C.O.E. Continuing Education Curriculum Coordinator

CONTINUING EDUCATION

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GEORGIA 5 HR. COSMETOLOGY COMPOSITION & TCSG HEALTH AND SAFETY

COURSE OUTLINE: Section 1:

 The Structure of Hair  The Cuticle  The Cortex  Peptide Bonds (End Bonds)  Side Bonds  Disulfide Bonds  Salt Bonds (Side Bonds)  Client Records

SECTION 2: C.O.E. Scalp andCONTINUING Hair Analysis EDUCATION  Hair Texture, Density, Porosity, and Elasticity  Permanent Waving Two-Step Process  Sectioning  Base Control  Wrapping Techniques  Perm Tools

SECTION 3:

 The Chemistry of Permanent Waving

 Selecting the Right Type of Perm  Permanent Wave Processing  Over and Under Processed Hair  Permanent Waving Neutralization  Post-Perm Hair Care  Safety Precautions for Permanent Waving  Metallic Salts

SECTION 4:

 Preparation for All Perms  Cleanup and Sanitation  Brick Lay Perm Wrap

 Weave Technique  Double Tool (Piggyback) Technique  Spiral Perm Technique  Perms for Men  Chemical Hair Relaxers  Chemical Hair Relaxing Procedures  Cleanup and Sanitation for All Relaxers  Soft Curl Permanent Procedure

SECTION 5:

 Georgia TCSG Health & Safety Rules and Regulations

LESSON OBJECTIVES:

Upon completion of this class the student will be able to:

1. Describe the various structures of the hair. 2. Develop client consultation records for effective services.

3. Perform a scalp analysis on clients to promote safe practices. 4. Generalize hair texture, density, and elasticity. 5. Summarize and identify hair wrapping techniques. 6. Underline sectioning, base control, and placement techniques in hair styling. 7. Acquire insight on the chemistry of permanent waving. 8. Define alkaline waves, cold waves, acid waves, and thio-free waves. 9. Apply techniques for permanent wave neutralization. 10. Break down procedures for post-perm hair care. 11. Recall basic, curvature, and brick lay wrapping. 12. Classify partial and basic perm preparation. 13. Demonstrate the procedure for processing permanents.

SECTION 1

The Structure of Hair

Although each distinct chemical texture service may use different chemicals and have different objectives and procedures, they all involve chemical and physical changes within the structure of the hair. Therefore, we need to begin by reviewing the structure of the hair and how chemicals can change that structure.

The Cuticle

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Starting from the outside in, we first encounter the cuticle, which is the tough outer layer and protects the hair from damage. A strong, compact cuticle layer makes for resistant hair, meaning that the hair resists penetration and is difficult to service. Although the cuticle is not directly involved in chemical texture services, the chemicals must be able to penetrate through the cuticle in order to be effective. Chemical hair texturizers offer you the ability to changer the hair's natural curl pattern. These alkaline solutions soften and swell the hair, raising the cuticle and thereby permitting the solution to penetrate through the cuticle to its target within the cortex. Coarse, resistant hair with a strong, compact cuticle layer requires a texturizer, which is highly alkaline (high pH). A less alkaline (lower pH) solution is more suited to porous, damaged, or chemically treated hair.

The Cortex

The cortex is the middle layer of the hair, located directly beneath the cuticle layer. The polypeptide chains of the cortex are connected by end bonds and cross-linked by side bonds that form the fibers and structure of hair. These chemical bonds hold the hair in its natural wave pattern and are responsible for the incredible strength and elasticity of human hair. Breaking the side bonds of the cortex makes it possible to change the natural wave pattern of the hair. Peptide Bonds (End Bonds)

The chemical bonds that join the amino acids are called peptide bonds, in turn, link together to form long chains of amino acids called polypeptide chains. Proteins are long, coiled, complex polypeptide chains make of many different amino acids linked together, end-to-end, like pop beads. It is important to note that peptide bonds should not be broken during any salon service. Breaking the hair's peptide bonds causes the polypeptide chains to come apart and dramatically weakens the hair. If used incorrectly, chemical hair texturizers can break peptide bonds and cause hair breakage. Chemical hair texturizers must be used carefully. Side Bonds

The cortex is made of millions of polypeptide chains cross-linked by three types of side bonds, or cross bonds: disulfide bonds, salt bonds, and hydrogen bonds, Altering these three types of side bonds is what makes wet setting, thermal styling, permanent waving, soft curl permanents, and chemical hair relaxing possible.

Disulfide Bonds

Disulfide bonds are formed between two cysteine amino acids, located on neighboring polypeptide chains. A disulfide bond joins a cysteine sulfur atom on one polypeptide chain with a second cysteine sulfur atom on a neighboring polypeptide chain to form cystine, the oxidized form of cysteine. Disulfide bonds are weaker than peptide bonds, but are much

stronger than hydrogen or salt bonds. Disulfide bonds are strong chemical side bonds that are not broken by heat or water. Although there are far fewer disulfide bonds that are not broken by heat or water. Although there are far fewer disulfide bonds than hydrogen or salt bonds, disulfide bonds are the strongest of the three side bonds and account for about one-third of the hair's overall strength. The chemical and physical changes in disulfide bonds make permanent waving, soft curl permanents (curl re-forming), and chemical hair relaxing possible.

Salt Bonds (Side Bonds)

Salt bonds are relatively weak physical side bonds that are the result of an attraction between opposite electrical charges. Salt bonds are easily broken by changes in pH, as in permanent waving, and re-form when the pH returns to normal. Even though salt bonds are far weaker than disulfide bonds, the hair has so many salt bonds that they account for about one-third of the hair's total strength.

Hydrogen Bonds (Side Bonds)

Hydrogen bonds are relatively weak physical side bonds that are the result of an attraction between opposite electrical charges. Hydrogen bonds are easily broken by water, as in wet setting, or heat, as in thermal styling, and re-form as the hair dries or cools. Although individual hydrogen bonds are very weak, there are so many of them that they account for about one-third of the hair's total strength.

A wet set is an example of a physical change that results from breaking and re-forming the hydrogen bonds within the hair. Wetting the hair breaks the hydrogen bonds and permits the hair to be stretched and wrapped on rollers. Drying the hair removes the water and re-forms the hydrogen bonds in their new shape. These changes are only temporary. As soon as the hair is wet or is exposed to high humidity, it will return to its original shape. Thermal styling with hair dryers, curling irons, and pressing combs also break hydrogen bonds. These styles involve a physical change with temporary results. The hair returns to its original shape as soon as it is wet.

C.O.E.THE CLIENT CONTINUING CONSULTATION EDUCATION

The client consultation is one of the most important parts of a successful texture service. Before proceeding with any service, you must first determine exactly what the client expects and what is possible. No matter how advanced your technical skills are nothing will compensate for a lack of communication between you and your client.

 Always greet your client by name and introduce yourself  Ask open-ended questions that allow you to find out why the client wants the texture service and what results are expected.  Look at pictures with your client to determine exactly what she wants.  Ask about past texture services. Determine what the client liked and did not like.  Ask how the client currently styles her hair and discuss any changes that would result from the texture service.  Determine the finished hairstyle the client wants, considering the haircut and the degree of texture or relaxing that is needed.  Evaluate the condition, texture, and wave pattern of the hair to make sure that the desired style is possible.  Fill out a permanent wave record to document the condition of the hair and the desired outcome.

Client Records

Client records should include a complete evaluation of the length, texture, color, and condition of the hair prior to the service, and the results that are expected. Extra caution should be used to determine any previous problems or adverse reactions the client may have had in the past. This information must be reevaluated prior to each service since there may have been changes in the client's history or in the formulation of the product since it was last used.Also include in your records the type of perm, the type and size of perm tools (rods), base direction, base control, wrapping technique, wrapping pattern, processing time, and the results achieved. Always remember to update your records and note any changes.

Name ______Age: ______Contact Phone: ______Email: ______Occupation: ______Employment Environment: Outside___ Inside___ Hot___ Humid___ Dry_____ Dirty____ clean____ Age(s) of children? ______Is your hair thinning or breaking? ______How often do you shampoo your hair? ______What type of shampoo do you use? ______How often do you condition your hair? ______What type of conditioner do you use? ______When was your hair trimmed last? ______List areas of hair loss or breakage. ______Any family history of thinning or balding? ______How Long is your hair? ______Have you sought professional help to correct hair loss or thinning? Dermatologist? Hair care specialist? If so, what were the results of those visits? ______Do you bleach, press, relax or have your hair permanently waived? ______When last? ______Other hair & scalp products used: i.e., hair spray, scalp cleansers, scalp oil, etc. ______Are you now, or have you: (check all that apply) a. Worn a hair piece or wig b. Had hair transplants or fusion c. Been on a diet d. Lost of gained more than 15 lbs in the past year

e. Been eating a well balanced diet f. Been taking daily vitamins or supplements g. Have any allergies h. Had a recent accident i. Been using drugs or medications j. Under excessive emotional distress k. Been in good health l. Subconsciously twist hair or scratch scalp m. Been under a physician’s care

Hair Condition: Straight Wavy Curly Excessively Curly (circle one) Oily os ow oc oec Normal ns nw nc nec Dry ds dw dc dec

Is your scalp: oily___ dry___ flaky/crusty ____ red/inflamed ____ itchy ____ Women only: pregnant? ____ Menopausal? _____ menstrual cycle (regular/irregular) ______Using contraceptives? _____ are you taking hormones? ______Hysterectomy? _____ Hair Maintenance: Do you relax your hair? ______How often? ______What type of relaxer do you use (lye/no lye)? ______When was your last relaxer? ______Who applied your last relaxer? ______Do you use color in your hair? ______Do you use permanent or semi-permanent color? ______Do you use synthetic or human hair? ____ Do you or have you worn: Braids, weaves, dread locs, wigs, twists, corn rows or rubber bands? Do you sleep in rollers? ______Do you wrap your hair up at night? ______How often do you use Hot curlers or other hot appliances on your hair? ______In what condition is your hair? Good___ moderately good ___ fair ___ poor ___ seriously needs professional help ______What do you do to your hair before going to bed? ______What do you do to your hair when you wake up? ______What is it that you would ultimately like to do or have done with your hair? ______Any other comments? ______

Client Release Form C.O.E.Some schools CONTINUINGand salons may require a client to sign a release form EDUCATION prior to receiving any chemical service. Although most release forms state that the school or salon is not responsible for any damages that may occur, they do not release the school or salon from all responsibility. Release forms do indicate that the client knew, before the chemical service was given, that there was a possibility of damage to the hair or an unexpected adverse reaction. Scalp Analysis An analysis of the scalp should always be performed prior to a chemical service. A complete analysis will help you determine how the hair will react to the service and will help avoid most

problems. The condition, texture, and wave pattern of the hair must be considered when selecting the type of relaxer, perm, the type and size of perm tool, and the wrapping method.

Hair Analysis

Hair is the fastest growing appendage on the human body. Anything that affects our general health also affects our hair. Diet, exercise, medications, and stress all affect hair growth. The quality of any permanent wave is directly related to the quality of the hair. All other things being equal, strong hair usually produces much stronger curls than weak hair.

Hair analysis is an essential part of a successful chemical hair service. A complete analysis will help you determine how the hair will react to the service and will help avoid most problems. The condition, texture, and wave pattern of the hair must be considered when selecting the type of relaxer, per, the type and size of perm tool, and the wrapping method. The five most important factors to consider in hair analysis are texture, density, porosity, elasticity, and growth direction.

Hair Texture

Hair texture describes the diameter of a single strand of hair and is classified as coarse, medium, or fine. Hair density differs not only from one individual to another but also from strand to strand on the same person's head. It is best determined by feeling a single, dry strand between the fingers. The three types of hair have the following characteristics.

 Coarse hair usually requires more processing than medium or fine hair and may also be more resistant to that processing. It is usually more difficult for permanent waving solutions to penetrate coarse hair.

 Medium hair is the most common hair texture. It is considered normal and does not pose any special problems or concerns.

 Fine hair is more fragile, easier to process, and more susceptible to damage from perm services than is coarse or medium hair. As a general rule, fine hair will process faster and more easily than medium or coarse hair.

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Hair Density

Hair density measures the number of strands of hair on the head, indicating how thick or thin the hair is. Individuals with the same hair texture can have different densities. Some individuals with fine hair texture, characterized by each hair having a small diameter, may have high density, with many individual hairs per square inch. Others with coarse hair texture, characterized by each hair having a large diameter, may have low density, with few individual hairs per square inch.

Hair Porosity

Hair porosity is the ability of the hair to absorb moisture. The degree of porosity is directly related to the condition of the cuticle layer. Hair porosity is classified as resistant, normal, or porous. Resistant hair has a tight, compact cuticle layer that resists penetration. Chemical services performed on resistant hair require a more alkaline solution. A high pH raises the cuticle and permits uniform saturation and processing. Resistant hair also requires a slow and thorough application of perm solution to ensure complete saturation.

Hair with normal porosity is neither resistant not overly porous. Texture services performed on this type of hair will usually process as expected.

Normal Porosity

Overly porous hair has a raised cuticle layer that easily absorbs solution. Chemical services performed on overly porous hair require a less alkaline solution than those performed on resistant hair. A lower pH minimizes swelling and helps prevent excessive damage to the hair.

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High Porosity

Hair Elasticity

Hair elasticity is an indication of the strength of the side bonds that hold the individual fibers of the hair in place. More than any other single factor, the elasticity of the hair determines its ability to hold curl. Hair elasticity is usually classified as normal or low.

 Wet hair with normal elasticity can stretch up to 50 percent of its original length and then return to that same length without breaking. Hair with normal elasticity usually holds the curl from wet sets and permanent waves.

 Wet hair with low elasticity does not return to its original length when stretched. Hair with low elasticity may not be able to hold the curl from wet sets and permanent waves.

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Direction of Hair Growth

The individual growth direction of the hair causes hair streams, whorls, and cowlicks that influence the finished hairstyle and must be considered when selecting the base direction and wrapping pattern for each permanent wave. Permanent waving is a two-step process.

1. The first part of any perm is the physical change caused by wrapping the hair on the perm rods. 2. The second part involves the chemical changes caused by the permanent waving solution and the neutralizer. SECTION 2

The Chemistry of Cosmetology

You might be wondering why you are reading a chapter with the words "chemistry" and "electricity" in the title. After all, didn't you leave those subjects behind in high school? The fact is a large part of a cosmetologist's work has to do with chemicals and electricity. Today's salon services would not be possible without them. Permanent waving, chemical hair relaxing, hair coloring, wet setting, and thermal styling all rely on the use of chemicals and electricity. To use

chemicals and electricity effectively and safely, you need to have a basic working knowledge of these sciences. This chapter will provide you with the overview you need.

Chemistry

Chemistry is the science that deals with the composition, structures, and properties of matter and how matter changes under different chemical conditions. Organic chemistry is the study of substances that contain carbon. All living things, whether they are plants or animals, are made up of compounds that contain carbon. Although the term "organic" is often used to mean "natural" because of its association with living things, the term also applies to anything that has ever been alive. Cow manure, for instance, is an organic fertilizer.

You may also be surprised to learn that gasoline, motor oil, plastics, synthetic fabrics, pesticides, and fertilizers are also organic substances. These products are all manufactured from natural gas and oil, which are the remains of plants and animals that died millions of years ago. Organic compounds will burn.

The majority of products that are used in modern salon are organic (again, in the sense of being derived from plants or animals, not in the sense of being "natural" or "healthful"). All hair coloring products, chemical hair texturizers, shampoos, conditioners, and styling aids are made with organic compounds from either natural or synthetic sources.

Inorganic chemistry is the branch of chemistry dealing with compounds lacking carbon. Inorganic substances are not, and never were, alive. Metals, minerals, pure water, and clean air are examples of inorganic substances. Inorganic substances do not burn.

Matter

Matter is any substance that occupies space, has physical and chemical properties, and exists in the form of a solid, liquid, or gas. Although matter has physical properties that we can touch, taste, smell, or see, not everything that we can see is necessarily matter. For instance, we can see visible light and electric sparks, but these are forms of energy, and energy is not matter. Energy does not occupy space or have physical properties, like weight. We will discuss energy later in this chapter. C.O.E.Elements CONTINUING EDUCATION An element is the simplest for of matter and cannot be broken down into a simpler substance without loss of identity. There are about 90 naturally occurring elements, each with its own distinctive physical and chemical properties. All matter in the universe is made up of one or more of these 90 different elements.

Each element is identified by a letter symbol, such as O for oxygen, C for carbon, and H for hydrogen. You can look up these symbols in the Periodic Table of Elements, found in any chemistry textbook.

Atoms

Atoms are the structural units that make up the elements. Atoms are particles from which all matter is composed. An atom is the smallest particle of an element that still retains the properties of that element. Atoms cannot be divided into simpler substances by ordinary chemical means.

Molecules

A molecule is formed by joining two or more atoms chemically. The tow types of molecules are elemental molecules and compound molecules.

Elemental molecules contain two or more atoms of the same element that are united chemically. Atmospheric oxygen, in the air we breathe, is the elemental molecule O 2. The ozone in the atmosphere, which protects us from ultraviolet radiation, is the elemental molecule O3.

Compound molecules are chemical combinations of two or more atoms of different elements. Sodium chloride (NaCl) or common table salt is a compound molecule that is a chemical combination of one atom of sodium (Na) and one atom of chlorine (CI).

States of Matter

All matter exists in one of three different physical forms: solid, liquid, or gas. These three forms are called the "states of matter". Matter assumes one of these states depending on its temperature.

Like most other substances, water (H2O) can exist in all three states of matter, depending on its temperature. For instance, when water freezes, it turns to ice. When ice melts, it turns to water. When water boils, it turns to steam. When steam cools, it turns to water. The form of the water changes according to changes in the temperature, but it is still water (H2O). It does not become a different chemical. It stays the same chemical but in a different physical form.

The three different states of matter have the following distinct characteristics:

 Solids have a definite shape and volume. Ice is an example of a solid.  Liquids have a definite volume but not a definite shape. Water is an example of a liquid.  Gases do not have a definite volume or shape. Steam is an example of a gas.

Physical and Chemical Properties of Matter

Every substance has unique properties that allow us to identify it. The two different types of properties are physical and chemical.

Physical properties are those characteristics that can be determined without a chemical reaction and that do not cause a chemical change in the identity of the substance. Physical properties include color, odor, weight, density, specific gravity, melting point, boiling point, and hardness.

Chemical properties are those characteristics that can only be determined with a chemical reaction and that cause a chemical change in the identity of the substance. Rusting iron and burning wood are examples of a change in chemical properties. In both these examples, the chemical C.O.E.reaction known CONTINUING as "oxidation" creates a chemical change in the identity EDUCATION of the substance. The iron is chemically changed to rust, and the wood is chemically changed to ash.

Physical and Chemical Changes

Matter can be changed in two different ways: physically and chemically.

 A physical change is a change in form or physical properties of a substance without the formation of a new substance without the formation of a new substance. There is no chemical reaction involved, and no new chemicals are formed. A change in the state of matter is an example of a physical change. Solid ice undergoes a physical change when it melts into liquid water.

