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REVIEW
Beauty Salons are Key Potential Sources of Disease
Spread
This article was published in the following Dove Press journal:
Infection and Drug Resistance
Najwa Menwer Alharbi
Hanan Mohammed Alhashim
King Abdelaziz University, Science
College, Biology Department, Jeddah,
Saudi Arabia
Abstract: Beauty salons can do marvel prettiness for their customers; however, they are
also considered as major health concern. They are a reason for the spread of viral, fungal and
bacterial diseases. Many research isolated pathogenic bacteria and fungi from beauty salons
products and tools. In this review we aim to increase the public’s awareness of the potential
for disease transmission through the common tools and products used in beauty salons.
Furthermore, heighten salons’ standards of care in sterilizing beauty tools and products and
storing them properly.
Keywords: beauty salon, bacterial infection, cosmetic product, salons’ tools, viral diseases
Introduction
The concept of a salon is linked to beauty, an establishment dealing with cosmetic
products and tools to improve the appearance of one’s hair, face, and body. Cosmetics
are generally mixtures of chemical compounds derived from natural (such as coconut
oil) or synthetic sources. In the United States, the Food and Drug Administration
(FDA), which regulates the cosmetics industry, denes cosmetics as
Intended to be applied to the human body for cleansing, beautifying, promoting
attractiveness, or altering the appearance without affecting the body’s structure or
functions. (Sources of Cosmetic Products & Ingredients)
1
Salons provide a wide range of services including hairdressing, nail care
(manicures and pedicures), hair removal by waxing and threading, mud baths,
and many other services. However, they are also considered a major health
concern.
2,3
The health risks associated with beauty salons vary depending on the
products and tools used, the nature of the business, and the service providers
themselves.
4
Salons can contribute to and cause the spread of viral, fungal, and
bacterial infections.
3,5
Among the diseases that can be transmitted in beauty salons
are hepatitis B
& C, herpes, AIDS, skin and eye infections, hair lice, and chronic fungal
diseases.
2,6–12
The ingredients in cosmetic products and the materials used in the tools make
the salon an ideal environment for the proliferation of microbes, thus contributing
to the spread of various diseases.
2,3
Cosmetics fulll all of the requirements for
microbial growth;
13,14
the ingredients of most beauty products include sugar, starch,
protein, amino acids, organic acids, acids, alkalis, salts, parafn, fatty acids,
alcohols, esters, moisturizers, colors and dyes, preservatives, antioxidants
Correspondence: Najwa Menwer Alharbi
King Abdelaziz University, Science College,
Biology Department, P.O. Box: 80200,
Jeddah, 21589, Saudi Arabia
Tel +966 508414338
Email Nmaalharbi@kau.edu.sa
submit your manuscript | www.dovepress.com Infection and Drug Resistance 2021:14 1247–1253 1247
http://doi.org/10.2147/IDR.S303461
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fragrances, and essential oils. In addition, most of these
ingredients are water soluble, which is an essential factor
for the growth of microorganisms.
13
Cosmetics that con-
tain a high-water content are at a higher risk of contam-
ination, which can lead to an alteration in the composition
of the product and/or constitute a threat to the health of the
consumer (Sources of the chemistry of cosmetics;
Australian Academy of Science).
15–17
Here, we review the literature that examines the micro-
bial contamination of salon products and tools, the stan-
dard hygienic and sterilization practices used in salons,
and the risks of disease spread through these businesses.
Literature Review
Salon Hygiene
Salons tend to use chemical and physical methods to
sterilize tools and equipment, such as chemical reagents,
boiling water, autoclaving, chemical reagents, quartz bead
sterilization, and UV light (Sources of Salon Hygiene,
Proper Practices for Sanitation, Disinfection, and
Sterilization).
18
The method of using hot water steriliza-
tion involves placing the tools in boiling water for a period
of no less than 3–5 min. While this method is relatively
fast, it has been shown to be insufcient for killing all
microorganisms.
