Heath and Safety must be the microblade technician’s top priority. Microblading is an invasive procedure because the artist is puncturing the client’s skin. If the microblading tools or work area is not properly cleaned and sanitized, there is risk of transmitting diseases and skin infections. Microblading can lead to infections with blood-borne pathogens including Hepatitis B (HBV), Hepatitis C (HCV), Human Immunodeficiency Virus (HIV), human retroviruses, bacteria and pathogens (SOURCE).

Public Health Routine inspections are required for all microblade artists at least once a year. It is important to contact Public Health prior to beginning servicing clients to make sure the work station and tools are up to their standard. To contact your Public Health branch call 647- 260-7100.

Proper training, knowledge and constantly practicing health and safety is important for the client and artist’s health and wellbeing. Chapter 1: Health and Safety, will explore allergic reactions, proper requirements for microblading, cross contamination and bloodborne pathogens. This chapter is based off the Infection Prevention and Control Best Practices for Personal Services Settings from Public Health.

1.1 Allergic Reactions

There is a risk a client will have an allergic reaction to pigment, aftercare ointment or latex gloves. Prior to any appointment, ask clients if they have any allergies and always bring latex and non- latex gloves. Patch tests are not ideal for microblading because an allergic reaction may not show right away. Clients should contact their physician prior to receiving microblading and sign a consent form(Appendix A).

1.2 Work Station Requirements

The microblading workstation must be safe, clean and sterile. The space should be only for microblading and not used for any other purpose. There should be:

1. Insurance: The technician should have insurance in case a client falls or becomes injured.
2. Durable Equipment: All equipment and tools should be durable, cleaned and sanitary. No cracked chipped, rusted or damaged tools.
3. Washable Surfaces: Floors, ceilings, walls and cabinets used for working or storing tools should be clean and sanitary. They must be free of holes, smooth and non-absorbent (no carpet).
4. Washable Equipment: Work table, chairs and benches should be made from smooth, non-absorbent material which can be cleaned with a germicidal solution.
5. Proper Lighting and Ventilation: The work area must be well lit.
6. Handwashing Sink: A designated handwashing sink with hot and cold water must be available during the microblading procedure. All sinks should be kept sanitized and free of dirty equipment. Dirty equipment must be at least 1 meter away from where sterile equipment is located.
7. Proper Plumbing: Plumbing should follow local plumbing codes.
8. Hand Towels: Single use hand drying towels are required to avoid cross contamination.
9. Soap and Disinfectant: Plain dispensable soap must be used for routine hand washing. If the soap container is refilled, it must first be cleaned, disinfected with low-level disinfectant, rinsed and allowed to thoroughly air dry.
10. Disposable Drop Sheets: Disposable drop sheets add an extra barrier to prevent cross contamination.
11. Sharps Container: Any sharps or blades need to be disposed of in a proper sharps container directly following the microblading procedure. The container must be puncture resistant, tamper-resistant, leak-proof container and impenetrable by sharps. It should have a tight-fitting lid and have a clear biological hazard label. Used blades should be handled with care. Sharps containers must be deposed of with biomedical waste regulations.
12. No Extra People or Animals: No animals shall be permitted in the work area. No one who can interfere with the microblading procedure shall be allowed in the work area.

1.3 Uniform Requirements

Personal protective equipment (PPE) helps decrease the risk of transmitting bloodborne pathogens. Microblading technicians have several different PPE requirements:

1. Disposable Gloves (latex and non- latex). Gloves must be worn before beginning a microblade procedure and changed if they touch any surface other than the clients prepared skin or material used during the procedure. Gloves should be disposed into a lined trash container and replaced if they become punctured.
2. Aprons or Lab Jackets: Aprons should be worn over clean clothing as a second barrier to prevent the spread of bloodborne pathogens.
3. Protective Eyewear: Protective eyewear protects the eyes from cross contamination decreases the chances of cross contamination.

Face Protection: Face masks helps protect mucous membranes of the nose and mouth during procedures.

4. Lotion: Hand lotion should be available to prevent dry or cracked skin.

1.4 Handwashing Requirements

Proper handwashing procedures are important for overall health and safety. Hands must be washed:

1. Before and after working on each client
2. If interrupted during a procedure (answering phone, touching un- sanitized equipment, adjusting light)

Cuts/breaks in the skin must be covered with a dressing under the gloves. Gloves are required for microblade technicians, however are not a substitute for hand hygiene. 

