Provide UV tanning services

Transcription

1 Unit B21 Provide UV tanning services What you will learn Maintain safe and effective methods of working when providing UV tanning treatments Consult, plan and prepare for treatments with clients Monitor UV tanning treatments Provide aftercare advice Skin cancer risks and causes 1

2 Introduction Well-informed clients realise that prolonged use of a sunbed is not good for the skin, but appreciate that it is a wellbeing treatment and still want a tanned appearance. So, therapists can combine treatments using short exposure to UV light on a sunbed and fake tanning to boost health. An American company has recently launched the fi rst horizontal tanning bed that also delivers a spray of self tan to accentuate the treatment. Sunbeds are also used in hospitals by dermatologists for the treatment of skin disorders such as psoriasis, eczema and jaundice with encouraging results, but the dosage is strictly timed and only minimal exposure is allowed. B21 The sun provides us with our main source of vitamin D, which is important for bones, muscles and the immune system. Being out in the sun also makes you feel good, as sunlight is thought to stimulate the production of endorphins which can improve our mood. Provide UV tanning services Creating a tan using a sunbed with ultraviolet (UV) tubes is often referred to as indoor tanning. Sunbed treatments create something of a professional dilemma for the therapist we are acutely aware of the dangers of skin cancer as a result of over-exposure to UV light, and yet we are aware of demand from clients who still want to look healthy and tanned. The main advantage of sunbed treatments is that they are controlled treatments, with a known dosage of UV being given within a specifi c treatment time. For the safety of the client, a responsible approach to sunbed use must be taken and full information given to clients to allow them to make decisions about their treatment, and its risks. Modern UV apparatus means therapists can control the emissions, the intensity of the rays and the type of radiation delivered to the body, in addition to ensuring a thorough consultation, contraindication check and good aftercare, thus maximising the safety of the treatment. Promotes a feeling of wellbeing and relaxation Used for sterilisation and can kill off bacteria on the skin Increases vitamin D production essential to help with the absorption of calcium, blood coagulation (clotting) and a healthy capillary network Benefits of UV light Used in the treatment of skin disorders such as acne, psoriasis and eczema to promote healing Helps people suffering with seasonal affective disorder [SAD] UV is used to treat jaundice in newborn babies because UVA helps to metabolise the excess bilirubin in their bloodstream Increases blood flow to the skin and helps with the growth and repair of cells 2

3 Premature ageing of the skin There is a risk of sunburn in some skin types if exposed for too long Dehydration of the skin Potential harmful effects of excess UV light Loss of elasticity in collagen and elastin fi bres Development of cancerous tumours or skin abnormalities The Standards set out detailed performance criteria regarding: maintaining safe and effective methods of working when providing UV tanning services consulting, planning and preparing for treatments with clients. The majority of these requirements apply to all beauty therapy treatments and are therefore covered in detail in Professional Basics, pages 2 86, the Body consultation section, pages , and Unit G22 Monitor procedures to safely control work operations, pages (see the Level 3 Student Book). Page references will be provided to these sections where relevant. You should also refer back to You and the skin and Anatomy and physiology, as required. For information about your responsibilities under current health and safety legislation see You, your client and the law on pages While medically-controlled exposure to UV light is known to help clear up skin conditions such as psoriasis and can contribute to the effective treatment of depressive disorders such as Seasonal Affective Disorder (SAD), long-term exposure is very damaging. Key terms Seasonal affective disorder (SAD) psychological condition of a depressive nature thought to be the result of a biochemical imbalance in the hypothalamus, the part of the brain responsible for metabolism and poor sleeping patterns, weight gain and irritability. The condition is brought about by lack of sunshine and depletion of vitamin D stores throughout the winter months. It can be improved by exposure to sunlight or ultraviolet light, and improve their condition. Jaundice bilirubin levels in the blood cause excessive destruction of the red blood cells leading to poor liver function, usually because of a blockage in the bile and often occurs in babies. The condition is treatable and Bilirubin orange colour. It is a waste product resulting from the normal breakdown of red blood cells which pass through the liver where chemical changes occur. It is mainly excreted in the faeces. Treatment-specifi c requirements for UV tanning are covered within this unit. Maintain safe and effective methods of working when providing UV tanning treatments In this section you will learn about: Tanning equipment and materials how sunbeds work Before you can advise your clients on the use of sunbeds and related products, you will need to understand how they work and the different types of sunbed available. Sunbeds vary in strength and design, and there is a huge choice of machines on the market. Provide UV tanning services B21 3

4 B21 Provide UV tanning services Sunbeds come in two basic designs and can either be: horizontal beds: the client lies on perspex with the lamps/bulbs encased in top and bottom canopies or casing these beds may be a bit confining for a claustrophobic client; vertical beds: an upright booth in which the client stands to tan the body all over, very quickly. These vertical walk-in booths are most popular within salons, both because they are fast acting and because they take up less space in the salon than a lie-down double canopy. There are also fewer requirements for privacy, as some of the upright cubicles have a changing area before entering the tanning chamber. Modern units have additional features including speakers for music, CD players, headphones, an intercom for communication while tanning and a cooling fan so the body does not get too hot during treatment. Tanning bulbs Sun bulbs emit ultraviolet light and act as the key element in all of the different types of tanning beds and booths that are available on the market. The depth and colour of the tan they produce will depend on the spectrum of light created by the tanning bulbs. There are various types of sunbed bulbs on the market including reflector sunbed lamps and high output lamps. Nearly all tanning lamps use a device called a ballast to control their power consumption. The ballast stabilises the flow of electrical energy inside the lamp. It makes sure that the bulbs use only the amount of wattage they need to work effectively. So, even if you were to replace the bulbs with a higher output, the ballast cannot be altered. You cannot get more energy than the ballast setting and therefore cannot advertise your sunbed as a higher-powered one. UVA tubes also come in various power ratings. In some machines, using stronger tubes can cut down on the length of time required for the tanning process, depending on the client s skin tone and type, as long as the ballast setting is in keeping with the lamp output. UV radiation can be produced artificially by two means and bulbs generally fall into two main categories: high pressure and low pressure types. Both high and low pressure tanning bulbs need a lack of oxygen inside the casing in order to work effectively. Inside a low-pressure fluorescent lamp Examples of vertical and horizontal tanning beds 4

