Hairdressers and barbers

Transmission of blood-borne viruses and infections is considered to be low risk in the hairdressing industry because majority hairdressing procedures are not intended to cut or puncture the skin. 

However, it is still important that a hairdresser or barber consistently follow good hygiene practices to prevent the possible transmission of infection to their clients. 

Although the risks are minimal, a range of procedures performed by the hairdressing industry may potentially expose clients and the hairdresser to infections if precautions are not taken.  

Types of infections may include:

• bacterial such as Staphylococcus aureus (Golden staph or MRSA)
• viral such as herpes, HIV, hepatitis B, hepatitis C
• fungal such as Candida albicans infections
• infestations such as head lice, scabies.

A hairdresser should examine the steps of a procedure or treatment, and identify what risks are involved and know how to best prevent those risks. 

Accidently nicking or cutting a client, who has a blood-borne virus (such as HIV, hepatitis B or hepatitis C), with scissors, may put the next client or the hairdresser at risk if appropriate measures are not taken.  

A person with a blood-borne virus does not have to disclose that they have the disease to a hairdresser.

There are many people in the community who are unaware that they have a blood-borne virus or other type of infection. Therefore, it must be assumed that all blood and body fluids are potentially infectious and therefore standard precautions must be applied to prevent the transmission of infections.

The hairdressing industry should be informed of diseases that can be transmitted in the course of their work and should develop their protocols /standards in response to this information. If you want to know more about a particular disease or infection, refer to Healthy WA for a range of fact sheets that explain how each disease is transmitted, symptoms and common health care advice. It is recommended that hairdressers familiarise themselves with at least basic information about blood-borne viruses such as:

• HIV and AIDS
• Hepatitis B and
• Hepatitis C.

It is the responsibility of the business owner or supervisors to ensure all employees who perform hairdressing procedures have an understanding of how infections are spread, and how they can prevent the spread of infection by adopting and using the recommended standards.  

Staff and supervisors must be able to do their work in ways that ensure a business performs safe and hygienic procedures.

Staff and supervisors must know about issues associated with infection control, cleaning and disinfection relevant to the business activities and the jobs they do.

Personal hygiene and preventing the spread of infection is the responsibility of everybody working in the hairdressing and barber industry. 

Knowing how and when to apply standard hygiene precautions is critical for any successful business. 

Safe and hygienic work practices need to be applied to every client because some people may not be aware that they have an infection or a blood borne virus, and they are not obliged to disclose such information to a hairdresser. 

Successful infection prevention and control involves: 

• good personal hygiene practices, including tying long hair back, trimming nails, clean clothing and the wearing waterproof coverings on cuts and abrasions
• washing and drying hands before and after client contact
• the use of protective barriers such as gloves, gowns, plastic aprons, masks etc.
• appropriate handling and disposal of sharps, e.g. razors 
• use of single use equipment when applicable
• appropriate processing of re-usable equipment and instruments. 

Hand hygiene and hand washing

Hand hygiene is the most important step in preventing the spread of infection from one person to another. 

Hands can become contaminated through contact with a client, the environment or other workers. 

As a general rule, a hairdresser should wash their hands:

• before and after contact with each client or after any interruptions in a procedure
• after eating or smoking, or answering the phone
• after going to the toilet
• after blowing their nose, coughing or sneezing
• after handling laundry or waste 
• after contact with blood or other bodily substances
• when hands become visibly contaminated.

Important steps to follow when hand washing include

• Wash hands with soap and warm water
• Hands should be rubbed together for a minimum of 15 seconds so that the cleaning solution (soap) comes into contact with all surfaces of the hands, paying particular attention to  the fingertips, thumbs and the areas between the fingers
• Hands should be rinsed then patted dry using disposable paper towels or a hot air dryer
• Paper towels, soap and a waste receptacle should be located next to the hand basin
• Scrubbing brushes are not recommended for scrubbing hands as they can cause damaged to the skin.

