In hospitals and other healthcare facilities, harmful pathogens are most often transmitted to patients via the contaminated hands of healthcare workers, so it’s a logical assumption that the same would be true in other professions that involve close physical contact and bloodborne pathogens, like tattooing and piercing.
The Institute for Health Care Improvement reports that hand hygiene — which includes hand-washing with soap and water or use of alcohol-based, waterless hand sanitizers — has long been considered one of the most important measures for preventing infections in health care environments. The Centers for Disease Control and Prevention (CDC) provides Guidelines for Hand Hygiene in Health Care Settings, which include tattoo and piercing shops. As a tattoo or piercing artist or shop owner, it’s important to familiarize yourself with the CDC’s hand hygiene guidelines and make sure you practice them to the letter to minimize the spread of infectious diseases and protect your clients, your employees, and yourself, physically and legally.
A Brief History of Hand Washing
In our modern society, we tend to take good hand hygiene for granted. We’ve been told our whole lives to wash our hands before meals and after going to the bathroom. We see signs in health care facilities, restaurants, and even gas station bathrooms reminding employees to wash their hands properly before returning to work, but the value of proper hand hygiene was a fairly recent scientific discovery.
According to the CDC, the idea of washing one’s hands with an antiseptic agent most likely emerged in the early 19th century. It was around that time that a “French pharmacist demonstrated that solutions containing chlorides of lime or soda could eradicate the foul odors associated with human corpses and that such solutions could be used as disinfectants and antiseptics.” Even still, it took many more years for physicians to recognize that by not washing their hands with antiseptics, especially after handling cadavers, they were spreading puerperal fever among their patients. Even after making the connection, however, there was no systematic effort to ensure proper hand hygiene in hospitals.
In 1961, the U.S. Public Health Service made a training film for healthcare workers recommending that they wash their hands with soap and water for 1-2 minutes before and after coming into physical contact with patients. The need for an antiseptic agent like alcohol was deemed less important than hand-washing with plain soap and water; it was only recommended in emergencies or when sinks were unavailable.
The CDC first published hand-washing guidelines for healthcare professionals in 1975. Up until the mid-1980s, those guidelines recommended using “non-antimicrobial soap between the majority of patient contacts and washing with antimicrobial soap before and after performing invasive procedures or caring for patients at high risk.” They also only recommended using waterless, alcohol-based solutions to cleanse the hands when sinks were unavailable.
It wasn’t until 1995 that the Association for Professionals in Infection Control (APIC) published hand-washing guidelines that also supported the use of alcohol-based hand sanitizers in most clinical settings. Around that time, the Healthcare Infection Control Practices Advisory Committee (HICPAC) “recommended that either antimicrobial soap or a waterless antiseptic agent be used for cleaning hands upon leaving the rooms of patients with multidrug-resistant pathogens,” as well as during routine patient care. Their guidelines have since been adopted by the majority of U.S. hospitals. In 2002 a Hand Hygiene Task Force composed of members of APIC, HICPAC, the Society for Healthcare Epidemiology of America (SHEA), and the Infectious Diseases Society of America (IDSA) was established to re-evaluate hand hygiene practices in health care facilities.
With the emergence of COVID-19, it has become even more important to understand and follow the CDC’s hand hygiene and health care cleanliness guidelines. Keep reading for even more detailed information about handwashing, glove fitting, and the use of antiseptics and disinfectants.
Everything You Need to Know About Bacteria on Hands
Human skin is literally covered with bacteria. On average, however, bacterial counts on the hands are higher than on any other part of the body, which makes sense considering that we use our hands to do everything from feeding ourselves to cleaning up after going to the bathroom and a million other things in between.
There are two general types of bacteria that tattoo and piercing artists need to concern themselves with: transient flora and resident flora. Transient flora takes root in the superficial layers of the skin and can be picked up by touching clients or contaminated surfaces. Transient flora can usually be eradicated with routine hand-washing. Resident flora, on the other hand, attaches to deeper layers of the skin and is harder to remove. They’re more likely to cause staph infections and other more serious health issues compared to the infections that transient flora are most likely to cause.
Since bacteria are found all over our bodies, even touching a client’s head or back carries some risk of bacterial transmission to your hands. The types of bacteria common in such areas may not be as severe as what you could pick up from touching an open wound or a client’s hands, but there’s still a chance of bacterial contamination. If you don’t properly cleanse your hands before a body modification procedure and wear sterile gloves throughout, you could then transfer that harmful bacteria to another client or be negatively impacted by it yourself. You also shouldn’t assume that washing your hands with plain soap and water will rid you of all bacteria you’ll come in contact with during the body modification process. That’s why the CDC includes the use of alcohol-based hand sanitizers in its detailed hand hygiene guidelines, which all health care workers and body modification artists should follow.
Glove Size Chart
Aside from washing hands with soap and water and using alcohol-based hand sanitizers as needed, wearing sterile, single-use glo
ves is the best way to help prevent the transmission of harmful bacteria during tattooing and piercing. Every tattoo and piercing sh
op should have a large supply of disp
osable nitrile or latex gloves at all times. Like any other piece of personal protective equipment, you should make sure that your gloves are sized appropriately to ensure they protect you and those around you properly.
To find your glove size, wrap a tape measure completely around your hand as shown in the chart below, making sure that it is
positioned over each of your knuckles. You can use the circumference of your hand (in inches) to determine which size of gloves is correct for you. If you don’t have a flexible tape measure, you can use a length of string and a ruler to obtain the measurement instead.
