Mechanisms Of The Manicure...
Dah duh dum..... The Russian manicure - this of course must be said aloud in the voice of a James Bond style villain. In all my years in the industry, I think this may well be the topic that has caused the most controversy. Every so often a hot topic will come along, everyone will get up in arms over it, some very healthy debates will ensue and eventually conclusions will be made, (after heated discussions) opinions amended and back to business we go. I'm glad to be in such an empowered industry, an industry where people speak out, demand answers and get down to the nitty gritty of it. We are not content to
roll over and accept anything 'just because'.
Go us - we are awesome!
Well, I've been doing a little reading up....
After putting my two cents worth into the world wide conversation that's taking place about the 'not so new' Russian manicure technique, I decided that although I'm pretty well versed in most nail matters, (twenty year veteran and caring advocate of my beloved nail industry) I need to be more than 'well versed' I must, nay 'need' gather all relevant information, and hopefully come to some educated conclusions.
I still have more questions than answers and I see myself agreeing and disagreeing with members of opposing teams. My mind goes back and forth, and my intuition tells me that's why we must have such cut and dry rules, because the masses will inevitably do serious damage, due to ill guided attempts of services they are not properly trained for.
We are fortunate to have a few members of our community that are faultless givers of quality technical information. Many of us don't realise how lucky we are to have education and facts on tap. All we need do is look for it. The World Wide Web has glued our nail family closer. But growth can be problematic, with facts getting lost in translation. Trust your instincts, but mostly, trust your text book.
The name of a manicure service involving various e-file bits, sometimes trimming of the eponychium with nippers/scissors, e-filing the area after dehydrating with powder and the lifting of the proximal nail fold, breaking the natural seal.
This leaves the area open to infection. Dead skin is dead skin, eponychium is living tissue. Non living tissue is the cuticle, the sticky white stuff that grows out on the surface of the nail plate. Over vigorous filing may compromise the protective seal the eponychium and cuticle form, leaving the area vulnerable to bacteria and chemicals.
Nicks, or injury to the eponychium can cause permanent damage to the nail plate.
A less invasive manicure that involves exfoliation with an e-file of calloused skin on the lateral nail fold, and around the cuticle, the dead part, the detached part of the cuticle that's rides out on the nail plate, and any dry skin on the proximal nail fold of the eponychium. Advocates express that its not ok to over abrade or break any seals. The cuticle forms a seal to prevent pathogens entry, so only cuticle visible on the nail plate should ever be removed.
Advanced techniques like these take proper training and experience to perform correctly. Like
'any' service accidents may happen, so the right steps must be taken in the event of broken skin. There is a fine line as to how much exfoliation the epidermis can take before the skin becomes vulnerable. Once eponychium has been pushed back, the cuticle should be carefully scraped away, never should any implement be pushed under the nail fold.
The cuticle is in fact shed stratum corneum cells from the underside of the eponychium.
Note: cuticle is dead skin. Eponychium is live skin, an e-file doesn't differentiate between the two, it's up to the technician wielding the e-file to determine the difference.
SO MANY VARIABLES
I don't have all the answers. I do know that when you cut the eponychium it grows back harder, a self defense mechanism, we all know and agree on this point.
When you pick at a scab, it grows a new scab, if you keep picking this will lead to hardened scar tissue, the body has a wonderful way of protecting as it heals, it's telling you- don't pick or cut- are you mad? Your just opening yourself up to infection and forcing unsightly thickening of the skin.
I also know that gentle exfoliation encourages new skin cells to resurface. If the exfoliation is superficial, the skin remains soft as it replaces itself. Microdermabrasion is a form of exfoliation,
often involving machinery. The skin has a built in epidermal renewal ability whereby the cells differentiate and migrate from the horny layer to eventually desquamate from the surface, (the skin cells travel from the bottom layers of skin up to the top, die and jump ship.). Hardened skin is often a build up of these dead skin cells. To exfoliate below the epidermis (dermabrasion) is a medical cosmetic procedure.
NOTE: In New Zealand to offer exfoliation treatments, a therapist should hold a National Certificate of Beauty Therapy (or have worked in continued commercial industry experience for five consecutive years.)
Exfoliation is considered safe, we are only dealing with the stratum corneum, dead skin cells (corneocytes) on the outer most layer of the skin (the epidermis). However, there is minimum risk of breaking skin, therefore infection is a possibility.