Another example of physical change is the change brought about by temporary hair color. Temporary hair color changes the appearance of the temporary hair by physical adding color to the surface of the hair. There is no change in the chemical structure of the hair or its color. There is no chemical reaction and no new chemicals are formed.  A chemical change is a change in the chemical composition of a substance, in which a new substance or substances are formed having properties different from the original. It is the result of a chemical reaction.

As described above (iron into rust, wood into charcoal), oxidation is an example of a chemical reaction that causes a chemical change.

Permanent hair color is an example of a chemical change. A chemical reaction (oxidation) develops the dye in the color and creates a chemical change in the hair. The hair is a different color because of changes in the chemical structure of both the dye and the hair. This is a chemical reaction and new chemicals are formed.

The Perm Wrap

In permanent waving, the size, shape, and type of curl are determined by the size, shape, and type of tool used in wrapping the hair. Permanent waving solution, by itself, does not cause the hair to curl any more than water causes a wet set to curl. Permanent waving solution simply softens the hair, allowing it to conform to the shape in which it was wrapped. As long as a perm is processed correctly, what you wrap is what you get. The first part of any permanent involves wrapping the hair in the desired shape. In a perm wrap, just as in a wet set, wetting the hair with water breaks the hydrogen bonds and permits the hair to be wrapped in the desired shape.

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A perm wrap is essentially a wet set on perm rods instead of rollers. The major difference between a wet set and a permanent wave is the type of side bonds that are broken. A wet set breaks hydrogen bonds. A permanent wave breaks disulfide bonds.The size of the perm tool determines the size of the curl. Small tools produce small curls and large tools produce large curls. Wrapping the hair on small tools increases the tension, which increases the amount of curl. Although it is tension that produces the curl, too much tension, especially in one spot, can mark or break the hair. Keep the hair wet while wrapping, and always wrap with uniform, even tension.

Sectioning

All perm wraps begin by sectioning the hair into panels. The size, shape, and direction of these panels vary, based on the type of wrapping pattern and the type and size of the tool being used. Each panel is further divided into subsections called base sections. One tool is normally placed on each base section. The size of each base section is usually the length and width of the tool being used.

Base Control

Base control refers to the position of the tool in relation to its base section and is determined by the angle at which the hair is wrapped. Tools can be wrapped on base, half off base, or off base. In on- base placement, the hair is wrapped at an angel 45 degrees beyond perpendicular to its base section. The tool is positioned on its base section. Although on-base placement may result in greater volume at the scalp area, any increase in volume will be lost as soon as the hair begins to grow out. Caution should be used with on-base placement because of the additional stress and C.O.E.tension it places CONTINUING on the hair. Wrapping hair on base may damage orEDUCATION break the hair.

Half-off base placement refers to wrapping the hair at an angle of 90 degrees (perpendicular) to its base section. The tool is positioned half off its base section. Half-off-base placement minimizes stress and tension on the hair. Off-base placement refers to wrapping the hair at an angle 45 degrees below perpendicular to its base section. The tool is positioned completely off its base section. Off base placement creates the least amount of volume and results in a curl pattern that begins farthest away from the scalp.

Base Direction

Base direction refers to the angle at which the tool is positioned on the head: horizontally, vertically, or diagonally. Base direction also refers to the directional pattern in which the hair is wrapped. Although directional wraps can be wrapped backward, forward, or to one side, wrapping with the natural direction of hair growth causes the least amount of stress to the hair. Wrapping against the natural growth pattern causes excess stress that may damage or break the hair.

Wrapping Techniques

There are two basic methods of wrapping the hair around the perm tool: croquignole and spiral.In croquignole perms, the hair strands are wrapped from the ends to the scalp, in overlapping layers. Because the hair is wrapped at an angle perpendicular to the length of the tool, each new layer of hair is wrapped toward the scalp on top of the previous layer. This increases the effective size of the tool with each new overlapping layer and produces a tighter curl at the ends and a larger curl at the scalp. Longer thicker hair increases this effect. In most spiral perms, the hair is wound from the ends to the scalp although depending on the tools used, some may also be wrapped from the scalp to the ends. The difference should not affect the finished curl. C.O.E. CONTINUING EDUCATION

In a spiral perm wrap, the hair is wrapped at an angle other than perpendicular to the length of the tool. The angle at which the hair is wrapped caused the hair to spiral along the length of the tool, like the grip on a tennis racquet.Although the layers in a spiral perm wrap may partially overlap the preceding layers, as long as the angle remains constant, any overlap will be uniform along the length of the tool and the entire strand of hair. This wrapping technique causes the effective size of the tool to remain the same along the entire length of the strand, producing a uniform curl from the scalp to the ends. Longer, thicker hair will benefit the most from this effect.

Perm Tools

As we have noted, in permanent waving, the size of the tool determines the size of the curl. The shape and type of curl is determined by the shape and type of tool and the wrapping method. Selecting the correct perm tool and wrapping method is the key to creating a successful permanent. Perm tools come in a wide variety of sizes and shape that can be combined with different wrapping methods to provide an exciting range of styling options.

Types of Rods

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Concave rods are the most common type of perm rod. They are usually used with a croquignole wrapping technique. Concave rods have a smaller circumference in the center that increases to a larger circumference on the ends. They produce a tighter curl in the center and a looser, larger curl on either side of the strand.

Straight rods are also usually used with a crquignole wrapping technique. Since straight rods are equal in circumference along their entire length or curling area, they produce a uniform curl along the entire width of the strand.Concave and straight rods come in different lengths. Since the length All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 26 CONTINUING EDUCATION

of the base section is usually the same length as the rod, fewer rods are required when using long rods. Long, straight rods can also be used with a spiral wrapping technique to produce spiral perms, as long as the length of the rod will accommodate the length of the hair.Although more rods may be needed when using short rods, they fit closer to the rounded curvatures of the head. Short rods can also be used for wrapping small and awkward sections where long rods would not fit.

Other Perm Tools

Soft bender rods are usually about 12 inches long with a uniform diameter along the entire length. These soft foam rods have a stiff wire inside that permits them to be bent into almost any shape. Soft bender rods can be used with either a croquignole or spiral wrapping technique. The circle tool or loop rod is usually about 12 inches long with a uniform diameter along the entire length of the rod. The extra length of the circle tool is ideal for spiral wrapping on extremely long hair. After the hair is wrapped, the rod is secured by fastening the ends together to form a circle.

End Papers

End papers or end wraps are absorbent papers used to control the ends of the hair when wrapping and winding hair on the perm tools. End papers should extend beyond the ends of the hair to keep them smooth and straight and prevent "fishhooks". The most common end paper techniques are the double flat wrap, the single flat wrap, and the bookend single paper wrap.

 The double flat wrap uses two end papers, one placed under and one over the strand of hair being wrapped. Both papers extend past the hair ends. This wrap provides the most control over the hair ends and also helps keep them evenly distributed over the entire length C.O.E.of the tool.CONTINUING EDUCATION

 The single flat wrap is similar to the double flat wrap, but uses only one end paper, placed over the top of the strand of hair being wrapped.

 The bookend wrap uses one end paper folded in half over the hair ends like an envelope. Prefolded end papers are available, or you can fold a single large end paper and place it over the top and bottom of the hair so that it extends past the hair ends. The bookend wrap All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 28 CONTINUING EDUCATION

eliminates excess paper and can be used with short rods or with very short lengths of hair. Be careful to distribute the hair evenly over the entire length of the rod. Avoid bunching the ends together toward the center of the rod.

The Chemistry of Permanent Waving

Hair saturated with alkaline solution

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The same hair saturated with acid balanced permanent waving solution.

Alkaline permanent waving solution softens and swells the hair, which raises the cuticle and permits the solution to penetrate into the cortex, Note that there is far less swelling of the cuticle layer. Once in the cortex, the waving solution breaks the disulfide bonds through a chemical reaction called reduction. A reduction reaction involves either the addition of hydrogen or the removal of oxygen. The reduction reaction in permanent waving is due to the addition of hydrogen. In examining the reduction reaction more closely, we can see that a disulfide bond joins a sulfur atom on one polypeptide chain with a second sulfur atom on a neighboring polypeptide chain. Permanent waving solution breaks a disulfide bond by adding a hydrogen atom to each of the sulfur atoms in the disulfide bond. The sulfur atoms attach to the hydrogen from the permanent waving solution, breaking their attachment to each other. Once the disulfide bond is broken, the polypeptide chains are able to slip into their new curled shape.

The reducing agents used in permanent waving solutions are thiol compounds, commonly referred to simply as thio. Thioglycolic acid is the most common. It is a colorless liquid with a strong unpleasant odor. Thioglycolic acid provides the hydrogen that causes the reduction reaction in permanent waving solutions. The strength of the permanent waving solution is determined by the concentration of thio. Stronger perms have a higher concentration of thio with a greater number of hydrogen atoms. When more hydrogen atoms are available, more disulfide bonds are broken. Thioglycolic acid is an acid, and since acids do no swell the hair or penetrate into the cortex, it is necessary for manufacturers to add an alkalizing agent. The addition of ammonia to thioglycolic acid produces a new chemical called ammonium thioglycolate which is alkaline. ATG is the main active ingredient or reducing agent in alkaline permanents. The degree of alkalinity (pH) is a second factor in the overall strength of the permanent waving solution. Coarse hair with a strong, resistant cuticle layer may need the additional swelling and penetration that is provided by a more alkaline permanent waving solution.

By contrast, porous hair or hair with a damaged cuticle layer is easily penetrated and could be damaged by a highly alkaline permanent waving solution. The pH (alkalinity of the perm solution should correspond to the resistance, strength, and porosity of the cuticle layer.

Types of Permanent Waves

A variety of permanent waves is available in salons today. Brief descriptions of the most commonly used perms follow.

Alkaline Waves or Cold Waves

The first alkaline waves (or cold waves) were developed in 1941 and relied on the same ATG that is still used in most alkaline waves today. Since alkaline waves process at room temperature without the addition of heat, they became commonly known as cold waves. Most alkaline waves have a pH between 9.0 and 9.6.

True Acid Waves

The fist true acid waves were introduced in the early 1970s. Most true acid waves have a pH between 4.5 and 7.0 and require heat to speed processing. Glyceryl monothioglycolate is the main active ingredient and is an acid, with a low pH. Although a lower pH tends to cause less damage to the hair, acid waves process more slowly, may require the added heat of a hair dryer, and do not usually produce as firm a curl as alkaline waves. All acid waves have three separate components: permanent waving solution, activator, and neutralizer. The activator tube contains GMTG, which must be added to the permanent waving solution immediately before use.

Although GMTG is the primary reducing agent in all modern acid waves, it may not be the only reducing agent. Most of these waves also contain ATG, just like a cold wave. Although the low pH of acid waves may seem ideal, repeated exposure to GMTG is known to cause allergic sensitivity C.O.E.in both hairstylists CONTINUING and clients. EDUCATION Exothermic Waves

An exothermic chemical reaction produces heat. Exothermic waves create an exothermic chemical reaction that heats up the solution and speeds up the processing. All exothermic waves have three components: permanent waving solution, an activator, and a neutralizer. The permanent waving solution contains thio, just as in a cold wave. The activator contains an oxidizing agent (usually

hydrogen peroxide.) that must be added to the permanent waving solution immediately before use. Mixing an oxidizer with the permanent waving solution causes a rapid release of heat and an increase in the temperature of the solution. The increased temperature increases the rate of the chemical reaction, which shortens the processing time.

Recommended Perm Type Active Ingredient Process Results Advantages Disadvantages Hair Type

alkaline/cold ammonium thioglycolate room coarse, thick, firm, processes unpleasant wave ph: 9.0 (ATG) temperature or resistant strong quickly at ammonia odor; to 9.6 curls room may damage temperature delicate hair exothermic ammonium thioglycolate exothermic coarse, thick, firm, exothermic unpleasant wave ph: 9.0 (ATG) or resistant strong reaction ammonia odor; to 9.6 curls causes may damage solution to delicate hair get hot true acid glyceryl endothermic extremely soft, low pH requires heat wave ph 4.5 monothioglycolate porous or very weak produces from hair to 7.0 (GMTG) damaged hair curls minimal dryer; will not swelling produce firm strong curls acid- glyceryl room porous or soft minimal repeated balanced monothioglycolate temperature damaged hair curls swelling; exposure wave ph: 7.8 (GMTG) processes at causes allergic to 8.2 room sensitivity in temperature clients and stylists ammonia- monoethanolamine room porous to medium no overall free wave (MEA)/ temperature normal hair to fine unpleasant strength varies ph: 7.0 to Aminomethylpropanol curls ammonia with different 9.6 (AMP0 odor manufacturers thio-free mercaptamine/cysteamine room porous to medium may be overall wave temperature normal to fine gentler strength varies curls depending with different on formula manufacturers low-pH ammonium endothermic normal, fine or weak minimal requires heat waves ph: sulfite/ammonium damaged curl or swelling from hair 6.5 to 7.0 bisulfite body dryer; All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 32 CONTINUING EDUCATION

wave produces weak curls

Endothermic Waves

An endothermic chemical reaction is one that absorbs heat from its surroundings. Endothermic waves are activated by an outside heat source, usually a conventional hood-type hair dryer. Endothermic waves will not process properly at room temperature. Most true acid waves are endothermic and require the added heat of a hair dryer.

Ammonia-Free Waves

Ammonia-free waves use an ingredient that does not evaporate as readily as ammonia, so there is very little odor associated with their use. Aminomethylpropanol (AMP) and monoethanolamine (MEA) are examples of alkanolamines that are used in permanent waving solutions as a substitute for ammonia. Even though these solutions may not smell as strong as ammonia, they can still be every bit as alkaline and just as damaging. Ammonia-free does not necessarily mean damage-free.

Thio-Free Waves

Thio-free waves use an ingredient other than ATG as the primary reducing agent. The most common thio-free waves rely on cysteamine, or mercaptamine. Although these thio substitutes are not technically ATG, they are still thio compounds. Although thio-free is often marketed as damage-free, that is not necessarily true. At a high concentration, the reducing agents in thio-free waves can be just as damaging as thio.

Low-pH Waves

The use of sulfates, sulfites, and bisulfites presents an alternative to ATG known as low-pH waves. Sulfites work at a low pH and have been used in perms for years, nut they have never been very popular. Permanents based on sulfites are very weak and do not provide a firm curl, especially on strong or resistant hair. Sulfite permanents are usually marketed as body waves or alternative C.O.E.waves. CONTINUING EDUCATION Selecting the Right Type of Perm

It is extremely important to select the right type for each client. Every client has hair with its own distinct texture and condition, so individual needs must always be addressed. After a thorough consultation, you should be able to determine which type of permanent is best suited to your client's hair type, condition, and desired results.

SECTION 3

Permanent Wave Processing

The strength of any permanent wave is based on the concentration of its reducing agent. In turn, the amount of processing is determined by the strength of the permanent waving solution. If weak permanent waving solution is used on coarse hair, there may not be enough hydrogen atoms to break the necessary number of disulfide bonds, no matter how long the permanent processes. But the same weak solution may be exactly right for fine hair with fewer disulfide bonds. On the other hand, a strong solution, which releases many hydrogen atoms, may be perfect for coarse hair, but too damaging for fine hair. The amount of processing should be determined by the strength of the solution, not necessarily how long the perm processes. In permanent waving, most of the processing takes place as soon as the solution penetrates the hair, within the first five to ten minutes. The additional processing should be determined by the strength of the solution, not necessarily how long the perm process. In permanent waving, most of the processing takes place as soon as the solution penetrates the hair, within the first five to ten minutes. The additional processing time allows the polypeptide chains to shift into their new configuration.

Over processed Hair

If you find that your client's hair has been over processed, it probably happened within the first five to ten minutes of the service, and a weaker permanent waving solution should have been used. If the hair is not sufficiently processed after ten minutes, it may require a reapplication of solution. Resistant hair requires a stronger solution, and a more thorough saturation. Thorough saturation of the hair is essential to proper processing in all

permanent waves, but especially on resistant hair. Regardless of the strength or pH of the solution, resistant hair may not become completely saturated with just one application of waving solution. You may need to apply the solution slowly and repeatedly until the hair is completely saturated. A thorough saturation with stronger solution will break more disulfide bonds and process the hair more, but processing the hair more does not necessarily translate into more curl. A properly processed permanent wave should break and rebuild approximately 50 percent of the hair's disulfide bonds. If too many disulfide bonds are broken, the hair may not have enough strength left to hold the desired curl. Weak hair equals a weak curl. Contrary to what many believe, over processed hair does not necessarily mean hair that is overly curly. If too many disulfide bonds are broken, the hair will be too weak to hold a firm curl. Over processed hair usually has a weak curl or may even be completely straight. Since the hair at the scalp is usually stronger than the hair at the ends, over processed hair is usually curlier at the scalp and straighter at the ends. If the hair is over processed, processing it more will make it straighter.

Under processed Hair

Under processed hair is, as the name suggests, the exact opposite of over processed hair. If too few disulfide bonds are broken, the hair will not be sufficiently softened and will not be able to hold the desired curl. Under processed hair usually has a very weak curl, but it may also be straight. Since the hair at the scalp is usually stronger than the ends, under processed hair is usually straighter at the scalp and curlier at the ends. If the hair is under processed, processing it more will make it curlier.

Permanent Waving Neutralization

Neutralization is the process of stopping the action of a permanent wave solution and hardening the hair in its new form by the application of a chemical solution called the neutralizer. Neutralization C.O.E.performs two importantCONTINUING functions. EDUCATION

1. It deactivates (neutralizers) any waving solution that remains in the hair. 2. It rebuilds the disulfide bonds that were broken by the waving solution.

The neutralizers used in permanent waving are oxidizers. In fact, the term neutralizer is not very accurate because the chemical reaction involved is actually oxidation. The most common

neutralizer is hydrogen peroxide. Concentrations vary between 5 volume (1.5 percent) and 10 volume (3 percent).

Neutralization: Stage One

The first function of permanent waving neutralization is the deactivation, or neutralization, of any waving lotion that remains in the hair after processing and rinsing.

The Chemical reaction involved is oxidation. As we know, oxidation reactions can also lighten hair color, especially at an alkaline pH. To avoid scalp irritation and unwanted lightening of hair color, always rinse perm solution from the hair fro at least five minutes before applying the neutralizer. After rinsing and before applying the neutralizer, the hair should be blotted with towels to remove as much moisture as possible. Blot each rod several times using dry towels. Excess water left in the hair prevents even saturation and dilutes the neutralizer. Some manufacturers recommend the application of a preneutralizing conditioner after blotting and before application of the neutralizer. An acidic liquid protein conditioner can be applied to the hair and dried under a warm hair dryer for five minutes or more prior to neutralization.

This added step is especially beneficial with much damaged hair because it strengthens the hair prior to neutralization. This step is optional, however. Always follow the manufacturers' directions and the procedures approved by your instructor.