5 Low-pressure tanning bulbs are very similar to normal fluorescent tubes, but the glass naturally filters out the harmful UVC radiation. All fluorescent lamps are lowpressure gas discharge lamps. The glass tube is filled with an inert gas at a low pressure and a small quantity of mercury. The inside of the glass wall is coated with a phosphor which when heated gives off UVA light and a little UVB to produce a lasting tan. They often also have an added infrared or radiant heat lamp to provide warmth. At the ends of the glass tube are pasted electrodes. When an electrical charge is passed between them, the mercury vapour emits UV radiation. When the UV radiation hits the phosphor, the phosphor emits visible light. The colour can be varied for different applications by selecting different phosphor mixes and can be white, blue or pink, depending upon the manufacturer. hours even though they will continue to produce some light manufacturer and follow their guidelines. High-pressure tanning bulbs range in length and operate with 250 to 2,000 watt ballasts, 400 watt high-pressure tanning bulbs being the most common. Some shorter bulbs of between two and five inches are usually included in the face tanning component of a sunbed. High-pressure tanning bulbs are usually made of quartz glass and an additional specialised coating, which is essential to filter out the harmful UVC radiation. High-pressure tanning bulbs contain a small amount of mercury or argon and create ultraviolet light in high amounts. They can be small, straight or U-shaped quartz tubes, filtered to produce a high-intensity UVA output which results in a very rapid tan. They are popular in the industry because the shape of the tube allows more flair in the shape of the canopy design. The tube can be filtered to produce almost pure UVA rays which, in turn, produce a very intense output. These beds need special electrical installation and a forced ventilation system. High-pressure facial tanning units are sometimes incorporated into low-pressure beds. that the mercury content of a bulb should be clearly identified on the side. The performance of standard UVA tubes can be enhanced during manufacture by painting a reflective coating on the top side of the tube. This ensures that more of the tanning power is reflected down towards the user rather than being spread over a wider area. These tubes are designated as RUVA tubes; here the R stands for reflective UVA tubes. In beds that use tubes with this built-in reflector, the tubes can be placed closer together, which maximises the UV reflection. The intensity of this type of bed ensures a fasttanning result. The bed requires a starter to operate the tubes and this may take several attempts hence the flickering of the tubes when they are first switched on. If a tube will not work, check the starter before replacing the tube. UV radiation, like solar radiation, can cause eye and skin injury if the appropriate safety measures are not followed. manufacturer s instructions for the new tube type. The electromagnetic spectrum To fully understand how sunbeds work, you will need to look at natural sunlight and its properties and understand the theory of wavelengths and their roles. The sun emits a full range of electromagnetic radiations at a very high intensity. These include: radio waves used in radio, television and radar use infrared rays heat light visible light ultraviolet rays X-rays used in hospitals gamma rays radioactive substances cosmic rays in outer space. Provide UV tanning services B21 5

6 B21 Provide UV tanning services The electromagnetic spectrum Most of these rays are absorbed by the atmosphere, and only seven per cent of rays will reach the Earth s surface. The number of rays passing through the atmosphere is dependent upon where they meet the Earth, and the season or time of year. On the equator, where the sun is nearly overhead, the sun s rays will be strongest. The 93 per cent of rays absorbed in the atmosphere include the ones most dangerous to humans X-rays, gamma rays and cosmic rays, plus a lot of ultraviolet (UV) light, in the form of UVC. The rays which get through (7%) are made up of: infrared (80%) visible light (13%) ultraviolet light (7%). Frequencies Electromagnetic rays can be measured by their length or frequency. They are measured in Angstrom units (Å): an Angstrom unit = one ten-millionth of a millimetre a nanometre (nm) = one millionth of a millimetre an Angstrom equals a tenth of a nanometre. We tend to think of heat, light and radio waves as being entirely different from each other but this is not the case. Just as red, blue and yellow seem entirely different but are all part of a spectrum of colour, so heat, light and radio waves are all part of an electromagnetic spectrum. They all consist of waves which travel at the speed of light. The way they differ is in the length of those waves. The greater the length of the waves (wavelength), the less frequently they occur in a given period hence low frequency. Just as our ears can only hear part of the range of possible sounds, so our eyes can see only a small central section of the electromagnetic spectrum. Properties The seven types of electromagnetic (EM) wave travel at the same speed. The properties of EM waves change as the frequency (or wavelength) changes. Our eyes can detect only a narrow range of EM waves these are the ones we call visible light. As a rule, the EM waves at each end of the spectrum (e.g. radio waves or X-rays) pass through materials, while those nearer the middle (e.g. visible light) are usually absorbed by objects. The EM waves at the top end (high frequency, short wavelength like gamma rays) are the most dangerous, while those lower down (like radio waves) are generally harmless. When any EM radiation is absorbed it can cause two effects: heating and the creation of a tiny alternating current with the same frequency as the radiation. This is what happens in a radio receiver aerial when a radio or TV wave passes over it. 6