So, I guess we really need to concentrate more on safe SAFE PRACTICE, than generalising different services. Many of us are confused about the difference between a Russian Manicure and an E-file Manicure (dry manicure). We also have to remember that cuticle pushers can also cause damage in the wrong hands.
Repeat after me: I do use an e-file, but I am fully trained and I use it respectfully. I don't cut living tissue from the eponychium or break the seal on the proximal nail fold. Ommmmmmmmmmm....
My interest in this matter lies mainly within Australasia, New Zealand specifically, it being somewhat unguarded.
New Zealand is my homeland. It is unfortunate the government hasn't the means to implement any regulations to protect our industry. I get it, it comes down to the ever elusive 'Time & Money' factor. For over fifteen years I have kept a close eye on changes to health and safety regulations and although the last few years have seen changes for the better, we sure have a long way to go. So, no regulations? Some City Councils within New Zealand have introduced bylaws but unless incidents take place, salons are seldom investigated. This being said, last year - 2016, an
unprecedented case took place due to complaints of an Auckland salon using banned substances in their premises. The salon pleaded guilty and the result was a large fine. At the very least this sentencing may increase awareness among some salons.
At this point it's up to responsible salon owners or sole traders, any PCBU (person conducting business/ undertaking) to own up to their responsibilities.
Last year in New Zealand ACC Accident Compensation Corporation paid out over one million dollars for beauty related accidents.
Practicing outside your SOP 'Scope Of Practice' may well mean you are in breach of proposed health and safety regulations, or seriously affect your insurance policies. It's advisable when different treatments are being offered, to revisit your insurance policies, especially indemnity, liability cover and add in any treatment procedures to make sure you are covered. The
'Association for Registered Beauty Professionals' Code Of Practice States: 'An e-file should never be used on the natural nail'. If this rule was to be properly enforced most NSS 'Non Standard Salons' would be out of business along with many other registered salons. But this is again where we meet a grey area, many experienced techs are well trained and a master of their tools and know the best way to use an e-file in a safe way. As I mentioned before, cuticle nippers and salon grade files can also inflict abrasions that can lead to infections.
Know your risks, from the placement of power cords, to the type of manicure you offer.
To understand this latest issue more clearly, I think we need to look at current regulations. [source: I have noted information from the New Zealand Association of Registered Beauty Therapists 'Code Of Practice', revised March 2017. http://www.beautynz.org.nz/ and the Health And Safety At Work Act].
STERILIZATION AND DISINFECTION PROCEDURES
Good argument has been made, that while it is very possible to break or abrade the skin with an electric file 'bit' it is just as easy to cut skin with a paper file. True, but when skin is compromised during a manicure with a paper file, cut eponychium for example, the correct procedure is to dispose of said file (sealed bag and into a covered bin) and work on that area should cease.
Drill bits are not disposable, therefore we must understand minimum disinfection standards.
Any implement that comes into contact with non- intact skin, blood or bodily secretions should be transferred to an appropriate area to be disinfected/ sterilized.
1. Clean. This means to physically remove visible debris, scrub in warm water with a surfactant
(detergent) and rinse thoroughly.
2. Immerse cleansed implement into applicable disinfectant. (Remember, that even the strongest disinfectants are compromised if correct cleaning hasn't been carried out prior to immersion).
3. Correct storage, once dry implements should be stored in a clean dry space. Many guidelines suggest storing implements in airtight containers or zip lock bags, this actually promotes the growth of bacteria, a lined ventilated container is best. Always store disinfected items separately from dirty items to avoid cross contamination.
Remember, a current first aide certificate should be held, for at least one staff member on site at
any given time. [source: http://www.worksafe.govt.nz/ ]
If blood is drawn, it should be noted down in the Accident Register. This requires date, full name, address and contacts of client and therapist involved. It must also be noted what procedures were carried out after bleed occurred and stored at least two years.
In New Zealand, all technicians that may carry out a service whereby skin may be vulnerable to abrasions, should look into the rules and regulations as provided by The Ministry of Health
"Guidelines for the safe piercing of skin": http://www.health.govt.nz/publication/guidelines-safe- piercing-skin
Here it is stated that tools that come into contact with blood or bodily excretions (non intact skin) must be cleaned and 'sterilized' in accordance with the provisions relating to minimum standard. E-file bits used during a natural nail manicure are considered 'Semi Critical' as they 'may' come into contact with non-intact skin.
