Patients arriving for surgery must completely remove all cosmetics, jewelry, and many personal care products. This preparation is a fundamental safety measure designed to ensure the surgical team can accurately monitor the patient and maintain a sterile environment. This rule directly relates to patient safety during anesthesia and the operation. The following explains the specific reasons behind this mandate and how patients should prepare their skin.
Why Cosmetics Must Be Removed
The primary concern regarding facial makeup is the ability of the anesthesia team to accurately assess a patient’s physiological status during the procedure. Skin color, especially around the lips and nail beds, provides a rapid, visible indicator of circulation and oxygen saturation. Makeup, such as foundation or tinted moisturizer, can mask subtle changes in the skin’s natural color, potentially delaying the recognition of complications like poor tissue perfusion or low blood oxygen.
Lipstick and lip gloss are problematic because the color of the lips is a direct visual cue for monitoring blood oxygen levels; a bluish tint, known as cyanosis, signals a significant issue. Facial products can also interfere with the placement and adhesion of monitoring equipment, such as electrocardiogram (ECG) pads or surgical tape. Clean skin is a prerequisite for the antiseptic solutions applied near the incision site, reducing the risk of a post-operative infection.
Specific Items That Interfere with Monitoring
Products applied to the extremities, particularly the fingers, pose an interference risk with standard monitoring devices. The pulse oximeter, which is typically clipped onto a fingertip, measures blood oxygen saturation. Nail polish and artificial nails, including acrylics, gels, and dips, can absorb or scatter the light used by the oximeter, leading to inaccurate or falsely low readings.
Darker colors, such as blue, green, black, and brown, cause the most significant interference, sometimes leading to an underestimation of oxygen saturation by several percentage points. Facilities often require all polish and artificial enhancements to be removed to ensure reliable access to monitoring sites. Other accessories, like wigs or hairpieces, must also be removed, as they can interfere with the sterile field or the proper application of electrocautery grounding pads.
Preparing Your Skin for Surgery
For most procedures, the skin preparation process involves a specialized cleansing routine performed by the patient before arriving at the hospital. Patients are instructed to shower the night before and the morning of surgery using an antiseptic wash, such as a chlorhexidine gluconate (CHG) solution. This special cleansing significantly reduces the normal bacterial count on the skin to minimize the risk of a surgical site infection.
After the final pre-operative wash, patients should avoid applying any products to the skin, including creams, lotions, or perfumes, as these can leave a residue that interferes with the surgical preparation or the adhesion of monitoring electrodes. Permanent makeup, such as tattooed eyeliner or microbladed eyebrows, is generally left in place, though patients should inform their care team. A light application of plain deodorant is sometimes permitted, but this should be confirmed with the surgical team.