7 Visible light The visible light we can see as humans, you probably learnt at school as: Richard Of York Gave Battle In Vain. This is a mnemonic way of remembering Red, Orange, Yellow, Green, Blue, Indigo/Purple and Violet, which are the colours in the rainbow seen when the atmospheric ratios of water from rain and sunlight are right. At one end of the electromagnetic spectrum are X-rays and at the other are radio waves; both of which we know exist, but we cannot see them. Ultra-violet rays The rays that cause tanning effects are: UVA [wavelength nm with a peak effect at 340 nm.] These are the longest waves and this wavelength will affect the dermis. They produce a rapid direct tan only in those people who tan easily. The tan is not very long lasting. UVA rays can penetrate deep within the skin, which can cause damage to the supporting collagen and elastin fi bres, resulting in premature ageing. There is also an increased possibility of skin cancer developing. UVA rays can also cause photosensitivity and dehydration resulting in dry, inflexible skin. If excess UVA rays are absorbed by the eye it can result in the lens developing a cataract. UVA rays produce less erythema than UVB rays, but can react with certain chemicals to cause damage to the skin. For example, antibiotics, such as tetracycline antifungal preparations, coal tar derivatives used topically for psoriasis, retinoids used for acne, nonsteroidal antiinflammatory drugs (NSAIDs), chemotherapy agents, some diabetic medicines, antimalarial drugs, such as quinine, antidepressants, such as the tricyclics, and antianxiety medications, such as benzodiazepines, can cause a reaction following exposure to UVA rays. UVB [wavelength nm with a peak effect at nm.] These shorter rays only penetrate into the basal layer of the epidermis. The melanocytes are stimulated, giving a deeper tan. These rays are responsible for both erythema and sunburn, and cause a thickening of the epidermis. Because of the power of their penetration they are potentially carcinogenic. They can also be absorbed by the cornea leading to photophobia. UVC [wavelength nm or less.] These rays are the shortest and very harmful to living cells, so do have a use as a result of their germicidal affect on Diagram to illustrate how far UVA, UVB and UVC rays penetrate into the skin Light is reflected back from the Earth s surface, so it is possible to burn from the sun s reflection off snow when almost double the intensity of sunshine. Water absorbs infrared, so you can cool off in the water, but it will not shield sunburn even when in the water. A A for ageing B B for burning C C for cancerous bacteria. UVC has in the past been fi ltered by the Earth s atmosphere and was not found in natural daylight. However, with the Earth s protective layer the ozone layer being eroded by pollution and CFC gases, this can no longer be taken for granted. UVC is not present in any tubes in sunbeds and is classed as highly carcinogenic. Provide UV tanning services B21 7

8 B21 Provide UV tanning services The Sunbed Code of Practice When using sunbeds, it is vital that you follow your organisational procedures, manufacturers instructions and the current Sunbed Code of Practice. These measures will impact on every part of the treatment, so you need to be aware of them, and make your client aware of them where relevant, to safeguard your client at all times. The Sunbed Association, launched in 1995, is the trade association for the sunbed industry. It represents manufacturers and distributors of lamps and sunbeds, domestic sunbed hirers and sunbed operators, from leisure centres to clubs, salons to hotels in fact any establishment large or small that provides sunbed facilities. One of the main aims of the Association is to promote good practice throughout the industry to ensure the welfare of sunbed users. Until recently, the sunbed industry in the UK was unregulated by national government. However, the Sunbeds (Regulation) Act was passed on 8 April It bans under 18s from using sunbeds in licensed premises and gives law enforcement officers powers to inspect salons and to penalise salon owners if minors under the age of 18 are found to be using their sunbeds. However, this does not take into account people who buy their own beds or go to unmanned salons where there is no therapist providing safety guidance. There are four codes, one for each membership sector: Manufacturers and distributors of active components Manufacturers and distributors of sunbeds This code primarily covers the lamps. This code covers sunbeds either manufactured in the UK or manufactured abroad and available through a UK-based distributor. All Codes of Practice follow the requirements of the European Standard EN : 2003 (initiated by an International Standards Committee, published in Europe through the European Standards Institution; the English translation is available in the UK through the BSI the British Standards Institution). The International Committee which reviews the Standard is called MT16. The Sunbed Association has direct representation on MT16 through a technical consultant. The codes also implement most of the requirements of the Health and Safety Executive s Guidance Note INDG209 Controlling Health Risks from the use of UV Tanning Equipment. The HSE Guidance Note is automatically supplied to every member joining the Association. The basic requirements of the codes include the following. Sunbeds and lamps must be manufactured to recognised standards. Sunbeds should be installed by a competent person. Sunbeds should be regularly serviced and daily or regular checks of important components undertaken. Sunbeds should be regularly cleaned and disinfected. Protective goggles must be provided. Emergency procedures must be in place. Staff must be trained to an adequate level. Information/advice must be available to customers on the contra-indications, sensible use and warnings of the risks from abuse etc. Information on skin types must be available to allocate the appropriate length of sessions. No one under the age of 18 is permitted to use the sunbeds. Hirers of sunbeds for domestic use Operators This code covers companies who hire out sunbeds for use in domestic premises. This code covers any outlet offering example, leisure centres, sunbed salons, health and fitness clubs, hotel health suites or hair and beauty salons. There is also a sunbed code for users of sunbeds which provides information and instructions to customers. 8

