Professional Documents
Culture Documents
Tattoo Toolkit
Tattoo Toolkit
body piercing
guidance
Toolkit
Main contents
ISBN 978-1-906989-72-9
July 2013
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CONTENTS
Acknowledgements7
PART A
Section 01
8 14
Legislative background on tattooing and skin
piercing activities
Section 02a
Standard Principles of Infection Control
15
Section 02b
16 17
Principles of Infection Control Hand hygiene
Section 02c
18 20
Principles of Infection Control Personal
protective equipment
Section 02d
21 23
Principles of Infection Control Management
of sharps and exposure to blood and body fluids
Section 02e
24 25
Principles of Infection Control Safe handling,
storage and disposal of waste materials
Section 02f
26
Principles of Infection Control Cleaning and
disinfection of the environment
Section 02g
References
27
Section 03
28 29
Before and aftercare of a tattoo or body piercing
Section 04
Decontamination
30 34
Section 05
Product quality of tattoo ink
35 36
Section 06
Body piercing jewellery
Section 07
Governance
Appendix 02
42 43
Infection, its causes and spread, including
a glossary of infection-related terms
Appendix 03
Blood borne viruses
44
Appendix 04
Safe use and disposal of sharps
45
Appendix 05
46
First Aid following a blood/body fluid exposure
Appendix 06
Protocol for cleaning up blood or a blood
stained body fluid spill
47
Appendix 07
Principles for good waste handling
48
Appendix 08
49
Template protocol for environmental cleaning
of premises
Appendix 09
Tattooing/body piercing consent form
50
Appendix 10
Aftercare follow-up record sheet
51
Appendix 11
52
Decontamination requirements for equipment
used in tattooing and skin piercing
Appendix 12
53
Equipment sterilization standard- self
assessment and decision making tool for
tattoo and body piercing practitioners
Appendix 13
54
Equipment and body piercing jewellery
sterilization standard for tattooists and body
piercers
Appendix 14
Autoclave daily record sheet
55
PART C
37
38 39
Section 08
40
Management of infectious disease incidents
relating to tattooing and body piercing
PART B
Appendix 01
41
Model Byelaws: Acupuncture, tattooing, semipermanent skin-colouring, cosmetic piercing
and electrolysis
56
57
58
59
60
61
62
Poster to download
How to handwash
63
PART D
Audit Tool to download
64
PART E
Literature review to download
65
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Graham Jukes
Dr Paul Cosford
Endorsing organisations
Introduction
Using the guidance
toolkit
Acknowledgements
Alan Beswick
Principal Scientist, Health & Safety
Laboratory
A substantial amount of care and effort has
gone in to producing this new guidance toolkit,
and its underlying strength lies in the evidence
based nature of its content; further supported
by expert consensus where published
evidence may be lacking. The combination of
contributors to the toolkit confirms the desire
of the authors to get it right in terms of the
subject matter, presentation style and general
accessibility of the information. Those who
have contributed include senior tattooing and
body piercing industry representatives, health
care professionals, infection control scientists
and health and safety specialists. The Health
and Safety Laboratory is grateful to Public
Health England and The Chartered Institute of
Environmental Health for the opportunity to be
involved in this guidance toolkit preparation,
and is fully supportive of its content.
Main contents
2
Marcus Henderson
President, Tattoo and Piercing
Industry Union
The vast majority of members of the
professional tattoo and body piercing
community recognise the importance of
the promotion and adoption of good practice in
order to safeguard both practitioners and public
alike. It is our hope that this document will
provide an easy access reference guide to assist
those engaged in the industry in understanding
the necessity for examining their current
practices and, where needed, making changes
to improve operational standards.
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Main contents
3
Chartered Institute of
Environmental Health (CIEH)
The CIEH is a registered charity and the
professional voice for environmental health.
It sets standards, accredits courses and
qualifications for the education of members
and other environmental health practitioners.
It provides information, evidence and policy
advice to local and national government
and environmental and public health
practitioners in the public and private sectors.
As an awarding body, the CIEH provides
qualifications, events, and support materials on
topics relevant to health, wellbeing and safety
to develop workplace skills and best practice.
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4
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Foreword
Endorsing organisations
Introduction
Using the guidance
toolkit
Acknowledgements
Main contents
5
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The guidance has been written as a key point of reference for use nationally
by tattoo and body piercing practitioners who work in regulated premises,
local authority officers in their regulatory role and health protection staff
who are asked to provide expert advice. The guidance does not cover mobile
operators or non-registered practitioners, although the risks encountered
in relation to their activities will be of equal or greater concern. It does not
address the risks associated with procedures other than those commonly
accepted as necessary for tattooing and the insertion of body jewellery,
although the procedures recommended for infection control are based upon
sound principles of infection control and will have wider application.
The material is arranged so as to be readily
accessible as a web-based toolkit, organised
in a manner that reflects the tattoo and
body piercing setting, and with supportive
documentation and literature that can be
downloaded and saved or printed in the
manner that users prefer.
It is intended that the adoption of the
standards recommended in this guidance,
particularly those relating to infection control
and decontamination, will help to establish
standards for good practice. Governance is
promoted by the inclusion of template consent
forms, aftercare advice leaflets and a good
practice infection control audit tool.
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6
Providing feedback
The working group intend to reconvene to
consider all feedback provided on the use
of this guidance toolkit after it has been in
operation for 6 months after publication.
To that end feedback on your experience
is positively encouraged and will be
acknowledged and recorded for consideration.
Please send your feedback to Ian Gray,
i.gray@cieh.org Principal Policy Officer at the
Chartered Institute of Environmental Health.
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Editorial Group
Alan Beswick
Marcus Henderson
Susanne Howes
Ann Lusmore
Independent Advisor
Main contents
Special acknowledgement
The working party would like to record its
appreciation of the Chartered Institute of
Environmental Health for undertaking the
design and publication of the guidance toolkit.
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Summary
Outside London
Specific controls
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8
In London
General controls
The primary health and safety legislation applies
across the whole of England & Wales and is
available for use by all local authorities without
the need for adoption. It can be used to impose
and enforce infection control requirements in
relation to all skin piercing activities, including
peripatetic practitioners who visit a clients home.
It allows for immediate prohibition of persons or
premises that pose an imminent risk to health or
safety. The use of health and safety legislation is
governed by substantial amounts of regulatory
guidance and approved codes of practice.
However, none of this relates specifically to skin
piercing and therefore, regulatory officers need
to use their skills of risk assessment within an
infection control setting.
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9
Determining requirements
It is intended that this national guidance will
provide an additional authoritative source
of information to support local authorities in
determining their requirements for effective
control of risk in these activities and adopting
a consistent approach in the application of the
legislation. Similarly, it will be of assistance to
those businesses and practitioners undertaking
these activities to ensure that they are able
to operate safely and comply with legal
requirements.
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General duties
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Risk assessment
A risk assessment is the key step in protecting
workers and the public, as well as complying
with the law. The risk assessment is a careful
examination of what work activities could
cause harm to people and this then guides
decisions about precautions that need to
be taken, including infection prevention and
control measures.
The HSE provides detailed advice on carrying
out risk assessments http://www.hse.gov.uk/
risk/risk-assessment.htm including interactive
tools http://www.hse.gov.uk/risk/shop.htm
The Management of Health and Safety at
Work Regulations 1999 requires all employers
and self employed persons to:
Undertake a risk assessment of their
activities;
Remove, where possible, that risk or;
Where residual risk is unavoidable, to
provide control measures to reduce it as
far as possible, including as a last resort,
provision of personal protective equipment;
Provide training to staff and persons they
use to undertake their business activities
(contractors) to ensure they understand the
risks and the control measures.
One of the risks that must be considered here
is that of possible complications relating to
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Management of contractors
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Enforcement
The requirements of HASWA74 are enforceable
through improvement and prohibition notices.
Improvement notices give a time limit for
compliance with requirements. Prohibition
notices can have the effect of immediately
stopping the operations of a business or the
activities of a person where imminent risk
is apparent. All offences under HASWA74
are punishable by unlimited fines and prison
sentences, so they provide a substantial
inducement for business to comply with
requirements.
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Summary
Specific controls
Outside London
In London
General controls
Determining requirements
Licensing and
registration in England &
Wales (excluding London)
Licensing/registration in
London
Exemptions within London
Health and Safety At
Work etc. Act 1974
General duties
Risk assessment
Control of substances
hazardous to health
Management of contractors
Enforcement
Public health controls
Age limits and consent
Tattooing
Other skin piercing activities
Acupuncture and electrolysis
Ear and nose piercing
Consent
Use of local anaesthetic
medication
Appendix 1 Model Byelaws
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Tattooing
The Tattooing of Minors Act 1969 imposes
a statutory minimum age of 18 years for
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Summary
Specific controls
Outside London
In London
General controls
Determining requirements
Licensing and
registration in England &
Wales (excluding London)
Licensing/registration in
London
Exemptions within London
Health and Safety At
Work etc. Act 1974
General duties
Risk assessment
Control of substances
hazardous to health
Management of contractors
Enforcement
Public health controls
Age limits and consent
Tattooing
Other skin piercing activities
Acupuncture and electrolysis
Ear and nose piercing
Consent
Use of local anaesthetic
medication
Appendix 1 Model Byelaws
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Introduction
Responsibilities
Introduction
Standard Principles of
Infection Control
15
Main contents
Standard Principles of
Infection Control
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Principles of Infection
Control Hand hygiene
Hand hygiene is a major component of the
standard principles and one of the most
effective methods to prevent transmission
of pathogens by reducing the number
of microorganisms that may be present.
The spread of infection from hands is well
recognised and the importance of compliance
with hand hygiene practices is emphasised in
all national and international guidelines.
16
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Standard Principles of
Infection Control
Section 02b
1. Preparation
Section 02a
Introduction
Principles of Infection
Control Hand hygiene
Hand washing facilities
When to wash hands
What to use to wash hands
How to carry out hand washing
Use of hand rubs
Hand care
Use of hand cream
Care of broken skin
Poster How to handwash
Section 02c
Principles of Infection
Control Personal
protective equipment
Section 02d
Principles of Infection
Control Management of
sharps and exposure to
blood and body fluids
Section 02e
Principles of Infection
Control Safe handling,
storage and disposal of
waste materials
Section 02f
Principles of Infection
Control Cleaning and
disinfection of the
environment
Section 02g References
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Hand care
Use of hand cream
A hand cream can be applied regularly to
protect skin from the drying effects of regular
hand decontamination (National Institute
for Health and Care Excellence, 2012). Each
practitioner should have their own supply and
a communal pot should not be used.