Figure 2 Hand Washing Chart

1.5 Artist Requirements

The microblade technician must be healthy to work on a client. They should:

1. Be up to date with their immunization records
2. Contact Public Health before beginning microblading
3. Come to an appointment healthy, clean, hair tied back and ready to work.

They should not perform a procedure if they are experiencing diarrhea, vomiting, fever, rash, productive cough, jaundice draining skin infections, boils, impetigo, or scabies. They should not eat, smoke or drink while performing microblading.

1.6. Microblading Tools and Product Requirements

Each tool used during the microblading procedure has its own sanitization requirements.

1. Pigments: Only use unopened, commercially manufactured pigments.
2. Single Use Blades: All blades must be single use, sterilized and unopened with no package tampering prior to use. They must have a DIN number. The Ministry of Health and Long-Term Care recommends that product labels of disinfectants have a drug identification number (DIN). The DIN indicates that upon a Health Canada review it has been established to be safe and effective for its intended use (source). Use tap water to rinse pigment from the blades prior to using another colour.
3. Tools: All tools, such as tweezers and handheld pens should be kept in a sterilized, clean, dry and labeled container. They should be stored in a clean area protected from dust and moisture.
4. Topical Anesthetic (numbing cream): A topical anesthetic can be applied with a clean, single-use, disposable swab. The anesthetic should be applied on the site before the skin in cleansed with an antiseptic.
5. Skin Antiseptic (70% alcohol wipe). The skin antiseptic is applied with a clean swab in a circular motion prior to puncturing the skin. Some examples of an approved skin antiseptic include povidone-iodine solution, chlorhexidine 2-4% chlorhexidine gluconate, 0.5% chlorhexidine gluconate with 70% alcohol or 70% alcohol.
6. Pigment cups: Pigment is placed in an individual cup. The blades are dipped into these cups and so dispense pigments in a manner that prevents contamination (no double dipping into the pigment bottle). Pigment cups should be cleaned at a high-level disinfectant before and after use.
7. Handheld tool: Handheld tool used to hold microblading blades needs to be properly disinfected. Cover pen with plastic barrier (baggy) during microblading procedure and sanitize in CS20 for a 40 minutes between clients. Change CS20 every 15 days and document dates (Appendix A). Keep the handheld tool in a sanitized, labelled and sealable container.
8. Distributors of products should provide Material Safety Data Sheets (MSDS), which list ingredients and first aid measures, according to Workplace Hazard Information and Material Information Safety (WHMIS) guidelines (SOURCE).

1.7 Client Requirements

It is essential to make sure clients are educated and healthy prior to a microblading procedure:

1. Client Records and Forms: Microblade technicians must keep client records on site for 1 year and on file for a minimum of 5 years. Consent, Pre-care and Aftercare documents must be available to the clients to ensure they are fully educated on how to properly care for their eyebrows. The records includes date of procedure and full name of microblade technician, client name, complete mailing address and telephone number, and details of the procedure.
2. Allergies: Ask clients prior to a procedure if they have any allergies.
3. Free of Cuts: The procedure skin must be free from cuts, wounds, rash, fungus or visible skin disease.

1.8 Cleaning

Cleaning removes visible dirt and microorganisms from work surfaces, instruments and equipment, allowing the disinfection or sterilization processes to work effectively (source).  Prior to disinfection or sterilization, all equipment, tools and surfaces must be thoroughly cleaned. Use detergent, enzymatic cleaner/detergent and a scrubbing brush to properly clean.  

1. Scrub dirty tools below the water surface to prevent splashing into the eyes or onto clothing.
2. Keep clean and dirty equipment separate from each other.
3. Clean dirty tools immediately after each client.
4. Always wear appropriate a pair of thick rubber gloves to protect hands and lower arms.
5. Materials used for cleaning (e.g. rubber utility gloves, scrub brushes, etc.), must be cleaned and low-level disinfected after each cleaning session and stored in a dry area.
6. If you cannot clean a dirty tool right away, place it in lukewarm water.
7. Sinks should be used to clean dirty equipment.
8. Label all dirty instruments.
9. Clean at the beginning and end of each day and between clients.
10. All solutions used for high-level disinfection must be tested daily at a minimum when such test strips exist to ensure that the concentration is within acceptable limits. (source)
11. Surfaces should be cleaned and sanitized before and after each client and dried with a clean paper towel. The paper towel must then be disposed into the garbage. The floors should be swept and washed before and after each client.

