DISINFECTION OF REUSABLE MAKE-UP APPLICATORS 169 people with atopic dermatitis. After using the soap for 9 weeks, there was a reduction in the total number of aerobic organisms in the antibacterial soap group when compared with the placebo group. In addition, dermatitis in the group testing the antibacterial soap remained less severe than in the placebo soap group during the regression period when the use of corticosteroids was banned. There ar e few reports in the literature concerning the disinfection of make-up applicators. Naz et al. (1) examined the frequency of the occurrence of human skin pathogens on cos- metic tools used in beauty salons One hundred samples taken from tools such as blush brushes, make-up sponges, and waxing tools from 33 different beauty salons were tested and microbiologically examined for the occurrence of S. aureus, P. aeruginosa, yeast, and fungi. The samples from the sponges and brushes had 100% of S. aureus impurities, with the samples from the wax tools having 88%. Almost 51.5% of all the sponge samples, and 30.3 and 20.5% of the brush and wax tool samples, respectively, showed the presence of fungal and yeast colonies. The sponge samples showed high contamination (24.24 × 104 colony-forming units (CFU)/mL) of S. aureus 22.96 × 104 CFU/mL was obtained for P. aeruginosa, whereas for yeast and fungi, the maximum contamination was estimated at 26.57 × 104 CFU/mL. Analysis of microbiological contamination of the brush samples showed that for S. aureus, CFU/mL was equal to 22.76 × 104, whereas the maximum con- tamination of P. aeruginosa was estimated to be equal to 21,52 × 104 CFU/mL. The growth of yeast and fungi was equal to 20.06 × 104 CFU/mL. In the wax tool samples, the estimated impurity of S. aureus was equal to 25 × 10³ CFU/mL, whereas for P. aeruginosa, it amounted to 26.55 × 104 CFU/mL. The contamination with yeast and fungi was equal to 120 × 104 CFU/mL. It was observed that the main reason for the contamination of tools used in beauty salons is their repeated use for all customers without taking into account hygiene conditions. In practice, disinfection it self cannot be considered separately, but instead should be treated as one of the elements of hygiene procedures, and that is why we reviewed the available literature regarding biosafety in beauty salons. Kukulowicz conducted an assess- ment of the state of sanitary conditions in beauty salons (10). The cleanliness of the fol- lowing was assessed: the beauticians’ hands, the surface of the cosmetic apron, towels, the treatment chair cover, and also other furniture such as the table and pedicure tub. After- ward, the total number of microorganisms that were found on them was verifi ed. All sa- lons met the sanitary requirements that are required by law. The test results indicated heterogeneous contamination of the analyzed samples. The most numerous microorgan- ism colonies turned out to be aerobic mesophilic microorganisms, fi lamentous fungi, yeast, and trace amounts of Staphylococcus epidermidis. The occurrence of S. aureus was not reported. The hands of the beauticians and the pedicure tubs, which constituted 14% of the tested surfaces, were particularly inhabited by staphylococci 92% of their surface was colonized by fi lamentous fungi and 75% by yeast. The largest amount of aerobic bacteria was found on the tables and aprons, and the smallest amount on the towels. Staphylococci and yeasts, which belong to human microfl ora, were also isolated from the beauticians’ hands. In only 7% of tests was the limit of permitted impurity for class D rooms ex- ceeded. Tests conducted by Villar et al. (10) showed that 81.5% of beauticians reported the use of disposable sandpaper, nail sticks and sterilized pliers, but only 40% admitted compliance with the proper disinfection/sterilization rules. Moreover, most of them were not vaccinated against HBV, which creates an additional risk of occupational diseases, such as an increased risk of infections for customers. Many other researchers point out the lack of appropriate biosafety procedures in beauty salons (12,13).

JOURNAL OF COSMETIC SCIENCE 170 In addition to disinf ectants, the level of knowledge about compliance with hygiene and prevention principles among the staff of beauty salons and hairdressers is also important in maintaining an adequate level of hygiene (14). A survey showed that 65% of respon- dents do not know the defi nition of the word “disinfection,” and the word “sterilization” was defi ned by only 23% of respondents. Some respondents admit that they do not always follow the rule of putting on and changing disposable gloves after each treatment that may cause mechanical damage to the skin 6% of respondents admitted that they do not change gloves between clients. Half only put on new gloves after the previously used ones were damaged. Regarding reusable equipment, as many as 83% of respondents use man- ual disinfection, 15% use automatic devices, and ultrasound is used in just 2% of cases. Autoclave sterilization is performed by 57% of respondents, and chemical disinfectants are used by 33% of them. About 6% of respondents are not able to sterilize equipment and tools. Handwashing before and after a procedure was declared by 94% of respon- dents, after using the toilet by 93%, after contact with various types of secretions by 62%, after contact with potentially pathogenic objects and tools by 52%, after removing and putting on protective gloves by 41%, and after removing gloves by only 14%. Hand disinfection after their previous washing is used by 53% of respondents, before proce- dures where there is a risk of mechanical damage to the skin by 42%, before contact with mutilation by 35%, and before applying gloves by 14% of respondents. This study shows that the knowledge of beauty salon employees is low and translates into insuffi cient use of hygiene procedures. An interesting report, however, is the fact that educational pro- grams targeted at beauty salons are highly effective (15). The study has several limita tions, some of which are inherent to the preliminary study. We have tested a limited number of samples, and for this reason, we were unable to con- duct a statistical analysis. Sabouraud agar mainly supports the growth of yeasts and molds, but not bacteria. For this reason, different broader approach should be used for continuation of this study. Despite these limitations, our fi ndings have important impli- cations because they draw attention to the importance of implementing proper disinfec- tion procedures in beauty salons and contribute to the body of real-world data. CONCLUSIONS Our study, when c ompared with the reports that can be found in the literature, indicates that the disinfection process should be selected according to the used applicator and cos- metic product. This fact, combined with the low level of knowledge of beauty salon employees about disinfection and the low level of compliance with hygiene procedures, is worrying because it increases the risk of infection among beauticians and the spread of infection among customers. There is a need to conduct further research on the selection of appropriate disinfection procedures for individual applicants and for those who prepare makeup. It is also necessary to provide education among employees of beauty salons on disinfection procedures. ACKNOWLEDGEMENTS We thank the University Clinic in Göttingen, Germany (Universitätsmedizin Göttingen), for providing laboratory tests for this research.