Care of broken skin
Unbroken skin is the best defence because it
provides the perfect barrier against infection.
Small areas of broken or infected skin on
exposed parts of the practitioners body should
be covered with a waterproof dressing that
completely covers the affected area.
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Principles of Infection
Control Personal
protective equipment
Assessment of risk
Regulation 3 of the Management of Health
and Safety at Work Regulations 1999 (Health
and Safety Executive, 2008) requires every
employer to make a suitable and sufficient
assessment of:
a) risks to the health and safety of their
employees to which they are exposed
whilst they are at work; and
b) risks to health and safety of persons not in their
employment arising out of or in connection
with the conduct by them of their undertaking.
Therefore the selection of protective
equipment must be based on an assessment
of the risk of transmission of infection between
the practitioner and client and vice versa:
Anticipated Wear
level of
disposable
exposure
gloves
No
exposure
to blood/
body fluids
anticipated
Exposure
to blood/
body fluids
anticipated
but low risk
of splashing
Exposure
to blood/
body fluids
anticipated
with high
risk of
splashing
to the face
Yes
Yes
Yes
Yes
Yes
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Nitrile
Polythene
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Aprons
A disposable plastic apron must be worn when
there is a risk that clothing may be exposed
to blood, body fluids, secretions or excretions
(with the exception of sweat or tears) (National
Institute for Health and Care Excellence, 2012).
Plastic aprons should be used as single-use
items and changed between clients. They
should be discarded and disposed of as
offensive waste after use.
Eye and face protection
Eye protection and face masks must be worn
where there is a risk of blood, body fluids,
secretions or excretions splashing into the eyes
and face (National Institute for Health and
Care Excellence, 2012). A risk assessment of
the planned procedure should be undertaken
to help inform decision making (e.g. when
manually cleaning equipment as part of
decontamination processes).
If reusable goggles/protective glasses are
used, they should be washed after each client
or task using a general purpose detergent,
rinsed and stored dry. Eye protection should be
compatible with any facemask used.
Face masks (such as surgical masks) should
only be used if there is a risk of splashing of
blood/body fluid droplets into the mouth
or nose. If used, masks should be changed
between clients and disposed of immediately
after use. They must not be carried or worn
around the neck.
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Principles of Infection
Control Management of
sharps and exposure to blood
and body fluids
Introduction
All body fluids should be regarded as potentially
infectious. Blood carries the highest risk of
transmitting blood borne viruses such as hepatitis
B, C , D and human immunodeficiency virus (HIV).
Blood borne viruses may also be transmitted by
other body fluids, especially if contaminated by
blood (Health Protection Agency, 2009).
See appendix 03 Blood borne viruses
Sharps and needles
The word sharps is a generic term that
includes needles, scalpels, stitch cutters, glass
ampoules and sharp instruments that may
become contaminated with blood or body
fluid. In tattooing/body piercing premises,
sharps include equipment such as razors,
needle bars with needles attached and
cannulae (sometimes used for body piercing).
Sharps contaminated with blood or other
body fluids should be classified as hazardous
waste and handled accordingly.
See Section 02e
All sharps must be handled and disposed of
safely and with extreme care. After use they
should be placed immediately into yellow sharps
boxes/bins with orange lids, compliant with UN
3291 and BS7320 standards. This is to reduce
the risk of exposure to blood-borne viruses,
for example through an accidental sharps
or needlestick injury (National Institute for
Health and Care Excellence, 2012).
See Appendix 04 Safe use and disposal
of sharps
Sterile needles
Only sterile single-use needles should be
used for skin piercing or tattooing. Needles
should be examined for imperfections prior
to their use and discarded if any are found.
Needles should either be used directly from the
packaging or placed on a sterile surface/tray
for immediate use.
Sharps/needlestickinjuries and
exposure to blood and body fluids
Types of injury/exposure
A blood/body fluid injury/exposure incident
includes:
Inoculation of blood by a needle or
other sharps.
Contamination of broken skin with
blood.
Blood splashes to mucous membrane,
e.g. eyes or mouth.
Swallowing a persons blood, e.g. after
mouth-to-mouth resuscitation.
Contamination where the individual has
an open wound, and clothes have been
soaked by blood.
Bites (where the skin is broken).
Risks of transmission of blood-borne
viruses following a significant injury/
exposure
Transmission of blood borne viruses (BBVs)
may result from contamination of mucous
membranes of the eyes or the mouth, or
of broken skin, with infected blood or other
infectious material. There is no evidence
that BBVs can be transmitted by blood
contamination of intact skin, inhalation or by
faecal-oral contamination.
The transmission risks after a mucocutaneous
exposure (splash exposure) are lower than
those after a percutaneous exposure (sharps
injury), estimated at 1 in a 1000 for HIV
(Health Protection Agency 2008). There is
currently no evidence on the risk of transmission
for hepatitis B virus (HBV) and hepatitis C virus
(HCV) following mucocutaneous exposure
(Health Protection Agency, 2008).
The risk of infection following a percutaneous
injury, especially deep penetrating injuries
involving a hollow-bore needle or a device visibly
contaminated with blood has been estimated at:
1 in 3 when a source patient is infected
with HBV and is classed as being highly
infectious at the time.
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Introduction
Standard Principles of
Infection Control
Section 02b
Principles of Infection
Control Hand hygiene
Section 02c
Principles of Infection
Control Personal
protective equipment
Section 02d
Principles of Infection
Control Management of
sharps and exposure to
blood and body fluids
Introduction
Sharps and needles
Sterile needles
Sharps/needlestick injuries
and exposure to blood/
body fluid spills
Types of injury/exposure
Risks of transmission of bloodborne viruses following a sharps
injury/exposure
Management of sharps/
needlestick injuries and exposure
to blood and body fluids
Sharps/needlestick injuries
Blood/body fluid spills
Occupational health for blood
borne virus prevention
Risk assessment
Vaccination requirements
Appendix 03 Blood borne viruses
Appendix 04 Safe use and
disposal of sharps
Appendix 05 First Aid following
a sharps/ needlestick injury and
exposure to blood/body fluid
Section 02e
Disposable cloths.
Principles of Infection
Control Cleaning and
disinfection of the
environment
Section 02g References
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Section 02f
Risk assessment
Vaccination requirements
Those at risk of blood/body fluid exposure
through sharps or splashes, therefore, should
have a full course of hepatitis B vaccine. An
accelerated course consisting of three doses at
zero, one and two months (followed by a fourth
dose at twelve months after the first dose
for those at continued risk of exposure), and
antibody titres (blood levels) should be checked
one to four months after the completion of the
primary course of vaccine. It is recommended
that those at continued risk of infection
should be offered a once only single booster,
approximately five years after completion of the
primary immunisation course (antibody levels
do not need to be checked before or after this
booster dose). (Department of Health 2006).
Under the Health and Safety at Work etc
Act 1974, employers must pay for protective
measures such as immunisation. This is usually
provided through the company occupational
health provider. In the absence of an
occupational health service, the employee
could be asked to arrange immunisation
through their own GP, but the employer must
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Standard Principles of
Infection Control
Principles of Infection
Control Safe handling,
storage and disposal of
waste materials
Section 02b
Principles of Infection
Control Hand hygiene
Section 02c
Principles of Infection
Control Personal
protective equipment
Section 02d
Section 02a
Introduction
Principles of Infection
Control Management of
sharps and exposure to
blood and body fluids
Section 02e
Principles of Infection
Control Safe handling,
storage and disposal of
waste materials
Responsibility for waste
materials
National guidance on waste
management
Offensive waste
Sharps
All other waste
Disposal of aerosol cans, glass,
bottles, broken crockery and dry
cell batteries
Appendix 07 Principles for
good waste handling
Section 02f
Principles of Infection
Control Cleaning and
disinfection of the
environment
Section 02g References
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Principles of Infection
Control Cleaning and
disinfection of the
environment
Cleaning is the process that physically removes
contamination with organic material such as
blood and body fluids, along with dirt and
dust. Cleaning does not necessarily destroy
microorganisms from the item that is being
cleaned. However, providing and maintaining
a clean and readily cleanable environment
facilitates the prevention and control of
infections.
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Use of chemicals
Household detergent is adequate for most
routine environmental cleaning. For high risk
environmental surfaces such as treatment
surfaces, a hypochlorite solution of 1000 parts
per million (PPM) available chlorine should be
used. This solution should be made up for use
on a daily basis, following the manufacturers
instructions, in a labelled container
provided by the commercial manufacturer
(using, for example, one tablet of sodium
dichloisocyanurate (NaDCC) per litre format).
After twenty-four hours the solution must be
discarded. The hypochlorite solution must
not be transferred into a trigger spray bottle
but be used directly from the container onto
a disposable cloth or paper towels. Surfaces
contaminated with blood should be cleaned in
accordance with the guidance on dealing with
blood spillage as a higher concentration of
hypochlorite will be required (see Appendix 06
Protocol for cleaning up blood or a blood
stained body fluid spill).
All chemicals should be handled and stored
in accordance with the manufacturers
instructions/COSHH guidance (Health and
Safety Executive, 2002). Material safety data
sheets should be accessible to all staff. All
chemicals used on the premises should be
used and stored in an identified cool, dry and
well ventilated place (room/cabinet) that is
lockable, out of reach of visitors and members
of the public and in the original containers.
Expiry dates should be routinely checked.