Neutralization: Stage Two

As you have learned, waving solution breaks disulfide bonds by adding hydrogen atoms to the sulfur atoms in the disulfide bond. Neutralization rebuilds the disulfide bonds by removing those extra hydrogen atoms. The hydrogen atoms in the disulfide bonds are so strongly attracted to the oxygen in the neutralizer that they release their bond with the sulfur atoms and join with the All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 36 CONTINUING EDUCATION

oxygen. Each oxygen atom joins with two hydrogen atoms to rebuild one disulfide bond and make one molecule of water. The water is removed in the final rinse, and the disulfide bonds form in their new curled position.

When the neutralizer removes the extra hydrogen atoms, each sulfur atom forms a bond with its nearest neighboring sulfur atom. This is not the same pair that was originally bonded, by a newly created pair that is now closer together because of the physical forces involved in wrapping the hair around the perm rod. The strength of these newly formed disulfide bond pairs holds the hair in its new shape.

Post-Perm Hair Care

For a variety of reasons, most hairstylists have always recommended a three-day waiting period before shampooing freshly permed hair. Although some of their concerns may be valid, a properly neutralized perm is stable. The bonds in the hair are re-formed immediately, and there is no scientific basis for the standard three-day waiting period. Shampooing a properly processed permanent with the mild acid-balanced shampoos that are available today should not cause excessive relaxation or damage to the hair or scalp.

Most hairstylists have also recommended a three-day waiting period before performing haircolor services on freshly permed hair. Although there may be some concern about scalp irritation or excessive relaxation, a permanent is stable as soon as it has been properly neutralized. Unless there are signs of scalp irritation, modern demipermanent, deposit-only haircolors are safe to use on freshly permed hair. Always follow the manufacturers' directions and the procedures approved by C.O.E.your instructo r.CONTINUING EDUCATION

Safety Precautions for Permanent Waving

 Always protect your client's clothing. Have the client change into a gown, use a waterproof shampoo cape, and double drape with towels to absorb accidental spills.

 Do not give a permanent to any client who has experienced an allergic reaction to previous permanent.  Do not save any opened, unused waving lotion or neutralizer. These lotions may change in strength and effectiveness if not used promptly.  Do not dilute or add anything to the waving lotion or neutralizer unless specified in the manufacturer's directions.  Keep waving lotion out of the client's eyes and away from the client's skin. In case of accidental exposure, rinse thoroughly with cool water.  Always follow the manufacturer's directions.  Wear gloves when applying solutions.  Immediately replace cotton or towels that have become wet with solution.  Always examine the scalp before the perm service. Do not proceed if there are any skin abrasions or any signs of scalp disease.  Do not perm hair that is excessively damaged or shows signs of breakage.  Do not attempt to perm hair that has been previously treated with hydroxide relaxers.  Always perform a test for metallic salts to see if there is a possibility that metallic haircolor was used on the hair previously.  Always apply protective barrier cream around the client's hairline and ears prior to applying permanent waving solution.  The hair should be given reconditioning treatments until the condition improves and the damaged hair can be cut off.

Metallic Salts

Some home haircoloring products contain metallic salts that are not compatible with permanent waving. Metallic salts leave a coating on the hair that may cause uneven curls, severe discoloration, or hair breakage.

Metallic salts are commonly found in men's haircolors that are sold for home use. Haircolor restorers and progressive haircolors that darken the hair gradually with repeated applications are the most likely to contain metallic salts. If you suspect that metallic salts may be present on the hair, perform the following test.

In a glass or plastic bowl, mix 1 ounce of 20 volume peroxide with 20 drops of 28 percent ammonia. Immerse at least 20 strands of hair in the solution for 30 minutes. If metallic salts are not present, the hair will lighten slightly and you may proceed with the service. If metallic salts are present, the hair will lighten rapidly. The solution may get hot and give off an unpleasant odor, indicating that you should not proceed with the service.

Let us now turn to the basic perm procedures. The information presented earlier in the chapter on sectioning, base control, base direction, perm tools, wrapping techniques, and wrapping patterns should be used with the following procedures. These basic wrapping methods may be combined in

different ways to create a wide variety of specialized perm wraps that provide an unlimited number of styling options.

The basic perm wrap is also called a straight set wrap. In this wrapping pattern, all the tools within a panel move in the same direction and are positioned on equal-size bases. All base sections are horizontal, with the same length and width as the perm tool. The base control is half off base.

Basic perm wrapping pattern

In the curvature perm wrap, the movement curves within sectioned-out panels. Partings and base radiate throughout the panels to follow the curvature of the head. This wrapping pattern uses pie- shaped base sections in the curvature areas.

C.O.E. CONTINUING EDUCATION

Curvature perm wrapping pattern

The brick lay perm wrap is similar to the actual technique of bricklaying. Base sections are offset from each other row by row, to prevent noticeable splits and to blend the flow of the hair. Different brick lay patterns use different starting points (front hairline, occipital area, and crown), and these can be used with different combinations of sectioning, base control, base direction, wrapping techniques, and perm tools.

Bricklay perm wrapping pattern

The weave technique uses zigzag partings to divide base areas. It can be used throughout the entire perm wrap or can be kept to selected areas. This technique is very effective for blending between perm rods with opposite base directions. It can also be used to create a smooth transition from the rolled areas into the unrolled areas of a partial perm. The wave technique can be used with a variety of base directions, wrapping patterns, and perm tools.

Weave technique

The double tool technique is also called a piggyback wrap because two tools are used for one strand of hair, one on top of the other. The lower half of the strand is wrapped around one tool, and then the upper half of the same strand is wrapped around a second tool and stacked on top of the first.

C.O.E. CONTINUING EDUCATION

Piggyback Wrap

The double tool technique doubles the number of tools used. Using more tools increases the amount of curl in the finished perm, making this technique especially effective on long hair. Tools with different diameters may be used to create different effects. This technique can also be used with a variety of base directions, wrapping patterns, and perm tools.

Unlike other techniques that are performed at an angle perpendicular to the length of the tool, the spiral perm technique, also called a spiral perm wrap is done at an angle that causes the hair to spiral along the length of the tool, like the grip on a tennis racquet.

Although the layers in a spiral perm may partially overlap as they go along, as long as the angle remains constant, any overlap will be uniform along the length of the tool and the entire stand of hair. Since the effective size of the tool remains constant along the entire strand of hair, this technique produces a uniform curl from the scalp to the ends. Longer, thicker hair will benefit most from this effect.

The spiral wrapping technique can be used with a variety of base sections, base directions, and wrapping patterns. Base sections may be either horizontal or vertical and do not affect the finished curl. Conventional rods, bendable soft foam rods, and the circle tool can all be used for this technique, depending on the length of the hair. The implements and materials and the procedures for preparation, processing, and cleanup are the same for all perms, as described in the Basic Perm Wrap.

Preliminary Test Curls

Taking preliminary test curls helps you predict how your client's hair will react to a perm. It is advisable to take preliminary test curls if the hair is damaged or if there is any uncertainty about the results.

Preliminary test curls provide the following information:

 Correct processing time for optimal curl  Results you can expect from the type of perm solution you have selected C.O.E. Curl resultsCONTINUING for the tool size and wrapping technique you areEDUCATION planning to use

Partial Perms

If your client wants a perm but does not wish for the entire head of hair to be curled, a partial perm may be the answer. Partial perms also allow you to give a perm when some of the hair is too short to roll on tools. Partial perms can be used for:

 Male and female clients who have long hair on the top and crown, but very short hair with tapered sides and nape.  Clients who only need volume and lift in certain areas.  Clients who desire a hairstyle with curls along the perimeter but a smooth, sleek crown. Partial perms rely on the same techniques and wrapping patterns as those used with other perms, but there are some additional considerations.  In order to make a smooth transition from the rolled section to the unrolled section, use a larger tool for the last tool next to an unrolled section.  Applying waving lotion to unrolled hair may straighten it or make it difficult to style. To protect the unrolled hair, apply a protective barrier cream to the unrolled section before applying the waving lotion. SECTION 4

Basic Perm-implements and Materials

The following is a general list of the implements and materials used in permanent waving.

 Perm solution  Neutralizer  Acid-balanced shampoo (optional)  Preneutralizing conditioner (optional)  Conditioner (optional)  Protective barrier cream  Applicator bottles  Perm tools  Shampoo cape  Towels

 Neutralizing bib  Roll cotton  Plastic clips for sectioning  Styling comb  Plastic rat-tail comb  End papers  Roller picks (optional)  Spray bottle  Disposable gloves  timer

Preparation for All Perms

1. Wash your hands.

2. Conduct a client consultation and evaluation. Fill out the client's perm record. Note any changes in the client's history. C.O.E. CONTINUING EDUCATION

3. Perform an analysis on the client's air and scalp.

4. Have the client change into a gown and remove eyeglasses, earrings and necklace. 5. Drape the client for shampoo. 6. Gently shampoo and towel-dry hair. Avoid irritating the client's scalp.

7. Perform a preliminary test curl procedure.

Procedure for Preliminary Test Curls

C.O.E. CONTINUING EDUCATION

1. Wrap one tool in each different area of the head (the top, the side, and the nape)

2. Wrap a coil of cotton around each tool. 3. Apply waving lotion to the wrapped curls. Do not allow waving lotion to come into contact with unwrapped hair.

4. Set a time and process according to the manufacturer's directions. 5. Check each test curl frequently for proper curl development. Unfasten the tool and unwind the curl about 1 ½ turns of the tool. Do not allow the hair to become loose or completely unwound. Gently move the tool toward the scalp to encourage the hair to fall loosely into the wave pattern. 6. Curl development is complete when a firm and definite "5" is formed that reflects the size of the tool used. Different hair textures will have slightly different "S" formations. The All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 48 CONTINUING EDUCATION

wave pattern for fine, thin hair may be weak, with little definition. The wave pattern for coarse, thick hair is usually stronger and better defined.

7. When the curl has been formed, rinse thoroughly with warm water for at least five minutes, blot thoroughly, apply neutralizer, and process according to the manufacturers' directions. Gently dry the hair and evaluate the results. Do not proceed with the permanent if the test curls are extremely damaged or over processed. If the test curl results are satisfactory, proceed with the perm, but I DO NOT re-perm these preliminary test curls. Procedure for Basic Perm Wrap

(Straight Set Wrap)

1. Divide the hair into nine panels. Use the length of the tool to measure the width of the panels. Remember to keep the hair wet as you wrap.

C.O.E. CONTINUING EDUCATION

2. Begin wrapping at the front hairline or crown. Make a horizontal parting the same size as the tool. Using two end papers roll the hair down to the scalp in the direction of hair growth and position the tool half-off base.

The band should be smooth, not twisted, and should be fastened straight across the top of the tool. Excessive tension may cause band marks or hair breakage. Continue wrapping the remainder of the first panel using the same technique.

Option: Insert roller picks to stabilize the tools. Although roller picks may be used to C.O.E.eliminate CONTINUING any tension caused by the band, they will not compensate EDUCATION for a poorly wrapped perm. If roller picks are not used correctly, they can cause the same damage as the incorrect placement of the rubber band. 3. Continue wrapping the remaining eight panels in numerical order, holding the hair at a 90- degree angle.

Procedure for Processing Permanents

1. Apply protective barrier cream to the hairline and the ears. Apply roll cotton around the entire hairline and offer the client a towel to blot any drips.

2. Slowly and carefully apply the perm solution with a bottle to the hair on each tool. Ask the client to lean forward while you apply solution to the back area, and then ask the client to lean back as you apply solution to the front and sides. Avoid splashing and dripping. Continue to apply the solution slowly until each tool is completely saturated.

3. If a plastic cap is used, punch a few holes in the cap and cover the hair completely. Do not allow the plastic cap to touch the client's skin.

4. Check cotton and towels. If they are saturated with solution, replace them. C.O.E.5. Process CONTINUING according to the manufacturer's directions. Processing EDUCATION time varies according to the strength of the solution, the hair type and condition, and the desired results. Processing usually takes less than 20 minutes at room temperature. 6. Check frequently for curl development. Unwind the tool and check the "S" pattern formation described in the preliminary test curl procedure.

7. When processing is completed, rinse the hair thoroughly for at least five minutes, then towel-blot the hair on each tool to remove any excess moisture. Another option that some manufacturers recommend is to apply a preneutralizing conditioner to the hair, after rinsing and blotting and before applying the neutralizer. Remember, though, that this step is optional. Always follow the manufacturers' directions and the procedures approved by your instructor.

8. Apply the neutralizer slowly and carefully to the hair on each tool. Ask the client to lean forward while you apply solution to the back area, then to lean back as you apply solution to the front and sides. Avoid splashing and dripping. Continue to apply the neutralizer until each tool is completely saturated.

9. Set a time for the amount of time specified by the manufacturer. After processing, remove the tools and work the remaining neutralizer through the hair gently with your hands. 10. Rinse thoroughly. It is optional, at this point, to also shampoo and condition. Always follow the manufacturers' directions and the procedures approved by your instructor. 11. Style the hair as desired.

C.O.E. CONTINUING EDUCATION

Cleanup and Sanitation

1. Discard disposable supplies in appropriate receptacles. 2. Sanitize implements and store according to sanitation requirements. 3. Clean, sanitize, and prepare your workstation for the next service.

4. Wash your hands thoroughly with soap and warm water. 5. Complete the client record

Curvature Perm Wrap

Implements and Materials

Same as for basic perm

Preparation

Same as for basic perm

Procedure:

1. Begin sectioning at the hairline on one side of the part. Comb the hair in the direction of growth, then section out individual panels to match the length of the rod.

2. Alternate from side to side as you section out all the curvature panels over the entire head. Sectioning the panels in advance creates a road map that provides direction and gives continuity to the wrapping pattern.

3. Begin wrapping the first panel at the front hairline, on one side of the part. Comb out a base section the same width as the diameter of the rod. The base direction should pint away from the face. Hold the hair at a 90-degree angle to the head. Using two end papers roll the hair down to the scalp and position the rod half-off base.

C.O.E. CONTINUING EDUCATION 4. The remaining base sections in the panel should be wider on the outside of the panel (the side farthest away from the face). Continue wrapping the rest of the rods in the panel, alternating rod diameters.

Option: Insert picks to stabilize the rods and to eliminate any tension caused by the band.

5. When you reach the last rod at the hairline, comb the hair flat at the base and change the base direction. Direct the rod up and toward the base, keeping the base area flat.

6. Continue with panel two, which is the front panel. 7. Continue with the third panel, which is the panel behind and next to the first panel. Repeat the same procedure until you reach the last two rods at the hairline. Comb the hair flat at the base and change the base direction. Direct the last two rods up and toward the base, keeping the base area flat.

C.O.E. CONTINUING EDUCATION 8. Continue with the fourth panel, on the opposite side of the head, behind and next to the second panel. Repeat the same procedure you used with the third panel. 9. Follow the same procedure with the fifth panel. The base direction should remain consistent with the pattern already established. The base direction in the back flows around and contours to the perimeter hairline area.

10. All panels should fit the curvature of the head and should blend into the surrounding panels.

11. Process and style the hair.

12. Follow cleanup and sanitation procedures for the basic perm.

Brick lay Perm Wrap

Implements and Materials

Same as for the basic perm procedure

Preparation

Same as for the basic perm procedure

Procedure

1. Begin by parting out a base section parallel to the front hairline that is the length and width of the rod being used. The base direction is back, away from the face. Hold the hair at a 90- degree angle to the head. Using two end papers roll the hair down to the scalp and position the rod half-off base.

2. In the second row directly behind the first rod, part out two base sections for two rods offset from the center of the first rod. Hold the hair at a 90-degree angle to the head. Using two end papers roll the hair down to the scalp and position the rods and eliminate any tension C.O.E.caused CONTINUING by the band. EDUCATION

3. Begin the third row by parting out a base section at the point where the two rods meet in the previous row. This same pattern is used throughout the entire wrap.

4. Continue to part out rows that radiate around the curve of the head through the crown area. Extend rows around and down the side hairline, parting out base sections at the center of the point where the two tools meet in the previous row.

5. Stop the curving rows after you have finished wrapping the crown area. Part out horizontal sections throughout the back of the head and continue with the brick lay pattern. You may need to change the length of the rods from row to row to maintain the pattern.

C.O.E. CONTINUING EDUCATION

6. Process and style the hair.

7. Follow cleanup and sanitation procedures for the basic perm procedure.

Weave Technique

The weave technique can be used with any of the wrapping patterns in this chapter.

Implements and Materials

Same for the basic per procedure

Preparation

Same for the basic perm procedure

Procedure

1. Part out one base section the same size as two rods. Comb the entire base section at a 90- degree angle to the head and use a rat-tail comb to make a zigzag parting along the length of the base section.

2. Using two end papers roll half of the strand down to the scalp. Comb the remaining half of the base section at a 90-degree angle, use two end papers, and roll the strand down to the scalp. Option: Secure the rods and insert picks to stabilize the rods and to eliminate any tension caused by the band.

C.O.E. CONTINUING EDUCATION 3. Continue with the same procedure in any sections where the effect is desired.

4. After processing and styling, follow cleanup and sanitation procedures for basic perm.

Double Tool (piggyback) Technique

The double tool (piggyback) technique can be used with any of the wrapping patterns in this chapter.

Implements and Materials

Same as for the basic perm procedure

Preparation

Same as for the basic perm procedure

Procedure

1. Begin by placing the base rod in the middle of the strand. Wrap the end of the strand one revolution around the rod while holding it to one side.

Roll the rod to the base area, letting the loose ends follow as you roll. Option: insert picks to stabilize the rods and to eliminate any tension caused by the band.

2. Place two end papers on the ends of the strand and position a rod to roll from the ends toward the base area. C.O.E. CONTINUING EDUCATION

Secure the end rod on top of the base rod.

3. Depending on the length and size of the rods, it may be possible to roll as many as three end strands together on the same end rod.

4. Continue with the same procedure in any sections where the effect is desired.

5. Process and style the hair.

C.O.E.6. Follow CONTINUING cleanup and sanitation procedures for the basic perm. EDUCATION

Spiral Perm Technique

Implements and Materials All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 69 CONTINUING EDUCATION

Same as for the basic perm procedure

Preparation

Same as for the basic perm procedure

Procedure

1. Part the hair into four panels, from the center of the front hairline to the center of the nape and from ear to ear. Section out a fifth panel from ear to ear in the nape area.

2. Section out the first row along the hairline in the nape area. Comb the remainder of the hair up and secure it out of the way. 3. Part out the first base section on one side of the first row. Hold the hair at a 90-degree angle to the head. Using one or two end papers, begin wrapping atone end of the tool. Starting the wrap from the right or left side of the tool will orient the curl in that direction.

4. Roll the first two full turns at a 90-degree angle to the tool to secure the ends of the hair and then start spiraling the hair on the tool by changing the angle to an angle other than 90 degrees. Continue to spiral the hair toward the other end of the tool. Roll the hair down the scalp, position the tool half off base, and secure it by fastening the ends of the tool together.

C.O.E. CONTINUING EDUCATION 5. Continue wrapping with the same technique, in the same direction, until the first row is completed.

