“It is such a simple thing to do, but why do so many salons not understand the importance of patch testing, or bother to do it on their clients?” – so says this blog’s guest author, Marie Louise Coster.

There are so many reasons why thorough patch testing is essential in every salon. The risks involved with not giving one can be serious – allergic reactions can be catastrophic for your clients, while financially they can leave you with heavy legal bills, fines and settlements.

So, what exactly do you need to know about patch testing? What is it, how is it carried out and what are the reasons behind it?

Allergic Reactions to Hair Colour & Covid-19

The Coronavirus outbreak of 2020 has caused countless disruptions to not just the salon industry, but the lives of people across the world.

One observation that has emerged from salon owners however, is an increase in allergic reactions among those who had previously tested positive for Covid-19.

While there has been no official research into the effects the disease may have on the immune system longterm, or the effect this may have on the development of allergies – it does highlight one undeniable point. Regular patch testing for every hair colour client is vital.

Allergies can develop suddenly, even where there has been no reaction previously. For this reason, Casey Coleman of Chair Salons delayed his post-lockdown reopening to invite all clients to get a new patch test. Meanwhile, hairdresser Charlotte Barker from London shared the below video when one of her clients experienced an extreme reaction to her dye after falling ill with the virus, despite being within the 6 months of her last patch test…

It has always been important for patch tests to be carried out every 6 months or whenever a new product is introduced. However, with many of us now potentially having weakened immune systems, keeping on top of your patch tests is more essential than ever.

The Importance of Patch Testing Post-Lockdown

With the end of the third national lockdown creeping closer, it’s important that you start thinking about how patch testing is included in your re-opening plan.

You will need to be extra vigilant when clients request hair colour services. But, vigilance shouldn’t be confined to hair treatments. Even when a client is requesting eyebrow or eyelash tinting, you and your staff should be extra aware of potential allergic reactions.

Just because your salon or barbershop has been closed for a while, doesn’t mean your staff should let their guard down. The usual rules still apply. 

When a client books a hair colour service, make sure that you:

  • Check that the client is over 16 years of age. Your staff should also be aware of the allergy alert testing procedures for over-16s.
  • New clients must have an allergy alert test at least 48 hours before their appointment.
  • Returning clients will need an allergy alert test if they have; not had a test for six months, they’ve had a tattoo or black henna tattoo, or you have changed your colour brand or product in salon (this also applies if your client has been using home colour which contains PPD or similar during lockdown).

You should be particularly cautious following the lockdown as it may have been a considerable amount of time since the last service. Your client may have used a home colouring product or treatment – and they may forget to tell you, so ask them! You must keep a written record of every test for at least six years. Each written record must be signed by the client.

A note on black henna tattoos

It’s very important that you ask your client if they’ve had a black henna tattoo since their last allergy alert test. This is because black henna often contains illegally high levels of the chemical PPD (paraphenylenediamine). Clients who have had black henna tattoos can subsequently become very sensitive to PPD in hair colour – even if its a hair colour they’ve had many times before. The NHS has issued warnings about black henna tattoos. One woman died from a serious anaphylactic reaction when colouring her hair after having a black henna tattoo five years earlier.

Carry out a post-lockdown consultation

An important part of welcoming your clients back to your salon should be a post-lockdown consultation. You should do this even if your client has had an allergy alert test within the past six months.

Under-16s and hair colour

It’s important that you do not apply hair colour or highlights that contain PPD (or similar ingredients) to anyone under the age of 16. You also shouldn’t carry out an allergy alert test on anyone under the age of 16. Your insurance will not be valid if you apply hair colour (that contains PPD) to an under-16.

You must keep a written record of every consultation for at least six years. Each written record must be signed by the client.

Can I carry out allergy alert tests before the official re-opening date?

No. It may be tempting to get a head start and do allergy tests before the re-opening date, but you should not. You must wait until the Government has given the official go-ahead for salons and barber shops to re-open.

What happens if my client has a reaction?