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References
Calderdale Local Authority (2008). Advice and
safe practice for permanent tattooing plus advice
and safe practice for body piercing. (http://www.
calderdale.gov.uk/business/licences/skinpiercing/
index.html)
Dartford Borough Council (2009). Code of practice
for hygienic piercing. (www.dartford.gov.uk)
Department of Health (1998). UK Health
Departments Guidance for Clinical Health Care
Workers: Protection Against Infection with
Blood-borne Viruses Recommendations of the
Expert Advisory Group on AIDS and the Advisory
Group on Hepatitis. HMSO (http://www.dh.gov.
uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_4002766)
Department of Health (2006). Immunisation
against Infectious Disease. (http://www.dh.gov.
uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_079917)
Department of Health (2010a). The Health
and Social Care Act 2008. Code of Practice
on the prevention and control of infections
and related guidance. (http://www.dh.gov.
uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_122604)
Department of Health (2010b). Uniforms and
workwear: guidance on uniform and workwear
policies for NHS employers. (http://www.dh.gov.
uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_114751)
Department of Health (2012). Safe management
of healthcare waste V2.0. (http://www.dh.gov.
uk/prod_consum_dh/groups/dh_digitalassets/
documents/digitalasset/dh_133874.pdf)
Health Protection Agency (2008). Eye of the
Needle: UK surveillance of significant exposures to
BBV in healthcare workers. (www.hpa.org.uk/web/
HPAwebFile/HPAweb_C/1227688128096)
Health Protection Agency (2009). Inoculation
Injuries and Children in Schools and similar settings:
Risk Assessment Guidelines for Health Protection
Units. (http://www.hpa.org.uk/webc/HPAwebFile/
HPAweb_C/1259152291335)
Health and Safety Executive (2002). Guidance
on Control of Substances Hazardous to Health
Regulations.(http://www.hse.gov.uk/coshh/)
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Skin Preparation
Where shaving is required, only single-use
razors are acceptable. Either a 70% alcoholimpregnated single use swab (typically 70%
isopropyl alcohol) or a 0.5% chlorhexidine in
70% alcohol single use swabs (National Institute
for Health and Care Excellence, 2012) can be
used for skin disinfection. If the skin is visibly dirty
then the area should first be cleaned with soap
and water and dried with a paper towel.
Where it is necessary to mark the skin, a single
use toothpick dipped into gentian violet or
other suitable dye could be used. The dye
should be dispensed into a single-use pot
for each client. Otherwise the entire bottle
should be discarded after each client. As an
alternative, or where large areas of skin need
to be marked, then a single-use commonly
available marker pen could be used, or a
suitable single-use alternative. (Dartford
Borough Council, 2009)
Where products such as petroleum jelly are
used for procedures, an appropriate amount of
material should be dispensed, using a singleuse implement (Calderdale Local Authority,
2008), into a single-use pot for every client.
Practitioners should not use cream/lotion direct
from a jar/tube. Roll-on or stick applicators
are not acceptable for use. The practitioners
hands, even if gloved, should never come into
contact with the contents of these jars/tubes.
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Aftercare leaflets
What to do if a client
returns with an infection
01
References
Tattoo after
care
Key Advic
e
02
Tattoo
Key Advic
e
The afterc
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are
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infection.
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and
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d area, therefo to touching
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n. warm water
d
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hands in warm
re reducing
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gs.
of the pierci type and position
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and redness
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it is
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the wound
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es
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and prevent
dry your hands
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transferred
n.
be red
and tende
with a clean
cause swelling . Any knock or bangfrom
to the affecte
A severe
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can be tender,
few weeks
up again
the healing
throbbing
and preven
sensation round
slightly red
normal for
phase.
t them being most germs
it
and can remain itchy and
the site.
As with all
Do not use
the affecte
the area to is
transferred
few weeks.
so for a
cotton wool
body
d area.
to
A
tender and
be red,
Increased
piercing as
to clean the
sometimes pale, odourless fluid
a risk. To reduc art, infection is
swollen.
tendern
the
discharge from
may
may get caughtfibres in the cotton
painful to touch. ess and increasingly
e these risks
Tattoo afterca
form a crust.
wool
in the piercing
advice from
This should the piercing and
Approximat
take
re
with pus, which
not
.
e
your practi
Do not pick
An unusua
would indicatbe confused
various piercinhealing times for the
Good practic
tioner
regarding
l discharge
e infection.
not move, at any discharge and
e is to cover
aftercare.
gs are:
(yellow or green)
with an offensi
twist or turn
do
area with non-sti
the tattooe
Ear piercin
whilst dry.
ve smell.
d
g aftercare
ck gauze which
If any secretethe piercing
Ear lobe piercin
secured with
Including Lobes/
hardened then
is then
d dischar
Speak to your
The risk of
hypo-allergeni
g 6 to
Tragus/ Anti
permits ventilat
turning jewelle ge has
Conch/ Helix/
practitioner
Ear cartila
infection
c
cause the dischar
attention immed
ge piercing 8 weeks
or seek medica
ry may
can be
ion and aids tape. Gauze
Snug/ Diath/ Tragus/
greatly reduc
Translo
ge
to
healing
iately if you
Industrial/
l Cheek piercin
6 to 8 weeks
tear the piercing
bal/ Transve
any of the
.
ed
Rook/ allowing bacteria to enter
suffer from
A tattoo coverin
rse Lobe.
above
,
g 2 to 3
prolonging
general hygie by good
g a large area
Eyebrow piercin
regarding infectioor have any concern
months
the healing the wound and
Facial piercin
need to be
ne including:
may
s
time.
n in your tattoo
covered
g 2 to 4
g aftercare
there are any
Nose piercin
Do not use
Including Eyebro
adhesive dressin with a sterile, nonor if
sunbeds for
g up to 6 months
to any of the signs of an allergic reactio
weeks, or if
Hand washi
Labret, Septum w, Bridge, Jestum
journey home. g, at least during
months
products used.
you decide the first two
, Vertical
n Reme
your
/ Nostril.
ng before
wound area
to
the area clean However, simply keeping
mber these
touching
the tattoo
with a breathathen cover the
Soak the piercing
times are
during tanning
ble plaster
best approa and dry is likely to be
approximat
for a few minute
.
submerging
ch.
the
e
s
Do not swim
how health and will depend on
piercing in the area of skin contain by
Keeping
A tattoo coverin
y you
a
following a for the first 24 hours
ing the
the tattoo
a warm waterclean jug or bowl contain
you look after are and whether
piercing.
g a large
ed
plastic film
solution (1/4
ing
area covere
the piercin
wrap applied area may have
of
Signs
prefera
level
prope
g
of infecti
d with non-s
teaspo
bly
clean (taken
, this must
rly until heale
be
glass of warmsea salt to an egg cup/shoon
straight from
tick
If appropriate on
gauze which
d.
used immed
water). Alterna
t
is secured
clean cloth
iately) and the pack and
infection may aftercare is not followe
tively wet a
As with all
or gauze in
with
you should
advised when
hypo-allerg
d
body
apply as a
the
be
infection are: occur. The signs of
enic tape.
warm compre solution and
a risk. To reduc art, infection is
your practiti to replace this coverin
any dischar
ss. This will
oner.
g by
Swelling
ge
advice from e these risks take
and
entry and exit and allow you to cleansoften
around the redness that increas
your practi
Any cream
es
that
wound.
a cotton bud points of the piercing the
regarding
tioner
from an approp you apply must be
aftercare.
with
A severe
is removed or gauze. Once the dischar
used
burning and
or softened
and you should riate pot/tube at home
throbbing
sensation
ge
be gently moved
then jewelle
The risk of
round the
wash your
application.
site.
infection can
Increased
water through so as to work a littlery can
Cream can hands before
greatly reduc
be
tenderness
warm
the
be purchased
from your
piercing
and increas
always tighten
painful to
practitioner
. When cleanin
touch.
ingly
hygiene included by good general
or a pharma
g
screwing the the ball on any bars
An unusua
cist.
ing:
Antibiotic creams
by
ball to the
l discharge
right.
(yellow
with
Hand washi
an offensive
except if infectio should not be used
or green)
Do this twice
ng before
smell.
n has occurre
Speak to your
touching
supervision
the piercin
washing or each day, preferably
d and under
of your Doctor
bathing.
after
practitioner
g.
attention immed
or seek medica
.
Keeping
iately if
You can also
l
any of the
the piercin
above or have you suffer from
and soaps use mild antibacterial
g clean.
regardi
any concern
to
s
piercing. Ask wash the wound site solutions there ng infection in your piercing
are any signs
your local pharma of an ear
you and always
of an allergic or if
cist to advise to any of the
reaction
follow the
products used.
instructions.
manufacturers
For furthe
For furthe
occurs discontIf irritation, redness or
r advice or
r advice or
information:
information:
Contac t your
Contac t your
NOT suitable inue use. Antibacterialdrying
local Environ
wash is Depart
lips due to for nostrils, septum
Department, local Environmental
mental Health
ment, or your
or vertical
the tissues
Health
or your local
local Public
delicate nature.
England Health
England Health
Public Health
Health
Dry the piercing
Protection
Protection
Team
Team
This Inform
This Inform
paper towel/k using ONLY fresh
ation is provide
ation is provide
disposable Public
Public Health
d by:
d by:
hand/bath itchen roll. A commu
Health
towel should
nal
Public Health England North West
Public Health England North West
never be used.
Tattoo and England East Midlan
Tattoo and England East Midlan
ds
ds
Piercing Industr
Piercing Industr
y Union
y Union
The afterc
are follow
ing a tattoo
is important
to promote
good
healing and
prevent the
risk of
infection.
Your practiti
Your practiti
oner is:
June 2013
Swelling.
Heat.
Immobility of, or reluctance to move, a
limb/digit/part of the body.
Where the client informs the practitioner
of a concern or problem, the practitioner is
advised to keep records of any action taken
and advice given.
oner is:
June 2013
03
Body and
surface piercing
Oral pierci
ng
Key Advic
e
The afterc
are of body
piercing
is important
to promote
healing and
good
prevent the
infection.
risk of
04
Oral
piercing
aftercare
Hand washin
Hand washin g
g is the single
method of
most importa
reducin
nt
must be washed g infection. Hands
affected area, prior to touching the
of infection. therefore reducing the
risk
Key Advic
e
Do not pick
at any dischar
not move,
ge and do
twist or turn
whilst dry.
the
If any secrete piercing
hardened
then turning d discharge has
jewelle
cause
Body and
surface pie
rcing
Hand washin
g
Hand washin
g is the single
method of
reducing infectiomost important
be washed
prior to touchin n. Hands must
area, therefo
re reducing g the affected
the risk of infectio
The afterc
are of body
piercing
is important
to promote
good
healing and
prevent the
risk of
infection.
References
Calderdale Local Authority (2008). Advice and
safe practice for permanent tattooing plus advice
and safe practice for body piercing. (http://www.
calderdale.gov.uk/business/licences/skinpiercing/
index.html)
Dartford Borough Council (2009). Code of practice
for hygienic piercing. (www.dartford.gov.uk)
National Institute for Health and Care Excellence
(2012). Infection control: Prevention and control of
healthcare-associated infections in primary and
community care (CG139). (http://guidance.nice.org.
uk/CG139)
aftercare
Do not pick
at any dischar
not move,
ge and do
twist or turn
the piercing
whilst dry.
If any
hardened then secreted discharge
has
turning jewelle
cause
Healing times
Wash your
n.