Intact skin acts as a barrier to most micro-organisms, it's only when living tissue is abraded that issues can arise. Therefore implements (cuticle nippers, E-file bits) that enter living tissue must be sterile. Even this doesn't rule out infection, keep in mind any skin that becomes compromised has been opened up to receive bacteria and in turn become infected. The risk of pathogens entering the body 'could' transmit disease. It's unlikely, but it is our responsibility to always use best
practice to avoid this.
For example, tweezers are a semi critical item that may come into contact with blood.
Correct procedure between use is to wash and scrub in warm soapy water, rinse, immerse in appropriate disinfectant solution for required holding time, dry completely then autoclave. Note: autoclaving is only effective if used correctly. For dry heat sterilization, temperature must be 170 degrees Celsius for a minimum of 60 minutes. Store according to best practice.
We must also remember our SOP scope of practice, we must be certified in our field or have worked in continued commercial industry experience for five consecutive years. Note: Only a qualified podiatrist is certified to use a callous shaver, a nail technician who cuts or slices the skin during a pedicure is acting irresponsibly. qualified nail technician is not qualified to work on broken skin, if skin becomes compromised during treatment we are advised to cease treatment.
So, the general Code Of Practice rules in New Zealand currently, that may relate to this type of manicure, pretty much rules out the aggressive Russian technique of dehydrating the entire eponychium area, cutting away excess skin and using various drill bits to abrade the living tissue in the proximal and lateral nail folds, the seal being broken between the cuticle and eponychium and bits used to dig under this area to clean it up'.
I imagine very few health and safety regulators are going to grant that these methods are safe and o.k for nail technicians to carry out. There are so many reasons why; it's really common sense.
For me, it's the fact that the eponychium and cuticle are there for good reason, a seal to keep bacteria 'out' and protect the matrix,therefore compromising that area is essentially inviting infections and future nail deformity.
Bearing that in mind, the dry manicure or e-file manicure offered by many of the worlds leading nail technicians is a safe treatment when performed correctly. With so much confusion around the different types of machine based manicures, we must concentrate on the skill, experience and education of those who offer the service. It is only a safe option to offer in salons that are experienced enough to rightfully offer this specialized treatment. Many services offered in salons today are extremely dangerous in the wrong hands- so as a community let's help raise awareness, not incite mistrust.
So to recap, I think we all agree, Russian Manicure - bad.
Well, this research has led me on quite a journey, and my views have opened up since I started out, proving to me, that I, like many, jump to conclusions.
When this topic first blew up, my initial response was 'Wow, this kind of manicure is barbaric, and any one practicing or associated with this is irresponsible at the very least. After reading, watching, researching and talking to many industry leaders, I still believe the more aggressive Russian mani technique is a bad idea for our industry, but I have learnt that there's a place for a conservative, professional e-file manicure within the realms of good practice.
Due to much conflicting information, it's a contentious subject to say the least, there is a lot of confusion surrounding this manicure. Everyone I respect agrees, nipping and cutting of the dry skin around the 'nail rim' (a generic term to encapsulate any thickened dead skin around the perimeter of the nail bed) is a bad idea, as is breaking the seal or digging under with any implement, BUT many experienced techs have offered a comprehensive dry machine manicure to clients for many years stating that, that very dry skin, when exfoliated gently (epidermal only) grows back smoother and diminishes over time. This service is backed up by home care on the clients part, a long term solution as opposed to a quick fix. It would seem the epynichium is somewhat different in character to the thickened skin on the soles of the feet, in that, when buffed
(not cut or over abraded) it will grow back softer, not thicker. We are talking about dead skin, not living tissue, and the cuticle that rides out on the nail bed surface.
This does not of course overrule good practice. Above and beyond all else, this is what we must consider as nail technicians. The things we must consider as a community are correct education and guidelines, and each tech should understand their limitations- this kind of service is for the established, if your not very confident already with your e-file, this is not a service you should offer. The devil is in the details they say, know your trade, know the difference between a healthy manicure and practices that could cause a client harm. Check with local governing body as to guidelines, educate with experienced licensed teachers and always put health and safety first. Gather the facts so you can make your own informed decision, care more about morals, integrity
and best practice over and above anything.
Disclaimer: The views in this blog are just that; views. Whilst I have done my best to research and only quote facts, I'm not a scientist, and I don't play one on TV.
Also, if anyone wants to sue me due to reckless over use of the word "eponychium". (I counted- 15 times) get in line...