9 Compliance testing To ensure that members meet their commitment to follow the Sunbed Code of Practice, the Sunbed Association employs the services of independent inspectors who visit members premises and check their operations. All new members are inspected as quickly as possible after joining but at least during their first few months of membership. After the initial inspection, all members are inspected every two years. If any member is found to be in serious breach of the Sunbed Code of Practice (and does not intend to rectify the situation) they are disqualified from membership. Preparing the sunbed Sunbeds generate a lot of heat, despite the fact that most modern units have built-in fans to cool down the body. Germs love heat and combined with the body s moisture content, through perspiration, the sunbed can become an ideal breeding ground. It is therefore essential that the sunbed is thoroughly cleaned to prevent the spread of infection and to make the area welcoming for the client. Always clean the sunbed with the correct preparations, as per the manufacturer s instructions, before the client enters the booth or treatment area. Unstaffed salons are not permitted membership of the must be used under supervision of appropriately trained staff. For your portfolio practice for sunbed usage and include it in your portfolio of able to provide guidelines for risk assessments and the law and suitable controls to have in place. Setting up the treatment area The solarium area in a spa Most colleges and training establishments employ a cleaning firm, usually on a fixed contract, which provides staff to carry out the daily chores for hygiene maintenance such as floor cleaning, emptying of general waste bins, sweeping the stairs, and so on. More staff may be employed to carry out longer-term spring cleaning of windows, paintwork and re-sealing of the floors. Small salons do not normally subcontract their cleaning duties it tends to be done on a rota system, with junior staff doing most of the jobs. Any idle pair of hands will be asked to help with cleaning duties, and all staff can expect to share the workload it is almost part of the job description and it would be unrealistic to expect otherwise. As with all treatments, it is important that you ensure your personal hygiene, protection and appearance meet industry and organisational requirements before and during your treatments. Remember also to thoroughly disinfect your hands prior to treatment. For more information, see pages 4 29 in Professional basics, You the therapist. Before the client starts their sunbed session, you should ensure that: the sunbed is in good working order the sunbed surface has been cleaned prior to use there is disposable floor covering by the sunbed sterilised goggles are available for the client couch roll is used to protect the head rest and foot rest instructions are made available to the client on how to use the sunbed safely and effectively instructions are given to the client on the preparation of the skin prior to using the sunbed and in a safe position for access; the client should be encouraged to shower if possible written instructions are displayed in an area clearly visible to both clients and therapists. Ideally, a poster explaining Provide UV tanning services B21 9

10 B21 Provide UV tanning services how to use and prepare for the sunbed should be displayed prominently in the changing area or reception so the client has time to read the information prior to getting changed client modesty and privacy is upheld at all times and the client feels comfortable with the treatment a bin is available and that all waste is disposed of safely; this would include the couch roll placed on the head covering and foot area, as well as couch roll on the floor for the feet as it will not contain any contaminating bodily fluids or blood, it can be disposed of in the normal bin and replaced for the next client a client record card has been filled out, written permission for treatment has been given by the client and both therapist and client have signed the card. For more information on the importance of client record cards and the Data Protection Act see Professional basics, page 81 parental or guardian consent has been obtained for minors, where relevant you must refuse treatment to minors under 18 years of age. After the treatment is complete, ensure that the treatment area and equipment are left clean and suitable for others to use immediately. Remember also to complete the client record card, noting the time and length of treatment, the number of treatments within the course and the results of the treatment so far. Do not use household cleansers on the sunbed s perspex canopy as you will certainly scratch it and reduce its effectiveness. Only use the manufacturer s recommended sunbed cleaner. Personal protective equipment (PPE) Ensure sterilised goggles are worn by each client to prevent eye damage, as recommended by both the HSE and the Sunbed Association. Also remember your own PPE when cleaning the sunbed and surrounding areas. Ensure your overall or tunic is protected by wearing an apron and wear gloves to make sure that your hands do not come into contact with any chemicals. Always follow the manufacturer s instructions when cleaning and only use products recommended for the make of machine in your salon. Do not use ordinary domestic cleaning products as you may damage the machine. Environmental conditions It is important to ensure that the whole sunbed area is clean and appropriately equipped so that the client feels comfortable and ready to undress. When preparing and managing your treatment area, you will need to ensure that your working environment meets the legal, hygiene and treatment requirements, as set by both your awarding body and government guidelines. Hygiene is important for permanent fixtures in the salon, such as: walls flooring doors windows. It is also important for portable equipment you use, including: the couch the sunbed small equipment such as hairdryers products. You will need to refer to the Health and Safety at Work (HASAW) Act 1974 for full guidance and also work to the specifications of the Workplace (Health, Safety and Welfare) Regulations 1992, which require all premises used as workplaces to have effective means of: lighting ventilation temperature control providing adequate work space maintaining cleanliness arranging safe salon layout. Lighting must be adequate enough to allow the client to see what they are doing and to be able to read safety signs and information posters. They are getting undressed and need to be able to find storage space for clothing as to well as to read the dials and settings of the machines. Ventilation is important if the room is too stuffy the client may overheat and faint. There should be fresh air coming in through vents, without causing a draft. Temperature should be maintained at a constant level and kept slightly cool as the client will get hot under the UV lamp. Remember though that if the temperature is too cold, the client will be uncomfortable while getting undressed and will not enjoy their treatment. 10