6. Section out the second row above the parallel to the first row. Comb the remainder of the hair up and secure it to keep it out of the way. 7. Begin wrapping at the opposite side from the side where the first row began, and move in the direction opposite the direction established in the first row.

8. Follow the same procedure to wrap he second row but begin wrapping each tool at the opposite end established in the first row. Continue wrapping with the same technique, in the same direction, until the second row is completed.

9. Section out the third row above and parallel to the second row. Follow the same wrapping procedure, alternating the rows from left to right as you move up the head. This will alternate the orientation of the curl throughout the head.

C.O.E. CONTINUING EDUCATION

10. Process and style the hair.

11. After processing and styling, follow cleanup and sanitation procedures for the basic perm.

Perms for Men

Do not assume that perms are only for women. Many male clients are looking for the added texture, fullness, style, and low maintenance that only a perm can provide. Perms help thin hair look fuller, make straight or coarse hair more manageable, and help control stubborn cowlicks. Although men's and women's hairstyles may be different, the techniques for permanent waving are essentially the same.

Chemical Hair Relaxers

Chemical hair relaxing is the process of rearranging the basic structure of extremely curly hair into a straight form. Whereas permanent waving curls straight hair, chemical hair relaxing straightens curly hair. Other than their objectives being so different, the two services are very similar. In fact, the chemistry of thio relaxers and permanent waving is exactly the same. And even though the chemistry of hydroxide relaxers and permanent waving may be different, all relaxers and all permanents change the shape of the hair by breaking disulfide bonds. The two most common types of chemical hair relaxers are this (ATG) and hydroxide.

Extremely Curly Hair

Extremely curly hair exists in all races. That means anyone of any race, or mixed race, can have extremely curly hair. It is also true that, within races, individuals can have hair with different degrees of curliness. Extremely curly hair grows in long twisted spirals, or coils. Cross-sections are highly elliptical and vary in shape and thickness along their lengths. Compared to straight or wavy hair, which tends to possess a fairly regular and uniform diameter along a single strand, extremely curly hair is irregular, exhibiting varying diameters along a single strand. The thinnest and weakest sections of the hair strands are located at their twists. These sections are also bent at an extremely sharp angle and will be stretched the most during relaxing. A chain is only as strong as its weakest link, and hair is only as strong as its weakest section. Hair breaks at its weakest point. Extremely curly hair usually breaks at the twists because of the inherent weakness in that section and the extra physical force that is required to straighten it.

Thio Relaxers

Thio (AGT) is the same reducing agent that is used impermanent waving. Thio relaxers usually have a pH above 10 and a higher concentration of ATG than is used in permanent waving. Thio relaxers are also thicker, with a higher viscosity that is more suitable for application as a relaxer. Thio relaxers break disulfide bonds and soften hair, just as in permanents. After enough bonds are broken, the hair is straightened into its new shape and the relaxer is rinsed from the hair. Blotting comes next, followed by a neutralizer. The chemical reactions of thio relaxers are identical to those in permanent waving.

Thio Neutralization

The neutralizer used with thio relaxers is an oxidizing agent, usually hydrogen peroxide, just as in permanents. The oxidation reaction caused by the neutralizer rebuilds the disulfide bonds that were broken by the thio relaxer.

Hydroxide Relaxers

The hydroxide ion is the active ingredient in all hydroxide relaxers. Sodium hydroxide, potassium hydroxide, lithium hydroxide, and guanidine hydroxide are all types of hydroxide relaxers. All hydroxide relaxers are very strong alkalis that can swell the hair up to twice its normal diameter.

Hydroxide relaxers are not compatible with thio relaxers because they use a different chemistry. C.O.E.Thio relaxers haveCONTINUING a pH of about 10 and use thio to break the disulfide EDUCATION bonds. Although the high pH of a thio relaxer swells the hair, thio breaks the disulfide bonds. Hydroxide relaxers have an even higher pH. The average pH of the hair is 5.0 and many hydroxide relaxers have a pH over 13.0. Since each step in the pH scale represents a tenfold change in concentration, a pH of 13.0 is 100 million (100,000,000) times more alkaline than a pH of 5.0.

Hydroxide relaxers break disulfide bonds differently then in the reduction reaction of thio relaxers. Hydroxide relaxers remove one atom of sulfur from a disulfide bond, converting it into a lanthionine bond by a process called lanthionization. Disulfide bonds contain two sulfur atoms. Lanthionine bonds contain only one sulfur atom. The disulfide bonds that are broken by hydroxide relaxers are broken permanently and can never be re-formed.

Hydroxide Neutralization

Unlike thio neutralization, the neutralization of hydroxide relaxers does not involve oxidation. The deactivation (neutralization) of hydroxide relaxers neutralizes the alkaline residues left in the hair by the relaxer. The pH of hydroxide relaxers is so high that the hair remains at an extremely high pH, even after thorough rinsing. Although rinsing is important, rinsing alone does not deactivate the relaxer or restore the normal acidic pH of the hair. Acids neutralize alkalis. Therefore, the application of an acid-balanced shampoo or normalizing lotion neutralizes any remaining hydroxide ions to lower the pH of the hair and scalp.

Some neutralizing shampoos intended for use after hydroxide relaxers have a built in pH indicator that changes color to indicate when the pH of the hair has returned to normal. Since the disulfide bonds that have been broken by hydroxide relaxers cannot be re-formed by oxidation, application of a neutralizer that contains an oxidizing agent will not rebuild the disulfide bonds and will only damage the hair.

Types of Hydroxide Relaxers

Metal hydroxide relaxers are ionic compounds formed by a metal---sodium (Na), potassium (K), or lithium (Li) which is combined with oxygen (O) and hydrogen (H). Metal hydroxide relaxers include sodium hydroxide (NaOH), potassium hydroxide (KOH), and lithium hydroxide (LiOH). Although calcium hydroxide (CaOH) is sometimes added to hydroxide relaxers, it is not used by itself to relax hair.

All metal hydroxide relaxers contain only one component and are used exactly ad they are packaged in the container, without mixing. The hydroxide ion is the active ingredient in all

hydroxide relaxers. There is no significant difference in the performance of these metal hydroxide relaxers.

Sodium hydroxide (NaOH) relaxers are commonly called lye relaxers. Sodium hydroxide is the oldest and sill the most common type of chemical hair relaxer. Sodium hydroxide is also known as lye or caustic soda. Sodium hydroxide is the same chemical that is used in drain cleaners and chemical hair depilatories.

Lithium hydroxide (LiOH) and potassium hydroxide (KOH) relaxers are often advertised and sold as "no mix-no lye" relaxers. Although technically they are not lye, their chemistry is identical and there is very little difference in their performance.

Guanidine Hydroxide Relaxers

Guanidine hydroxide relaxers are usually advertised and sold as "no lye" relaxers. Although technically they are not lye, the hydroxide ion is still the active ingredient. Guanidine hydroxide relaxers contain two components that must be mixed immediately prior to use.

They straighten hair completely with much less scalp irritation than other hydroxide relaxers. Most guanidine hydroxide relaxers are recommended for sensitive scalps and are sold over-the-counter for home use. Although they reduce scalp irritation, they do not reduce hair damage. They swell the hair slightly more than other hydroxide relaxers and are also more drying, especially after repeated applications.

Low-pH Relaxers

Sulfites and bisulfites are sometimes used as low-pH hair relaxers. The most commonly used are ammonium sulfite and ammonium bisulfite. Sulfties are marketed as mild alternative relaxers. They are compatible with thio relaxers, but not compatible with hydroxide relaxers. They do not completely straighten extremely curly hair. Low -pH relaxers are intended for use on color-treated, damaged, or fine hair.

Base and No-base Relaxers

Hydroxide relaxers are usually sold in base and no-base formulas. Base cream is an oily cream C.O.E.used to protect CONTINUING the skin and scalp during hair relaxing. Base relaxers EDUCATION require the application of base cream to the entire scalp prior to the application of the relaxer.

No-base relaxers do not require application of a protective base. They contain a base cream that is designed to melt at body temperature. As the relaxer is applied, body heat causes the base to melt and settle out onto the scalp in a thin, oily, protective coating. No-base relaxers are simply an improvement on the protection that is provided by the oils in all hydroxide relaxers. For added

protection, base cream may be applied to the entire hairline and around the ears, even with no base relaxers.

Relaxer Strengths

Most chemical hair relaxers are available in three different strengths: mild, regular, and super. The difference in strength of hydroxide relaxers is due to the concentration of hydroxide.

 Mild strength relaxers are formulated for fine, color-treated, or damaged hair.

 Regular strength relaxers are intended for normal hair texture with a medium natural curl.  Super strength relaxers should be used for maximum straightening on coarse hair that is extremely curly.

Chemical Hair Relaxing Procedures

Many of the steps for applying thio and hydroxide relaxers are the same, but they do differ in some ways.

Hydroxide Relaxer Procedures

Some of the steps for hydroxide relaxers are different from those for thio relaxers. The procedure below should be used for all hydroxide relaxers. Although all hydroxide relaxers follow the same procedure, different application methods are used for virgin relaxers and retouch relaxers.

 A virgin relaxer application should be used for hair that has not had previous chemical texture services. Since the scalp area and the porous ends will usually process more quickly than the middle of the strand, the application for a virgin relaxer starts ¼ inch. To ½ inch away from the scalp and includes the entire strand, up to the porous ends. To avoid over processing and scalp irritation, do not apply relaxer to the hair closest to the scalp or to the ends until the last few minutes of processing.  A retouch relaxer application should be used for hair that has had previous chemical texture services. The application for a retouch relaxer starts ¼ inch to ½ inch away from the scalp and includes only the new growth. To avoid over processing and scalp irritation, do not apply relaxer to the hair closest to the scalp until the last few minutes of processing. In order to avoid breakage of the previously relaxed hair, apply cream conditioner over the hair that received the earlier treatment. Avoid overlapping on the previously relaxed hair unless it requires additional strengthening. If the previously relaxed hair requires additional straightening, relaxer may be applied for the last few minutes of processing.

Option: Some manufacturers recommend the use of a normalizing solution after rinsing out the relaxer and prior to shampooing. Normalizing solutions are conditioners with an acidic pH that condition the hair and restore the natural pH prior to shampooing.

Periodic Strand Testing

Periodic strand testing during processing will help to tell you when the hair is sufficiently relaxed. After the relaxer is applied, stretch the strands to see how fast the natural curls are being removed. You may also smooth and press the strand to the scalp using the back of the comb or your finger. If the strand remains smooth, it is sufficiently relaxed. If the curl returns, the strand remains smooth, it is sufficiently relaxed. If the curl returns, continue processing. Processing time will vary according to the strength of the tool, the hair type and condition, and the results you are looking for.

Relaxing with Hydroxide Relaxer C.O.E.Implements andCONTINUING Materials EDUCATION  Hydroxide relaxer  Hydroxide neutralizer  Protective base cream  Acid-balanced shampoo  Conditioner  Bowl and applicator brush

 Shampoo cape  Towels  Plastic clips  Styling comb  Plastic rat-tail comb  Spray bottle  Disposable gloves

Timer Preparation

1. Wash your hands 2. Perform an analysis of the hair and scalp. Perform tests for porosity and elasticity.

3. Complete the client consultation. Fill out the client relaxer record. Note any changes in the client's history. 4. Have the client change into a gown and remove eyeglasses, earrings and necklace. Drape the client with a shampoo cape and two towels. To avoid scalp irritation, do not shampoo the hair prior to a hydroxide relaxer.

Procedure for Applying Virgin

Hydroxide Relaxers

1. Part the hair into four sections, from the center of the front hairline to the center of the nape, and from ear to ear. Clip the sections up to keep them out of the way.

2. Apply protective base cream to the hairline and ears. Option: Take ¼ to ½ inch horizontal partings and apply a protective base cream to the entire scalp. (Always follow the manufacturers' directions and the procedures approved by your instructor).

C.O.E. CONTINUING EDUCATION

3. Wear gloves on both hands. Begin application in the most resistant area, usually at the back of the head. Make ¼-inch horizontal partings and apply the relaxer to the top of the strand first,

then to the underside.

Apply the relaxer with an applicator bottle, brush, or the back of a rattail comb. Apply relaxer ¼ inch to ½ inch away from the scalp and up to the porous ends. To avoid scalp irritation, do not allow the relaxer to touch the scalp until the last few minutes of processing. 4. Continue applying the relaxer, working your way down the section toward the hairline. 5. Continue the same application procedure with the remaining sections. Finish the most resistant sections first. 6. After the relaxer has been applied to all sections, use the back of the comb or your hands to smooth each section.

7. Process according to the manufacturer's directions. Perform periodic strand tests. Processing usually takes less than 20 minutes at room temperature. 8. During the last few minutes of processing, work the relaxer down to the scalp and through the ends of the hair, using additional relaxer as needed. Carefully comb and smooth all sections.

C.O.E. CONTINUING EDUCATION 9. Rinse thoroughly with warm water remove all traces of the relaxer.

Neutralization Procedure

1. Optional step: Apply the normalizing solution and comb it through to the ends of the hair.

Leave it on for approximately five minutes and then rinse thoroughly. Always follow the manufacturers' directions and the procedures approved by your instructor. 2. Shampoo at least three times with an acid-balanced neutralizing shampoo. It is essential that all traces of the relaxer be removed from the hair. Option: If you are using a neutralizing shampoo with a color indicator, a change in color will indicate when all traces of the relaxer are removed and the natural pH of the hair and scalp has been restored. 3. Rinse thoroughly, condition, and style as desired.

Cleanup and Sanitation for All Relaxers

1. Discard disposable supplies in appropriate receptacles. 2. Disinfect implements and store according to sanitation requirements. 3. Clean, sanitize, and prepare your workstation for the next service. 4. Wash your hands with warm soap and water. 5. Complete the client record.

Hydroxide Relaxer Retouch

Implements and Materials

Same procedure for the hydroxide relaxer

Preparation

Same procedure for the hydroxide relaxer

Procedure

1. Do not shampoo the hair. Divide the hair into four sections, from the center of the front hairline to the center of the nape, and from ear to ear. Clip sections up to keep them out of the way. 2. Wear gloves on both hands. Apply a protective base cream to the hairline and ears. Option: Take ¼-inch to ½-inch horizontal partings and apply base cream to the entire scalp. 3. Begin application of the relaxer in the most resistant area, usually at the back of the head. Make ¼-inch to ½-inch horizontal partings and apply the relaxer to the top of the strand. Apply the relaxer ¼ inch to ½ inch away from the scalp and only to new growth. Do not allow the relaxer to touch the scalp until the last few minutes of processing. To avoid over processing or breakage, do not overlap the relaxer onto the previously relaxed hair.

C.O.E. CONTINUING EDUCATION

4. Continue applying the relaxer, using the same procedure and working your way down the section toward the hairline. 5. Continue the same application procedure with the remaining sections, finishing the most resistant sections first. 6. After the relaxer has been applied to all sections, use the back of the comb or your hands to smooth each section.

7. Process according to the manufacturer's directions. Perform periodic strand tests. Processing usually takes less than 20 minutes at room temperature. 8. During the last few minutes of processing, work the relaxer down to the scalp. 9. If the ends of the hair need additional relaxing, work the relaxer through to the ends for the last few minutes of processing.

C.O.E. CONTINUING EDUCATION

10. Rinse thoroughly with warm water to remove all traces of the relaxer. 11. Follow virgin hydroxide neutralizing procedure. Style the hair as desired. 12. Follow cleanup and sanitation procedures for the relaxing with hydroxide relaxer procedure.

Relaxing With Thio Relaxer

Implements and Materials

Use the same implements and materials as for the hydroxide relaxer, but use thio relaxer, normalizing lotion, and neutralizing shampoo (with color indicator).

Preparation

Follow the same preparation steps as for the hydroxide relaxer. A light shampoo is optional. Do not forget to perform an analysis of the client's hair and scalp. Test the hair for elasticity and porosity in several areas of the head. If the hair has poor elasticity, do not perform a relaxer service.

Procedure for Virgin Thio Relaxer All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 88 CONTINUING EDUCATION

Follow the same application procedure as for the hydroxide relaxer.

Neutralization Procedure for Thio Relaxers

1. Blot excess water from the hair. Apply thio neutralizer in ¼ to ½-inch sections throughout the hair, and smooth with your hands or the back of the comb. 2. Process the neutralizer according to the manufacturer's directions. 3. Rinse thoroughly, shampoo, condition, and style.

Cleanup and Sanitation

Follow the same cleanup and sanitation procedure as for the hydroxide relaxer.

Procedure for Thio Relaxer Retouch

1. Follow the preparation and application procedures for the hydroxide relaxer retouch. A shampoo prior to relaxer application is optional. 2. Follow the virgin thio relaxer neutralizing and cleanup procedures from the hydroxide relaxer retouch. The Relaxer Procedures

The application steps for thio relaxers are the same as those for hydroxide relaxers, although the neutralization procedure is different. Relaxer may be applied with bowl and brush, applicator bottle, or the back of a rattail comb. Although all thio relaxers follow the same procedure, different application methods are used for virgin relaxers and retouch relaxers.

Soft Curl Permanents (curl re-forming)

Soft curl permanents (curl re-forming) do not straighten the hair; they simply make the existing curl larger and looser. A soft curl permanent may also be called a Jheri curl or simply a curl. It is a combination of a thio relaxer and a thio permanent that is wrapped on large tools. Soft curl permanents use ATG and oxidation neutralizers, just as thio permanent waves do.

Soft Curl Permanent Procedure

A soft curl permanent is actually two services. Extremely curly hair must be relaxed with a thio C.O.E.relaxer (curl reCONTINUING-arranger) before is wrapped on tools. All base sections EDUCATION should be horizontal, with the same length and width as the perm tool. The base direction should be in the direction of hair growth. The base control should be half off base. Once it is wrapped on large tools, it is then processed with a second thio solution (curl booster). After processing, the hair is rinsed, blotted, and neutralized, just as with any other permanent.

Safety Precautions for Hair Relaxing

 Perform a thorough hair analysis and client consultation prior to the service.  Examine the scalp for abrasions. Do not proceed with the service if redness, swelling, or skin lesions are present.  Keep accurate and detailed client records of the services performed and results achieved.  Have the client sign a release statement that indicates that the client understands the possible risks involved in the service.  Do not apply a hydroxide relaxer on hair that has been previously treated with a thio relaxer.  Do not apply a thio relaxer on hair that has been previously treated with a hydroxide relaxer.  Do not chemically relax hair that has been treated with a metallic dye.  Reconstruction treatments.  Do not shampoo the client prior to the application of a hydroxide relaxer.  The client's hair and scalp must be completely dry and free from perspiration prior to the application of a hydroxide relaxer.  Apply a protective base cream to avoid scalp irritation.  Wear gloves during the relaxer application.  Protect the client's eyes.  If any solution accidentally gets into the client's eye, flush the eye immediately with cool water and refer the client to a doctor.  Do not allow chemical relaxers to accidentally come into contact with the client's ears, scalp, or skin.  Perform periodic strand tests to see how fast the natural curls are being removed.  Avoid scratching the scalp with your comb or fingernails.  Do not allow the application of a relaxer retouch to overlap onto previously relaxed hair.  Never use a strong relaxer on fine or damaged hair. It may cause breakage.  Do not attempt to remove more than 80 percent of the natural curl.  Thoroughly rinse the chemical relaxer from the hair. Failure to rinse properly can cause excessive skin irritation and hair breakage.  Use a normalizing lotion to restore the hair and scalp to their normal acidic pH.  Use a conditioner and wide-tooth comb to eliminate excessive stretching when combing out tangles.  Do not use hot irons or excessive heat on chemically relaxed hair. Performing texture services involves using powerful chemicals, which must be handled with the utmost caution. If you act responsibly and perfect your techniques, your services will be in great demand.

