The Patch Test

Stylists are required to patch test clients before a chemical service but rarely do, why is it so often ignored, and is it helpful to start implementing?

Has it ever felt unnatural, or even anxiety-inducing to be applying a chemical to someone's scalp and hair within the first 15 mins of meeting them? That is because it is highly risky, and your brain knows it, even if you were not taught that it, you intuitively know something is not all right with this workflow.

Here are some reasons why it is necessary to patch test before a chemical service.

We are required to patch test before a chemical service, if we skip this we are legally liable if the client reacts to our service chemical.

Many allergies happen hours, even days later. A PPD (Para-phenylenediamine) reaction, for example, can be delayed and happen days later. The skin swells and most people are rushed to the hospital and placed on steroids.

If a prior reaction has occurred the client has more than a 50% chance of sensitization and risks a worse reaction that may be fatal.

48-72 hours is the ideal time to wait to perform a client's service after their patch test.

Walk-in or same-day chemical services don't make sense to do on clients when we are legally required to wait for a minimum of 24 hrs, as some MSDS say, but most say 48 hrs.

This is a serious flaw in the way most salons operate, but most are ignorant of this because the majority of the industry operates this way so it seems normal to do what everyone does. This is THE reason you can give clients as to why you cannot service a client the first time you meet them, unlike the other salons that have serviced them in times past.

When we analyzed this at our test salon for safety, we realized we were liable if someone had an anaphylactic reaction if we hadn't done the due diligence of patch testing. The MSDS for the chemical says If we haven't informed our clients of the risks associated with the hair chemical and skipped the patch test, the liability transfers from the chemical maker, to the hairstylist. So if a client was to react to the chemical and you didn't do the patch test, the client would be able to find the stylist personally at fault, not the color chemical manufacturer/ seller.

This is the reason why we started using chemical waivers on our invoice/quote before service.

HOW TO PATCH TEST

BOY OH BOY, THERE'S SOME CONFUSING STUFF OUT THERE ON THIS ONE.

So I am going to just go over what standard we have created here on the hair hug based on some of the things we have evaluated for risk.

Ideally, you want to wait 3 days after a patch test before you service a client, do not perform the service sooner than 48 hrs after the patch test because reactions can be delayed in some cases up to 72 hrs, like a PPD allergy, which is found in most color lines, found in dark pigments usually levels 6-1.

Some videos on YouTube demonstrate patch tests but I assure you there are many flaws in these videos, one is that some recommend you only test the color, not the developer, but doing just the color excludes the variable of the developer changing the chemical reaction when they become a mixture, which assumes that someone can't be allergic to the developer or mixture. Well, people are allergic to both so they should both be considered and tested when performing the patch test.

Mix a pea size of each chemical the color + the developer + any other additives you plan on using.

Patch test where the client can see if there is any itch, redness, swelling, or discoloration.

Patch test away from vital lymph nodes and veins.

You will see many people recommend putting the chemical mixture behind the ear. We disagree with patch testing behind the ear because humans have so many sensitive, vulnerable nerves and lymph nodes around the face, ears, and neck. We, humans, absorb the chemical through the skin, into our bloodstream and that just seems risky to put cancer-causing chemicals on that area. The reasoning why to test behind the ear is purely vanity so that the chemical dye color won't be noticeable to the client while they carry on their activities. But it's more reasonable, from a safety practicality standpoint, for the client to be able to see if they are having a reaction and be able to take a picture of it to show their stylist.

We recommend a patch test on the side of the arm between the elbow and the inside of the arm as pictured below.

Do not leave the color chemical mixture on the skin for more than the timing of what the service would be, but do not wash off before 20 mins because it needs time to get to the chemicals highest activity point, then wash the chemical off with gentle soap and water.

Over the next 48 hrs have the client look for and document

1. Discoloration

2. Redness

3. Itch

4. Swelling

5. Blistering

Some people on the internet will say to not wash off the chemical, but most MSDS says to wash off, so go with the MSDS recommendation.

WHY PATCH TEST FOR EVERY SERVICE?

Even if you are using the same chemical, doing the same service the client has received for years there is a chance of developing sensitization & reactions. If you are doing a maintenance color service, like a root application every month you can opt to do a 20 min patch test prior to service. I need to stress this is not for first time services, this is for someone who you see within a month. After 20 mins wash off with gentle soap.

Any rash, itching, redness, or discoloration don't apply, you will need to switch to a different color line.

If you have a new client who has expressed their sensitivities to synthetics and chemicals... It would be most appropriate for the stylist to test all the products you are using at the time of service (this includes shampoos, masks, chemical bond additives, and conditioners because they also are hazardous, as their MSDS admit, seriously do go look up the shampoos you regularly work with and you will be floored at how hazardous they actually are).

Here are some reasons why most salons and stylists do not patch test.

• Most salons and stylists are not aware. They do not read their chemical's MSDS and instructions ( because reps and suppliers do not offer these to stylists easily when they purchase the chemical). The MSDS states the maker's instructions and recommendation for patch testing, including the transferring of liability to the stylist if they do not patch test and inform their clients of the risks associated with using and being exposed to the such chemical.

• They charge too little so they need to service more guests to meet their overhead.

• They do not afford the time for the stylist to do one before a service because they need to serve guests the same day to provide room for more, prioritizing quantity over the safety of staff and clients and quality of service.