As we mentioned at the start of this article, there have been observations that people who have had Covid are more likely to suffer a reaction (even if they were fine in the past). So, you need to be aware of this when you conduct a post-lockdown consultation with your client. Ask them if they have previously tested positive for Covid.

If the worst does happen and your client suffers a reaction during a treatment (which can happen even if their allergy alert test proved negative), rinse their hair immediately. If your client becomes dizzy, faints or finds it difficult to breathe, seek medical assistance straight away.

Want to know more about patch testing? 

Our guide from Marie-Louise Coster has everything you need to know…

Is Patch Testing Worth It?

Patch testing can be seen as an inconvenience. Maybe a client is pushing to have their hair coloured the next day, or doesn’t see the point in making the journey to your salon just for a 2 minute task.

However, it is always worth insisting on patch testing when you consider the potential consequences.

Lash Tint Allergic Reaction…

These pictures were provided to me by a client of mine who reacted to an eyelash tint. Believe it or not, this occurred whilst she was a student at a local college. Although she had reacted to the patch test, her lecturer said she could have it done anyway and they would just use the tint and not the peroxide… What are people learning at college these days? And who on earth is teaching them?

The reaction was so bad and her eyes were so swollen that she could not open them for several weeks, and doctors advised her she may never see again. This is obviously a very serious reaction to the chemicals used, though the reactions can be even worse – some severe cases of allergic reactions to salon products have resulted in death.

Thankfully the client above is fine now, but you must agree that seeing these pictures makes you realise (if evidence was needed) that a patch test that takes just a few minutes is essential.

How Patch Testing Works

When we are at college we are taught to patch test a client with the mixed tint and peroxide, prepared just as if it were a treatment, by applying the mixture to either the crook of the elbow or behind the ear 48 hours before.

If the client has a positive reaction this area will become red, itchy and irritated. If there is a negative reaction nothing will happen and it is safe for the treatment to take place. It is not good enough that the client has had the treatment previously elsewhere – they MUST have a patch test with you as your product may be produced by a different manufacturer. It is also important to repeat your patch test regularly, as repeated exposure to a product can eventually develop into an allergy.

You should record all instances a patch test has been given to a client – ask them to sign to show they have agreed to the patch test, and keep it on file.

It’s not just hair dye that requires a patch test, though. Patch tests are also needed for treatments such as lash lifts, lash and brow tints, lash perming,  perming or even hair removal wax. Always check the advice given by the manufacturer to see if a patch test is required first. If you aren’t sure, carry one out anyway.

Health vlogger shares her story of a severe allergic reaction to henna…

Vegan and fitness blogger Chemese Armstrong from Texas shared her experience of having a severe allergic reaction to henna dye. While Chemese was under the imporession her ‘all natural and chemical free’ dye would be perfectly safe, it actually included PPD within the ingredients. After a few hours, her scalp began itching and burning, while over the course of the next day her face began to swell so much her eyes couldn’t open, leading to a rush to the doctors. Despite a shot of adrenaline to ease the pain, the swelling worsened and resulted in a trip to the emergency room.

Thankfully, Chemese’s condition began to improve, though even after a few weeks, her skin was still dry and peeling.

https://www.instagram.com/chemese/

What Does Patch Testing Test For?

Patch testing is the safest way to test whether your client is prone to a skin reaction called ‘contact dermatitis’. This is a type of skin sensitivity that can be triggered when the skin comes into direct contact with certain ingredients. It often results in itching, dryness and irritation that can also cause swelling.

One of the most common causes of contact dermatitis is a chemical called paraphenylenediamine (PPD). This is present in many hair dyes. Allergies to PPD can occur even when the client has had no previous reaction to it before as they can develop over time. A severe allergic reaction to PPD can also result in allergies to other substances that have never been present before.

However, it’s not just dyes containing PPD that you need to patch test for. Some beauticians and stylists assume products labelled as ‘natural’ or ‘organic’ don’t require a patch test. This is incorrect – every dye, tint or chemical that will come into contact with the skin needs to be patch tested first.

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How Often Should You Repeat the Patch Test?

