1. Guidelines for patient scheduling:
- Advance scheduling on the phone or online should be compulsory and walk-in patients should be discouraged.
- Time gap between the appointments should be evaluated according to the clinic’s features to allow social distancing.
- Patient should be encouraged to visit the clinic alone, with a mask and their own pen if possible.
- In countries where applicable, encourage patients to have “contact tracing apps” downloaded on their phone when coming to the clinic.
2. Patient evaluation and triaging:
- Staff should be trained to take the necessary information on the phone before giving an appointment and at the patient arrival in the clinic: travel history, occupation of the patient and partner, a history of exposure to a test positive COVID-19 case and a history of living or visiting a known COVID-19 positive cluster.
- Non-contact thermometers can be used for screening, but usage can be limited due to a shortage of locally available equipment and patients taking paracetamol to cover the fever.
3. Preferred guidelines for risk categorization and safety precautions for the aesthetic procedures :
These are preferred guidelines and are not intended to be complete or exhaustive. Local guidelines regarding safety measures and use of PPEs should also be followed to prevent infection in aesthetic clinics.
Table 1. Risk categorization of various aesthetic procedures based on consensus guidelines
| Low Risk | Moderate Risk | High Risk |
| Injectables (Botulinum toxin, dermal fillers) for upper third face and extra-facial sites
Injection Lipolysis on extra-facial sites Cryolipolysis on the body Non-ablative fractional resurfacing lasers for extra-facial sites HIFU, extra-facial parts RF tightening for extra-facial areas PRP therapy for scalp, body areas LHR upper face and body areas with contact cooling device Low-level light therapy (LLLT) Chemical peels Body treatments with EMS devices IV injection therapy Sclerotherapy Hydrafacial |
Injectables (Botulinum toxin, dermal fillers) for middle and lower third face
Injection lipolysis on submental area Cryolipolysis for double chin Non-ablative fractional resurfacing lasers for facial sites HIFU, face RF Tightening for facial area PRP therapy for face LHR on the middle and lower face with contact cooling device Microneedling procedures (with or without RF) on the face and extra-facial sites Thread lifting on the face and extra-facial sites Invasive RF devices for face and extra-facial sites Soft-tissue fillers in the lips Soft-tissue fillers/ PRP in the genital areas RF/ lasers for genital area |
Aerosol-generating procedures (AGPs) or plume producing procedures such as Q-switched Nd:YAG, Alexandrite, Ruby lasers, Pulsed-dye laser, ablative resurfacing lasers (fractional and non-fractional)
LHR with non-contact cooling devices (generating plume) Electrofulguration, Electrocautery Microdermabrasion Jet infusions / facials Dermajet devices Micropigmentation, Microblading Body treatments with plasma devices |
Table 2. Consensus guidelines for the use of PPEs in various aesthetic procedures, based on the risk categorization of the procedure
| Low Risk | Moderate Risk | High Risk | |
| Sterile, Disposable Gloves | Yes | Yes | Yes |
| Surgical Cap | Yes | Yes | Yes |
| Shoe Cover | – | – | Yes |
| Eye protection | Yes | Yes | Yes |
| Face Shield | – | – | Yes |
| 3-Ply Surgical Mask | Yes | – | – |
| N-95 Masks | – | Yes | Yes |
| Plastic apron/fluid repellent gown | – | Preferred | Yes |
4. Guidelines for staffing in the aesthetic clinics:
- Older staff members (> 60 years) or with comorbidities like diabetes, pulmonary conditions or cardiac conditions should be given leave or work with limited patient contact.
- No more than 33% to 50% of staff should be working at the clinic at the same time.
- Staff should be provided with appropriate personal protective equipment and must get training in donning and doffing PPE.
- Staff should be encouraged to frequently wash their hands with soap and water for at least 20 seconds.
5. Guidelines for general housekeeping in the aesthetic clinics:
- Registration desk :
- Provide a direction of traffic.
- Sanitizing stations, shoe-covers and masks should be available at the entrance.
- Plastic/Acrylic windows should be used to protect the staff.
- Allow a 1-2 meters distance away from the registration desk.
- Waiting room :
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- Advertise the hygiene procedures of local authorities.
- Provide sanitizing stations.
- Chairs should be spaced 1-2 meters apart.
- Non-essential material should be removed.
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- Cleaning guidelines :
- Avoid wearing jewelry and makeup.
- Hand washing should be done at least every hour with water and soap, and with alcohol-based product when necessary.
- All staff should change their clothes on arrival to the clinic and wash the dedicated clothes every day.
- No vacuum cleaning of floors; mopping should be done at least once a day.
- Cleaning of frequently touched areas should be done at least 2-3 times a day.
- Maximum air changes should be facilitated : 10-15 minutes, 2-3 times a day or after every patient if possible.
These recommendations come from guidelines published by the French Society of Dermatology and by Kapoor et al in regard of the reopening of aesthetic clinics during the COVID-19 pandemic.
Sources :
- Groupe laser de la Société française de dermatologie. (April 21, 2020) Recommandations générales pour la reprise de l’activité en période de pandémie à SARS-CoV-2. Retrieved from https://evenements-sfd.fr/coronavirus-covid-19/
- Kapoor KM, Chatrath V, Boxley SG, et al. ( May 16, 2020) COVID-19 Pandemic: Consensus Guidelines for Preferred Practices in an Aesthetic Clinic [published online ahead of print]. Dermatologic Therapy. https://doi.org/10.1111/dth.13597