Soft Curl Permanent

Implements and Supplies for Soft Curl Perms

 Thio cream relaxer (curl re-arranger)  Thio curl booster All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 90 CONTINUING EDUCATION

 Preneutralizing conditioner (optional)  Thio neutralizer  Protective base cream  Acid-balanced shampoo  Conditioner  Plastic or glass bowl  Applicator brush  Applicator bottles  Shampoo cape  Neutralizing bib  Disposable gloves  Roll cotton  Towels  Plastic clips  Styling comb  Plastic tail comb  Perm tools  End papers  Spray bottle

Timer Preparation

1. Follow procedure for applying virgin hydroxide relaxer. 2. After rinsing the hair, part it into nine panels. Use the length of the rod to measure the width of the panels. 3. Wear gloves on both hands and begin wrapping at the most resistant area. Apply and distribute the thio curl booster to each panel as you wrap the hair. Make a horizontal parting the same size as the rod. Hold the hair at a 90-degree angle to the head. Using two end papers roll the hair down to the scalp and position the rod half-off base. Option: Insert roller picks to stabilize the rods and eliminate any tension caused by the band. 4. Continue wrapping the remaining eight panels in numerical order using the same technique. 5. Continue wrapping the remaining eight panels in numerical order using the same technique. 6. Place cotton around the hairline and neck and apply thio curl booster to all the curls until they are completely saturated. 7. If a plastic cap is used, punch a few holes in the cap and cover all hair completely. Do not C.O.E.allow theCONTINUING plastic cap to touch the client's skin. EDUCATION 8. Check cotton and towels. If they are saturated with solution, replace them. 9. Process according to manufacturer's directions. Processing time will vary according to the strength of the product, the hair type and condition, and desired results. Processing usually takes less than 20 minutes at room temperature. 10. Check for proper curl development. 11. When processing is completed, rinse the hair thoroughly, for at least five minutes. Then towel-blot the hair on each tool to remove excess moisture. Option: Apply preneutralizing All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 91 CONTINUING EDUCATION

conditioner according to the manufacturers' directions. Always follow the manufacturers' directions and the procedures approved by your instructor. 12. Apply the neutralizer slowly and carefully to the hair on each tool. Avoid splashing and dripping. Make sure each rod is completely saturated. 13. Set a time and neutralize according to the manufacturers' directions Remove the rods, distribute the remaining neutralizer through the ends of the hair and rinse thoroughly. Option: shampoo and condition. Always follow the manufacturer's direction and the procedures approved by your instructor. 14. Style the hair as desired.

Cleanup and Sanitation

1. Discard all disposable supplies in appropriate receptacles. 2. Disinfect implements and store according to sanitation requirements. 3. Clean, sanitize, and prepare your workstation for the next service. 4. Wash your hands with soap and warm water. 5. Complete the client record. Basics of Chemistry and Electricity

BIBLIOGRAPHY RESOURCES:

Allied Beauty Association (ABA) http://www.abacanada.com

Intercoiffure, America http://www.intercoiffure.us

American Health & Beauty Aids Institute (AHBAI) http://www.ahbai.org

Personal Care Products Council (formerly CTFA) http://www.personalcarecouncil.com

Cosmetology Industry Association of British Columbia (CIABC) http://www.ciabc.net

Wikipedia:

http://en.wikipedia.org/wiki/Cosmetology

http://en.wikipedia.org/wiki/Cortex

http://en.wikipedia.org/wiki/Perm_%28hairstyle%29

Wikipedia the Free Encyclopedia, “Hairstyle” by Victoria Sherrow (2001): http://en.wikipedia.org/wiki/Hairstyle

Milady’s Standard Cosmetology 2012 EDITION

Stock photography photos, dreamstime.com: http://www.dreamstime.com/?gclid=CN7- 2d3inq8CFQjd4AodzHgKZw

SECTION 5

GEORGIA TCSG HEALTH AND SAFETY—3 HRS.

COURSE TABLE OF CONTENTS

SECTION 1: SKIN, DISEASES, DISORDERS

 Anatomy and Histology of the Skin

o Nerves of the Skin

o Glands of the Skin C.O.E. o CONTINUINGNourishment of the Skin EDUCATION o Functions of the Skin

o Terminology

 Diseases and Disorders

o Skin Conditions/Descriptions

o Nail Diseases/Disorders

o Hair Disease/Disorders

o Skin Conditions/Descriptions

SECTION 2: BLOODBORNE PATHOGENS

 What are Bloodborne Pathogens?

 Hepatitis B Virus (HBV)

 Human Immunodeficiency Virus (HIV)

 Signs and Symptoms

 Transmission

 Transmission Routes

 Risk Factors and Behaviors

 Personal Protective Equipment

SECTION 3: DECONTAMINATION & STERILIZATION

 Common Questions

 HIV

 Precautions

SECTION 4: DECONTAMINATION AND INFECTION CONTROL

 Professional Salon Environment

 Safety Precautions

 Material Safety Data Sheet (M.S.D.S.)

 Organizing an M.S.D.S. Notebook

SECTION 5: GEORGIA STATE BOARD OF COSMETOLOGY SANITARY REGULATIONS FOR SALONS AND SCHOOLS

SECTION 6: APPENDIX A GEORGIA STATE BOARD OF COSMETOLOGY GLOSSARY OF LEGAL

DEFINITIONS

C.O.E. CONTINUING EDUCATION

Georgia Department of Technical and Adult Education

Skin, Diseases, Disorders

C.O.E. CONTINUING EDUCATION

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 97 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 98 of 257 C.O.E.

by Georgia Department of Technical and Adult Education.

All rights reserved. No part of this manual may Skin, Diseases, Georgia Department of Technical and Adult Education iii Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 99 of 257 C.O.E.

be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

C.O.E. CONTINUING EDUCATION

Skin, Diseases, Georgia Department of Technical and Adult Education iii Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 100 of 257 C.O.E.

Table of Contents

Skin, Diseases, Disorders ...... 1

Introduction ...... 1

Objectives ...... 2

Anatomy and Histology of the Skin ...... 3

Nerves of the Skin ...... 5

Glands of the Skin ...... 5

Nourishment of the Skin ...... 6

Functions of the Skin ...... 6

Skin, Diseases, Georgia Department of Technical and Adult Education v Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 101 of 257 C.O.E.

Terminology ...... 7

Diseases and Disorders ...... 11

Skin Conditions /Descriptions ...... 12

C.O.E. CONTINUING EDUCATION

Skin, Diseases, Disorders

Introduction

The flexible, waterproof, tough protective covering known as the skin is the largest organ in the body both by weight and surface area. Skin accounts for approximately 16% of the body’s weight.

Healthy skin has a fine texture that is slightly moist, soft, and flexible. Varying in thickness, the skin is thinnest on the eyelids and thickest on the palms and soles. A callous can be caused by continuous friction on any part of the skin.

The skin has appendages that include the hair, sweat and oil glands, and the nails. Composed of the substance known as keratin, this protein gives the

skin its protective ability. The skin is slightly acidic in pH, which enables good immunity responses to intruding organisms. Normally the skin separates the internal environment from the external. However skin diseases and Skin, Diseases, Georgia Department of Technical and Adult Education 1 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 103 of 257 C.O.E.

infections can invade that barrier. For this reason, a thorough understanding of the histology of the skin and its diseases and disorders is needed for a better position to give clients professional advice.

C.O.E. CONTINUING EDUCATION

Skin, Diseases, Georgia Department of Technical and Adult Education 1 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 104 of 257 C.O.E.

Objectives

Upon completion of this course, trainees will be able to:

• Explain the structure and the composition of the skin.

• Identify the functions of the skin.

• Describe terms relating to skin disorders.

• Recognize which skin diseases/disorders may be dealt with in the salon and which should be referred to a physician.

• Identify online dermatology resources.

2 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 105 of 257 C.O.E.

Anatomy and Histology of the Skin

The two major divisions of the skin are the dermis and the epidermis.

The outermost layer of the skin is the epidermis that is composed of sheets of dead cells that serve as the major waterproof barrier to the environment. The epidermis is the visible layer of skin. This layer contains numerous nerve endings, but no blood vessels. The human epidermis is renewed every

15-30 days.

C.O.E. CONTINUING EDUCATION

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The epidermis consists of many layers. The stratum corneum is the outer layer that is often called the horny layer. Cells are continually being shed and replaced. This layer of skin for the most part is dead – it is composed of cells that are almost pure protein.

The stratum lucidum consists of translucent cells through which light can penetrate.

The stratum granulosum, known as the granular layer, consists of cells that resemble granules. These cells are transforming into a harder form of protein.

The stratum mucosum is also known as the basal cell layer. Basal cells are continuously being reproduced. It is the deepest layer of the epidermis. This layer also contains melanocytes that produce the coloring matter known as melanin and determines skin color. Melanocytes also react to ultraviolet rays to darken the skin for added protection.

The middle layer, the dermis, provides a tough, flexible foundation for the epidermis. In the dermis, body temperature is regulated by sweat glands and blood vessels. It also contains arector pilli muscles, papillae, and hair follicles. Nerve endings send sensations of pain, itching, touch, and temperature to the brain. The skin is moisturized by oil glands that produce sebum.

The dermis consists of two layers. The papillary layer connects the dermis to the epidermis. Tactile corpuscles are nerve fiber endings that contain looped capillaries. Tactile corpuscles are responsible for the sense of touch. The papillary layer also contains some of the melanin.

The reticular layer is the deepest layer of the dermis. It contains fat cells, blood vessels, lymph vessels, oil glands, sweat glands, hair follicles, C.O.E. CONTINUINGand arrector pilli muscles. The reticular layer suppli EDUCATIONes the skin with oxygen and nutrients.

Subcutaneous tissue is the fatty layer found below the dermis. It is also called the adipose or the subcutis tissue. It varies in thickness according to

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age, sex, and general health of the individual. The subcutaneous tissue contains fats

for energy, gives smoothness and contour to the body, and acts as a protective cushion for the outer skin. Arteries and lymphatics maintain circulation to

the body.

Anatomy and Histology of the Skin

Nerves of the Skin

Sensory nerves are receptors and send messages to the brain causing reactions to heat, cold, touch, pressure, and pain.

Motor nerve fibers, attached to the hair follicles, are distributed to the arrector pilli muscles which may cause goose flesh when you are frightened or cold.

The secretory nerve fibers regulate the excretion of perspiration from the sweat glands and regulate the flow of sebum to the surface of the skin.

C.O.E.Glands o fCONTINUING the Skin EDUCATION

There are two types of duct glands contained in the skin that pull out minerals from the blood to create new substances. The suderiferous glands are the sweat glands and the sebaceous glands are the oil glands.

Skin, Diseases, Georgia Department of Technical and Adult Education 5 Disorders CONTINUING EDUCATION

Sweat glands excrete perspiration. This secretion is odorless when excreted, but in a short period of time produces an offensive odor due to the bacteria on the skin’s surface feeding on the fats of its secretion. Perspiration is controlled by the nervous system. About 1-2 pints of liquid containing salts are excreted daily through the sweat pores in the skin. The sweat glands consist of a coiled base or fundus and a tube-like duct that ends at the skin surface forming the pores. Sweat glands are more numerous on the palms, soles, forehead, and armpits. Body temperature is regulated by the sweat glands that also aid in the elimination of waste.

Oil glands secrete sebum through little sacs whose ducts open in to the hair follicles. These glands are found in all parts of the body with the exception of the palms and soles. The oily substance produced by the oil glands is called sebum. Sebum lubricates the skin and preserves the pliability of

the hair. When the duct becomes clogged with hardened sebum, a blackhead is formed.

Skin, Diseases, Georgia Department of Technical and Adult Education 5 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 111 of 257 C.O.E.

Nourishment of the Skin

Blood and lymph circulate through the skin providing nourishment essential

for growth and repair of the skin, hair, and nails.

Functions of the Skin

The major functions of the skin are sensation, heat regulation, absorption, protection, excretion, and secretion. The functions of the skin can easily be remembered using the acronym: SHAPES

S – ensation – response to heat, cold, pressure, and pain

H – eat regulation – maintains body temperature of 98.6

C.O.E. CONTINUINGA – bsorption - substances can enter the bodyEDUCATION through the skin and affect it to a minor degree

P – rotection – from bacterial invasion

E – xcretion – sweat glands excrete perspiration

6 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 112 of 257 C.O.E.

S – ecretion - sebum is secreted by the sebaceous glands

Anatomy and Histology of the Skin

Terminology

Dermatology study of the skin, its nature, functions, and treatment

Dermatologist a medical skin specialist

Disease a pathological condition of the body, organ, or mind making it incapable of carrying on normal functions

Disorder abnormal condition usually not contagious

Immunity freedom from or resistance to disease

C.O.E. CONTINUINGIntegumentary system one of the 10 systems EDUCATION of the body; pertains to

the

skin, its appendages and functions

Pathology study of disease

Skin, Diseases, Georgia Department of Technical and Adult Education 7 Disorders CONTINUING EDUCATION

Etiology study of the causes of diseases

Trichology study of hair

Diagnosis recognition of a disease by its symptoms

Prognosis foretelling of the probable course of a disease

Objective symptom visible symptom

Subjective symptom symptom that can be felt by client, but not by observation

Acute rapid onset with severe symptoms of short duration

Skin, Diseases, Georgia Department of Technical and Adult Education 7 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 115 of 257 C.O.E.

Chronic long duration, usually mild, but often recurring

Infectious invasion of body tissue by bacteria that cause disease

Contagious communicable; by contact

Occupational due to certain kinds of employment

Seasonal influenced by weather

Parasitic caused by vegetable or animal parasites

Pathogenic produced by disease causing bacteria

Systemic due to over or under functioning of the C.O.E. CONTINUINGinternal glands EDUCATION

Venereal disease acquired by sexual contact

Epidemic emergence of a disease that affects a large number of people simultaneously 8 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 116 of 257 C.O.E.

Allergy reaction due to extreme sensitivity to normally harmless substances

Inflammation skin disorder characterized by redness, pain, edema, and heat

Rhytidectomy face lift

Blepharoplasty eyelid surgery

Chemical peel chemical solution applied to skin areas causing a mild, controlled burn of the skin

8 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 117 of 257 C.O.E.

Anatomy and Histology of the Skin

Rhinoplasty plastic surgery of the nose

Mentoplasty chin surgery

C.O.E. CONTINUING EDUCATION Dermabrasion sandblasting irregularities of the skin Injectable

fillers tiny injections of collagen to soften wrinkles Retin–A

prescription cream used in the treatment of acne

Skin, Diseases, Georgia Department of Technical and Adult Education 9 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 118 of 257 C.O.E.

Notes:

All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 119 of 257 C.O.E.

C.O.E. CONTINUING EDUCATION

10 Skin, Diseases, Disorders

Diseases and Disorders

In a salon, you will come in contact with diseases and disorders of the skin and its appendages: the hair and nails. Your license requires you to be responsible for the recognition of potentially infections diseases. Some disorders can be treated in cooperation with and under the supervision of

a physician.

Skin, Diseases, Georgia Department of Technical and Adult Education 11 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 121 of 257 C.O.E.

Skin Conditions /Descriptions

WARNING: NEVER TRY TO DIAGNOSE A DISEASE; ALWAYS REFER TO A PHYSICIAN.

NOTE: COLOR CHANGES, A CRACK ON THE SKIN, A TYPE OF THICKENING, OR ANY DISCOLORATION, RANGING FROM SHADES OF RED TO BROWN AND PURPLE TO ALMOST BLACK, MAY BE SIGNS OF DANGER AND SHOULD BE EXAMINED BY A DERMATOLOGIST.

CAUTION: DO NOT TREAT OR REMOVE HAIR FROM MOLES.

Condition/ Description C.O.E. CONTINUINGDisease/Disorder EDUCATION

Pigmented Lesions

Lentigo small, yellow to brown spots 12 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 122 of 257 C.O.E.

Chloasma moth patches, liver spots = increased deposits of pigment

Naevus birthmark (portwine or strawberry) small-large malformation of skin due to pigmentation or dilated capillaries

Leucoderma abnormal light patches due to congenital defective pigmentations

Vitiligo acquired condition of leucoderma-may affect skin or hair

12 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 123 of 257 C.O.E.

Diseases and Disorders

Albinism congenital absence of melanin pigment

Stain abnormal, brown, skin patches having a circular

& irregular shape

Disorders of the Sebaceous Glands

Comedones blackheads, a worm-like mass of keratinized cells

& hardened sebum

C.O.E. CONTINUINGMilia whiteheads, an accumulation EDUCATION of dead, keratinized cells and sebaceous matter trapped beneath

the skin

Skin, Diseases, Georgia Department of Technical and Adult Education 13 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 124 of 257 C.O.E.

Acne Simplex chronic inflammatory disorder usually related to hormonal changes & overactive sebaceous glands

Acne Vulgaris acne-pimples

Acne Rosacea chronic inflammatory congestion of the cheeks

& nose

Seborrhea/Seborrhea overactive sebaceous glands-often the basis of acne

Oleosa = Oily Dandruff

Steatoma wen or sebaceous cyst (subcutaneous tumor)

ranges in size from a pea to an orange

Asteatosis dry, scaly skin characterized by absolute or partial deficiency of sebum

Furuncle boil-a subcutaneous abscess that fills with pus

Cysts sac-like, elevated (usually round) area, contains liquid or semi-liquid substance-when a follicle ruptures deep within the dermis & irritating oil

& dead cells seep into the surrounding tissuesoften cause acne pits

Pimples follicle filled with oil, dead cells, & bacteriainflammation causes white blood cells to rush to fight bacteria creating a pus

Disorders of the Sudoriferous Glands

Bromidrosis osmidrosis=foul-smelling perspiration

Anhidrosis lack of perspiration

C.O.E. CONTINUING EDUCATION Hyperhidrosis excessive perspiration

Miliaria Rubra prickly heat-eruptions of small red vesicles accompanied by burning & itching-caused by excessive heat

14 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 126 of 257 C.O.E.