What to use for hand washing

Soap (general hand washing)

For general hand washing, plain soap or liquid soap is sufficient. 

Alcohol-based hand rubs (ABHRs)

ABHR can be used for general hand washing in conjunction with soap and water e.g. use an ABHR in between client contacts 

ABHRs may also be used on hands that are already visibly clean. 

The active ingredient in ABHRs varies and may include ethanol or isopropanol. A product with at least 70% alcohol (isopropanol) is the most effective. 

When selecting an ABHR, the product must have Therapeutic Goods Administration (TGA) approval as a hand hygiene product and meet the EN1500 testing standard for bactericidal effectiveness.

It is important that the products are used in accordance with the manufacturer’s instructions. 

Please note the Department of Health does not promote specific products, nor do they mandate product selection.

Other aspects of hand hygiene

Cuts and abrasions

As intact skin is a natural defence against infection, cuts or breaks in the skin or the presence of skin lesions are possible points of entry for infectious organisms. If these are infected they can be a possible source of transmission of infectious organisms.

To reduce the risk of cross-transmission of infectious organisms, cuts and abrasions should be covered with waterproof dressings, or the hairdresser must not perform the procedure until the wound is treated. Alternatively gloves may be used.

Wounds and infections on client

If a client has an open wound or infection, open sores or abrasions, or the hairdresser does not feel comfortable providing a service to a client due to a skin condition, the hairdresser should recommend they consult their general practitioner and have the condition treated before they return. 

Alternatively the hairdresser may elect to provide a service to a client, even if they have a skin abrasion or infection, if they believe they can appropriately provide the service around the condition.

Personal protection

Personal protection is used to protect both the client and hairdresser by providing a physical barrier to infections caused by dirt, blood and excretions.

Protection includes:

• washable aprons
• disposable gloves
• surgical masks
• protective eyewear goggles.

When choosing the right protective clothing/equipment consider:

• the likelihood of being exposed to dirt, blood or excretions
• ways that a worker could be exposed.

Protective clothing/equipment must be made available for staff and training should be provided on ways to prevent transmission of infection and cleaning of equipment.

Instruments used for different types of hairdressing procedures will require different levels of cleaning and disinfection depending on the level of risk of exposing a client to potential blood-borne viruses.

• Cleaning is the physical removal of dirt from instruments by washing in detergent and warm water to reduce the number of micro-organisms.
• Disinfection is the killing of disease causing micro-organisms except bacterial spores.

Cleaning instruments

For majority of instruments used during a hairdressing procedure, scrubbing with warm water and detergent is sufficient.
Products used for cleaning instruments are at the discretion of the premises. As a general rule, detergent and water are all that is required. Chemical disinfectants are not recommended for cleaning instruments unless contaminated.

In general, when cleaning instruments:

1. put on appropriate protection e.g. gloves, apron and goggles, where appropriate check manufacturer’s advice or Material Safety Data Sheet for the chemicals you are using)
2. dismantle or fully open items to ensure all parts are present
3. rinse items in warm running water to remove particulates
4. immerse items in the sink with warm water and detergent, and scrub items
5. rinse items in warm to hot running water and dry
6. inspect the item for cleanliness and completeness.

Cleaning tips

Items that cannot be fully immersed should be wiped over using a lint-free cloth dampened in warm water and detergent, then rinsed and dried. A 70% ethanol alcohol solution should then be used to disinfect the item.

Disinfecting instruments

Instruments that do not come into contact with blood or bodily fluids during normal use do not need to be disinfected. However, if an instrument such as scissors accidently pierces nicks or cuts the skin it will need to be disinfected before being used on another client.

The use of disinfectants does not replace the need for good cleaning practices, and all equipment must be thoroughly cleaned before disinfection.

Thermal disinfection (hot/boiling water)

Thermal disinfection uses heat or boiling water, which will destroy most organisms. It is the simplest and most efficient method of disinfecting instruments that can be immersed in water.

