Sanitation, Disinfection, and Sterilization

Three Levels of Decontamination

TDLR's 16 Texas Administrative Code (TAC) Chapter 83 governs sanitation. The exam tests the three levels in strict order from weakest to strongest.

• Cleaning (sanitizing in lay terms): washing with soap/detergent and water to remove all visible debris and residue. Cleansing is NOT disinfection — it is only the first step.
• Disinfection: using chemicals to destroy pathogens on hard, non-porous surfaces, making an item safe to handle and reuse. It does not kill bacterial spores.
• Sterilization: destroying all microorganisms, including spores, using an autoclave (steam under pressure) or a dry-heat sterilizer.

TDLR also defines Sanitize narrowly as reducing microorganisms with a UV (ultraviolet) sanitizer — which is approved only as a clean, dry storage container, not a substitute for disinfection.

What Counts as a TDLR Disinfectant

Under 16 TAC 83.100(4), an approved disinfectant is one of two things:

1. An EPA-registered bactericidal, fungicidal, AND virucidal disinfectant used per the manufacturer's instructions; or
2. A chlorine bleach solution used per the chapter.

Know the bleach math — it shows up almost every exam:

Bleach must be mixed fresh daily, kept in a closed, covered container away from sunlight, and not stored near other chemicals or flame.

The Clean-Disinfect-Store Workflow

The correct three-step sequence for multi-use implements:

1. Clean — scrub off all visible debris with soap and water. Disinfectants are inactivated by debris, hair, and dirt (83.101(a)(1)).
2. Disinfect — fully immerse in an EPA-registered disinfectant (immersion solutions prepared fresh daily), or spray per label; observe the required contact time.
3. Store — place in a clean, dry, covered, debris-free container, separate from soiled implements.

Electrical items that cannot be immersed are wiped and disinfected before each use (83.102(e)). Shampoo bowls and facial chairs/beds must be disinfected after each client and made of a non-porous, disinfectable material.

Single-Use vs Multi-Use Items

16 TAC 83.104 (esthetician services) is explicit. Single-use items are discarded after one client:

• Lancets, cotton balls/pads, gauze, wooden applicators (orangewood sticks)
• Disposable gloves, tissues, disposable wipes, thread, fabric/wax strips

Multi-use items (metal tweezers, comedone/comedo extractors) are cleaned and disinfected after each client. Spatulas, sponges, and makeup brushes that contact skin or product must be replaced/cleaned for each client, and applicators must never be re-dipped into product (83.104(g)).

Bloodborne Pathogens and OSHA

Gloves are required during ANY extraction (83.104(a)). If a client bleeds, follow bloodborne pathogen protocol:

1. Stop the service and put on gloves.
2. Apply pressure with a single-use item; use powdered styptic or a liquid bandage applied with a disposable applicator that is discarded immediately.
3. Clean and disinfect any contaminated non-porous tool with an EPA hospital-grade/tuberculocidal disinfectant or a 10% bleach solution for 5 minutes.
4. Double-bag and discard any porous item that touched blood; place sharps in a sharps container.

OSHA (Occupational Safety and Health Administration) adds two salon requirements: an Exposure Control Plan (Bloodborne Pathogens Standard) and Safety Data Sheets (SDS) for every hazardous chemical, accessible to all employees (Hazard Communication Standard). The most infectious salon pathogen is Hepatitis B (HBV) — it survives on surfaces up to 7 days and is far more infectious than HIV, which is why hard-surface disinfection matters so much.

Asepsis vocabulary you must distinguish

• Antiseptic: safe for use on living skin to reduce surface bacteria (e.g., before extractions). It is NOT strong enough to disinfect tools.
• Disinfectant: for non-living surfaces and implements only; too harsh for skin.
• Sterilization: kills everything including spores; requires an autoclave or dry-heat unit.

Mixing up antiseptic and disinfectant is one of the most common exam mistakes — antiseptic on skin, disinfectant on surfaces.

Prohibited Products and Common Traps

TDLR 83.112 bans MMA (methyl methacrylate) monomer, razor-type callus shavers/credo blades, alum in stick/lump form, and formalin/formaldehyde fumigants. The biggest sanitation traps:

• Skipping the cleaning step and immersing dirty tools (debris inactivates disinfectant).
• Re-dipping an applicator or double-dipping a wax spatula.
• Reusing wax — wax may not be reused under any circumstances (83.105).
• Calling a UV unit a disinfectant — it is storage only.
• Forgetting foot-spa cleaning records must be kept at least 60 days.

Salon and Workstation Standards

Beyond implements, TDLR sets facility rules that surface as inspection questions:

• Towels and linens: clean towel for each client; wash in hot water with bleach; soiled towels go straight into a covered receptacle separate from clean linens.
• Product handling: never re-dip applicators; dispense with a disposable spatula or pump; discard leftover product before the next client.
• Wax pots: keep clean, no applicator may stand in the wax, and wax may never be reused (83.105).
• Hand hygiene: wash with soap and water or use a liquid hand sanitizer before every service; gloves for every extraction.
• Ventilation and floors: adequate ventilation to exhaust fumes; non-porous, washable floors where services occur.
• Labeling: all products labeled per OSHA; disinfectant containers show product, EPA number, and dilution.

A practitioner also may not perform a service if the client shows a contagious condition — head lice, ringworm, conjunctivitis, or open/inflamed skin in the treatment area (83.102(b)). The correct answer in those scenarios is to decline and refer, not to proceed with extra precautions.

Why It Matters

Sanitation and infection control are roughly a quarter of the Texas exam, and TDLR inspectors cite these rules first. When a scenario describes a tool, ask: clean it, disinfect it, or discard it? When blood appears, gloves go on and contaminated porous items are thrown away. Memorize the bleach ratios, the clean-before-disinfect rule, and the single-use list, and you will clear most of these questions.