Healing times
the dischar
ry may
the dischar
ry may
hands in warm
for piercing
Wash your
for piercin
allowing bacteri ge to tear the piercin
allowing bacteri ge to tear the piercing
soap, always
vary with
water and
will
hands in warm
g will
dry your hands
the type and
liquid
g, vary with the type
,
a to enter
a to enter
liquid soap,
water and
and prolong
prolonging
with a clean
and positio
always dry
position
of the pierci
the healing the wound and
ing the healingthe wound
towel or paper thoroughly
of the piercin
your hands
thoroughly
n
time.
ng and vary
should remove
time.
towel. This
g and vary
with a clean
Do not wear
Do not use
person to
from
most germs
towel. This
towel or paper
from
person to
them being
sunbeds for
person.
and prevent
should remove
person.
nipple piercin tight clothing followin
weeks, or if
transferred
and preven
g
you decide the first two
to the affecte
g
t them being most germs
wound area
to
For the first
d area. Do
the affecte
A new piercing
transferred
with a breathathen cover the For the first
not wear
few weeks
d area.
to
during tanning
can be tender,
few weeks
ble plaster
it is
normal for
slightly red
belts or high tight clothing e.g. tights,
.
it is
normal for
and can remain itchy and
the area to
A new piercin
waisted
the area to
few weeks.
clothin
Do not swim
piercing as
be red,
tender and
A pale, odourle so for a
be red,
tender and
this may irritate g after naval
slightly red g can be tender, itchy
swollen.
sometimes
following a for the first 24 hours
and delay
and can remain
swollen.
and
the wound
discharge fromss fluid may
piercing.
healing.
few weeks.
so
form
for
the
An approximat
a
a crust. This
A
piercing
Approximat
sometimes pale, odourless fluid
Special afterca
with pus, which should not be confuse and Do not use sunbed
may
discharge
e healing
for oral pierci e healing times
s for the first
re for tongue
would indicat
d
from the piercin
weeks, or if
and form a
times
For the first
two
ng are:
you decide
e infection.
crust. This
piercing for surface, navel
g
few days take
to then cover
wound area
should not
confused with
Body and
eating and
and nipple
care when
be
with
surface piercin
piercing can
Tongue pierci
pus, which
avoid spicy
during tanning a breathable plasterthe
infection.
would indicat
foods.
g aftercare
be as long
including Nape,
ng 2 to 4
.
e
as
6 months
Lip 3 to
Cold produc
weeks.
Horizontal
Horizontal
to 1 year.
Navel, Niple,
6 weeks
ts
Do not swim
Eyebro
Oral piercin
can help reducesuch as ice and ice
Cheek 2
Madison, Chin, w, Wrist, Anti-eyebrow,
g
cream
following a for the first 24 hours
swelling.
to 3 mont
For the interna aftercare
Remember
piercing.
hs
Handweb and Vertical Bridge, Pubic,
these times
Refrain from
including all l healing of oral piercing
Prayer.
Signs of infecti
are
Remember
approximat
oral
piercing of
on
e and will
these times
until the piercin sex of any descrip
the tongue
and cheek
Soak the piercing
depend
tion on how
If appropriate
, lip
are
approximat
g has fully
for
a few minute
healthy you
submerging
healed.
e and will
s by
infection may aftercare is not followe
the area of
are and
Signs of infecti
depend
Gargle after
on how health
whether you
piercing in
skin contain
d
each meal
infection are: occur. The signs of
a clean jug
look after
ing the
y you are
If appropriate on
with
mouthwash
or bowl contain
a warm water
the
whether you
piercing prope
and
or a warm salt an alcohol-free
infection may aftercare is not followe
(1/4 level teaspoo
look after
water solution
rly until healed
Swelling
of preferably solution (1/4 level teaspoing
d
the
piercing prope
and redness
sea
.
infection are: occur. The signs of
an egg cup/sho n of preferably sea
that increas
glass of warm salt to an egg cup/shoon
around the
rly until heale
As with all
salt to
t glass of warm
es
wound.
water). Alterna
t
body art,
d.
clean cloth
water).
Swelling
tively wet a
infect
As with all
is a risk. To
A severe
or gauze in
For the externa
and
body
burning
the
apply as a
reduce these ion
around the redness that increases
warm compre solution and
including all l healing of oral piercing
sensation round and throbbing
a risk. To reduc art, infection is
risks take
wound.
any dischar
ss. This will
piercings to
:
advice from
the site.
ge
soften
the lip and
A severe
advice from e these risks take
your
practitioner
Increased
entry and exit and allow you to clean
cheek
burning and
Wet a clean
your practi
tenderness
the
points
regard
throbb
sensati
cloth
of
ing
and increas
a cotton bud
the
ing
painful to touch.
tioner
on round the
regarding
aftercare.
salt water solutionor gauze in the warm
ingly
or gauze. Oncepiercing with
aftercare.
site.
The
is removed
and apply
the dischar
Increased
compress.
or softened
An unusua
can be great risk of infection
as a warm
ge
This
tenderness
then jewelle
be gently moved
l discharge
The risk of
ly reduced
and increas
and allow you will soften any dischar
painful to
ry
(yellow or green)
with an offensi
infection
touch.
ingly general
ge
water through so as to work a little can
can be
ve smell.
hygiene includ by good
points of the to clean the entry and
greatly reduc
warm
An unusua
piercing with
exit
always tighten the piercing. When
ing:
ed
Speak to your
l discharge
or gauze dipped
a cotton bud
cleaning
hygiene includ by good general
practitioner
(yellow or
with an offensi
screwing the the ball on any bars
attention immed
or seek medica
green) Hand washing
solution. Once into the warm salt
ing:
ve smell.
by
ball to the
before
iately if you
l
water
right.
any of the
touching
Hand washi
suffer from
or softened the discharge is remove
above
Speak to your
Do this twice
the piercing
then jewelle
d
ng
regarding infectioor have any concern
each day, prefera
practitioner
moved so as
ry
attention immed
washing or
the piercing before touching
or seek medica
n in your piercing s
bly after
to work a littlecan be gently
bathing.
there are any
iately if you
l Keeping
through the
warm water
or if
any of the
signs of an
the
suffer
piercing
pierci
above
from
to
You
allergic
any of the
. When cleanin
Keeping
can also use
ng clean.
always tighten
reaction
regarding infectioor have any concern
products used.
the piercing
mild antibac
g
and soaps
n in your piercing s
terial solution
screwing the the ball on any bars
clean.
to wash the
there are any
by
ball to the
s
wound
or if
local
signs
right.
Do this twice
each day, prefera
washing or
bly after
bathing.
Dry the piercin
g using ONLY
disposable
fresh
paper towel/k
A communal
itchen roll.
never be used.hand/bath towel should
Do not use
cotton wool
piercing as
to clean the
the
may get caughtfibres in the cotton
wool
in the piercing
.
Your practiti
to any of the
pharmacist
site. Ask your
to advise
follow the
manufacturers you and always
If irritation,
instructions.
redness or
drying occurs
discontinue
For furthe
use.
r advice or
information:
Contac t your
Dry the piercing
Department, local Environmental
paper towel/k using ONLY fresh disposa
Health
or
ble England Health your local Public Health
hand/bath itchen roll. A commu
Protection
nal
towel should
Team
This Inform
never be used.
ation is provide
Do not use
Public Health
cotton wool
d by:
piercing as
to clean the
Public Health England North West
the fibres in
Englan
the
get caught
in the piercing cotton wool may Tattoo and Piercing d East Midlands
.
Industry Union
of an allergic
reaction
products used.
For furthe
r advice or
information:
Contac t your
Department, local Environmental
Health
or your local
England Health
Public Health
Protection
Team
This Inform
ation is provide
Public Health
d by:
Public Health England North West
Tattoo and England East Midlan
ds
Piercing Industr
y Union
Your practiti
oner is:
June 2013
oner is:
June 2013
05
Genital piercing
(female)
Genital pie
rcing
06
Genital
piercing (male)
(female) af
tercare
Genital pie
rcing
07
Microdermal
implants
Microderm
al implant
s aftercare
(male) after
care
Key Advic
Key Advic
Key Advic
e
e
e
The afterc
The afterc
Hand washin
Hand washin
The afterc
Hand washin
are
are of body
are of body
g
Hand washin g
Hand washin g
is important of body piercing
piercing
piercing
is important
Hand washin
is important
g is the single
to promote
g is the single
to promote
method of g is the single most importa
Do not swim
Do not pick
to promote
Do not use
method of
most import
important
healing
reducing infectio
good
most
healing and
at any dischar
good
healing and
reducin
antibacterial
good
nt not move,
method of
be washed
following a for the first 24 hours
must be washed g infection. Hands ant they can kill
ge and do
prevent the
produc ts as infect and prevent the
reducing infectio
prevent the
Hands must
prior to touchin n. Hands must
twist or turn
piercing.
the
risk of
infection.
risk of
be washed
area, therefo
infection.
ion.
risk of
whilst dry.
the piercin
n.
naturally presen good bacteria that
affected area, prior to touching
the affecte
prior
If
re reducing g the affected
g
are
therefore reducin the
Do not pick
d area, therefo to touching
t.
hardened any secreted dischar
the risk of infectio
of infectio
Wash your
risk of infectio
then turning
at any dischar
ge
Microderma
re reducing
g the risk
n.
Healing times
n. cause
Healing times
hands in warm
not move,
Do not swim
jewellery mayhas
n.
ge and do
the
l implants
the dischar
soap, always
twist or turn
water and
for piercing
for piercing
for the first
or dermal
anchors are
dry your hands
liquid
allowing bacteri ge to tear the piercin
whilst dry.
the piercin
vary with
followin
Wash
24
vary
will
hours
will
Wash
with
your
g
with
small
If any secrete
g
a piercing.
a clean towel
your hands
thoroughly
hands in warm
the type and
the type and
a to enter
g,
prolonging
hardened
jewellery made pieces of
in warm water
or paper
soap, always
the wound
water and
should remove
liquid soap,
position
of the pierci
position
then turning d discharge has of the pierci
the healing
and
and
dry your hands
liquid
always dry
from titaniu
Do not pick
most germs towel. This
time.
ng and vary
jewellery may
cause the
ng and vary
with a clean
them being
insert
your hands
Do not wear
thoroughly
thoroug
at
dischar
and
m
any
ed
person to
prevent
from
towel
hly
dischar
perso
into
from
transferred
with a clean
not move,
or paper towel.
the skin with
n to perso
ge and do
allowing bacteri ge to tear the piercin
should remove
person.
to the affecte
the piercin clothing that will rub
towel. This
towel or paper
twist or turn
stem protru
n.