Hypertrophies

Keratoma callus-superficial, round, thickening of the epidermis caused by friction (inward growth is called a corn)

Mole a small, brown spot-believed to be inheritedmay be flat or deeply seated-pale tan-brown or bluish black

Verruca wart, a viral infection of the epidermis-benign

Diseases and Disorders

Skin Tag bead-like fibrous tissue that stands away from the flat surface-often a dark color

Polyp growth that extends from the surface or may also grow with the body

Inflammations

Eczema dry or moist lesions accompanied by itching, burning, & various other unpleasant sensationsusually red-blistered, & oozing

C.O.E. CONTINUINGPsoriasis rarely on the face, lesions EDUCATION are round, dry patches covered with coarse, silvery scales-if irritated, bleeding points occur-may be spread to larger area-not contagious

Herpes Simplex/ fever blisters/cold sores-single group of vesicles

Skin, Diseases, Georgia Department of Technical and Adult Education 15 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 128 of 257 C.O.E.

Herpes Zoster = Shingles on a red swollen base

Allergy Related Dermatitis

Dermatitis allergy to ingredients in cosmetics, etc.- Venenata protection is the prevention-gloves, etc.

Dermatitis dermatitis that occurs after an injection of a substance

Medicamentosa

Urticaria hives-inflammation caused by an allergy to specific drugs/foods

Primary Skin Lesions

Macule small, discolored spot or patch on the skin's surface, neither raised nor sunken-ex: freckles

Papule small elevated pimple containing no fluid, but may have pus

note: yellow or white fatty papules around the eyes indicate an elevated cholesterol level-refer to a physician (xanthelasma).

Wheal itchy, swollen lesion that lasts only a few hoursex: mosquito bite

Tubercle solid lump larger than a papule-projects above the skin or lies with-sized from pea to hickory nut

C.O.E. CONTINUING EDUCATION

Tumor external swelling-varies in size, shape & color

Vesicle blister with clear fluid-lie within or just beneath the epidermis-ex: poison ivy 16 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 130 of 257 C.O.E.

Bulla blister containnig a watery fluid-larger than a vesicle

Pustule elevation with inflamed base, containing pus

Secondary Skin Lesions

Scale accumulation of epidermal flakes, dry or greasyex: abnormal dandruff

Crust accumulation of serum & pus-mixed with epidermal material-ex: scab

16 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 131 of 257 C.O.E.

Diseases and Disorders

Excoriation abrasion produced by scratching or scraping-ex:

raw surface after injury

Fissure crack in the skin penetrating into the dermis

Ulcer open lesion on skin or mucous membrane, accompanied by pus & loss of skin depth

Acne Scars

C.O.E. CONTINUING EDUCATION Ice Pick Scar large, visible, open pores that look as if the skin has been jabbed with an ice pick-follicle always looks open-caused by deep pimple or cyst

Skin, Diseases, Georgia Department of Technical and Adult Education 17 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 132 of 257 C.O.E.

Acne Pit Scar slightly sunken or depressed appearance-caused by pimples/systs taht have destroyed the skin & formed scar tissue

Acne Raised Scar lumpy mass of raised tissue on the surface of the skin-caused where cysts have clumped together

Contagious Disorders

Tinea ringworm, due to fungi

Tinea Capitis - Ringworm of Scalp (plant or vegetable

Tinea Sycosis - Barber's Itch parasites)-small reddened Tinea Favosa - Honeycomb Ringworm patch of little blisters that Tinea Unguium - Ringworm of Nails spread outward and heal in Athlete's Foot - Ringworm of Feet the middle with scaling

CAUTION! NEVER ATTEMPT TO DIAGNOSE BUMPS, LESIONS, ULCERATIONS, OR DISCOLORATIONS AS SKIN CANCER, BUT YOU SHOULD BE ABLE TO RECOGNIZE THE CHARACTERISTICS OF SERIOUS SKIN DISORDERS AND SUGGEST THAT THE CLIENT

SEE A PHYSICIAN OR DERMATOLOGIST.

Extremely Serious Disorders-Skin Cancers

Basal Cell Carcinoma least malignant-most common skin cancer- characterized by light or pearly nodules & visible blood vessels

Squamous Cell Carcinoma scaly, red papules-blood vessels are not visible- more serious than basal cell

Malignant Melanoma most serious-characterized by dark brown, black, C.O.E. CONTINUINGor discolored patches EDUCATION on the skin

Tumor abnormal growth of swollen tissue

Nail Diseases/Disorders 18 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 134 of 257 C.O.E.

Onychophagy nail biting

Onychogryposis overcurvature of the nail-clawlike

Pterygium sticky overgrowth of the cuticle

Eggshell Nail extremely thin nail

Leuconychia white spots under the nail plate

18 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 135 of 257 C.O.E.

Diseases and Disorders

Paronychia bacterial inflammation of tissue (perionychium)

around the nail

Tinea Corporis ringworm of the hand

Tinea Pedia ringworm of the foot

Agnail hangnail

Onychia an inflammation somewhere in the nail

Onychocyanosis blue nail (usually caused by poor circulation)

Hematoma Nail bruised nail (usually caused by a hammer or

C.O.E. CONTINUINGslammed door) EDUCATION

Skin, Diseases, Georgia Department of Technical and Adult Education 19 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 136 of 257 C.O.E.

Tinea Unguium onychomycosis-ringworm of the nail

Onychorrexis split or brittle nails with a series of lengthwise ridges

Beau's Lines ridges/corrugations/furrows

Onychatrophia atrophy or wasting away of the nail

Onychocryptosis ingrown nail

Onychauxis overgrowth of the nail plate

Onychosis any nail disease

Onychophosis accumulation of horny layers of epidermis under the nail

Hair Disease/Disorders

Pityriasis Capitis dry dandruff

Simplex

Pityriasis Capitis greasy dandruff

Steatoids Seborrhea Oleosa

= Oily Dandruff

Trichoptilosis split hair ends

Trichorrehexis Nodosa knotted

C.O.E. CONTINUINGTinea Favosa honeycomb ringworm EDUCATION Tinea Capitis ringworm of the scalp

Tinea Sycosis barber's itch

20 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 138 of 257 C.O.E.

Androgenetic Alopecia common hereditary hair loss

Alopecia Adnata loss of hair shortly after birth

Alopecia Areata hair loss in patches

Alopecia Follicularis hair loss caused by inflammation of hair follicles

Alopecia Prematura hair loss early in life

Alopecia Senilis hair loss from old age

Alopecia Totalis hair loss from entire scalp

Alopecia Universalis hair loss from entire body

Diseases and Disorders

Traction/Traumatic patchy hair loss sometimes due to repetitive

Alopecia traction on the hair by pulling or twisting

Postpartum temporary hair loss at the conclusion

Alopecia of pregnancy

Telogen Effluven hair loss during the telogen phase of the hair growth cycle

Canities gray hair

C.O.E. CONTINUINGPediculosis Capitis headlice EDUCATION

Monilithrix beaded hair

Fragilitis Crinium brittle hair

Hirsuities/Hypertrichosis superfluous hair, excessive

Skin, Diseases, Georgia Department of Technical and Adult Education 21 Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 140 of 257 C.O.E.

Scabies contagious disease caused by the itch mite

Impetigo/Infantigo highly contagious bacterial infection, usually staphylococcal

Discoid Lupus chronic autoimmune disorder, causes red

Erythematosus (DLE) often scarring plaques, hair loss, &

internal effects

Keloids forms when excess collagen forms at the site of a haeling scar-overhealing

Asteatosis excessive dry skin

Websites: Online Dermatology Resources

http://tray.dermatology.uiowa.edu/DermImag.htm

http://www.medic.mie-u.ac.jp/derma/world/worldd1.html

http://www.skin-information.com/

http://www.skin-disease.com/

http://www.skin-cancers.net/

http://www.age-spot.com/

C.O.E. CONTINUING EDUCATION http://www.i-wrinkle.com/

http://www.i-wrinkle.com/

22 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 142 of 257 C.O.E.

http://www.asds-net.org American Society of Dermatologic Surgery

http://www.aad.org American Academy of Dermatology

22 Skin, Diseases, Disorders All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. CONTINUINGContinuing Education. TheEDUCATION course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 143 of 257 C.O.E.

Diseases and Disorders

Skin Conditions /Descriptions

WARNING: NEVER TRY TO DIAGNOSE A DISEASE; ALWAYS REFER TO A PHYSICIAN.

C.O.E. CONTINUING EDUCATION

CAUTION: DO NOT TREAT OR REMOVE HAIR FROM MOLES.

Condition/ Description

Disease/Disorder

CONTINUING EDUCATION

Pigmented Lesions

Lentigo small, yellow to brown spots

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Chloasma moth patches, liver spots = increased deposits of pigment

Naevus birthmark (portwine or strawberry) small-large malformation of skin due to pigmentation or dilated capillaries

Leucoderma abnormal light patches due to congenital defective pigmentations

C.O.E. CONTINUING EDUCATION

Vitiligo acquired condition of leucoderma-may affect skin or hair

Albinism congenital absence of melanin pigment

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Stain abnormal, brown, skin patches having a circular

& irregular shape

Disorders of the Sebaceous Glands

Comedones blackheads, a worm-like mass of keratinized cells

& hardened sebum

C.O.E. CONTINUING EDUCATION

Milia whiteheads, an accumulation of dead, keratinized cells and sebaceous matter trapped beneath the skin

Acne Simplex chronic inflammatory disorder usually related to hormonal changes & overactive sebaceous glands

Acne Vulgaris acne-pimples

Acne Rosacea chronic inflammatory congestion of the cheeks & nose

Seborrhea/Seborrhea overactive sebaceous glands-often the basis of acne

Oleosa = Oily Dandruff C.O.E. CONTINUING EDUCATION Steatoma wen or sebaceous cyst (subcutaneous tumor)

ranges in size from a pea to an orange

Asteatosis dry, scaly skin characterized by absolute or partial deficiency of sebum

Furuncle boil-a subcutaneous abscess that fills with pus

Cysts sac-like, elevated (usually round) area, contains liquid or semi-liquid substance-when a follicle ruptures deep within the dermis & irritating oil

& dead cells seep into the surrounding tissuesoften cause acne pits

Pimples follicle filled with oil, dead cells, & bacteriainflammation C.O.E. CONTINUINGcauses white blood cells to rush EDUCATION to fight bacteria creating a pus

Disorders of the Sudoriferous Glands

Bromidrosis osmidrosis=foul-smelling perspiration

Anhidrosis lack of perspiration

Hyperhidrosis excessive perspiration

Miliaria Rubra prickly heat-eruptions of small red vesicles accompanied by burning & itching-caused by excessive heat

Hypertrophies

Keratoma callus-superficial, round, thickening of the epidermis caused by friction (inward growth is called a corn)

Mole a small, brown spot-believed to be inheritedmay

be flat or deeply seated-pale tan-brown or bluish black

C.O.E. CONTINUING EDUCATION

Verruca wart, a viral infection of the epidermis-benign

Skin Tag bead-like fibrous tissue that stands away from the flat surface-often a dark color

Polyp growth that extends from the surface or may also grow with the body

Inflammations

Eczema dry or moist lesions accompanied by itching,

burning, & various other unpleasant sensationsusually red-blistered, & oozing

C.O.E. CONTINUING EDUCATION

Psoriasis rarely on the face, lesions are round, dry patches covered with coarse, silvery scales-if irritated,

bleeding points occur-may be spread to larger area-not contagious

Herpes Simplex/ fever blisters/cold sores-single group of vesicles

Herpes Zoster = Shingles on a red swollen base

Herpes Simplex Herpes Zoster

Allergy Related Dermatitis

Dermatitis allergy to ingredients in cosmetics, etc.- Venenata protection is the prevention-gloves, etc. C.O.E. CONTINUING EDUCATION

Dermatitis dermatitis that occurs after an injection of a substance

Medicamentosa

Urticaria hives-inflammation caused by an allergy to specific drugs/foods

Primary Skin Lesions

Macule small, discolored spot or patch on the skin's surface, neither raised nor sunken-ex: freckles

Papule small elevated pimple containing no fluid, but may have pus note: yellow or white fatty papules around the eyes indicate an elevated cholesterol level-refer to a physician (xanthelasma).

C.O.E. CONTINUING EDUCATION

Wheal itchy, swollen lesion that lasts only a few hoursex:

mosquito bite

Tubercle solid lump larger than a papule-projects above the skin or lies with-sized from pea to hickory nut

Tumor external swelling-varies in size, shape & color

Vesicle blister with clear fluid-lie within or just beneath the epidermis-ex: poison ivy

Bulla blister containnig a watery fluid-larger than a vesicle

C.O.E. CONTINUING EDUCATION

Pustule elevation with inflamed base, containing pus

Secondary Skin Lesions

Scale accumulation of epidermal flakes, dry or greasyex:

abnormal dandruff

Crust accumulation of serum & pus-mixed with epidermal material-ex: scab

Excoriation abrasion produced by scratching or scraping-ex:

raw surface after injury

Fissure crack in the skin penetrating into the dermis

Ulcer open lesion on skin or mucous membrane, accompanied by pus & loss of skin depth

Acne Scars

Ice Pick Scar large, visible, open pores that look as if the skin has been jabbed with an ice pick-follicle always looks open-caused by deep pimple or cyst

C.O.E. CONTINUING EDUCATION

Acne Pit Scar slightly sunken or depressed appearance-caused by pimples/systs that have destroyed the skin & formed scar tissue

Acne Raised Scar lumpy mass of raised tissue on the surface of the skin-caused where cysts have clumped together

Contagious Disorders

Tinea ringworm, due to fungi

Tinea Capitis - Ringworm of Scalp (plant or vegetable

Tinea Sycosis - Barber's Itch parasites) -small reddened Tinea Favosa - Honeycomb Ringworm patch of little blisters that Tinea Unguium - Ringworm of Nails spread outward and heal in Athlete's Foot - Ringworm of Feet the middle with scaling

C.O.E. CONTINUING EDUCATION

Extremely Serious Disorders-Skin Cancers

Basal Cell Carcinoma least malignant-most common skin cancer characterized by light or pearly nodules & visible blood vessels

Squamous Cell Carcinoma scaly, red papules-blood vessels are not visible more serious than basal cell

C.O.E. CONTINUING EDUCATION

Malignant Melanoma most serious-characterized by dark brown, black, or discolored patches on the skin

Tumor abnormal growth of swollen tissue

Nail Diseases/Disorders

Onychophagy nail biting

Onychogryposis overcurvature of the nail-clawlike

Pterygium sticky overgrowth of the cuticle

Eggshell Nail extremely thin nail

C.O.E. CONTINUING EDUCATION

Leuconychia white spots under the nail plate

Paronychia bacterial inflammation of tissue (perionychium)

around the nail

Tinea Corporis ringworm of the hand

Tinea Pedia ringworm of the foot

Agnail hangnail

Onychia an inflammation somewhere in the nail

C.O.E. OnCONTINUINGychocyanosis blue nail (usually caused bEDUCATIONy poor circulation) Hematoma Nail bruised nail (usually caused by a hammer or

slammed door)

Tinea Unguium onychomycosis-ringworm of the nail

Onychorrexis split or brittle nails with a series of lengthwise ridges

Beau's Lines ridges/corrugations/furrows

Onychatrophia atrophy or wasting away of the nail

C.O.E. CONTINUING EDUCATION

Onychocryptosis ingrown nail

Onychauxis overgrowth of the nail plate

Onychosis any nail disease

Onychophosis accumulation of horny layers of epidermis under the nail

Hair Disease/Disorders

Pityriasis Capitis dry dandruff

Simplex C.O.E. CONTINUING EDUCATION Pityriasis Capitis greasy dandruff

Steatoids Seborrhea Oleosa

= Oily Dandruff

Trichoptilosis split hair ends

Trichorrehexis Nodosa knotted

Tinea Favosa honeycomb ringworm

Tinea Capitis ringworm of the scalp

Tinea Sycosis barber's itch

Androgenetic Alopecia common hereditary hair loss

Alopecia Adnata loss of hair shortly after birth

Alopecia Areata hair loss in patches

Alopecia Follicularis hair loss caused by inflammation of hair follicles

C.O.E. CONTINUING EDUCATION

Alopecia Prematura hair loss early in life

Alopecia Senilis hair loss from old age

Alopecia Totalis hair loss from entire scalp

Alopecia Universalis hair loss from entire body

Traction/Traumatic patchy hair loss sometimes due to repetitive

Alopecia traction on the hair by pulling or twisting

Postpartum temporary hair loss at the conclusion

Alopecia of pregnancy

Telogen Effluven hair loss during the telogen phase of the hair growth cycle

Canities gray hair

Pediculosis Capitis headlice

Monilithrix beaded hair

Fragilitis Crinium brittle hair

Hirsuities/Hypertrichosis superfluous hair, excessive

Scabies contagious disease caused by the itch mite C.O.E. CONTINUING EDUCATION

Impetigo/Infantigo highly contagious bacterial infection, usually staphylococcal

Discoid Lupus chronic autoimmune disorder, causes red

Erythematosus (DLE) often scarring plaques, hair loss, &

internal effects

Keloids forms when excess collagen forms at the site of a healing scar-overhealing

Asteatosis excessive dry skin

C.O.E. CONTINUING EDUCATION

Georgia Department of Technical and Adult Education

Bloodborne Pathogens

C.O.E. CONTINUING EDUCATION

by Georgia Department of Technical and Adult Education.

Bloodborne Georgia Department of Technical and Adult Education iii Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 184 of 257 C.O.E.

be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

Table of Contents

Introduction ...... 1

Objectives ...... 1

What Are Bloodborne Pathogens? ...... 3

Hepatitis B Virus (HBV) ...... 4

Human Immunodeficiency Virus (HIV) ...... 4

Signs and Symptoms ...... 5

Signs and Symptoms of (HVB) ...... 5

Signs and Symptoms of (HIV) ...... 5

Transmission ...... C.O.E. CONTINUING7 EDUCATION Transmission Mediums ...... 7

Transmission Routes ...... 8

Risk Factors and Behaviors ...... 9

Bloodborne Georgia Department of Technical and Adult Education v Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 186 of 257 C.O.E.

Personal Protective Equipment ...... 11

Decontamination & Sterilization ...... 15

Common Questions ...... 17

Discuss with the class: ...... 17

HBV ...... 17

HIV ...... 18

Precautions ...... 19

Summary ...... 23

Introduction

A bloodborne pathogen is a specific cause of disease, such as a virus or bacteria. “Bloodborne” means carried by or in blood and certain other body fluids. AIDS, hepatitis B and C, malaria, and syphillis are examples of diseases that are caused by bloodborne pathogens.

Objectives

Upon completion of this course, you will be able to:

• Discuss bloodborne pathogens,

• Identify two bloodborne pathogens of concern in the workplace,

C.O.E. CONTINUING EDUCATION • Explain how bloodborne pathogens are transmitted,

• List four high risk factors, and

• Discuss the precautions to be used in the workplace.

Bloodborne Georgia Department of Technical and Adult Education 1 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 188 of 257 C.O.E.

Notes:

C.O.E. CONTINUING EDUCATION

2 Bloodborne Pathogens

What Are Bloodborne Pathogens?

Two types of pathogens of concern in the workplace are:

1. Hepatitis B Virus (HBV)

2. Human Immunodeficiency Virus (HIV)

Hepatitis B is much more contagious than HIV.

Bloodborne Georgia Department of Technical and Adult Education 3 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 191 of 257 C.O.E.

