Infection Control & Bloodborne Pathogens

Why This Section Carries the Most Weight

Infection Control is about 25% of the written exam (~19 questions) and ties Facial Treatments as the largest single topic. It also dominates the practical exam, which scores pre-exam disinfection, end-of-exam disinfection, and a mandatory blood-exposure demonstration. Master this and you secure a quarter of the written test.

TDLR's Chapter 83 health and safety rules (16 TAC Chapter 83), including the blood-and-body-fluid handling standards and the prohibited-products standards, drive these questions.

The Decontamination Hierarchy

Three terms are constantly confused — and constantly tested. Learn the exact difference:

• Cleaning (or sanitizing): physically removing visible debris, oils, and many microbes with soap/detergent and water. It is the required first step but does not kill enough pathogens to be safe alone.
• Disinfection: using a chemical agent to destroy most pathogens (bacteria, fungi, viruses) on hard, non-porous surfaces. This is the standard salon level for multi-use tools.
• Sterilization: destroying all microbial life, including bacterial spores, usually with an autoclave. It is the highest level but is not required for routine esthetic tools.

Key rule: you must clean before you disinfect — a disinfectant cannot work through dirt and oil.

Hierarchy at a Glance

Disinfectant Requirements

TDLR requires an EPA-registered hospital-grade disinfectant that is labeled bactericidal, fungicidal, and virucidal. Acceptable agents also include isopropyl or ethyl alcohol at proper concentration, or a high-level chlorine bleach solution, depending on the item.

Practical rules an esthetician must follow:

• After each client, multi-use implements (tweezers, metal tools, comedone extractors) are cleaned, then immersed or sprayed with disinfectant for the full contact time stated on the label.
• Facial chairs, beds, and headrests must be cleaned and disinfected after every client and must be made of or covered with a disinfectable material.
• Disinfectant solutions must be mixed per label dilution and changed when contaminated or expired (commonly daily).
• Store disinfected (clean) implements separately from soiled ones, clearly labeled.

Single-Use vs. Multi-Use Items

A core distinction on both exams:

• Single-use (disposable) items — discarded after one use, never disinfected and reused: disposable gloves, tissues, cotton swabs, wax applicators (no double-dipping), lash extensions, face masks, fabric strips, eye pads.
• Multi-use items — cleaned and disinfected between clients: metal tweezers, comedone/blackhead extractors, electrodes, facial equipment surfaces.

Prohibited under Rule 83.112: practitioners may not use methyl methacrylate (MMA), credo/razor-type callus shavers, alum or astringents in stick/lump form (powder or liquid is fine), or fumigants such as formalin/formaldehyde.

Bloodborne Pathogens and Standard Precautions

Bloodborne pathogens are infectious microorganisms carried in blood and body fluids. The three most tested are:

• HBV (Hepatitis B virus) — very hardy; can survive on surfaces; a vaccine exists.
• HCV (Hepatitis C virus) — attacks the liver; no vaccine.
• HIV (Human Immunodeficiency Virus) — causes AIDS; more fragile outside the body.

The guiding rule is Standard (Universal) Precautions: treat every client's blood and body fluids as if infectious, because you cannot tell by looking. Licensees should never touch a client's open sore or wound, and should use disposable, single-use applicators (cotton-tipped) for any product applied to broken skin, discarding them immediately.

The Blood-Exposure Incident Procedure

If a client is cut during a service, follow this TDLR-aligned procedure (you must demonstrate it on the practical exam):

1. Stop the service immediately.
2. Put on gloves (the licensee protects themselves first).
3. Clean the injured area; offer the client antiseptic and an adhesive bandage (apply styptic with a disposable applicator — never let containers or applicators touch the wound).
4. Cover the injury to prevent further blood exposure.
5. Bag and dispose of all single-use contaminated items; double-bag and discard any porous implement that touched blood in a closed trash or biohazard container (per the Chapter 83 blood-and-body-fluid health and safety rule).
6. Clean and disinfect the workstation and any multi-use implements with EPA-registered hospital-grade disinfectant.
7. Remove gloves, wash hands, then return to service.

Common traps: Do not reuse a wax stick or any item that contacted blood — porous items are double-bagged and discarded, not disinfected. Do not skip gloves. Do not disinfect before cleaning. And remember disinfection (not sterilization) is the salon standard for hard surfaces, while truly contaminated porous items are thrown away.

Worked example: During tweezing, a client's brow area bleeds slightly. The esthetician stops, gloves up, cleans and bandages the area, drops the used cotton and the contaminated tweezers handling into the proper waste, double-bags the porous wax strip that touched blood, disinfects the metal tweezers and station, removes gloves, and washes hands. That exact sequence is what the exam rewards.

Personal Protective Equipment and Hand Hygiene

PPE (Personal Protective Equipment) and hand hygiene are the everyday backbone of infection control:

• Wash hands with soap and running water before and after each client, and immediately if you contact blood (lather at least 10-20 seconds).
• Wear disposable gloves for hair removal, extractions, any service near broken skin, and any blood exposure; change gloves between clients.
• Cover your own cuts or broken skin with a bandage and glove before working.
• Use a clean, single-use spatula to remove product from a multi-use container — no double-dipping wax sticks or fingers, which contaminates the whole jar.

Why These Rules Exist

Most salon-spread infections are cross-contamination: pathogens move from one client to another via unclean hands, tools, or surfaces. Standard precautions and single-use discipline break that chain, which is why the exam frames infection control as protecting the public, not just the individual client.

Foot Spas, Spas, and Specialty Equipment

TDLR's health and safety rules also cover equipment cleaning intervals. For example, whirlpool foot spas/basins (relevant on combination manicurist/esthetician licenses) must be cleaned and disinfected after each client and given a deeper disinfection on a set schedule using an EPA-registered disinfectant or a high-level chlorine bleach solution. Electrical facial devices (steamers, high-frequency electrodes) must have their client-contact parts disinfected between uses.

Pulling It Together: The Sanitation Mindset

For the exam, internalize this checklist for every service:

1. Set up with clean/disinfected tools stored separately from soiled ones.
2. Wash hands and glove as appropriate.
3. Use single-use items where required; never reuse disposables.
4. After the client, clean then disinfect all multi-use tools and the station with an EPA-registered, hospital-grade, bactericidal/fungicidal/virucidal product for the full label contact time.
5. On any blood exposure, follow the stop-glove-clean-cover-bag-disinfect-wash sequence; double-bag and discard porous contaminated items.
6. Document infections and exposures as required.

If you can recite the cleaning/disinfection/sterilization hierarchy, the single-use vs. multi-use split, the HBV/HCV/HIV bloodborne trio, and the blood-exposure steps, you have covered the bulk of the heaviest-weighted section on the Texas esthetician written exam.