11 It is important that you have enough space in all work areas to maintain good air flow and to avoid the risk of slips or falls. Adequate storage for outdoor clothing, shoes and personal belongings such as a handbag should be provided in a secure and safe area. A lockable unit is ideal as the client only has to take the key with them to the treatment area. Vertical sunbeds do not take up too much room, but a double canopy horizontal unit does and there should be adequate room for the top canopy to be fully opened and for the client to exit the sunbed without the risk of tripping over obstacles. For more information on the HASAW Act 1974 and a full list of treatment and working regulations, refer to Professional basics, You, your client and the law on pages A careful log of hours used by the tubes must be kept. Some beds have counters; if not, a daily record of all sessions should be kept. Ensure that reflectors are not dented. Replace any tubes or starters that are faulty. If you feel a tube or starter is not working efficiently, call out the engineer. Only use a qualified technician for your particular make of machine. If any replacement parts are needed, contact the service technician. Servicing and repair must be carried out by a qualified technician at least once a year and records should be kept of the servicing. For information on the Electricity at Work regulations, see You, your client and the law on page 76. Dust and dirt in the salon are made up of particles of old skin cells, fluff from towels and clothing, ash and dirt brought in from outside and floating particles of products. In a busy Sunbed maintenance The sunbed area needs a strict cleaning regime to maintain high standards of hygiene, due to the nature of the treatment and the heat it generates. The following checklist indicates how to look after the sunbed area and equipment. There should be adequate ventilation in the sunbed area to prevent a build-up of body odour, to disperse generated heat and to prevent a build-up of fumes from cleaners, sun preparations and possible production of ozone gas. The most common causes of poor tanning are dust, dirt or oil on the canopy. It is essential to keep the equipment clean to ensure its effectiveness. Even though the surface of the acrylic sheet is cleaned between clients, dust still builds up on the underside of the acrylic sheet and on the reflectors. A suitable sunbed cleaner should be used after each client. This should be refilled each day to prevent cross-infection. Once a week, the sunbed should be turned off at the mains and the acrylic sheets removed and cleaned on both sides. Reflectors should be dusted (not polished this will leave a film which will interfere with the reflection). The acrylic sheets should be cleaned with a cleaner specifically for sunbeds. The use of harsh products such as surgical spirit can cause cracking and glazing of the acrylic. Suitable skincare preparations and products Before a sunbed treatment, the client should remove jewellery, contact lenses and any make-up they are wearing. The skin will tan more evenly if it is clean and free of grease. Ideally, clients should take a cool shower using unperfumed soap prior to treatment to remove any remaining skin creams or body lotions which could cause a skin reaction or sensitisation. There are tanning accelerator products which can be used with a sunbed but you must only use the one recommended for your particular brand of sunbed do not use an ordinary suntan lotion. Remember that you cannot lengthen the treatment time by using products always stick to the recommended treatment times to prevent damage to the client s skin. Further information on preparing the client for treatment can be found in the next section. Skin cleansers All skin cleansers used prior to a sunbed treatment should be perfume free and suitable for the client s skin type. Clients should be encouraged to shower before the treatment to clean the skin and remove any products likely to cause a reaction such as deodorants, perfume, make-up or body spray. Avoid alcohol-based toner for the same reason. Provide UV tanning services B21 11

12 B21 Provide UV tanning services Client modesty You must ensure that client modesty is protected during the sunbed session and also while the client is changing before and after the treatment. Make sure to provide a gown for the client and fully explain the importance of keeping swimwear on while on the sunbed to avoid burning delicate areas, such as the skin on the breasts. The sunbed should be located in a private room so the treatment is undisturbed but do advise the client against locking themselves in, for safety reasons. You do need access to the treatment room in case of emergency or evacuation of the premises. Consult, plan and prepare for treatments with clients In this section you will learn about: Consultation for UV sunbed treatments A consultation is vital before beginning a sunbed treatment, both to check for contraindications and to determine the skin type of the client and the appropriate duration of the treatment. treatment outcome. Clients will be disappointed if they think that a sunbed can change their genetic make-up and override their natural colouring. If a client is very fair or sensitive, always carry out a pre-sensitising or skin reaction test. If the skin reacts badly, the client will not be suitable for UV treatment. Make sure that you explain the cost of the treatment, the duration and the frequency of sessions needed. At the end of your consultation, remember to agree in writing the client s needs and the outcomes for the treatment so you can be sure they are achievable. Contra-indications to sunbed treatments The following points are contra-indications to sunbed treatments. If you identify any of them, the treatment cannot go ahead. Extremely sensitive skin, which burns easily in natural sunlight. Any pigmentation disorders of the skin; for example, chloasma or vitiligo. A client who has no natural pigment present a person with albinism. Clients with the herpes simplex virus, who are prone to cold sores. Any fungal infection, such as athlete s foot. Clients who do not like heat, are prone to migraines or have a tendency to faint. Use appropriate questioning techniques to elicit the information you need and remember to accurately record your client s response. It is important to give clients the opportunity to ask questions to check their understanding. It also important to manage the client s expectations if clients have very pale skin, they are never likely to develop a deep mahogany tan, and it is essential to ascertain the client s perception of the Sunbed treatment record card (Source: Courtesy of Ellisons) 12