Hepatitis B Virus (HBV)

The HB Virus infects the liver: it’s more common than HIV and is a greater risk on the job. Many HBV infected people have no problems or symptoms. Some, however, do develop serious or fatal problems such as cirrhosis, liver cancer, or chronic liver disease. There is a vaccine for HBV which is

dispensed in three doses. Any employee at risk should take the vaccine.

C.O.E. CONTINUING EDUCATION

Human Immunodeficiency Virus (HIV)

HIV causes AIDS, it attacks the body’s immune system, reducing its ability to fight disease.

4 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 192 of 257 C.O.E.

To protect yourself against HIV and HBV, avoid direct exposure to infectious blood or body fluids - the prime transmitters of HBV and HIV.

Signs and Symptoms

Signs and Symptoms of (HVB)

Discuss and list different signs and symptoms of HVB.

C.O.E. CONTINUING EDUCATION

Bloodborne Georgia Department of Technical and Adult Education 5 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 194 of 257 C.O.E.

Signs and Symptoms of (HIV)

Discuss and list different signs and symptoms of HIV.

Notes:

C.O.E. CONTINUING EDUCATION

6 Bloodborne Pathogens

Transmission

Transmission Mediums

Body Fluids that can transmit infection are:

• Blood

• Semen

• Vaginal secretions

• Cerebrospinal fluid (brain and spinal fluid)

C.O.E. CONTINUING• Synovial fluid (lubricating fluid of EDUCATIONjoints and tendons)

• Pleural fluid (fluid around the lungs)

• Pericardial fluid (fluid around the heart)

• Peritoneal fluid (fluid in the abdomen) Bloodborne Georgia Department of Technical and Adult Education 7 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 198 of 257 C.O.E.

• Amniotic fluid (fluid that surrounds an embryo)

• Saliva (in dental procedures)

Bloodborne Georgia Department of Technical and Adult Education 7 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 199 of 257 C.O.E.

Transmission Routes

HIV and hepatitis are transmitted only in the following ways:

C.O.E. CONTINUING EDUCATION You can’t catch HIV through casual contact, such as touching, hugging, being coughed on or sneezed on or working around someone who has AIDS. Family members and health care workers who are constantly around patients with AIDS do not catch AIDS when they use proper precautions.

8 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 200 of 257 C.O.E.

Risk Factors and Behaviors

In light of what we know about the way the HBV and HIV virus are transmitted, risk of exposure to either virus is increased for people who:

• Have unprotected sex or multiple partners.

• Have unprotected sex with an IV drug user.

• Have shared needles while using drugs.

• Have occupational exposure to the blood or body fluids of others.

• Between 1978 and the spring of 1985, received blood or blood products in transfusion.

• Between 1978 and the spring of 1985, received an organ transplant.

• Received artificial insemination from an untested donor.

Bloodborne Georgia Department of Technical and Adult Education 9 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 201 of 257 C.O.E.

• Between 1978 and the spring of 1985, received treatment for a clotting disorder.

• Have been exposed to blood or body fluids of a person known to have AIDS or be HIV-positive.

• Are immigrants from high risk areas (southeast Asia, Africa, Southern and Central Europe):

• Have tattoos.

• Are family of infected persons.

C.O.E. CONTINUING EDUCATION

Notes:

C.O.E. CONTINUING EDUCATION

10 Bloodborne Pathogens

Personal Protective Equipment

"Universal Precautions" is the name used to describe a prevention strategy in which all blood and potentially infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual. In other words, whether or not you think the blood/body fluid is infected

with bloodborne pathogens, you treat it as if it is. This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work pratice controls shall always be utilized in situations where exposure may occur.

Probably the first thing to do in any situation where you may be exposed to bloodborne pathogens is to ensure you are wearing the appropriate personal protective equipment (PPE). For example, you may have noticed that emergency medical personnel, doctors, nurses, dentists, dental assistants, and other health care professionals always wear latex or protective gloves. This is a simple precaution they take in order to prevent blood or potentially infectious body fluids fromcoming in contact with their skin. To protect yourself, it is essential to have a barrier between you and the potentially infectious material.

Discuss and List 4 Rules to Follow with PPE:

Bloodborne Georgia Department of Technical and Adult Education 11 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 205 of 257 C.O.E.

If you work in an area with routine exposure to blood or potentially infectious materials, the necessary PPE should be readily accessible. Contaminated gloves, clothing, PPE, or other materials should be placed in appropriately labeled bags or containers until it is disposed of, decontaminated, or laundered. It is important to find out where these bags or containers are located in your area before beginning work.

C.O.E. CONTINUING EDUCATION

This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work pratice controls shall always be utilized in situations where exposure

may occur.

Gloves

Gloves should be made of latex, nitril, rubber, or other water impervious materials. If glove material is thin or flimsy, double gloving can provide an additional layer of protection. Also, if you know you have cuts or sores on your hands, you should cover these with a bandage or similar protection as an additional precaution before donning your gloves. You should always inspect your gloves for tears or punctures before putting them on. If a glove is damaged, don't use it! When taking contaminated gloves off, do so

12 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 207 of 257 C.O.E.

carefully. Make sure you don't touch the outside of the gloves with any bare skin, and

be sure to dispose of them in a proper container so that no one else will come contact with them either.

C.O.E. CONTINUING EDUCATION

Personal Protective Equipment

Goggles

Anytime there is a risk of splashing or vaporization of contaminated fluids, goggles and/or other eye protection should be used to protect your eyes. Again, bloodborne pathogens can be transmitted through the thin membranes of the eyes so it is important to protect them. Splashing could occur while cleaning up a spill, during laboratory procedures, or while

providing first aid or medical assistance.

Bloodborne Georgia Department of Technical and Adult Education 13 Pathogens CONTINUING EDUCATION

Face Shields

Face shields may be worn in addition to goggles to provide additional face protection. A face shield will protect against splashes to the nose and mouth.

Aprons

Aprons may be worn to protect your clothing and to keep blood or other contaminated fluids from soaking through to your skin. Normal clothing

that becomes contaminated with blood should be removed as soon as possible because fluids can seep through the cloth to come into contact with skin. Contaminated laundry should be handled as little as possible, and it should be placed in an appropriately labeled bag or container until it is C.O.E. CONTINUINGdeconaminated, disposed of, or laundered. EDUCATION

Bloodborne Georgia Department of Technical and Adult Education 13 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 210 of 257 C.O.E.

Notes:

C.O.E. CONTINUING EDUCATION

14 Bloodborne Pathogens

Decontamination & Sterilization

All surfaces, tools, equipment and other objects that come in contact with blood or potentially infectious materials must be decontaminated and sterilized as soon as possible. Equipment and tools must be cleaned and decontaminated before servicing or being put back into use.

Decontamination should be accomplished by using:

• A solution of 5.25% sodium hypochlorite (household bleach/ Clorox) diluted between 1:10 and 1:100 with water. The standard recommendation is to use at least a quarter cup of bleach per one gallon of water.

• Lysol or some other EPA-registered tuberculocidal disinfectant.

Check the label of all disinfectants to make sure they meet this requirement.

If you are cleaning up a spill of blood, you can carefully cover the spill with paper towels or rags, and leave it for at least 10 minutes. This will help ensure that any bloodborne pathogens are killed before you actually begin cleaning or wiping the material up. By covering the spill with paper towels

or rags, you decrease the chances of causing a splash when you pour the bleach on it.

If you are decontaminating equipment or other objects, you should leave the disinfectant in place for at least 10 minutes before continuing the cleaning process.

Of course, any materials you use to clean up a spill of blood or potentially infectious materials must be decontaminated immediately, as well. This would include mops, sponges, reusable gloves, buckets, pails, etc.

Bloodborne Pathogens Georgia Department of Technical and Adult Education 15

C.O.E. CONTINUING EDUCATION

Notes:

C.O.E. CONTINUING EDUCATION

16 Bloodborne Pathogens

Common Questions

Discuss with the class:

HBV

What symptoms do I have if I am suffering from hepatitis B infection?

Many people with HBV do not have any symptoms and feel perfectly well. Occasionally, the hepatitis B infection may become active and make the patient feel ill with nausea, have a loss of appetite, and become jaundiced.

What kind of outlook can I expect if I have a hepatitis B infection?

Many patients with the hepatitis B infection can expect to lead a full and normal life. It is most important to regard yourself as a normal individual who happens to be infected with hepatitis B. However, it is important to take precautions not to spread the disease and to get medical checkups regularly.

Bloodborne Georgia Department of Technical and Adult Education 17 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 217 of 257 C.O.E.

Can I get hepatitis from the vaccine?

No. The hepatitis vaccine is a safe and highly purified vaccine. It does not contain any blood products or living or dead viruses.

What should be done if the second or third vaccine dose is delayed?

If the doses are delayed for less than one year, the remaining doses can be resumed to complete the vaccination without the need to restart the vaccination series. If the lapsed doses are more than one year apart, extra doses or restarting of the series may be required for high risk individuals.

C.O.E. CONTINUING EDUCATION

HIV

What will the AIDS test tell me?

A positive result indicates the presence of antibodies to HIV, which has been found in people with AIDS.

Does a negative test mean that I am not infected?

Unfortunately, no. Although the test is reliable, there is a “window”- some say it’s six to twelve weeks, some say longer-when you could be developing the antibody, but the test will still be negative. That’s why you need to be retested at six to twelve weeks and again in 6 months.

If you test negative, but still carry HIV, it is still possible to transmit the virus. Counseling will be provided when you receive your test results whether they are negative or positive.

What happens if I test HIV positive?

Currently, there is no known therapy to reverse antibody status. If an employee tests HIV positive, we recommend ongoing medical monitoring and possible anti-retroviral (contains RNA for protein productions) drugs.

What is the prognosis?

18 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 219 of 257 C.O.E.

Research indicates that HIV - positive individuals will eventually develop AIDS. Currently, there is no treatment for AIDS and it is generally believed to be eventually fatal. As discussed previously, there is a vaccine for hepatitis B which is available to all employees at risk.

What HIV symptoms should I watch for?

Almost half of the people who contract HIV experience a flu-like illness six to twelve weeks after exposure. Employees who experience an exposure incident should report any illness that feels like the flu or mononucleosis, especially if

it is accompanied by fever, rash, or swollen glands.

Will my employer know the results of my test?

No. The health care professional will give the results of your tests to you only. All records, including test results, relating to an exposure incident are Strictly Confidential.

C.O.E. CONTINUING EDUCATION

Precautions

The following precautions should be taken by anyone who has had an exposure incident so that others are not exposed.

• Inform sexual or needle-sharing partners so they can be tested for the virus.

• Inform physicians and other health care givers so they can protect themselves.

• Don't give any blood, tissue, organs, or semen.

• Remove the organ donor designation from your driver’s license.

• Hold off on getting pregnant until your health care provider says it is okay.

• If you are pregnant, get counseling.

• Don’t breast-feed.

Bloodborne Georgia Department of Technical and Adult Education 19 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 221 of 257 C.O.E.

• Be careful not to expose others to your blood or bodily fluids.

• Don’t share personal items such as toothbrushes, razors, etc.

• Use a bleach solution of 1:10, 70% isopropyl alcohol or other

EPA-approved germicide to clean up any spills of blood.

• Refrain from sexual activity, or at least take the following precautions:

- Limit the number of partners

- Use latex condoms from start to finish, even if your partner is HIV-positive.

C.O.E. CONTINUING EDUCATION

Job situations which may result in exposure include:

• Job duties that bring you into contact with needles or other sharp objects such as glass that might be contaminated with infected blood.

• Providing emergency first-aid assistance to co-workers.

Discuss with the class other circumstances in which exposure is possible:

It is important that you use universal precautions to prevent becoming infected by contaminated blood. Universal precautions means that all blood and body fluids are considered a potentially infectious.

20 Bloodborne Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 223 of 257 C.O.E.

Precautions

When first aid measures are needed, make sure that you adhere to the following:

1. Mouth-to-Mouth Breathing – The safest course of action is to

use a breathing mask whenever you are called on to give mouth- to- mouth resuscitation.

2. Controlling Bleeding – To help the victim without infecting yourself

(or the victim), wear rubber gloves.

While chance of infection on the job are small, why take unnecessary risks with your life? Following the necessary safety precautions is the best way to minimize risks.

C.O.E. CONTINUING EDUCATION

Bloodborne Georgia Department of Technical and Adult Education 21 Pathogens All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 224 of 257 C.O.E.

Notes:

C.O.E. CONTINUING EDUCATION

22 Bloodborne Pathogens

Summary

Bloodborne pathogens are a very real risk in the workplace. However, protective measures are in place for employees at risk. To avoid infection of bloodborne pathogens, it is very important to follow all precautions.

Knowing how infection occurs is the first step in preventing the spread of disease. Certain factors and behaviors put employees at risk. Avoid these behaviors as much as you can.

Education combined with practicing safe behaviors can save your life.

C.O.E. CONTINUING EDUCATION

Bloodborne Pathogens Georgia Department of Technical and Adult Education 23

Georgia Department of Technical and Adult Education

Decontamination and Infection Control

C.O.E. CONTINUING EDUCATION

by Georgia Department of Technical and Adult Education.

All rights reserved. No part of this manual may Decontamination and Infection Georgia Department of Technical and Adult Education iii Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 230 of 257 C.O.E.

be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system,

without written permission from Georgia Department of

Technical and Adult Education.

Published December 2002 (C121002)

Decontamination and Infection Georgia Department of Technical and Adult Education iii Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 231 of 257 C.O.E.

Table of Contents

Decontamination and Infection Control ...... 1

Introduction ...... 1

Objectives ...... 2

Professional Salon Environment ...... 3

Safety Precautions ...... 6

Material Safety Data Sheet (M.S.D.S.) ...... 7

Organizing an M.S.D.S. Notebook ...... 10

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Decontamination and Infection Georgia Department of Technical and Adult Education v Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 232 of 257 C.O.E.

Decontamination and Infection Control

Introduction

Infection and disease control is one of the most important aspects of being a professional salon operator or owner. Federal and state laws govern what must be done by operators and owners to ensure the safety of the public and that no germs are allowed to spread uncontrolled.

This unit provides you with the necessary elements to help control dangerous disease-causing germs. By following some very important basic procedures and by providing a clean salon it will be easy to provide your clients with the very best professional care without the fear of your clients becoming infected by a disease agent. It is important to understand that the removal of all disease-causing germs in a salon will be almost impossible, but the control of dangerous levels is the key to providing a safe salon.

Objectives

Decontamination and Infection Georgia Department of Technical and Adult Education 1 Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 233 of 257 C.O.E.

Upon completion of this course, you will be able to discuss the importance of:

• Decontamination

• Sanitation, disinfecting, and sterilization

• Use of disinfectant products

• Using disinfectants in the salon

• Salon professionalism.

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Decontamination and Infection Control

Professional Salon Environment

Let’s take a close look and see what can be done to identify and control the professional salon environment. Things like tables, chairs, walls, and floors are very likely contaminated with a number of germs that may be very serious disease-causing germs. There may be millions of germs present that do not affect humans when contact is made. However, one case of an infected client can send your career and the reputation of your salon downward. By understanding contamination and knowing the proper techniques of decontamination, shop operators and owners can avoid ugly lawsuits and having the business they worked hard to build destroyed.

It is important to understand the more people that enter the salon environment, the greater the chance that new germs will be introduced and reintroduced as a result of the human contact factor. Control over where and what people do before they get to the salon is impossible to monitor, so contamination concerns must be continuous and ongoing.

Your responsibility as a professional to eliminate and control contamination is vital.

Decontamination and Infection Georgia Department of Technical and Adult Education 3 Control CONTINUING EDUCATION

Decontamination of surfaces and tools used in the salon will allow for a safe and professional experience for the client. Contamination can occur in many forms and on the surface of equipment, implements, and furnishings may not show signs of contamination. Soiled towels, combs, brushes, and even clippers can and more than likely are sources for contamination if not disinfected or sterilized properly.

Sanitation and disinfection are required in the salon to provide a safe environment for clients, co-workers, employees and oneself. Sanitation is the removal of large amounts of living organisms from a surface. By sanitizing tools and other items used in the salon, bacteria and germs are eliminated or lowered to safer levels. Popular forms of sanitation are described below.

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Decontamination and Infection Georgia Department of Technical and Adult Education 3 Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 236 of 257 C.O.E.

• The Heat steam of an autoclave has been used for many

years and has proven to be one of the most dependable forms of sanitizing.

• Hospital-grade disinfectants are used to sanitize surfaces and tools as well.

• Quaternary Ammonium Compounds (quats) are available in liquid or tablet form. Implements should be immersed for 20 minutes or longer to ensure elimination of germs and bacteria.

• Glutaraldehyde is a germicidal used to disinfect and sterilize implements that cannot be heat sterilized.

• Ethyl Alcohol is used as a disinfectant. In order to remain effective, the strength of ethyl alcohol should be no less than 70%.

• Bleach (sodium hypochlorite), commonly known as house hold bleach, has for many years been utilized as a disinfectant at killing germs. As a result of more advanced techniques now being used, bleach is not the preferred method for decontamination. It is, however, very effective on floors, sinks, and general cleaning around the salon.

• Ultrasonic Cleaners are used in some salons but must be used with a disinfectant. The advantage of this device is that it may

4 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 237 of 257 C.O.E.

reach tiny crevices that may otherwise be omitted in the cleaning and sanitizing process.

• Disinfection is also a part of operating a safe salon.

Disinfection is used when objects can be damaged due to exposure to extreme heat. Disinfection kills microorganisms with the exception of spores. It is important to understand that disinfectants should never be used on clients.

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Decontamination and Infection Control

Note: It is important that directions are followed when using disinfectants. When directions are not followed money can be wasted. Furthermore, by not following directions properly, the product that is to be disinfected may not be if a solution is too weak. It is also important to understand that the disinfectant solution always remain at an effective level. In saying this, always remember to wash all products to be disinfected with soap and water. If you attempt to disinfect soiled implements, the solution may become too weak to do an effective job.

Notes:

C.O.E. CONTINUING EDUCATION

Decontamination and Infection Control 5

Safety Precautions

Remember that disinfectants are industrial strength cleaners that are powerful and can be harmful if used improperly. Never use a disinfectant to clean your hands. This is an unsafe practice and can cause skin disease. You should wear protective equipment such as gloves and safety goggles while mixing

chemicals for disinfection control. Use soaking baskets and tongs to insert and remove equipment in disinfectant solutions. Always remember to clearly mark containers that are used for storing disinfectants.

Look at the following definition.

Sanitation is the process of reducing the levels of pathogens found on a surface. While the surface may be clean, there are still many microorganisms residing on the surface.

6 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 241 of 257 C.O.E.

Material Safety Data Sheet (M.S.D.S.)

Every chemical used in the United States must have an M.S.D.S. report developed by the manufacturer that developed the chemical. The purpose of the M.S.D.S. is to report the product name, active ingredients, directions for use, and safety instructions in case of accidents involving the chemical. The following is a break down of the sections on an M.S.D.S. report.

Product information of the chemical is listed at the very start of the report. The Manufacturer’s/Distributor emergency contact number(s) along with product identity, product code number, product use, and hazard classification.

