Cosmetics must be restricted before surgery for patient safety and accurate medical assessment. Even “light makeup,” including minimal foundation, clear nail polish, or mascara, must be removed before entering the operating room. These products interfere with the medical team’s ability to monitor your physiological response to anesthesia and surgery. Requiring a bare face and bare nails ensures the medical team has unobstructed access for continuous monitoring and preparation.
How Cosmetics Interfere with Electronic Monitoring
Cosmetic products can directly compromise the accuracy of the electronic equipment used to monitor a patient’s well-being during a procedure. The pulse oximeter, which clips onto a fingertip to measure blood oxygen saturation (SpO2), is particularly sensitive to interference. This device works by shining light through the tissue and measuring absorption by hemoglobin.
Nail polish, especially dark shades, absorbs these light wavelengths, resulting in falsely low or inaccurate SpO2 readings. Gel manicures and acrylics pose similar issues, sometimes preventing the machine from getting a reading entirely. Inaccurate vital signs delay the detection of dangerously low blood oxygen levels, which the anesthesia team must spot immediately.
Makeup containing oils, creams, or powders can interfere with the adherence and function of monitoring electrodes. Electrocardiogram (EKG) electrodes track heart rhythm and electrical activity from the chest. Oils in foundation or lotions create a physical barrier between the electrode’s conductive gel and the skin, impeding the electrical signal. This compromised adherence can lead to a distorted or unreadable EKG tracing, making effective heart monitoring difficult.
Infection Risk and Maintaining a Sterile Field
The presence of cosmetics creates a significant risk for bacterial contamination and impedes necessary pre-operative skin preparation. Many cosmetic products, such as foundation, mascara, and lip gloss, can harbor bacteria, which increases the risk of a surgical site infection (SSI) once the skin barrier is breached. Introducing this bacterial load into the sterile operating environment is a serious concern for patient safety.
Before incision, the surgical site must be thoroughly cleansed with a powerful antiseptic solution, such as Chlorhexidine Gluconate (CHG) or an iodine-based product. Makeup, lotions, and creams act as physical barriers, preventing the antiseptic agent from reaching the skin’s surface to effectively kill microorganisms. The goal is to drastically reduce skin bacteria, and cosmetic residue undermines this process.
Common Cosmetic Items That Interfere with Care
Specific cosmetic items interfere with the medical team’s ability to visually assess a patient’s physiological status. Foundation and concealer must be fully removed because they mask the natural color of the skin, which indicates circulation and oxygenation. Changes in skin pallor can be one of the first visible signs of blood loss or shock. The anesthesia provider needs an unobstructed view of the patient’s face to look for these changes.
Lipstick and lip gloss must also be removed to allow for the visual assessment of the mucous membranes. The color of the lips can quickly indicate a lack of oxygen in the blood, known as cyanosis, which appears as a bluish tint. Lip products can also flake or transfer, potentially contaminating airway equipment during intubation or extubation procedures.
Eye makeup, including mascara and eyeliner, must be removed to prevent particles from flaking into the eyes during the procedure. Under general anesthesia, the protective blink reflex is lost, and stray particles can cause corneal abrasions or irritation. False eyelashes, which are secured with strong adhesive, must also be taken off, as they can interfere with the necessary placement of protective eye tape or eye shields by the medical team.