13 Clients with a family history of skin cancer or who are having treatment for any type of cancer. Clients with an excessive number of moles or freckles, or with moles that have changed colour or are itchy/ bleeding. Clients with a history of sunburn, particularly during childhood. Recent treatment involving heat, or where the skin is reactive; for example, after waxing, electrolysis, use of the wet area or aromatherapy. Clients who have had an X-ray within the previous 3 months. Pregnancy the hormone fluctuation may cause a pigmentation reaction, and chloasma may develop under the influence of UV light. Clients under the age of 18. All of these contra-indications should be considered a barrier to treatment either because the condition will be aggravated by sunbed use or because the law states that treatment is not allowed, as in the case of a client under the age of 18. The following conditions may restrict treatment. It is important to carefully consider each individual case GP approval may be required before treatment can proceed. Diabetics sufferers are prone to thin skin which may not heal quickly. Recent sunburn as the skin is already damaged and healing. Recent heat treatments it is important to allow the skin time to recover. Recent laser and IPL treatments these are strong treatments and the skin needs adequate recovery time. Recent microdermabrasion or chemical peels again, recovery time is required. Clients who are on medication, such as steroids the skin is already reactive and may be sensitive. High or low blood pressure the client may be more likely to faint. Always seek medical approval if the client: is on medication, especially any drugs known to cause a photosensitive reaction; for example, antibiotics, tranquillisers, some diuretics, the contraceptive pill (for the same reason as for pregnant clients) or quinine (once the prime drug for the treatment of malaria) has high blood pressure or is taking medication for the condition. Precautions to take before treatment Do not advise clients to use cosmetic tanning equipment if their skin is particularly sensitive. Some people are more prone to skin damage caused by UV radiation than others. Advise clients not to use cosmetic tanning equipment if: they are under 18 they have fair, sensitive skin that burns easily or tans slowly or poorly they have a history of sunburn, especially in childhood they have a large number of freckles and/or red hair they are taking medication or using creams which may sensitise the skin to sun they have a medical condition that is worsened by sunlight they or anyone in their family have had a skin cancer. of developing skin cancer. The European recommendation is sunbed being used. If you, as the therapist, have any doubts about recommending UV treatment, ask the client to visit the doctor to confirm whether it is safe for them to use tanning Provide UV tanning services B21 13

14 Solarium Instructions Please read carefully before you commence B21 Provide UV tanning services Suntanning may be hazardous to your health. Follow this guide for maximum benefit and safety. If you do not tan in natural sunlight, you are unlikely to tan using this equipment and you could develop a red (sunburnt) skin rather than a brown tanned skin. The degree of tan you achieve will depend on your skin and will vary from person to person. The safety goggles provided must be worn throughout the tanning period. It is not sufficient to just close your eyes. Contact lenses should be removed. Treat parts of your body not normally exposed to sunlight with extra caution as these areas are more sensitive to suntanning. Before suntanning remove all cosmetics and perfume as these may cause the skin to be over-sensitive to suntanning. These preparations are difficult to remove completely by washing and ideally you should refrain from using them during your course of treatment. Under the ultraviolet rays of this equipment some drugs and medicines can increase the skin s sensitivity to suntanning. These include, but are not limited to: many antibiotics diuretics some high blood pressure medications some oral medications used to treat diabetes some tranquillisers some analgesics used to treat arthritis and rheumatism some birth control pills. If in doubt, consult your doctor. You should consult your doctor before using suntanning equipment if you: are pregnant suffer from blood pressure and circulatory problems get frequent cold sores have any complaint whatsoever which makes you unsure of suntanning equipment. Do not use suntanning equipment if under the influence of alcohol. The tan you achieve from this equipment will give you little, if any, protection against natural sunburn. Do not exceed the recommended exposure times and frequencies. Leave 48 hours between sessions. An example of written instructions for display in a solarium 14

15 Sunbed safety It is important that the client understands the guidelines for safe tanning. They should be very clear about what the treatment entails, its potential benefits and also the restrictions and possible effects. Risks include the following: Short-term damaging effects Long-term health risks and red and may blister or peel which looks coarse, leathery and wrinkles easily greater the risk Alternatives to tanning treatments You may find your client has a contra-indication present and cannot have the sunbed treatment. If you suspect there is an underlying medical reason which means the client cannot have a UV treatment, remember that you are not medically trained and cannot make reference to a specific condition even the very obvious skin infections. Do not cause undue worry or alarm to the client merely suggest that they seek medical advice and return with GP approval, if obtained. If the client is still not able to have a UV treatment, then you can suggest a self tanning treatment, explaining the benefits of using self tan and how professional the results look. Remember that clients will still have to undergo sensitivity tests before a self tanning treatment can be carried out to check for reactions to the products being used. There are also lots of other treatments that link into tanning, especially if the client is going on holiday or has a special occasion coming up. You can suggest waxing, manicures and pedicures, facials to rejuvenate the skin and body treatments such as exfoliation or wraps. Even eyebrow shaping and eyelash tinting have a great benefit and are easy to perform. All of these treatments will produce a good result and can boost the client s sense of wellbeing. For more information on recommending and linking treatments refer to Unit H32 Contribute to the planning and implementation of promotional activities on pages Client skin type and colouring Before you can fully plan the client s treatment, the duration of the treatment and the number of sessions, it is important to ascertain their skin type and reaction to UV light. To refresh your knowledge of the structure of the skin, the different skin characteristics and types and how melanin levels are determined by the genes, refer to You and the Skin on pages As well as categorising the skin by type dry, oily, combination, etc it can be further categorised by how it reacts to UV tanning, regardless of whether the source is natural sunlight or indoor tanning. This categorisation provides a very good indication of how well the skin will develop a tan and how long the treatment will need to be. You can use a UV skin type finder form to determine the client s UV skin type. All salons should have one and it is a very good way to check the client s natural tanning capabilities in order to assess their suitability for treatment. To find out the client s UV skin type, ask him or her to fill in this form. To understand the results, count the ticks in the columns. If the majority of ticks are in one column, this will indicate the colouring and how well the client tans see the skin type grouping table which follows for how to interpret this. The client s UV skin type will indicate how long the client needs to use the sunbed to ensure a safe and effective treatment. Fill in the skin type finder form to find out your own UV skin type. Provide UV tanning services B21 15