The simplest way is to heat the water in a kettle and immerse the instrument in hot / boiling water for approximately 10 to 15 minutes.

Specific times and temperatures for optimal disinfection are outlined below.

Chemical disinfectants

Chemical disinfection should only be used when thermal disinfection is unsuitable. This is because chemical disinfectants are commonly misused or overused, and many microorganisms are becoming resistant to them. However, disinfectants must be used when equipment or the environment is contaminated with blood or other body substances.

Only disinfectants specified in the Australian Register of Therapeutic Goods (ARTG) (external site) should be used.

Solutions must be labelled appropriately (with the name, date and dilution strength), and must be used and stored according to the manufacturer’s instructions.

Head lice are tiny insect parasites that live on the head and feed on the scalp (the skin covering your head). They reproduce by laying their eggs (nits) on the hair shaft (the part of your hair closest to the scalp). Head lice are not dangerous, do not carry diseases, and are not a sign of poor hygiene (cleanliness).

How do people get head lice?

Head lice are spread by head-to-head contact with another person who has head lice. This kind of contact includes doing group work at school, playing, or hugging.

Head lice can run from one head to another in seconds. Head lice cannot fly, jump or swim, but they can sometimes swing from one hair to another.

Head lice are not spread through bed linen, clothing or head gear (hats and helmets) as they do not leave the scalp unless they are moving to another scalp, unless they are dead or dying.

Signs and symptoms

A hairdresser may be able to see head lice crawling in a client’s hair, although they can be difficult to spot as they move quickly.

• Adult lice are usually dark brown and about 2 to 3 mm long.
• Hatchlings (young lice) are often a lighter brown colour and about 1 to 2 mm long.
• Eggs will be attached to the hair shaft. They can be very tiny and hard to see, especially newly-laid eggs close to the scalp. They are grey-white and about the size of a grain of salt.
  Managing 

Managing a client who has head lice 

There is no regulation preventing a person who has head lice from using or attending a hairdressing salon. 
Head lice are not considered a physical threat to staff or others if recommended practice standards are used. However, hairdressers are within their rights to refuse service as long as it is not on racial or ethnic grounds under the Equal Opportunities Act. Therefore a hairdresser is not committing an offence against this Act by refusing to perform a hairdressing service on a person with head lice.

Hairdressers should not be alarmed when faced with a case of head lice. It is important that the business owner develops their own policies and procedures on how to manage a client who presents with head lice.  

Consider the following options for managing head lice:

• Should head lice be identified in a client, sensitively advise the client on appropriate treatments and offer options based on the extent of head infestation
• Cut the clients hair and take additional precautions to prevent the spread of head lice to yourself and other clients. Precautions may include containing the hair in the cape used on the client. On completion of the haircut, fold the cape inwards and roll into a ball to contain any shed lice and take the cape to the cleaning area to dispose of the hair in a disposable rubbish bag. Clean equipment used on that client. Wash hands.
• Alternatively, decline to cut the clients hair until they have treated their head lice. It is recommended the client is referred to the Department of Health’s website for information on methods to treat their hair, or keep up to date brochures to provide to the client. It may be pertinent for the hairdresser to keep this information on hand to present to a client. Information is available on the HealthyWA website. 

Treating brushes, combs and scissors

The treatment for equipment used on clients with head lice is no different than the treatment of equipment used on clients without lice.  This is because infections and infestations are not always detectable; therefore the equipment should always be treated as though a client has an infection.

It is important that any brushes, scissors or combs are cleaned and disinfected in hot water. Head lice are fragile insects, easily killed by water temperatures greater than 60ºC for a minimum of 30 seconds (however this temperature is too hot for washing hair).

Other cleaning

All hair should be swept up and placed in a plastic bag and disposed of in the rubbish bin. The disinfection, fumigation and cleaning of floors and walls is not necessary. Wash any capes used to capture hair in a standard laundering cycle. 

