Wearing makeup, including foundation, mascara, and lipstick, is strictly prohibited for patients undergoing surgery. This non-negotiable medical protocol ensures the surgical team can accurately monitor the patient and maintain a sterile environment. Being completely makeup-free addresses multiple risks that could complicate anesthesia, increase the chance of infection, or lead to equipment malfunction.
Obscuring Visual Monitoring of Vital Signs
Anesthesia teams rely on visual cues from the patient’s face, lips, and nail beds to quickly assess oxygenation and circulation. Foundation, concealer, and colored lip products mask subtle but significant changes in skin color that signal distress. A bluish tint, known as cyanosis, indicates low oxygen saturation, while excessive pallor suggests poor blood flow or anemia, both requiring immediate intervention.
Hiding these natural color changes can delay the recognition of a serious problem. Nail polish is also prohibited because it interferes with the pulse oximeter, the device clipped onto a finger to measure blood oxygen levels. The light-emitting sensor must pass through the nail bed to take an accurate reading. Pigments in dark, gel, or acrylic polishes can distort the results, leading to inaccurate data. Removing all cosmetic coverage provides the medical team with an unobstructed view of the patient’s perfusion status.
Infection Control and Contamination Risks
Makeup products, particularly those used around the eyes and face, pose a significant risk for introducing bacteria into the sterile surgical environment. Mascara, eyeliner, and foundation applicators are often contaminated with bacteria such as Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa from frequent use. These microbes can be transferred to the surgical site, increasing the risk of a Surgical Site Infection.
The presence of makeup compromises the effectiveness of the preoperative skin preparation process. Before an incision is made, the skin is thoroughly cleaned with antiseptic solutions like chlorhexidine gluconate to reduce the microbial load. Makeup acts as a barrier, preventing the antiseptic agent from effectively penetrating the skin’s surface. Under general anesthesia, patients do not blink, and tiny particles from eye makeup, such as glitter or mascara flakes, can shed into the eye. This particulate matter can cause irritation or corneal abrasions, potentially leading to a secondary eye infection.
Electrical Safety and Equipment Interference
Certain components in cosmetic products can interfere with the specialized heat and electricity-generating equipment used in the operating room. Surgical tools like electrocautery devices and lasers cut tissue and seal blood vessels, creating an electrical current or intense heat. Some makeup products, particularly metallic eyeshadows, shimmers, and glitters, contain trace amounts of inorganic metal pigments like iron oxides or mica.
These metallic particles can conduct electricity or heat up rapidly when exposed to the energy fields created by electrosurgery. While the risk is low, this interaction presents a potential hazard for localized skin burns, especially during head and neck procedures. Makeup products also contain oils, waxes, and alcohol that can serve as fuel sources. This increases the risk of a surgical fire in the oxygen-rich environment if an ignition source is present.