HABIA suggest repeating the patch test prior to every tinting treatment, other governing bodies suggest every 6 months. Personally, I patch test all of my clients every time they visit me (once a month), whether they currently have tinting treatments or not because at least if they ever want to have a tint we know whether they are allergic or not. This is a simple and effective procedure that works for me.

When a new client calls for the first time requesting a tint, I insist they have a patch test 48 hours before the treatment. I also have this printed on all of my price lists and also on my website so as there can be no confusion and all clients are aware. In the event that a client questions my method of insisting upon a patch test and is not keen on visiting the salon for the test (usually because they have never been made to have a patch test before), I just politely explain it is for their safety and comfort. In the end they will appreciate it and respect the thorough procedures of the salon and its high standards. If you are mobile, fit the patch test in at a time that you are in the area, and also a time that is convenient to the client, or if you have a receptionist you could teach them how to carry out the patch test making it more convenient for the client as she can pop in anytime.

If you are worried that you will lose clients (as is an excuse I have heard a couple of times) by insisting upon a patch test, all I can say is I would rather take such precautions and have the peace of mind that my business will not have a poor reputation, than take the risk and stand the chance of losing my business and my reputation overnight all because I didn’t carry out a 2 minute patch test.

A woman in Paris reveals how her head almost doubled in size after hair dye allergy…

Nineteen year old Estelle from Paris shared her horrifying experience of a severe allergic reaction to PPD in her home hair dye kit. While she did carry out a patch test, she only waited 30 minutes, rather than the recommended 48 hours. Almost immediately, Estelle’s scalp started to itch. After taking antihistamines under medical advice, she woke the next morning to an extremely swollen head and tongue along with difficulty breathing.

Luckily, Estelle made a full recovery after being rushed to hospital. However, wants to share her story to warn others of the dangers of PPD and ignoring patch testing guidance.

 

Why is Patch Testing Important?

Besides the client’s safety, comfort and well being, patch testing is an insurance requirement and is important for the good name and reputation of your business. If you have a client who does react to a tinting treatment without a patch test having taken place, some insurance companies will class your insurance as invalid and refuse to cover you or pay out for any claims made against you.

This will also make it difficult for you to obtain future insurance cover and will also give you a very poor reputation – after all, clients are much more vocal about the poor treatment and services they have received than they are the good experiences and a reaction to a tinting treatment is a sure fire way of ruining your reputation.

Other insurance companies may pay out due to your negligence, as it will be impossible for them to defend your actions – as you know you should have carried out the patch test. In the case that the insurance company covers you for negligence and settles the claim against you, there is sure to be an increase in your insurance premium.

It is also important to point out that getting a client to sign a disclaimer will also not provide you with any comeback. I am advised by a solicitor that such a thing will not stand up in court (ultimately you know you should not be doing it and you are the professional). Should something go wrong a client can claim that they were not made entirely aware of what was going on and the implications of not having a patch test.

It isn’t just lash and brow tint that should be patch tested prior to treatment, it is also essential to patch test adhesives for eyelash extensions and false lashes and to also patch test any products used in a required treatment on clients who are sensitive or reactive.

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Is Patch Testing a Legal Requirement?

If you are still questioning whether you really need to carry out patch tests on your clients – or are still struggling to convince clients that they do need them – then you should know it is actually covered by legal regulations.

The Healthy and Safety at Work Act covers a lot of the activities in your salon. While patch testing isn’t specified by name, Section 3 states that the employer is responsible to ‘ensure, as far is reasonably practicable, that persons other than themselves or their employees are not exposed to risks to their health or safety’.

This means that it is your legal obligation to ensure you take every necessary step to keep your clients safe from harm.

If you either deliberately or negligently fail to complete a patch test, or carry out a treatment after a patch test reveals a positive reaction, you have failed to protect your client when you should have known a risk was present. You are legally liable for any damage that might result from it – this could result in a fine or even prosecution.

– by Marie-Louise Coster

You can find more salon advice on the Salons Direct blog…

The Importance of Client Consultation | The Importance of Hygiene in a Salon | How to Deal With Difficult Clients