Disposable paper towels, capes, or clean linen are recommended where appropriate, and must be changed for each client.

Used/soiled linen, towels and protective clothing must be laundered using hot water (>60ºC) and detergent. Domestic laundering is sufficient, and washing may be taken offsite for laundering.

If linen or towels are stained with blood then those items must be washed in cold or cool water no more than 35°C (hot water will set blood stains). When the stains are removed the linen can then be processed as above.

All clean linen, towels and clothing must be stored in a clean area to reduce contamination.

Routine cleaning of work areas is important because deposits of dust, soil and viruses/bacteria on surfaces can transmit infection.

After each client, all chairs, couches, and benches where skin contact occurs should be washed with detergent and water. Hair should be regularly swept up between each client.

Products used for general cleaning must be suitable for the purpose and the types of products used are at the discretion of the premises.  As a general rule, detergent and water are all that is required for general cleaning. Chemical disinfectants are not recommended for routine cleaning.

Blood or body fluid spills clean-up

It is important for an owner to establish procedures for responding to a client where the skin has been cut and bleeding has occurred (e.g. with scissors), and ensure staff know how to manage this e.g. apply pressure with a clean tissue then apply a plaster. Clean up any blood spill on chair surfaces or equipment as soon as possible, wash area thoroughly and leave to dry.

For blood spills

• Spots or drops of blood or other small spills can easily be managed by wearing gloves and wiping the area immediately with paper towelling
• Then clean the area with detergent and lukewarm water
• Place any bloodied materials in two plastic bags, one inside the other (including the gloves used for cleaning) and discard into domestic waste
• Wash hands after removing gloves
• Where cleaning is difficult such as between tiles and there is a possibility of bare skin contact with that surface, then a disinfectant (such as bleach) may be used after the surface has been cleaned with detergent and water.

Cut throat razors

Cut throat razors, also known as straight razors, have a flick blade that folds back into the razor handle. 

Cut throat razors with a non-changeable blade are not permitted for use in any commercial hairdressing establishment in Western Australia due to the risk of spreading blood-borne viruses such as hepatitis B, hepatitis C and HIV. This is a requirement under the Health (Skin Penetration Procedures) Regulations 1998.

After use, micro-organisms and small, invisible quantities of blood and bodily fluids can remain on the razor blade. Washing and disinfecting the blade will not destroy these micro-organisms and will place other clients at risk of infection if the blade is reused.

Cutthroat razors with disposable single use blades are permitted. A new disposable blade must be used for each client, and the detachable blade must be disposed of into a sharps container as per Australian Standard AS4031 after each use.

The blade handle must be cleaned with lukewarm water and detergent to remove any contaminants before a new single use blade is attached.

Disposable razors

Disposable razors must be single use only and disposed of into a sharps container after use.

If razors have a detachable blade, the blade must be disposed of into a sharps container as per AS4031 after use.

The blade handle must be cleaned with lukewarm water and detergent to remove any contaminates prior to a new single use blade being attached.

Disposal of general waste

General waste which includes used hair, tissues or gloves shall be:

• disposed of into a lined waste bin with a tight fitting lid which is easily accessible during treatments
• stored and disposed of via normal refuse collection.

Disposal of sharps

Sharps include:

• razors
• blades
• anything capable of cutting or penetrating the skin.

Any person who has used a disposable sharp instrument or equipment must be responsible for its safe management and immediate disposal after use.

All used sharps shall be placed in a designated puncture resistant container that complies with the Australian Standard AS 4031:1992, ‘Non reusable containers for the collection of sharp medical items used in health care areas’ 

Sharps containers shall be disposed of in accordance with the Environmental Protection (Controlled Waste) Regulations 2004 using a licensed controlled waste carrier. 
Contact the Department of Environment and Regulation for more information on sharps disposal.