This
A new piercin
the
g,
a to enter
g as this may
most germs
should remove
against
d area. wound
whilst dry.
the
prolonging
ding above
them being
the wound
and prevent
irritate the
and prevent
If any secrete piercing
most germs
For the first
For the first
the healing
and delay
slightly red g can be tender, itchy
and
transfe
,
which
onto
them
harden
d
rred
healing
dischar
time.
and can remain
an attach
few weeks
being transfe
and
to the affecte
few weeks
ed
.
the affecte
few weeks.
Do not use
ment
it is
rred to
normal for
d area. cause the then turning jewelle ge haschoice
it is
so for a
normal for
d area.
Refrain from
A new piercin
A
sunbeds for
ry may
the area to
dischar
is fitted. This of your
the area to
any type of
sometimes pale, odourless fluid
weeks, or if
until the piercin
allowing bacteri ge to tear the piercin should
sexual activity tende
be red,
slightly red g can be tender, itchy
discharge
may
tender and
be red,
you decide the first two
attachment
A new piercin
r and swolle
and can remain
from
form a crust.
and
g has healed
wound area
to
g,
remain in
a to enter
swollen.
prolonging
few weeks.
This should the piercing and
with a breathathen cover the
n.
the wound least
or is dry.
place for at
slightly red g can be tender, itchy
so for a
the healing
with pus, which
A
during tanning
and
not
Always use
and can remain
and
ble plaster
three month
The healin
The healin
time.
sometimes pale, odourless fluid
.
would indicatbe confused
barrier protect
few weeks.
so
g time for
s
may
for
g
dischar
or
time
a
until
condom
A
piercing has
e infection.
Refrain from
ion such as genita
Keeping the
ge from
Do not swim
for a
the
a
form a crust.
s, otherwise
genital pierci
sometimes pale, odourless fluid
any type
fully heale
you are at
l piercing
This should the piercing and until the
may
risk of acquiri
discharge
The implan implant piercing
following a for the first 24 hours
ng
d. Once
increas
with pus, which
can be from
not be
piercing has of sexual activityhas fully heale
from the piercin
and form a
ng a sexuall
clean
t
piercing.
2 to12 weeks can be from
infection.
healed or is
crust. This
would indicat confused
d other pieces it
each day. needs to be cleaned
y transmitted ed 2 to12 weeks
g
.
should not
Cleaning more
dry. jewellery
.
confused with
twice
e infection.
Accidental
of
Always use
be
damage the
can be attach
Male Genita
pus, which
barrier protect
infection.
Remember
skin and slowfrequently may
Remember
would indicat
Contac t yourdamage or loss of
l piercing
ed.
Signs of infecti
condoms,
healing process
ion such as Healin
these times
down the
disc
aftercare
e
these times
otherwise
including glans
on
g times for
. Your practiti
gets caught practitioner if the implan
you are at
are
approximat
risk of acquiri
are
approximat
advise you
If appropriate
penis piercin
piercing will
in anythin
increas vary
oner may also becom
Female Genita
t
PA, Reverse
to
ng a sexuall
e and will
e and will
g such as
with the type
infection.
water twice soak the implant in
PA, Apadra
es damaged. g or the piercing
y transmitted ed
depend
l piercing
infection may aftercare is not followe
depend
on how health
on how health
warm salt
Dydoe and
vya, Ampal
a week.
and positi
aftercare
including Clitoral
d
of the piercin
y you are
lang,
Frenum
y you are
In the unlikely
on
infection are: occur. The signs of
Make up a
Hood, Inner
whether you
and
piercings includi , as well as for
g and vary
whether you
and
Labia, Fourch
event the
Signs of infecti
quantity of
and Outer
other
comes off,
person to
from
look after
ng Hafada
look after
ette, Christin
solution (1/4
warm salt
on
return to the disc breaks or
Foreskin and
person.
, Scrotum,
the
piercing prope
water
the
a and Triangl
piercing prope
level teaspoo
Swelling
have
If
practitioner
Guiche
approp
a
salt
new
e.
n of prefera
and
.
riate
to an egg cup/sho
Soak the piercin
disk fitted
rly until heale
rly until heale
immediately. and
around the redness that increases
infection may aftercare is not followe For the first
g for a few
t glass of warm bly sea disc is not replace
d.
Soak the piercin
d.
few weeks
submerging
If the
wound.
As with all
Use a clean
As with all
d norma
minutes by
d the implan
water). lost under
g for a few
the area of
it is
infection are: occur. The signs of
cloth or gauze
body art,
body
t
may
subme
the
l
for
minute
the
skin
art,
skin
solutio
rging
the area to
piercing in
infection
containing
and will require get
A severe
infection
dipped in the
s by
a risk. To reduc
the area of
n and
a risk. To reduc
is
burning and
is
be red,
Signs of infecti
tender and
the piercin
skin contain
removal.
a bowl contain a clean container, such
and also to apply as a warm compre
throbbing
g in
sensation
Swelling
ing
swollen.
dab the area
advice from e these risks take
ing a warm
as
advice from e these risks take
ss
If appropriate on
round the
and rednes
a bowl contain a clean container, such
(1/4 level teaspo
area under
to
water solutio
site.
make
s
your practi
that
your
afterca
around
ing a warm
as
the
sure the
increases As with
practitioner
re is not followe
n
infection may
on of prefera
the wound
(1/4 level teaspo
tioner
regarding
become encrustdisc is cleaned as
water
all body
regarding
to an egg
Increased
.
bly sea salt
d
this may
cup/shot glass
aftercare.
aftercare.
on of prefera solution
tenderness
ed.
infection are: occur. The signs of
a risk. To reduc art, infection is
to an egg
Alternatively
and increas
of warm water).
bly sea salt
painful to
A severe
cup/shot glass
This will soften
touch.
ingly The
burning and
The risk of
Alternatively
of warm water).
risk of infect
in the solutio wet a clean cloth or gauze
advice from e these risks take
throbbing
Swelling
sensation
you to clean any discharge and
infection
n and apply
and
round the
your practi
ion can be
allow
can be
An unusua
in the solutio wet a clean cloth or gauze
greatly reduc
compress.
greatly reduc
site.
around the redness that increas
cotton bud the piercing points with
tioner
regarding
l discharge
n and apply
This will soften as a warm
es
wound.
ed
or gauze dipped
ed by good
aftercare.
(yellow or
compress.
a
with an offensi
Increased
and allow
any dischar
salt water
general hygie by good
green) general
This will soften as a warm
tenderness
into the warm A severe
you
ve smell.
solution.
hygiene includ
and allow
and increas
any dischar
ne including:
painful to
points of the to clean the entry and ge
burning and
you
touch.
inglyThe risk of infect
If the area
ing:
throbbing
Speak to your
sensation
points of the to clean the entry and ge
ion can be
around the
or gauze. Oncepiercing with a cotton exit
round the
Hand washi
Hand washi
practitioner
greatly reduc
encrusted
site.
implant becom
bud
attention immed
An unusua
the dischar
or seek medica
ng before
ng before
or gauze. Oncepiercing with a cotton exit
ed
soak the piercin
Increased
or softene
es
l discharge
iately if
l touching
bud
touching
minutes by
hygiene includ by good general
d then jewelle ge is removed
the dischar
tenderness
any of the
(yellow or
with an offensi
or softene
the piercing
submerging g for a few
ge is remove
the piercing
and increas
painful to
moved so
above or have you suffer from
ry can be gently
green)
ing:
d
then
contain
ve
touch.
as to work
the
smell.
ingly
d
regardi
jewelle
area of
any concer
ing the
moved so
ry can be gently
ng infectio
a little
through the
Keeping
Hand washi
as to work
or bowl containpiercing in a clean skin
n in your piercin ns Keeping the
An unusua
Speak to your
piercing. When warm water
there are any
the piercing
a little
jug
through the
ng before
piercing clean.
l discharge
always tighten
g or if
practitioner
cleaning
solution and ing the warm salt
clean.
piercing. When warm water
touching
(yellow or
attention immed
with an offensi
or seek medica the implant.
to any of the signs of an allergic reactio
water
always tighten
green)
screwing the the ball on any bars
cleaning
ve smell.
produc ts used.
iately if
l
cotton bud loosen the discharge
n
any of the
by
ball to the
Speak to your
or clean floss.
using a
screwing the the ball on any bars
above or have you suffer from Keepi
right.
practitioner
by
ball to the
regarding
any concer
ng the impla
Always dry
attention immed
Do this twice
or seek medica
right.
infection in
the area thorou
nt clean.
each day, prefera
your piercin ns
iately if you
there are any
l
cleanin
any of
Do this
ghly
washin
g or bathing
Main contents
Your practiti
29
June 2013
twice
washing or each day, preferably
after
bathing.
When cleanin
any bars by g always tighten the
ball on
screwing the
ball to the
right.
Dry the piercin
g using ONLY
disposable
fresh
paper towel/k
A communal
itchen roll.
never be used.hand/bath towel should
bly after
For furthe
r advice or
information:
Contac t your
Department, local Environmental
Health
or your local
England Health
Public Health
Protection
Team
This Inform
ation is provide
Public Health
d by:
Public Health England North West
Tattoo and England East Midlan
ds
Piercing Industr
y Union
Your practiti
oner is:
June 2013
g your implan
the above
suffer from
after
or have any
t using
disposable
regarding
concer
paper towel/k ONLY fresh
infection in
A communal
your piercin ns
there are any
itchen roll.
g
never be used.hand/bath towel should
to any of the signs of an allergic or if
reaction
produc ts used.
