride 2% solution - used for diluting other pharmacological drugs (in cosmetology it is possible to dilute mesococtels);
• Articaine hydrochloride solution (with epinephrine or in pure form) - used for infiltration and conduction anesthesia during contouring procedures, thread lifting, etc.

NSAIDs (non-steroidal anti-inflammatory drugs) are more often used by patients at home to relieve pain and swelling. However, a drug such as Ketorolac tromethamine is used by some cosmetologists as a “premedication” before medium peels or injection procedures in patients with a low pain threshold.

Re-epithelizants, absorbable, wound-healing, anti-inflammatory drugs of local action:

• Panthenol in its pure form or in combination with antiseptics is used to accelerate healing for damage to the skin and mucous membranes of various origins: abrasions, burns, aseptic postoperative wounds, bullous and blistering dermatitis, skin grafts;
• Traumeel S cream and ointment is a complex homotoxic agent with anti-inflammatory, analgesic, anti-exudative, hemostatic, regenerating and immunomodulatory effects;
• Emollients of brands sold in pharmacies are also used as final preparations after invasive techniques, but are inferior to the above-mentioned agents and do not have a direct wound-healing and anti-inflammatory, absorbable effect.

In cosmetology, the listed drugs are used as a finishing agent after peelings of varying complexity and invasive procedures.

Angioprotectors and antiplatelet agents, for example, troxirutin, sodium heparin, are advisable to prescribe to patients at home as a course of treatment to prevent or treat complications of injection procedures.

II. Pharmacological preparations necessary for the prevention of personnel infection with viral infections (HIV, viral hepatitis B, C)

In the conditions of a cosmetology office, very often medical personnel find themselves at increased risk of infection with HIV and hepatitis B and C viruses. This is due, on the one hand, to the negligence and carelessness of the cosmetologists themselves (who, for example, can carry out manipulations associated with violation of the skin , without gloves), or do not properly disinfect instruments that come into contact with biomaterial. On the other hand, we do not always receive truthful information from our patients about their health status. Order of the Ministry of Health No. 120 dated May 25, 2000. regulates the procedure for contact of medical personnel (cosmetologist) with biological fluids. Any case of such contact, especially if the integrity of the cosmetologist’s skin is violated (injection, cut), should be considered as potentially dangerous.

Composition of the first aid kit for emergency prevention of parenteral viral hepatitis and HIV infection (Anti-AIDS First Aid Kit):

1. ethyl alcohol 70%, 100 ml;

2. iodine solution 5%, 1 bottle;

3. boric acid solution 1%;

4. protargol solution 1%;

5. potassium permanganate solution 0.05% (50 mg weighed portions of dry potassium permanganate);

6. distilled water in 100 ml containers;

7. glass pipettes - 5 pcs.;

8. cotton and gauze swabs - 5 pcs.;

9. antiseptic adhesive plaster - 1 pack;

10. metal scissors;

11. finger pads - 5 pcs.;

12. toilet soap;

13. chloramine B solution 3% or any other disinfectant solution;

14. labeled metal box.

Antiretroviral drugs:

• Azidotimidine (Retrovir, Zidovudine);
• Lamivudine (Elivir);
• Lopinavir/Ritonavir (Kaletra);
• Lamivudine + Zidovudine (Combivir).

The stock of antiretroviral drugs should be stored so that they can be started within the first two hours after the accident, but no later than 72 hours.

The procedure for providing emergency preventive care can be found in the above-mentioned order of the Ministry of Health.

III. Medications necessary to eliminate complications from cosmetic procedures

Table 1. Medications to eliminate complications from cosmetic procedures

The necessary medications to eliminate possible complications when performing aesthetic procedures are given in Table 1.

Anaphylactic shock occupies a special place among complications.

Anaphylactic shock, or anaphylaxis (from other Greek ἀνά - “against-” and φύλαξις “protection”) is an immediate allergic reaction, a state of sharply increased sensitivity of the body that develops with repeated introduction of an allergen . This is one of the most dangerous complications of drug allergies , ending in death in approximately 10-20% of cases.

The incidence of anaphylactic shock is 5 cases per 100,000 people per year. The rate of occurrence of anaphylactic shock is from a few seconds or minutes to 5 hours from the start of contact with the allergen . In the development of an anaphylactic reaction in patients with a high degree of sensitization, neither the dose nor the method of administration of the allergen plays a decisive role. However, a large dose of the drug increases the severity and duration of shock.

The unified protocol for emergency medical care for anaphylactic shock (Order of the Ministry of Health No. 34) in a beauty salon provides for the immediate call of an emergency medical team. A cosmetologist-esthetician does not have sufficient authority to provide emergency medical assistance, but must be able to diagnose this condition and, if necessary, begin non-drug cardiopulmonary resuscitation. Under the conditions of changed legislation, a cosmetologist is faced with a dilemma: lose precious minutes or face legal delays. Nevertheless, an “anti-shock styling” should be kept in every cosmetologist’s office.

Components of a first aid kit for anaphylactic shock:

• adrenaline 1 m 0.1% - for local injection and intramuscular injection to provide an almost instantaneous vasoconstrictor effect;
• glucocorticosteroids (prednisolone) - to create a powerful systemic anti-edematous, anti-allergic and immunosuppressive effect;
• antihistamines in the form of a solution for intravenous administration (first generation, such as Tavegil or Suprastin) - for the fastest possible antiallergic effect;
• the second antihistamine (Diphenhydramine) - to enhance the effect of Tavegil and Suprastin, as well as to sedate (calm) a person;
• Eufillin (bronchodilator) - to eliminate bronchospasm;
• consumables: syringes, the volume of which must correspond to the available solutions; cotton wool and gauze; ethanol;
• venous (usually cubital or subclavian) catheter - for permanent access to the vein;
• saline solution for use of solutions at the secondary care stage.

IV. Medications to assist with emergency conditions that may or may not be directly related to cosmetic procedures.

The necessary medications in order to be able to provide assistance in emergency conditions that may not necessarily be related to cosmetic procedures are in Table 2.

Table 2. Medicines to assist in emergency conditions

Recently, more opportunities have appeared for cosmetologists, aestheticians and cosmetologists to improve their theoretical diagnostic and practical skills in providing assistance to patients at the prehospital stage and, thereby, protect themselves and the life and health of our clients.

First published: Cosmetologist No. 4, 2016