It is standard hospital policy to require patients to remove all cosmetics, including makeup and nail polish, before undergoing any surgical procedure. This rule is a strict safety protocol designed to protect the patient during a vulnerable time, not a matter of aesthetics or arbitrary preference. The presence of these products can interfere with monitoring the patient’s physiological status, compromise the sterile field, and introduce a risk of serious burns from surgical equipment. These measures ensure the medical staff can react swiftly to any complication.
Interference with Patient Monitoring
Cosmetic products, such as foundation, blush, and lipstick, can obscure visual cues that anesthesiologists and surgical staff rely on to assess a patient’s well-being. Changes in skin color are early and important indicators of problems like blood loss, poor circulation, or low blood oxygen levels. For instance, paleness or a bluish tint, known as cyanosis, can signal oxygen deprivation, but face makeup can easily hide these subtle but significant changes in the patient’s natural skin tone.
Staff also need to visually examine the capillary refill time, often performed by pressing on a fingernail or the skin and observing how quickly the color returns. Nail polish prevents this quick assessment of blood flow to the extremities, which helps gauge the effectiveness of circulation. Furthermore, nail polish, particularly darker shades, can interfere directly with the pulse oximeter. This device clips onto a finger and uses light to measure the oxygen saturation in the blood, potentially leading to inaccurate readings.
Compromising Sterility and Surgical Prep
Makeup introduces foreign particles and harbors bacteria, which can directly compromise the sterile environment required for surgery. Even a light application of products can increase the microbial load on the skin’s surface. The primary concern is that this contamination increases the patient’s risk of developing a surgical site infection (SSI).
Cosmetics also create a barrier that interferes with the essential process of surgical skin preparation. Before an incision is made, the area must be cleaned with antiseptic solutions like chlorhexidine gluconate (CHG) or povidone-iodine. Makeup and other topical products can prevent the antiseptic solution from properly penetrating and cleaning the skin, making the disinfection less effective. This failure to achieve optimal skin sterilization can allow a patient’s own skin flora, or bacteria introduced by the products, to enter the wound during the procedure.
The Danger of Metallic Pigments and Electrocautery
A specific and severe safety risk stems from the metallic components found in many cosmetic products, particularly in shimmering eye shadows, eyeliners, and some lip products. These products often contain inorganic metal pigments such as iron oxides, which are used to achieve color or shimmer. During most surgeries, the staff uses electrocautery devices to cut tissue and seal blood vessels with heat generated by an electrical current.
The metallic pigments on the patient’s skin can act as conductors for this electrical current. If the electrocautery device is used near an area with makeup, the current can be channeled through the metallic particles. This channeling leads to a risk of sparking or causing serious burns to the patient’s skin. This hazard is especially pronounced for procedures near the face or eyes where metallic cosmetics are often applied.