Do not over
For furthe
r advice or
damage the clean the site as this
information:
Contac t your
may
skin around
the implan
Department, local Environmental
Do not change
t
Health
or your local
England Health
implant until the cap of the microde
Public Health
Protection
rmal
advice from fully healed. If in any
Team
This
Information
doubt take
your operato
is provided
r
Public Health
Do not use
by:
cotton wool
Public Health England North West
piercing as
to
clean
the
the
Tattoo and England East Midlan
may get caughtfibres in the cotton
ds
Piercing Industr
wool
in the piercin
y Union
g.
g or if
to any of the signs of an allergic reactio
produc ts used.
n
For furthe
r advice or
information:
Contac t your
Department, local Environmental
Health
or your local
England Health
Public Health
Protection
Team
This Inform
ation is provide
Public Health
d by:
Public Health England North West
Tattoo and England East Midlan
ds
Piercing Industr
y Union
Your practiti
oner is:
June 2013
oner is:
To
o
lki
Section 04 Decontamination
Click on text to view
Principles of
decontamination
Principles of
decontamination
Decontamination practice
Layout of decontamination
area
Decontamination of invasive
items
Cleaning
Use of disinfectants
Sterilization
Sterilizer operation, validation,
maintenance and record keeping
Care of items after sterilization
Decontamination of blood and
body fluids in the working
environment items
Appendix 11
Decontamination requirements
for equipment used in
tattooing and skin piercing
Appendix 12 Equipment
sterilization standard: selfassessment and decision making
tool for tattoo and body piercing
practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
Further reading
Categorization of risks
Use of item
High
Items
Sterile or sterile
introduced
single-use
into normally
sterile body
areas or in
contact with
a break in skin
or mucous
membrane
30
Risk
Main contents
Medium In contact
with intact
mucous
membranes
Low
In contact
with intact
skin
Decontamination
(minimum
standard)
Disinfect or singleuse
Clean or clean
and disinfect if
contaminated with
blood or body fluid
No specific
treatment
required, domestic.
cleaning. Spills or
splashes of blood
or body fluid
should be safely
cleared.
Decontamination Practice
Layout of decontamination area
The layout of a decontamination facility
is important, whether it is in a separate
room or a dedicated part of the treatment
room, within body art premises. Items to be
decontaminated must flow along a defined
process pathway from dirty (i.e. used and
contaminated), through cleaning (which may
have both a manual and an ultrasonic stage),
through sterilization and into a phase of clean
storage and return to use.
To
o
lki
Section 04 Decontamination
Click on text to view
Principles of
decontamination
Need for vigilance
Categorization of risks
Decontamination practice
Layout of decontamination
area
Decontamination of invasive
items
Cleaning
Use of disinfectants
Sterilization
Sterilizer operation, validation,
maintenance and record keeping
Care of items after sterilization
Decontamination of blood and
body fluids in the working
environment items
Appendix 11
Decontamination requirements
for equipment used in
tattooing and skin piercing
Appendix 12 Equipment
sterilization standard: selfassessment and decision making
tool for tattoo and body piercing
practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
Further reading
Main contents
31
To
o
lki
Section 04 Decontamination
Click on text to view
Principles of
decontamination
Need for vigilance
Categorization of risks
Decontamination practice
Layout of decontamination
area
Decontamination of invasive
items
Cleaning
Use of disinfectants
Sterilization
Sterilizer operation, validation,
maintenance and record keeping
Care of items after sterilization
Decontamination of blood and
body fluids in the working
environment items
Appendix 11
Decontamination requirements
for equipment used in
tattooing and skin piercing
Appendix 12 Equipment
sterilization standard: selfassessment and decision making
tool for tattoo and body piercing
practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
Further reading
Main contents
32
Sterilization
Sterilization is the complete elimination of all
microbial life to a very high level of quality
assurance. It must be a robustly efficient
process guaranteed to work on every occasion.
Whilst there are many theoretical ways in which
sterilization can be achieved, the only way that
body art practitioners can achieve it with the
required quality is by steam sterilization.
Other methods are either too complex or lack
equivalent quality assurance. Steam sterilizers
are devices that can expose items to be
sterilized to pure steam at above atmospheric
pressure in a chamber. The process must be
automatic and steam sterilizers must monitor
the process to ensure that all parameters
of sterilization have been met or, if any
have failed, to clearly indicate a failed cycle.
(Pressure cookers do not have this inbuilt
quality assurance and are not suitable for
body art instrument sterilization. Devices
sold as baby bottle steam sterilizers use
lower temperatures and are not suitable for
body art instrument sterilization). The type
of steam sterilizer suitable for use by body
art practitioners is known variously as a small
steam sterilizer, a benchtop steam sterilizer or a
transportable steam sterilizer. These are small
steam sterilizers that generate their own steam
and are powered by a standard domestic
electrical supply and should conform to the
standard BS EN 13060.
To effect the energy transfer necessary for
sterilization, steam must be able to condense
on all surfaces of an item, therefore hinged
items should be opened and items should
not overlap each other. If pockets of air are
present, this blocks the ability of steam to
make contact with the surface in air. If porous
(e.g. fabrics), hollow or wrapped items are
placed in chambers that are then filled with
steam, this will not remove air from these loads
but will only compress the air in them, leading
to inadequate sterilization.
To
o
lki
Section 04 Decontamination
Click on text to view
Principles of
decontamination
Need for vigilance
Categorization of risks
Decontamination practice
Layout of decontamination
area
Decontamination of invasive
items
Cleaning
Use of disinfectants
Sterilization
Sterilizer operation, validation,
maintenance and record keeping
Care of items after sterilization
Decontamination of blood and
body fluids in the working
environment items
Appendix 11
Decontamination requirements
for equipment used in
tattooing and skin piercing
Appendix 12 Equipment
sterilization standard: selfassessment and decision making
tool for tattoo and body piercing
practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
Further reading
Main contents
33
To
o
lki
Section 04 Decontamination
Click on text to view
Principles of
decontamination
Need for vigilance
Categorization of risks
Decontamination practice
Layout of decontamination
area
Decontamination of invasive
items
Cleaning
Use of disinfectants
Sterilization
Sterilizer operation, validation,
maintenance and record keeping
Care of items after sterilization
Decontamination of blood and
body fluids in the working
environment items
Appendix 11
Decontamination requirements
for equipment used in
tattooing and skin piercing
Appendix 12 Equipment
sterilization standard: selfassessment and decision making
tool for tattoo and body piercing
practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
Further reading
Main contents
34
Decontamination of blood
and body fluids in the working
environment
Blood and other body fluids in the environment
pose a risk of infection transmission: with blood
the main hazards are of blood borne viruses;
with other body fluids a wider spectrum of
infectious micro-organisms are relevant.
Environmental contamination with blood
or other body fluids should be dealt with by
the removal of the contaminating material
and disinfection as soon as possible after
the contamination occurs. The longer any
contamination remains on a surface, the more
it poses a direct risk to those who come in
contact with it, as well as the indirect risk of it
being transferred to other surfaces from which
it may contaminate instruments that come
into contact with clients.
Remember: The person most at risk, is the
person clearing the contamination. They
should have safe methods of working and use
appropriate personal protective equipment
(PPE ) which should always include single-use
gloves, with additional PPE such as aprons if
the contamination is extensive.
Most environmental contamination is likely to
be minor. Such contamination can be removed
using single-use wipes and then, once clean,
the area treated with a suitable disinfectant
such as hypochlorite. (See cautions on
hypochlorites above). If there is likely to be
more extensive contamination, purpose-made
disinfectant spill kits can be brought-in in
readiness and used.
Further reading
Medicines and Healthcare products Regulatory
Authority (MHRA). Sterilization, Disinfection
and Cleaning of Medical Equipment: Guidance
on Decontamination from the Microbiology
Advisory Committee to Department of Health.
Part 1 Principles (2010); part 2 Protocols
(2005); Part 3 Procedures (2006). http://www.
mhra.gov.uk/Publications/Safetyguidance/
Otherdevicesafetyguidance/CON007438
Medical Devices Agency (2002). Benchtop Steam
Sterilizers Guidance on Purchase, Operation and
Maintenance.
(http://www.mhra.gov.uk/groups/dts-bi/documents/
publication/con007327.pdf)
Hoffman PN, Bradley CR, Ayliffe GAJ (2004).
Disinfection in Healthcare. 3rd Edn. Blackwell
Publishing. ISBN 1405126426
To
o
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Main contents
35
Microbiological and
chemical quality concerns
The risks associated with tattooing treatments
have been acknowledged for many years, and
have been reported internationally (Lehman
et al., 2010). In addition to the standard safer
sharps controls to mitigate the risk of Blood
Borne Virus (BBV) transmission during tattooing,
another potential hazard is that of infection
via the environmental route. This is typically
associated with naturally occurring bacteria and
fungi that have gained entry to the ink product
at some stage during its manufacture or storage.
This form of environmental contamination
of inks, prior to their use on the client, is rarely
reported on. Despite the continually improving
standards in tattooing health and safety - much
of it related to eliminating the risk of BBV
transmission - the environmental aspect of
tattooing infection control remains beyond the
control of most practitioners.
Poor quality tattoo inks increase the potential
for localised bacterial skin infections as well as
dermal allergies following tattooing treatments
(Limentani et al., 1979; Jacob, 2002; Charnock,
2004; Suhair, 2007; Drage et al., 2010). Ink
related problems might therefore be directly
related to the chemical and/or microbiological
quality of the ink or pigments used. Where
this occurs, other efforts to maintain
tattooing hygiene standards could potentially
be undermined if the inks themselves are
contaminated at the point of use.
Tattoo ink products are typically purchased
from suppliers or directly from manufacturers
and are delivered intra-dermally during
treatment, so there is an increased potential
for the clients body to be exposed to their
components, compared with, for example, a
topically applied skin colorant.
Some inks are sold with little or no accompanying
product data, and their composition may remain
uncertain even at the point of use.
Reports of metal sensitivity following
tattooing have been published in the UK,
and dermatological responses have been
To
o
lki
Recommendations to
improve the quality of
ink products used for
tattooing
Recommendations to improve
the quality of ink products
used for tattooing:
References
Main contents
36
References
Charnock C (2004). Tattooing dyes and pigments
contaminated with bacteria. Tidsskr Nor
Laegeforen. 124(7):933-5.
Drage LA, Ecker PM, Orenstein R, Phillips PK and
Edson RS (2010). An outbreak of Mycobacterium
chelonae infections in tattoos. Journal of the
American Academy of Dermatology. 62(3):501-6.
Gass JK and Todd PM (2007). Multiple
manifestations of chromate contact allergy.
Contact Dermatitis. 56:290291.
Jacob CI (2002). Tattoo-associated dermatoses: a
case report and review of the literature. Dermatol
Surg. 28(10):962-5.
Lehman EJ, Huy J, Levy E, Viet SM, Mobley A and
McCleery TZ (2010).
Bloodborne pathogen risk reduction activities in
the body piercing and tattooing industry. American
Journal of Infection. 38(2):130-8.
Limentani AE, Elliott LM, Noah ND, Lamborn JK
(1979). An outbreak of hepatitis B from tattooing.
Lancet. 2(8133):86-8.
Mortimer NJ, Chave TA and Johnston GA (2003).
Red tattoo reactions. Clinical and Experimental
Dermatology. 28:508510.