16 UV skin type finder Group/skin type What happens to the skin How to recognise it Safe time in the sun with no sunscreen (minutes) Burns very easily, no tan. Usually a blond-haired person with very pale skin, with red undertones. This can also apply to redheads with freckles who tend to have sensitive or dry skins. 2. Fair, slightly sensitive Burns easily, but will tan eventually. The melanocytes have to be activated by exposure to UVB. Light brown hair and pale skin, blue or green eyes and a tendency towards combination skin type. B21 Provide UV tanning services 3. Medium, normal skin Normal skin which tans easily but may burn at first. The melanocytes are active but melanin production has to be stepped up. Dark or mousey brown hair with darker eyes. 4. Dark, olive skin Tans very easily with no burning. The skin never looks particularly pale and the hair and eye colour tends to be dark. The skin tends to be slightly oily. The skin is already genetically highly pigmented but it will get darker with exposure. The skin is dark with dark eyes and hair colour. UV skin types 16

17 Skin type 1: approximately 2 per cent of all central Europeans Skin type 2: approximately 12 per cent of all central Europeans Skin type 3: approximately 78 per cent of all central Europeans and people in North America Skin type 4: approximately 8 per cent of all central Europeans and most people in South America Skin type 5: found in the indigenous populations of Africa, Australia and Asia Always remember that this is just a rough guide. Many native Europeans and North Americans have UV skin type 5. You must always treat your client as an individual and carry out a skin reaction test if you need more information about how their skin reacts to UV light. The safe times given in the UV skin type table are for the fi rst exposure of an unprotected skin, and are intended as a general guide. There will always be clients who do not fi t into these categories, either because of genetic influences or because the client has lived in a hot climate for a number of years and so gained a tan over a long period of time. only circumstances under which such people might receive a sunbed treatment are for light use therapy under the supervision of a dermatologist, or for the treatment depression, and is thought to be aggravated by lack of provided that positive effects have been obtained, exposure could be very gradual. For example, start with just one minute a day and increase by one minute per day to a maximum of Do have any allergies or have you ever suffered a reaction to a product, food intolerance, reaction to medicine or cosmetics? Are you on any medication? (Some medications are photosensitising substances.) The answers the client gives will be an indication of how well they tan after all they know their own skin better than you do! but remember that they may be exposing parts of their body not normally exposed to the sun. Bare buttocks and breasts will burn easily as they are not often exposed to sunlight, especially as the skin on the breast area is finer and pale. Perfume, aftershave or cologne Quinine found in some skin tonics or hair lotions Essential oils especially bergamot, lemon and some cedar bases Substances applied to the skin which may cause an adverse reaction when exposed to UV light Antihistamine creams Tar based products used in the treatment of psoriasis Skin ointments Provide UV tanning services B21 The following questions can help you to ascertain which UV skin type your client has. What happens to your skin if you tan in natural sunlight a) in this country and b) if you go abroad? How does your skin react a) immediately and b) when you have been in the sun for a few days? Do you normally use sunscreen products and what strength do you use? Deodorants and antiseptic creams with a salicylic base 17

18 B21 Provide UV tanning services Oral contraceptive pill oestrogen- or progesterone-based Epileptic prevention drugs such as hydantoin Anti-malaria tables chloroquine or quinine Substances taken orally which may cause an adverse reaction following exposure to UV light Antibiotics especially tetracyclines Drugs for treatment of vitiligo and psoriasis with a psoralen base Some synthetic sweeteners Antidepressants and psychotropic drugs such as nitrazepam or imipramine A B C D A B C D A = covered after 1 minute Sunburn and the effects of tanning do not present themselves immediately. It takes time to develop and there lies the danger. Sunburn is not instant, like a burn from a hot object would be it is broken down into four degrees of erythema. People who stay on the beach all day on the fi rst day of their holiday will not realise they have burnt their skin until the evening. If, after questioning, you and the client are unsure of how well an erythema and tan will develop, and what category the skin falls into, there is a simple skin reaction test that can be carried out. Using an A4-sized piece of black card, cut out four shapes (for example, square, triangle, circle, rectangle) about 2.5 cm wide in the centre of the card, in a horizontal line, with a small gap between them. Now cut four squares of black card large enough to cover up each of the shapes you have cut out. Place the squares over the holes and attach to the card with sticky tape, so that they form a flap. With the rest of the body covered over with towels, place the black card over the stomach. Lift up all the flaps, exposing the shapes, and switch on the UV sunbed. Time the treatment and at one-minute intervals ask the client to put down each flap, working left to right, so that, for example, the square is covered over after one minute, the triangle after two minutes, the circle after three minutes and the rectangle after four minutes. Make a note on the client record card of which shape corresponds with which time. Ask the client to note the development of erythema in each of the shapes after 24 hours. This should range from a lesser reaction in the shape which had one minute of exposure, to a darker erythema appearing after each minute is added. Any sign of irritation, inflammation or blistering will tell you that the client is not suitable for treatment. A B C D B = covered after 2 minutes irritation present. A B C D C = covered after 3 minutes 2nd 3rd sore to the touch, generates lots of heat and lasts for A B C D Carrying out a skin reaction test D = covered after 4 minutes 4th will probably lead to blistering and peeling. The four degrees of erythema 18