CDC Hand Washing Guidelines
Proper hand hygiene is one of the most significant ways to prevent the spread of infectious diseases. The CDC recommends performing proper hand hygiene at these intervals:
- before physical contact with a client
- before invasive procedures like tattooing, piercing, inserting implants like dermal anchors, and performing scarification
- after contact with blood, bodily fluids, or contaminated surfaces, even if you’ve been wearing gloves
- after removing gloves, since wearing gloves alone isn’t enough to stop the transmission of pathogens in a tattoo & piercing shop.
Proper hand hygiene involves washing your hands and applying alcohol-based hand sanitizers in specific ways. The CDC offers downloadable How to Wash Your Hands and How to Hand Rub posters that you can post above hand-washing sinks and hand sanitizer stations in your tattoo and piercing studio. We’ve summarized these instructions below for your convenience.
In addition to their free downloadable posters, the CDC offers an interactive online course for hand hygiene that you and your employees can take to ensure that everyone in your tattoo and piercing shop engages in proper hand hygiene protocols.
How to Wash Your Hands Properly
- Wet your hands with water. Leave the water running until you get to step #11.
- Apply enough soap to cover all surfaces of your hands.
- Rub your hands palm-to-palm in a circular motion.
- Rub your right palm over the back of your left hand, interlacing your fingers as you rub up and down, and then repeat with your left palm over the back of your right hand.
- Rub your hands together palm-to-palm with your fingers interlaced, in an up-and-down motion.
- Interlock your fingertips while one palm is up and the other is down, and rub in an up-and-down motion that massages soap thoroughly into your fingertips.
- Grasp your left thumb with your right hand, rub in a rotational manner, and then do the same to your right thumb/web area.
- Clasp the fingers of your right hand together, use them to scrub your left palm in a circular pattern, and then repeat using your left fingers to scrub your right palm.
- Rinse your hands thoroughly with warm water.
- Dry your hands thoroughly with a single-use paper towel.
- Use the paper towel to turn off the faucet, so your clean hands don’t come in contact with the knobs and then throw away the paper towel.
- From start to finish, the whole process should take between 40 and 60 seconds. At that point, your hands will be safe.
How to Use Hand Sanitizer Properly
- Apply a palm-full of hand sanitizer in a cupped hand (enough to cover all surfaces of your hands).
- Rub your hands together palm-to-palm.
- Rub your right palm over the back of your left hand, interlacing your fingers as you rub up and down, and then repeat with your left palm over the back of your right hand.
- Rub your hands together palm-to-palm with your fingers interlaced, in an up-and-down motion.
- Interlock your fingers while one palm is up and the other is down, and rub in an up-and-down motion that massages the hand sanitizer thoroughly into your fingertips.
- Grasp your left thumb with your right hand, rub in a rotational manner, and then do the same to your right thumb/web area.
- Clasp the fingers of your right hand together, use them to scrub your left palm in a circular pattern, and then repeat using your left fingers to scrub your right palm.
- Once your hands are dry, which takes about 20-30 seconds of rubbing in hand sanitizer, your hands will be safe.
Soap & Hand Sanitizer Effectiveness
There are many different hand hygiene products to choose from, and not all of them are appropriate for use in tattooing and piercing. Whenever your hands are visibly dirty or have come into contact with blood or any other bodily fluid, you should wash them thoroughly with soap and water. When searching for the right soap, you will find both plain soaps and antibacterial/antimicrobial soaps. Washing your hands with plain soap will remove most transient flora bacteria, but because plain soap has little antimicrobial/antibacterial effect, it will not remove many pathogens and resident flora bacteria, which are more dangerous. That means you and your employees should use antibacterial hand soap to wash your hands at the intervals recommended by the CDC above. It’s also ideal to use hands-free soap dispensers, which carry a lower risk of cross-contamination compared to pump bottles, squeeze bottles, and bars of soap.
When your hands aren’t visibly soiled, sterilization with an alcohol-based hand sanitizer is sufficient. Hand sanitizers containing between 60% and 95% alcohol are most effective. Although alcohol-based hand sanitizers may contain isopropanol, ethanol, n-propanol, or a combination of these ingredients, the CDC only considers products containing isopropanol or ethanol to be appropriate for use in health care and body modification procedures. They’re known to effectively reduce bacterial counts on the hands and to slow the re-growth of bacteria. Hand sanitizers that also contain chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan are better equipped to fight residual bacteria that may linger after cleaning your hands with an alcohol-based hand sanitizer.
Remember: If your hands are visibly dirty or have come into contact with blood or other bodily fluids, alcohol-based hand sterilizers won’t be powerful enough to remove all possible bacteria. In those cases, you’ll need to wash your hands properly with an antibacterial soap. If you want to be extra thorough, you can apply hand sanitizer after proper hand-washing.
Hand Cleansers and Antiseptic from PainfulPleasures
You’ll find all of the professional-grade hand cleansers, hand sanitizers, and antiseptics you need for your tattoo or piercing shop in the Skin Prep & Skin Cleansers section of our online store. From antimicrobial soaps to alcohol-based hand sanitizers and skin prep wipes, we carry supplies to keep you and your customers safe at some of the best prices you’ll find online. Additionally, we carry antiseptic ointments and other tattoo skincare supplies, surface disinfectants, disinfectant wipes, and other sterilization and clean room supplies to help you keep your workspace as safe as possible.
The Bottom Line
The risks of bacterial contamination and infection are real, which is why all piercing and tattoo professionals must understand how to work safely. That includes knowing and practicing the CDC’s recommended handwashing and hand hygiene procedures, as well as how to clean and disinfect your workspace after each and every procedure. Together, we can make sure that body modification is safe for artists and clients alike.