Suhair OS, Miles HFJ, Simmons P, Stickley J and
De Giovanni JV (2007). Awareness of the risk
of endocarditis associated with tattooing and
body piercing among patients with congenital
heart disease and paediatric cardiologists in the
United Kingdom. Archives of Disease in Childhood.
92:1013-1014
To
o
lki
General
Nickel Directive
Main contents
37
To
o
lki
Section 07 Governance
Click on text to view
Training and
competencies
Procedure manuals/
policies
Audit and quality
monitoring
Record keeping
Consent and aftercare
documentation
See Appendix 09 contains an
example of a consent form and
there are a variety of written
aftercare leaflets available
See Appendix 10 Aftercare
follow-up record sheet
References
Procedure manuals/policies
It is recommended that practitioners produce
a written procedure/policy manual for use by
staff. It should be based on evidence based
guidance and be easily available and be easily
understood by all groups of staff. Policies/
procedures should be reviewed annually so
that practice is up to date and should indicate
ownership (i.e. who is responsible for managing
the policy) and authorship.
Policies/procedures should include:
Hand washing procedure.
Cleaning policy and rota.
Main contents
38
Decontamination procedures.
Management of waste.
Management of blood spillages.
Use of personal protective equipment (PPE).
To
o
lki
Section 07 Governance
Click on text to view
Training and
competencies
Procedure manuals/
policies
Audit and quality
monitoring
Record keeping
Consent and aftercare
documentation
See Appendix 09 contains an
example of a consent form and
there are a variety of written
aftercare leaflets available
See Appendix 10 Aftercare
follow-up record sheet
References
Record keeping
Accurate records are invaluable if infection
problems occur and may assist the practitioner
when investigations are conducted for
example, for verifying procedures performed
and equipment check-tests carried out, when
they were performed and on whom/by whom.
It is important to keep accurate records of
every client including:
Full name, address, telephone number, date
of birth and proof of age if needed.
Relevant medical history/ allergies.
NAME OF CLIENT:
____________________________
Date &
time
Signature of
practitioner
Main contents
39
To
o
lki
Definition of an outbreak or
incident
An infectious disease related outbreak or
incident can be defined as:
An incident in which two or more people
experiencing a similar illness are linked in
time/place.
References
Outbreak/incident initial
response
In England, incidents/outbreaks are recognised
using surveillance methodology by the Public
Health England (formerly the Health Protection
Agency)1, local authorities or microbiologists in
laboratories at a local or national level. At the
local level is the Health Protection Team. As
soon as it becomes apparent that an incident/
outbreak may exist, immediate contact
between these parties is essential.
A risk assessment is undertaken following
receipt of initial information and a decision
made as to whether an outbreak or incident
exists. In order to inform all subsequent
decisions and actions, key facts would be
established by the duty (or on-call) Health
Protection Team.
An outbreak/incident is usually declared by the
Consultant in Communicable Disease Control
(CCDC) or Consultant in Health Protection
(CHP) after consultation with a consultant
microbiologist and/or senior environmental
health officer. The involvement and assistance
of the tattoo/body piercing premises
concerned would be a high priority.
Main contents
40
References
Health Protection Agency (2011). London Infectious
Disease Outbreak Management Plan.
Health Protection Agency (2012). The
Communicable Disease Outbreak Plan V1.3.
(Internal document).
To
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PART B Appendix 01
Model Byelaws: Acupuncture, tattooing, semi-permanent
skin-colouring, cosmetic piercing and electrolysis
Click to
download
MODEL BYELAWS
Acupuncture, tattooing, semi-permanent skin-colouring,
cosmetic piercing and electrolysis
Byelaws for the purposes of securing the cleanliness of premises registered under sections 14(2) or
15(2) or both of the Local Government (Miscellaneous Provisions) Act 1982 and fittings in such
premises and of persons registered under sections 14(1) or 15(1) or both of the Act and persons
assisting them and of securing the cleansing and, so far as appropriate, sterilization of instruments,
materials and equipment used in connection with the practice of acupuncture or the business of
tattooing, semi-permanent skin-colouring, cosmetic piercing or electrolysis, or any two or more of
such practice and businesses made by in pursuance of sections 14(7) or 15(7) or
both of the Act.
Interpretation
1.(1) In these byelaws, unless the context otherwise requires
The Act means the Local Government (Miscellaneous Provisions) Act 1982;
client means any person undergoing treatment;
hygienic piercing instrument means an instrument such that any part of the instrument that
touches a client is made for use in respect of a single client, is sterile, disposable and is fitted
with piercing jewellery supplied in packaging that indicates the part of the body for which it is
intended, and that is designed to pierce either
(a) the lobe or upper flat cartilage of the ear, or
(b) either side of the nose in the mid-crease area above the nostril;
operator means any person giving treatment, including a proprietor;
premises means any premises registered under sections 14(2) or 15(2) of the Act;
proprietor means any person registered under sections 14(1) or 15(1) of the Act;
treatment means any operation in effecting acupuncture, tattooing, semi-permanent skincolouring, cosmetic piercing or electrolysis;
the treatment area means any part of premises where treatment is given to clients.
(2) The Interpretation Act 1978 shall apply for the interpretation of these byelaws as it applies
for the interpretation of an Act of Parliament.
Appendix 11
Decontamination requirements
for equipment used in tattooing
and skin piercing
2.(1) For the purpose of securing the cleanliness of premises and fittings in such premises a
proprietor shall ensure that
Appendix 12 Equipment
sterilization standard- self
assessment and decision
making tool for tattoo and body
piercing practitioners
(c) any needle used in treatment is single-use and disposable, as far as is practicable, or
otherwise is sterilized for each treatment, is suitably stored after treatment and is
disposed of in accordance with relevant legislation and guidance as advised by the local
authority;
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
(a) any internal wall, door, window, partition, floor, floor covering or ceiling is kept clean
and in such good repair as to enable it to be cleaned effectively;
(b) any waste material, or other litter arising from treatment is handled and disposed of in
accordance with relevant legislation and guidance as advised by the local authority;
(d) any furniture or fitting in premises is kept clean and in such good repair as to enable it
to be cleaned effectively;
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42
Transmission (spread) of
infection
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43
PART B Appendix 02
Infection, its causes and spread
(including a glossary of infection-related terms)
In tattooing and skin
piercing procedures,
infection transmission can
occur by direct contact and
indirect contact.
Direct contact (person to person)
Direct transmission occurs when
microorganisms are transferred from one
infected person to another person without a
contaminated intermediate object or person.
Examples of direct contact include:
Blood or other body fluids (including blood
stained) that enter the body through
contact with a mucous membrane or breaks
(i.e. piercings, cuts, abrasions) in the skin.
Indirect contact
Indirect spread of infection is said to occur when
an intermediate carrier is involved in the spread
of pathogens such as hands, fomites or vectors.
Hands The hands of the practitioners
are probably the most important vehicles
of cross-infection within the tattooing
and skin piercing environment. The hands
of staff and clients can carry microbes
to other body sites, equipment and staff.
Therefore, promotion of hygienic practices
for everyone is the key to preventing and
controlling infections.
A fomite is defined as an object that
becomes contaminated with infected
organisms and which subsequently
transmits those organisms to another
person. Examples of potential fomites are
instruments or practically any inanimate
article e.g. contaminated needles/
tattooing equipment (blood-borne viruses).
References
Bannister B, Gillespie S and Jones J (2006). Infection
Microbiology and Management. 3rd edition.
Blackwell Publishing.
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44
Reference:
British Liver Trust (http://www.britishlivertrust.org.uk)
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Click to download
PDF version
Before use:
After use:
Appendix 08 Template
protocol for environmental
cleaning of premises
Appendix 09 Tattooing/body
piercing consent form
Appendix 11
Decontamination requirements
for equipment used in tattooing
and skin piercing
Appendix 12 Equipment
sterilization standard- self
assessment and decision
making tool for tattoo and body
piercing practitioners
During use:
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
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45
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PDF version
4
5
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
7
46
Main contents
The priority
is to seek
advice/ medical
attention
immediately,
at a local
Emergency
Department,
ideally within
one hour of the
injury occurring
Reference:
Health and Safety
Executive (2012) How to
deal with an exposure
incident. Blood Borne
Viruses Guidance.
(http://www.hse.gov.
uk/biosafety/bloodborne-viruses/how-dealexposure-incident.htm)
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PART B Appendix 06
47
Main contents
Click to download
PDF version
Reference
National Patient Safety Agency (2009). The Revised
Healthcare Cleaning Manual. (http://www.nrls.npsa.
nhs.uk/resources/?EntryId45=61830)
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48
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PART B Appendix 08
FREQUENCY
At least daily
Appendix 08 Template
protocol for environmental
cleaning of premises
Appendix 09 Tattooing/body
piercing consent form
Appendix 10 Aftercare followup record sheet
Appendix 11
Decontamination requirements
for equipment used in tattooing
and skin piercing
Appendix 12 Equipment
sterilization standard- self
assessment and decision
making tool for tattoo and body
piercing practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
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49
Daily
Standard detergent
Floors
Daily
METHOD
Click to download
PDF version
Bins
As required
Couches
Between clients
Walls/ceilings
As required
Adapted from National Patient Safety Agency (2009). The Revised Healthcare Cleaning Manual.
(http://www.nrls.npsa.nhs.uk/resources/?EntryId45=61830)
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Word document version
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PDF version
Yes / No
Type of Procedure:
Appendix 08 Template
protocol for environmental
cleaning of premises
Appendix 09 Tattooing/body
piercing consent form
Appendix 10 Aftercare followup record sheet
Appendix 11
Decontamination requirements
for equipment used in tattooing
and skin piercing
Appendix 12 Equipment
sterilization standard- self
assessment and decision
making tool for tattoo and body
piercing practitioners
Appendix 13 Equipment
and body piercing jewellery
sterilization standard for
tattooists and body piercers
Appendix 14 Autoclave daily
record sheet
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50
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Word document version
Click to download
PDF version
NAME OF CLIENT:
____________________________
Date &
time
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51
Signature of
practitioner
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Equipment for
Tattooing:
Pierce skin
Single-use pre-sterilized
Ink caps
Single-use
Reduce contamination by
covering with impervious
barrier (e.g. plastic sleeving)
Application of item
Holders for needles i.e. tube, Hold needles that pierce skin
tip and grip
Single-use
Needles, cannulas
Pierce skin
Jewellery
Sterilize or pre-sterilized
Elastic bands
Body piercing:
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52
Appendix 09 Tattooing/body
piercing consent form
Recommendations
Single-use
Clean between uses
Single use or autoclavable
alternative should be used for
oral and genital piercings
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Is the equipment
for single use?