19 Preparing the skin for UV tanning treatments Before a UV tanning treatment can take place, it is important that the client prepares their skin. Advise clients to: Remove all make-up, lipstick and perfume with a nonperfumed product. Due to the risk of skin reaction from exposure of UV light (e.g. prickly heat), perfume and other oily-based products can cause uneven pigmentation to occur. Some cosmetics, deodorants and similar preparations for use on the skin can increase UV radiation. Remove all jewellery, watches and accessories they can block the light, leaving a white mark, and they may also get hot under the UV light. Take a shower to reduce the risk of cross-infection and the possibility of a reaction with products left on the skin. Remove contact lenses or spectacles the heat from the lamp may dry the eyes making lenses difficult to remove; the arms and frames of glasses can block the light and affect the tan. Cover recently coloured or bleached hair UV can react if any chemical is left on the hair. Also cover tinted hair and remove metal hair ornaments. Apply tan-accelerator products, if required, according to the manufacturer s instructions. Wear protective goggles at all times to prevent damage to the eyes. Wear swimwear or bikini bottoms depending on salon procedure. Tan accelerators Tan accelerators can enhance tanning on a UVA sunbed. They are collagen-based with added dihydroxyacetone (DHA), which stimulates melanin production and helps with the tanning. They also contain added moisturiser to protect and nourish the skin. Do not use oil or cream designed for sun tanning or any bergamot-based products as these are likely to cause irritation. Recommend that the client wears the same swimsuit or bikini bottoms for every treatment. This will ensure that the same skin is exposed each time and will help to ensure the tan is even, that no strap marks occur and that the client does not burn. Safe UV tanning It is the responsibility of the therapist to ensure the client understands the risks and dangers of sunbed treatments and the importance of keeping to the correct treatment times and UV dosage for their skin type. If you leave the client unattended, they may alter the timer to give themselves a longer treatment, unwittingly causing burning which may not be apparent for several hours. You need to eliminate or reduce the risk of this by giving the correct pre-treatment information, carrying out a thorough consultation, a patch test and giving the correct aftercare advice. Monitor UV tanning treatments Provide UV tanning services B21 In this section you will learn about: Equipment testing and functioning tests All sunbeds should be purchased from a reliable supplier and not purchased second hand unless from a reputable company. They should also be professionally installed and comply with the relevant British Standards for electrical supplies. Tanning accelerators 19

20 B21 Provide UV tanning services Just as with all electrical equipment, they should be regularly tested and a record of testing must be kept by a competent person. A record should also be kept of the use of tubes and when to replace them to avoid hot spots, manufacturers recommend replacing all tubes at the same time so that the client does not suffer burns from the newer, more efficient tube, while the surrounding ones are working less effectively. When cleaning the equipment at the start of the day, always switch it on to check that it is working correctly when the client is in the sunbed it may be too late to identify that there is a fault. Equipment safety The following measures should be taken to ensure that equipment is safe to use. The sudden collapse of any sunbed canopy or equipment can cause electric shock, fire or a physical injury to the client. Equipment should also have adequate mechanical strength to withstand a client falling against it. Lighting bulbs should be encased to protect the client so that the bulb cannot come into contact with the client s skin and is contained within the canopy if the lighting unit were to break. The canopy cover should have sufficient resilience so that it is not damaged by repeated UV exposure. If the canopy perspex is cracked or damaged, there is great potential for harm. Damaged equipment should be withdrawn from use immediately and repaired or replaced. Lighting units should be protected against coming into contact with a body s perspiration and a residual circuit breaker device (RCD) should always be incorporated into the equipment to shortcut the circuit should it malfunction. An accurate timer switch should be fitted to all sunbeds to terminate the UV radiation after a pre-set exposure time it should not be possible for this to be overridden by a client who wants five minutes more. Mechanisms should be designed to stop the equipment if the timer button fails to ensure client safety. European standards recommend no more than 60 tanning sessions in a year (per annum) so a client log should be kept on the record card to ensure that the client upholds this. If in doubt, refer to guidance given by the Sunbed Association or your local authority. An isolation switch must be fitted to isolate the equipment during maintenance. Any door to a cubicle or tanning booth should open outwards and be capable of being unlocked from the outside to allow access in the event of an emergency or evacuation. Tube replacement Tubes deteriorate gradually over their lifetime. The manufacturers generally state a useful life of between hours. For optimum performance, some manufacturers recommend that you replace tubes earlier than their stated lifespan if you suspect they are no longer tanning. New technology is developing all the time and some companies are stating that their bulbs will last up to 1500 hours with inbuilt safety factors. If the sunbed already uses, for example, a Philips tube, it is advisable to fit the same type of tube again, to avoid modifying the tanning programme. When changing from a different type of tube to Philips tubes (or from older types to up-to-date products), the wattage and ballast and above all the spectrum and UV output should be taken into account. Tube selection The following guidelines will provide a basis for tube selection: The same tube (type designation), or an equivalent type, should be used. Philips UV tubes have a standard geometry and base, making them easily interchangeable. To ensure compatibility with the unit s control gear, the electrical power of all the tubes must be identical. Do not mix different wattage tubes. If changing the tubes means that the equipment will fall into a different category (see type plate or operating instructions), it will have to be re-measured and classified. The tanning programme will then have to be modified. If changing over to a tube type whose tanning data differs by more than 20 per cent from that of the original tube type, the tube UV characteristics in the sunbed will have to be re-measured and the tanning programme modified (a new IEC classification may be needed). Changing from normal UV tubes without an integrated reflector (a UVA tube) to integrated-reflector tubes (an RUVA tube) is possible only to a limited extent on the base of a double bed. It is not usually a good idea the cooling must be geared to the total irradiance (if in doubt, consult the equipment manufacturer), but is usually possible without any restriction in the case of overhead canopies or stands. 20