Section I is a listing of the hazardous ingredients found in the product along C.O.E. CONTINUINGwith specific ingredient codes. EDUCATION

Section 2 is the characteristics both physical and chemical of the product in general. These characteristics include but are not limited to physical state (liquid or solid), odor appearances like smell and color of product.

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Section 3 is fire and explosion hazard information on the product. Usually the fire/flame point will be listed and the level of danger to which this product will burn. Also, the extinguishing procedures are listed here in case there is a need to control a chemical fire as a result of this product.

Section 4 is the reactivity data section. This section lists chemical(s), which this product must not come in contact with to ensure the product remains stable.

Section 5 lists the health hazards and if special precautions need to be followed. This section discusses or lists exposure concerns and first aid procedures to follow in case of an accident.

Section 6 lists control and protective measures that will need to be followed to ensure safe use of the product or chemical.

Section 7 are control measures and precautions on the product. Safe handling is necessary to ensure that accidents are minimized. Waste disposal is also listed in this area.

Section 8 is the regulatory information for the product. A listing of active ingredients that must be reported and a record maintained on file (M.S.D.S).

C.O.E. CONTINUING EDUCATION

8 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The courseCONTINUING provided was prepared byEDUCATION C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 244 of 257 C.O.E.

Material Safety Data Sheet (M.S.D.S.)

Below is an example of an M.S.D.S.

The Clorox Company

7200 Johnson Drive Material Safety Pleasanton, California 94588 Tel. (510) 847-8100 CLOROX Data Sheet

Product: CLOROX GERMICIDAL BLEACH

Description: CLEAR, LIGHT YELLOW LIQUID WITH CHLORINE ODOR Other Designations Manufacturer Emergency Telephone No.

EPA Registration No. 5813-1 The Clorox Company Rocky Mountain Poison Center

Sodium hypochlorite solution 1221 Broadway (800) 446-1014

LiquidII Health chlorine bleachHazard Data Oakland, CA III94612 Hazardous IngredientsFor Transportation Emergencies Chemtrec Causes substantial but temporary eye injury. May Irritate skin. May Clorox Liquid Bleach (800) 424-9300 cause nausea and vomiting if ingested. Exposure to vapor or mist may Irritate nose, throat and lungs. The following medical conditions may be Ingredients Concentration Worker Exposure Limit aggravated by exposure to high concentrations of vapor or mist; heart conditions or chronic respiratory problems such as asthma, chronic bronchitle or, obstructive lung disease. Under normal consumer use conditions the likelihood of any adverse health effects are low. Sodium hypochlorite 5.25% not established

CAS # 7881-52-9

FIRST AID: EYE CONTACT: Immediately flush eyes with plenty of water. If irritation persists, see a doctor. SKIN CONTACT: Remove contaminated clothing. Wash area with water. INGESTION: Drink a glassful of water and call a physician. INHALATION: If breathing None of the ingredients in this product are on the IARC, NTP or OSHA problemsIV Special develop removeProtection to fresh air. and Precautions carcinogenV Transportation list. Occasional clinical and reports Regulatory suggest a low Datapotential for sensitization upon exaggerated exposure to sodium hypochlorite if skin Hygienic Practices: Wear safety glasses. With repeated or prolonged U.S.damage DOT (e.g. Hazard irritation) Class: occurs during Notexposure. restricted Routine clinical tests use wear gloves. conducted on intact skin with Clorox Liquid Bleach found no sensitization in the test subjects.

U.S. DOT Proper Shipping Name: Hypochlorite solution with not more Engineering Controls: Use general ventilation to minimize exposure to than 7% available chlorine. Not Restricted per 49CFR172.101(c)(12)(lv) vapor or mist.

Work Practices: Avoid eye and skin contact and inhalation of vapor or Section 313 (Title lll Superfund Amendment and Reauthorization Act): mist.VI Spill or Leak Procedures VIIAs a consumerReactivity product, Data this product is exempt from supplier notification requirements under Section 313 Title lll of the Superfund Amendment and Reauthorization Act of 1988 (reference 40 CFR Part 372).

Keep out of reach of children.

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Small Spills (<5 gallons)

(1) Absorb, containerize, and landfill in accordance with local regulations. Stable under normal use and storage conditions. Strong oxidizing agent. Reacts with other household chemicals such as toilet bowl cleaners, rust (2) Wash down residual to sanitary sewer.* removers, vinegar, acids or ammonia containing products to produce hazardous gases, such as chlorine and other chlorinated species Prolonged contact with metal may cause pitting or discoloration. Large Spills (>5 gallons)

(1) Absorb, containerize, and landfill in accordance with local regulations;

wash down residual to sanitary sewer.* -OR - (2) Pump material to waste drum(s) and dispose in accordance with local regulations; wash down residual to sanitary sewer.* Vlll Fire and Explosion Data IX Physical Data Boiling point 212 F, 100 C

Specific Gravity (H2O) 1085 Not flammable or explosive. In a fire, cool containers to prevent rupture and release of sodium chlorate. Solubility in Water complete * Contact the sanitary treatment facility in advance to assure ability to process washed-down material. pH 11.4

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Organizing an M.S.D.S. Notebook

Suggestions for setting up an M.S.D.S. notebook include:

• Using a three-ring binder that pages can easily be placed in or removed from.

• Highlighting specific areas to identify key aspects of the

M.S.D.S. report within the notebook. (see example)

• Alphabetizing the M.S.D.S. reports so that locating the sheets will be fast.

• Clearly mark the notebook on all sides to indicate it as the

M.S.D.S. notebook.

• Use a white or bright colored notebook so it can be easily identified as the M.S.D.S. Notebook.

• When ordering products for the first time, request the company send you a product sheet (M.S.D.S.) page to add to your notebook.

• Remove any M.S.D.S. reports when the product is no longer used in the salon. 10 Decontamination and Infection Control All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing CONTINUINGEducation. The course provided EDUCATION was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 247 of 257 C.O.E.

• Establish an emergency contact sheet that will be the very first page in your M.S.D.S. notebook. List the local emergency numbers for your salon area.

• Add the Centers for Disease Control and the National Poison

Control Center to the emergency contact page.

• Have a sheet that states your salon operators have read and understand the concept of the M.S.D.S. notebook and have them sign a form stating the information has been read. Keep a copy of this form in their employment file.

• Make sure the M.S.D.S. Notebook is located in a place where all employees have access to it and they are aware of its location.

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POST THESE PAGES IN THE SALON/SCHOOL WHERE IT CAN BE READ BY ALL.

Georgia State Board of Cosmetology Sanitary Regulations for Salons and Schools

130-4-.01 Facilities.

(1) All facilities (salons/shops or schools) wherein cosmetology services are practiced or taught within the State of Georgia must provide suitable quarters equipped to give adequate services, subject to inspection by representatives of the Georgia State Board of Cosmetology.

(2) A beauty facility shall have a permanent and definite location in which the cosmetology professions of master cosmetologist, hair designer, nail technician, and/or esthetician, are practiced in accordance with the laws and rules of the Georgia State Board of Cosmetology. All mobile units, including kiosks, carts, mobile homes, trailers, and motor homes, shall not be licensed as salons/shops unless they meet all requirements

of the Board and are permanently anchored on the ground with wheels detached.

130-4-.02 Use of Facility for Home Salon/Shop.

Space used for a cosmetology facility must be separated by tight, ceiling high partitions from residence rooms and must have separate restrooms. The cosmetology facility shall have a separate outside entrance. Separate space must be provided for a cosmetology facility. The use of any such space for sleeping, dining or any other domestic purpose is prohibited.

130-4-.03 Facilities (salon/shop/school).

Space used for a cosmetology facility must be separated by tight, ceiling high partitions from other commercial facilities.

130-4-.04 Cleanliness.

Walls, ceiling, floors, furniture and equipment must be kept free from excessive dust, dirt and debris. All equipment must be kept in good and safe working condition.

1 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 2 of 257 C.O.E.

130-4-.05 Plumbing, Hot and Cold Water.

Each facility must have proper toilet and plumbing facilities and an adequate supply of hot and cold running water in accordance with recognized health standards.

130-4-.08 Posting of Licenses, Rules, Reports and Inspection Reports.

(1)Each salon/shop shall post in an open area the current salon/shop license issued to them by the Georgia State Board of Cosmetology, or a current copy of the online verification of licensure.

(2) Each person employed in the salon/shop shall post, in an open area, the current license/permit issued to them by the Georgia State Board of Cosmetology or the Georgia State Board of Barbers, or a current copy of the online verification of licensure.

(3) Salons/Shops shall have posted in an open area at all times a copy of the most recent inspection report.

(4) Salons/Shops shall comply with rules for sanitation, health and disinfectants in Chapter 130-5 of the Rules of Georgia State Board of Cosmetology.

(5) Sanitary rules and regulations governing salons or shops in the State of Georgia shall be posted in an open area in the salon/shop so as to be easily read by customers.

130-5-.01 Shampoo Equipment.

Shampoo bowls must be thoroughly cleansed and sanitized. C.O.E. CONTINUING EDUCATION

2 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 3 of 257 C.O.E.

130-5-.02 Linens.

Towels/linens, after being used once, must be placed in a closed container until properly laundered. Clean towels must be kept in a closed cabinet, container, or closet except linens which are designated for use on current patrons.

130-5-.03 Sterilization.

The use of any article that is not properly cleansed and disinfected on any patron is prohibited. Hands must be properly cleansed and sanitized prior to servicing each client.

130-5-.04 Waste and Garbage.

All waste material must be removed daily. Garbage shall be stored in a covered, washable container and shall not be left in the establishment overnight. Each facility must be free from stale food and soiled dishes.

130-5-.05 Cleaning and Recommended Disinfection of Implements.

(1) All multi-use tools, implements, and equipment used for cosmetology services that come in contact with a client must be cleaned of all visible debris after each use and disinfected after each use by complete saturation or immersion for at least 10 minutes in an EPA-registered, hospital-grade disinfectant according to the manufacturer’s directions. Autoclave is an acceptable method of sterilization. Each salon or shop shall provide correct wet disinfection and dry storage standards at all times.

(a) Multi-use items constructed of nonporous materials such as metal, glass, or plastic for use on more than one client include, but are not limited to the following items: nail clippers, cuticle nippers, cuticle pushers, scissors, shears, reusable nail forms, manicure and pedicure bowls, foot files, glass, metal and fiberglass files, metal drill bits, tweezers, comedone extractors, brushes, combs, clips, reusable pencil sharpeners, reusable gloves, and any other metal tools/non-porous implements not listed above.

(b) Single use items shall be discarded after being used one time. These items include: buffers, emery boards, nail files, sleeves and sanders for electric files, orangewood/birchwood sticks, wooden applicator

3 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 4 of 257 C.O.E.

sticks or spatulas, porous foot files, pedicure slippers and toe separators, disposable gloves, paraffin liners, cotton balls, cotton strips or swabs, neck strips and muslin strips or any items that cannot be disinfected.

(2) Wet disinfection standards for tools, implements, or equipment:

(a) After cleaning, all tools, implements and equipment must be disinfected by complete saturation or immersion (enough solution to cover all surfaces of the item) for 10 minutes in an EPA-registered, hospital- grade disinfectant that is bactericidal, viruscidal, fungicidal, and pseudomonacidal. The disinfecting solution must be changed daily and/or prepared according to manufacturer’s directions.

(b) All tools, implements, or equipment that come in contact with blood or body fluids must be disinfected by complete immersion for a minimum of 10 minutes in an EPA registered disinfectant that is effective against HIV-1 and Human Hepatitis B Virus, or tuberculocidal that is prepared and used according to the manufacturer’s directions. Autoclave is an acceptable method of sterilization.

(3) Dry storage standards for tools, implements, or equipment: (a) All disinfected tools and implements shall be stored in a sanitary manner in a covered container. The container must be labeled to show that it contains disinfected tools and implements.

(b) Soiled and dirty tools and implements must be stored in a separate and properly labeled covered container. Soiled and dirty tools and implements shall not be used again until properly cleaned and disinfected according to the procedures stated in this rule.

(4) Hand washing is required before and between providing services to each client. An anti-bacterial soap is recommended to sanitize the hands and the exposed portions of arms before providing services and after smoking, drinking, eating, and using restrooms.

(5) Pedicure equipment cleaning and disinfection procedures to be used for all pedicure equipment that holds water including sinks, bowls, basins, pipe-less, and whirlpool spas are as follows:

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(a) After each client, all pedicure units must be cleaned with a chelating soap or detergent with water to remove all visible debris, then disinfected with an EPA registered hospital-grade bactericidal, fungicidal, virucidal, and pseudomonacidal disinfectant used according to manufacturer’s instructions for at least ten (10) minutes. If

the pedicure unit has a foot plate, it should be removed and the area beneath it cleaned, rinsed, and wiped dry. (b) At the end of each day of use, the following procedures shall be used:

1. All filter screens in whirlpool pedicure spas or basins for all types of foot spas must be sanitized. All visible debris in the screen and the inlet must be removed and cleaned with a chelating soap or detergent and water. For all pedicure units, the jet components and/or foot plate must be removed and any debris removed and cleaned. The screen, jet, and/or foot plate must be completely immersed in an EPA-registered, hospital-grade

bactericidal, fungicidal, virucidal, and pseudomonacidal disinfectant that is used according to manufacturer’s instructions. The screen, jet, and/or foot plate should be replaced after disinfection is completed and the system flushed with warm water and low sudsing soap for 5 minutes, rinsed, and drained.

2. After the above procedures are completed, the basin should be filled with clean water and the correct amount of EPA-registered disinfectant. The solution must be circulated through foot spa system for 10 minutes and the unit then turned off. The solution should remain in the basin for at least 6 to 10 hours. Before using the equipment again, the basin system must be drained and flushed with clean water.

(c) Once each week, additional procedures should be performed. After completing the required cleaning procedures for the end of the day, the basin should be filled with water that contains one teaspoon of 5.25% bleach for each gallon of water. The solution should be circulated through the spa system for 5 to 10 minutes and then the solution should sit overnight in the basin, or for at least 6 to 10 hours. Before being used again, the system should be drained and flushed. (d) A record or log book containing the dates and times of all pedicure equipment cleaning and disinfection procedures must be documented and kept in the pedicure area by the salon or shop and made available for review upon request by a consumer and/or an inspector from the Board. (6) Signs shall be posted in clear view in the reception area of the salon/shop as follows: (a) Cosmetology laws, rules, and regulations are available upon request. (b) All cosmetology services shall only be performed on intact, healthy scalp, skin, and nails. (c) Customers should not shave their legs the same day as receiving pedicure services to reduce the risk of infection.

(7) Signs shall be posted in clear view in the pedicure services area of the salon/shop as follows: (a) All cosmetology services shall only be performed on intact, healthy scalp, skin, and nails.

5 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 6 of 257 C.O.E.

(b) Customers should not shave their legs the same day as receiving pedicure services to reduce the risk of infection.

(d) Pumice stones shall not be reused from one customer to another to prevent the spread of bacteria.

130-5-.06 Storage of Preparations.

Creams, lotions and other cosmetics for use on patrons must be kept in sanitary, closed containers.

130-5-.07 Pets.

Pets shall not be allowed in cosmetology facilities, with the exception of animals for handicapped patrons.

130-5-.08 Protective Clothing and Footwear for Patrons.

Patrons in all Georgia Schools/salons/shops shall wear appropriate clothing and footwear to prevent exposure to potential infectious materials.

C.O.E. CONTINUING EDUCATION

6 Revised November 2008 All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided CONTINUING was prepared by C.O.E. Continuing EDUCATION Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 7 of 257 C.O.E.

130-5-.09 Protective Clothing.

Cosmetologists, hair designers, nail technicians, and estheticians in Georgia are required to abide by all state laws for cosmetology, hair design, nail care, and esthetics. The professions of cosmetology, hair design, nail technology and esthetics are subject to the guidelines and rules promulgated by Georgia State Board of Cosmetology. Cosmetologists, hair designers, nail technicians, estheticians are also subject to the

provisions of O.C.G.A. §43-1-19. Practitioners of the cosmetology profession in Georgia shall wear appropriate protective clothing for clinical services to prevent occupational exposure to potential infectious materials. Appropriate clothing and footwear may include, but not be limited to, clinical jackets, gloves and/or similar outer garments for the protection from infectious or harmful materials.

7 Revised November 2008 CONTINUING EDUCATION

Appendix A

Georgia State Board of Cosmetology

Glossary of Legal Definitions

Master Cosmetologist

Any person who performs any one or more of the following services for compensation:

. Cuts or dresses the hair

. Gives facial or scalp massage or facial and scalp treatment with oils or creams and other preparations made for this purpose, either by hand or mechanical appliance

. Singes and shampoos the hair, dies the hair, or does permanent waving of the hair . Braids the hair by hair weaving, interlocking, twisting, plaiting, wrapping by

hand, chemical or mechanical devices, or using any natural or synthetic fiber for extensions to the hair

. Performs nail care, pedicure, or manicuring services as defined in Nail

Technician

. Performs the services of an esthetician as defined in Esthetician or Esthetics

Operator

C.O.E.Su chCONTINUING person shall be considered as practicing the occupatio n EDUCATIONof a cosmetologist within the meaning of this Code section; provided, however, that such term shall not mean a person who only braids the hair by hairweaving; interlocking; twisting; plaiting; wrapping by hand, chemical, or mechanical devices; or using any natural or synthetic fiber for extensions to the hair, and no such person shall be subject to the provisions of this chapter. Such term shall not apply to a person whose activities are limited to the application of cosmetics which are marketed to individuals and are readily commercially available to consumers.

8 Revised November 2008 CONTINUING EDUCATION

Hair Designer

Any person who performs any one or more of the following services for compensation:

. Cuts or dresses the hair

. Singes and shampoos the hair or dyes the hair.

Esthetician

A person who, for compensation, engages in any one or a combination of the following practices, esthetics, or cosmetic skin care:

. Massaging the face or neck of a person

. Trimming eyebrows

. Dyeing eyelashes or eyebrows

. Waxing, stimulating, cleansing, or beautifying the face, neck, arms, or legs of a person by any method with the aid of the hands or any mechanical or electrical apparatus or by the use of a cosmetic preparation.

Such practices of esthetics shall not include the diagnosis, treatment, or therapy of any dermatological condition. Such term shall not apply to a person whose activities are limited to the application of cosmetics which are marketed to individuals and are readily commercially available to consumers.

Nail Technician

A person who, for compensation, trims, files, shapes, decorates, applies sculptured or otherwise artificial nails, or in any way cares for the nails of the hands and feet of another person.

9 Revised November 2008 CONTINUING EDUCATION

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EVALUATION / TEST QUESTIONS

1. WERE YOU GIVEN ENOUGH TIME TO COMPLETE THIS CLASS? 2. DID THIS CLASS PROVIDE YOU WITH GREAT INFORMATION? 3. CAN THIS CLASS ASSISIT YOU IN YOUR TEACHING METHODS? 4. WILL YOU RECOMMEND THIS CLASS TO A CO-WORKER?

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