Yes
No
The instrument
is solid and
unwrapped
The instrument
is hollow and/or
wrapped (including
solid items)
Sterilize using
non-vacuum
autoclave with
temperature and
pressure indicator
gauges (type N) or
vacuum autoclave
(type B or S) with
drying cycle
Sterilize using
vacuum autoclave
(type B or S) with
drying cycle
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Dispose of safely
and appropriately
i.e. in offensive
waste bag or
sharps bin
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Option 2
Option 3
Using only:
Using:
Using only:
solid unwrapped
instruments
hollow instruments
Single-use
and
and
solid unwrapped
jewellery
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54
Click to download
PDF version
PART B Appendix 13
Your current
autoclave is
non-vacuum
(type N)
Your current
autoclave is
non-vacuum
(type N)
Your current
autoclave is
vacuum (type B
or S) with drying
cycle
No change in
your practice is
required
If you are
unable to
switch to using
a vacuum
autoclave
(type B or S)
with drying
cycle, then use
single-use
instruments
and
pre-sterilized
body piercing
jewellery
instead
No change in
your practice is
required
pre-sterilized
body piercing
jewellery
No change in
your practice is
required
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Click to download
PDF version
Serial Number
Week Commencing
Location
Daily test
Saturday
Sunday
Monday
Tuesday
Time to reach
holding temp
Temp during
holding period
Pressure during
holding period
Total time at
holding
temp/pressure
Water drained at
end of day where
appropriate
Process check
used
Printout attached
Initials of
authorised user
Weekly Safety Test
Door seals secure
Yes/No
Comments
Name
Date
Signature
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55
Wednesday Thursday
Cycle Counter
Number
Friday
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Tattoo aftercare
piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare following a tattoo
is important to promote good
healing and prevent the risk of
infection.
For the first week or so it is
normal for the area to be red
and tender.
Hand washing
Signs of infection
Tattoo aftercare
June 2013
Main contents
56
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piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
Approximate healing times for the
various piercings are:
Ear lobe piercing 6 to 8 weeks
Ear cartilage piercing 6 to 8 weeks
Cheek piercing 2 to 3 months
Eyebrow piercing 2 to 4 months
Nose piercing up to 6 months
Remember these times are
approximate and will depend on
how healthy you are and whether
you look after the piercing
properly until healed.
As with all body art, infection is
a risk. To reduce these risks take
advice from your practitioner
regarding aftercare.
The risk of infection can be
greatly reduced by good general
hygiene including:
Hand washing before touching
the piercing.
Keeping the piercing clean.
Hand washing
Hand washing is the single most important
method of reducing infection. Hands must
be washed prior to touching the affected
area, therefore reducing the risk of infection.
Wash your hands in warm water and liquid
soap, always dry your hands thoroughly
with a clean towel or paper towel. This
should remove most germs and prevent
them being transferred to the affected area.
A new piercing can be tender, itchy and
slightly red and can remain so for a
few weeks. A pale, odourless fluid may
sometimes discharge from the piercing and
form a crust. This should not be confused
with pus, which would indicate infection.
June 2013
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57
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piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
An approximate healing times
for oral piercing are:
Tongue piercing 2 to 4 weeks.
Lip 3 to 6 weeks
Cheek 2 to 3 months
Remember these times are
approximate and will depend
on how healthy you are and
whether you look after the
piercing properly until healed.
As with all body art, infection is
a risk. To reduce these risks take
advice from your practitioner
regarding aftercare.
The risk of infection can be
greatly reduced by good general
hygiene including:
Hand washing before touching
the piercing
Keeping the piercing clean.
Hand washing
Hand washing is the single most important
method of reducing infection. Hands
must be washed prior to touching the
affected area, therefore reducing the risk
of infection.
Wash your hands in warm water and
liquid soap, always dry your hands
thoroughly with a clean towel or paper
towel. This should remove most germs
and prevent them being transferred to
the affected area.
A new piercing can be tender, itchy and
slightly red and can remain so for a
few weeks. A pale, odourless fluid may
sometimes discharge from the piercing
and form a crust. This should not be
confused with pus, which would indicate
infection.
Oral piercing aftercare
For the internal healing of oral piercing
including all piercing of the tongue , lip
and cheek
Gargle after each meal with an alcohol-free
mouthwash or a warm salt water solution
(1/4 level teaspoon of preferably sea salt to
an egg cup/shot glass of warm water).
June 2013
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piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
Approximate healing times
for surface, navel and nipple
piercing can be as long as
6 months to 1 year.
Remember these times are
approximate and will depend
on how healthy you are and
whether you look after the
piercing properly until healed.
As with all body art, infection
is a risk. To reduce these
risks take advice from your
practitioner regarding
aftercare. The risk of infection
can be greatly reduced by good
general hygiene including:
Hand washing before
touching the piercing
Keeping the piercing clean.
Hand washing
Hand washing is the single most important
method of reducing infection. Hands must
be washed prior to touching the affected
area, therefore reducing the risk of infection.
June 2013
Main contents
59
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piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
The healing time for a
genital piercing can be from
2 to12 weeks.
Remember these times are
approximate and will depend
on how healthy you are and
whether you look after the
piercing properly until healed.
As with all body art, infection is
a risk. To reduce these risks take
advice from your practitioner
regarding aftercare.
The risk of infection can be
greatly reduced by good
general hygiene including:
Hand washing before
touching the piercing
Keeping the piercing clean.
Hand washing
Hand washing is the single most
important method of reducing infection.
Hands must be washed prior to touching
the affected area, therefore reducing the
risk of infection.
Wash your hands in warm water and
liquid soap, always dry your hands
thoroughly with a clean towel or paper
towel. This should remove most germs
and prevent them being transferred to
the affected area.
A new piercing can be tender, itchy and
slightly red and can remain so for a
few weeks. A pale, odourless fluid may
sometimes discharge from the piercing
and form a crust. This should not be
confused with pus, which would indicate
infection.
Female Genital piercing aftercare
including Clitoral Hood, Inner and Outer
Labia, Fourchette, Christina and Triangle.
Soak the piercing for a few minutes by
submerging the area of skin containing
the piercing in a clean container, such as
a bowl containing a warm water solution
(1/4 level teaspoon of preferably sea salt
to an egg cup/shot glass of warm water).
Alternatively wet a clean cloth or gauze
in the solution and apply as a warm
compress. This will soften any discharge
and allow you to clean the entry and exit
points of the piercing with a cotton bud
or gauze. Once the discharge is removed
or softened then jewellery can be gently
moved so as to work a little warm water
through the piercing. When cleaning
always tighten the ball on any bars by
screwing the ball to the right.
June 2013
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piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
The healing time for a
genital piercing can be from
2 to12 weeks.
Remember these times are
approximate and will depend
on how healthy you are and
whether you look after the
piercing properly until healed.
As with all body art, infection is
a risk. To reduce these risks take
advice from your practitioner
regarding aftercare.
The risk of infection can be
greatly reduced by good
general hygiene including:
Hand washing before
touching the piercing
Keeping the piercing clean.
Hand washing
Hand washing is the single most important
method of reducing infection. Hands
must be washed prior to touching the
affected area, therefore reducing the risk
of infection.
June 2013
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61
To
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lki
Click to
download PDF
piercing aftercare
Leaflet 03 Oral piercing
aftercare
Leaflet 04 Body and surface
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 06 Genital piercing
(male) aftercare
Leaflet 07 Microdermal
implants aftercare
Poster How to handwash
Key Advice
The aftercare of body piercing
is important to promote good
healing and prevent the risk of
infection.
Microdermal implants or dermal
anchors are small pieces of
jewellery made from titanium
inserted into the skin with the
stem protruding above, onto
which an attachment of your
choice is fitted. This attachment
should remain in place for at
least three months or until the
piercing has fully healed. Once it
has fully healed other pieces of
jewellery can be attached.
Healing times for piercing will
vary with the type and position
of the piercing and vary from
person to person.
For the first few weeks it is
normal for the area to be red,
tender and swollen.
As with all body art, infection is
a risk. To reduce these risks take
advice from your practitioner
regarding aftercare.
The risk of infection can be
greatly reduced by good general
hygiene including:
Hand washing before touching
the implant.
Keeping the implant clean.
Hand washing
Hand washing is the single most important
method of reducing infection. Hands must
be washed prior to touching the affected
area, therefore reducing the risk of infection.
June 2013
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How to Handwash?
WASH HANDS WHEN VISIBLY SOILED! OTHERWISE, USE HANDRUB
Duration of the entire procedure: 40-60 seconds
piercing aftercare
Leaflet 05 Genital piercing
(female) aftercare
Leaflet 07 Microdermal
implants aftercare
10
11
All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind,
either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
WHO acknowledges the Hpitaux Universitaires de Genve (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.
May 2009
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DATE OF AUDIT:
NAME OF AUDITOR:
Indicators met:
Indicators not met:
Indicators not applicable:
Overall score:
0
0
0
-
This audit tool is to be used by practitioners, primarily, to enable good practice to be captured and documented.
It can also identify best practice gaps which will need action to be taken using an action planning process. It can
be used as a discussion point between practitioner and local authority officers, as to what practice gaps need to
be prioritised.
Completion:
Please allow approximately two hours to undertake the audit.
In the "Met" column, record "Yes", "No" or "N/A" against all indicators.
To print all pages:
Go to "print" and choose "entire workbook".
Calculating scores:
Automatic - This tool will give you automated % scores for each standard, and an overall % score (above).
However, this requires data to be entered electronically during or after audit.
Manual - Count up the number of 'Yes' answers and divide by the number of questions answered for that
standard (excluding the "N/A"s), then multiply by 100 to get the percentage. To get the score for all the
standards and for the audit overall, add the total number for each standard and divide by the number of
questions and multiply by 100 to get the overall percentage.
*developed using Infection Prevention Society (IPS) audit tools for monitoring IC guidelines withing the community setting (2005); IPS
self assessment audit for assessing implementation of HTM 01-05: decontamination in primary care dental practices and related
infection prevention and control issues (2009); IPS audit tools for monitoring infection control standards (2004); International Scientific
Forum on Home Hygiene (IFH) and IPS home hygiene -prevention of infection at home: a training resource for carers and their trainers
(2003)
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Dr Victor Aiyedun
Specialist Registrar,
Public Health Medicine
Supervised by
Dr Fortune Ncube
Consultant Epidemiologist,
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