• There is no safety training or workflow implemented in the salon or school.

• There is no restructuring of chemical services to implement patch test appointments pre-full service chemical appointment. Example: create a first-time chemical consultation appointment.

Even in cosmetology school, they teach students to service first-time chemical guests the same day as meeting them, and all that is really expected of the stylists is to get an accurate color history where they can essentially guess if the guest has had a previous reaction or sensitivity. The color history isn't usually gathered for the reasons of safety, it's more result-driven and focused, meaning, cosmetology schools and salons teach students and staff to think primarily about how much work and obstacles they will potentially face during their service based on the previous chemical services.

Things like: "Will this lift evenly with one formula, or will there be multiple needed? What product and catalyst will be used to achieve results? How long will the service take? How much should be charged and estimated for maintenance?" All great questions to think about but none cover safety, or teach someone to spot risk and be careful with hazardous chemicals.

GET NERDY WITH ME

"This explains why the patch test is a such murky task, the fact that it varies from line to line and may not even be sufficient is concerning... I am confident that 48-72 hours is needed to determine if the patch test causes a delayed reaction. People are not reporting these reactions to healthcare providers. Nor to the manufacturer of the chemical." Whit's conclusions of the following study.

Link to study:

Self-testing for contact sensitization to hair dyes--scientific considerations and clinical concerns of an industry-led screening programme

Thyssen JP, Søsted H, Uter W, et al. Self-testing for contact sensitization to hair dyes--scientific considerations and clinical concerns of an industry-led screening programme. Contact Dermatitis. 2012;66(6):300-311. doi:10.1111/j.1600-0536.2012.02078.x

Abstract

"The cosmetic industry producing hair dyes has, for many years, recommended that their consumers perform 'a hair dye allergy self-test' or similar prior to hair dyeing, to identify individuals who are likely to react upon subsequent hair dyeing. This review offers important information on the requirements for correct validation of screening tests, and concludes that, in its present form, the hair dye self-test has severe limitations: (i) it is not a screening test but a diagnostic test; (ii) it has not been validated according to basic criteria defined by scientists; (iii) it has been evaluated in the wrong population group; (iv) skin reactions have been read by dermatologists and not by the targeted group (consumers and hairdressers); (v) hair dyes contain strong and extreme sensitizers that are left on the skin in high concentrations, potentially resulting in active sensitization; and (vi) recommendations and instructions on how to perform the hair dye self-test vary greatly even among products from the same company, again suggesting that the basis for safe use of the test has not been determined. If the use of a hair dye self-test to predict contact sensitization becomes widespread, there is severe risk that a tool has been marketed that may cause morbidity in European consumers.

© 2012 John Wiley & Sons A/S."

CREATE A CONSULTATION SERVICE THAT INCLUDES A PATCH TEST

What is the benefits?

1. Prioritizes the client relationship and experience.

2. Empowers the stylist to lead the service and not be led by the service.

3. Grounds the stylist in safety and helps them reduce the risks to their health.

4. The stylist makes a better income because they charge according to the value of the service instead of undercutting themselves.

When we are stressed and exhausted after a hair service, we tend to not be able to think clearly and end up not charging what the service is worth.

If we haven't insulated ourselves by giving an initial quote or base price we can end up taking from our pocket financially.

Set yourself up for success! Put a buffer between you and the financial part of the client's service with a consultation appointment.

By sending the quote of the service after the consultation you insulate yourself from undercharging and overworking yourself.

After the initial meeting and patch test, you can take the time to thoughtfully walk through the service needs and create a plan, when you do that you see the work and value you are providing, and you can even line item such things in an invoice/ quote so the guest can see what is going into their hair service. And then schedule the appointment after they have approved the invoice and signed the chemical waiver.

WHY DO IT THIS WAY?

Most trades come to a project to get the scope of the project needs so they can accurately quote a job, and that quote is pretty much always given after the paid consultation. If it works for other industry trades like electrical, plumbing, and such why do we not also operate that way?

MORE BENEFITS

You get to know your client without the pressure of the service at hand and all the social aspects of connecting with a client, you have time to ask as many questions as you want to get to know the needs of the client and their past experiences with other hair caregivers. Some of those experiences are hard for the client to talk about because they may have been traumatic to them.

The client has just as much anxiety in meeting their new stylist as the new stylist does meeting them.

Having a consultation before the service day sets the tone of your entire relationship with the client. All humans want to be cared for, but we all have different needs and boundaries, and they need to be respected.

Compassionately inquire to explore what your guest truly is looking for in a hair service. When you reinforce your thoughtfulness with careful actions of safety like patch testing and necessary PPE for you, the staff around you, and the guest, the guest truly feels like they are in a safe place, their needs are being met, and gain their confidence and trust in you.

When you create this environment for yourselves and your guests there is true independence and freedom from the anxiety, stress, and burnout that can come with performing chemical services. Stylists that have time to think and plan their creative chemical services reduce their risks of toxic chemical exposure and accidents, have a higher success and service satisfaction rate with clients, and significantly reduce their stress and anxiety.

These assets coming soon:

CONSULTATION GUIDE

CLIENT QUESTIONAIRE

INVOICE / WAIVERS 'CONTRACTS'

JOB TASK CARD FOR PATCH TESTING?

Our next article will address chemical consultations.

HUGS! XX