1.9 Avoiding Cross Contamination

Cross-contamination is the transfer of an infectious agent from a contaminated source to a non-contaminated source (source). Cross contamination can lead to Hepatitis, Staphylococcus, and Methicillin-Resistant Staphylococcus Aureus (MRSA).  If a microblade procedure is interrupted, the client’s open tissue should be covered with gauze.

Cross contamination can occur from:

• A cut from a contaminated blade
• Contaminated blood in contact with broken skin
• Contaminated blood in contact with a mucous membrane (eyes, nose, mouth)
• If multiple technicians share the same equipment
• If wet items are not dried a film may be left on the surface which may contain pathogens
• Clean tools touch dirty tools
• If clean tools are placed on unclean surface
• If the artist isn’t paying attention
• If contaminated gloves are left out
• If the facility isn’t cleaned before and after clients
• If towels are not changed between clients
• Articles of clothing touch an open wound
• Surfaces are not cleaned on a regular basis.

Figure 3 Bloodborne Pathogens Precautions

Care must be taken to prevent accidental puncture wounds to technician and clients. If a puncture does occur:

• Wear clean gloves prior to handling the wound
• Wash the exposed skin with water and soap
• Allow it to bleed freely
• After cleaning the wound, apply a skin antiseptic and cover with a clean dressing or bandage
• If it touched a mucous membrane, flush thoroughly with water
• The person exposed must immediately contact a physician
• Document all incidents and keep records on site for a minimum of one year, and on file for 5 years. Include full name, complete mailing address and phone number of the person exposed, name of technician involved, date of injury, site of injury, circumstances surrounding the injury; and action taken.

1.10 Other Cleaning, Sterilizing and Disinfecting Requirements

Study and follow Public Health requirements to decreasing the risk of cross contamination including but not limited to:

• Clean procedure area with a skin antiseptic prior to procedure.
• After the skin is cleaned with an antiseptic, mark it with an iodine/felt tip marker prior to the procedure. After one minute, once the pen mark has dried, clean the site is with the approved skin antiseptic just prior to the procedure.
• Working surfaces where microblading is performed must be cleaned and disinfected with a low-level disinfectant between clients.
• All tools that cannot be thoroughly cleaned, disinfected or sterilized between each use is considered as single-use and disposable.
• Cloths, gauze or paper towels used for wiping up blood or other body fluids must be discarded in a plastic bag and placed in regular garbage.
• Store items in a way that prevents cross contamination.
• Dismantle all tools before cleaning.
• Any tool that is touched during a procedure shall be considered contaminated.
• Discard used elastic bands.
• Keep a magnet in the first aid kit to pick up dropped blades.
• Do not use injectable anesthetics.
• Sterile tools that become contaminated must be immediately replaced with another sterile tool.
• All products must be dispensed in a manner that does not contaminate the remaining portion.
• Follow manufacturer’s instructions for product dilution, use, reuse and contact time in line. Solutions must be prepared, maintained and disposed of according to the manufacturer's instructions.
• Do not leave tools in disinfectants for longer than the required time.
• Containers used for storage of clean tools should be moisture-resistant and cleanable. It should be stored in a clean, dry, dust-free area not at floor level.
• Cleaning and disinfect the sink prior to reuse to reduce microorganisms.
• Transport equipment in a way that avoids contamination or damage.
• Disposable ink caps must be discarded immediately after each client. Any leftover ink must be discarded. Individual ink caps must be cleaned and then disinfected with an intermediate level disinfectant (e.g. 70%-90% isopropyl alcohol) for 10 minutes.
• Liquid used for rinsing between colors must be placed in disposable cups. The liquid and cups must be discarded after each client.
• Do not microblade within six inches of inflamed, rash or infected skin.
• If stencils are used, they must be single-use and discarded at the end of the procedure.
• Clients must be given verbal and written information regarding microblading after-care including: aftercare for microblading, clean hands immediately before touching microbladed skin, expected healing time of the site, possible complications and their signs and symptoms, advise on how to deal with slight redness, pain or swelling, recommend consultation with a family physician if the problem does not improve within 24 hours (source).