19
Autoclaving is the most reliable way to
kill all microbes, although it is not ideal for sterilizing
electrical equipment, and the process of sterilization
requires a relatively long time. Chemical disinfectants are
effective in killing microbes or at least slowing their
growth; however, most of these chemicals are hazardous
and need to be used with caution (Sources of Proper
Sanitation Protocols Can Make or Break Your Salon).
20
Currently, most salons use barbicide solution as
a disinfectant, which is highly toxic to humans (Sources
of Salon Hygiene, Proper Practices for Sanitation,
Disinfection, and Sterilization).
18
Some salons use a quartz sterilizer or a UV sterilizer.
The quartz sterilizer uses a process that consists of heating
air through quartz beads for a period of 5–15 s at 250 °C
(482 °F). This type of sterilizer accommodates a large
number of tools, but the shape and structure of the tools
may change after a period of time. The UV sterilizer is the
safest method for tools and brushes that cannot be ster-
ilized at high temperatures; the only disadvantage is that it
accommodates very few tools (Sources of Salon Hygiene,
Proper Practices for Sanitation, Disinfection, and
Sterilization)
18
. After cleaning and sterilizing, the tools
must be stored properly in cool, dry places to reduce the
risk of any growth of bacteria and fungi remaining on tools
and therefore, the spread of disease. Brushes should be
stored in makeup bags and metal and wooden tools should
be stored in closed plastic containers (Sources of Salon
Hygiene, Proper Practices for Sanitation, Disinfection, and
Sterilization).
18
About 35% of service providers use UV sterilization
and about 20% use quartz beads to sanitize their tools.
However, the use of an ultrasonic cleaner was reported by
only 1% of providers. None of these described methods
have been proven adequate in reaching a satisfactory level
of sterilization by themselves, and a combination of
approaches should be used.
21
Risks
Cosmetic products and tools are a favorable environment
for the multiplication of microbes, which contribute to and
cause the spread of viral, fungal, and bacterial
infections.
2,5
Numerous factors contribute to this problem.
First, the ingredients of most beauty products, such as
organic and inorganic compounds, moisturizers, basic
minerals, and growth factors, provide an environment con-
ducive to the multiplication of microbes. Second, the dates
of production and expiration are not marked on cosmetics;
consequently, the reduction in effectiveness of the preser-
vatives in the cosmetics over time is unknown.
15
Third,
cosmetics are not manufactured under sanitary conditions
and are frequently shared in beauty salons.
22
Fourth, the
regular tools used in cosmetic salons such as razors, scis-
sors, clippers, and nail care tools can accidentally pene-
trate the skin, which may lead to health problems ranging
from inamed skin to hepatitis.
23
Service providers them-
selves are susceptible to transferring infections among
their customers if they suffer from serious medical
problems.
4,10,24
Accordingly, several studies have been
undertaken to determine if the transmission of viruses,
bacteria, ring worm, or fungi is associated with cosmetic
procedures in beauty salons.
2
Some bacterial species in the Staphylococcus,
Streptococcus, and Pseudomonas genera are of major con-
cern because they are associated with many common dis-
eases and can cause respiratory problems and chronic
diseases owing to their toxicity.
15,25–27
A real-life case
was reported of an individual who acquired a methicillin-
resistant Staphylococcus aureus (MRSA) infection after
visiting a hairdresser in London, UK.
12
In 2006, in
Rivers State, Nigeria, unhygienic tools contributed to
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HIV infections and hepatitis, which are both blood-borne
diseases.
28
S. aureus in other studies has been shown to
cause outbreaks among salon customers in the United
States.
29
Unfortunately, most makeup brushes and other cos-
metics objects, even after being thoroughly disinfected,
still pose a risk in terms of bacterial transmission and
infection each time they come in contact with cracks in
the skin.
2,4,10,12
Four bacterial species are considered by
pharmacopeia in the United States as indicators of con-
taminated cosmetics: Pseudomonas aeruginosa,
Staphylococcus aureus, Salmonella spp., and Escherichia
coli.
Microorganisms Isolated from Salon Tools
Several literature reports document the existence of
a variety of microorganisms isolated from beauty tools
used in salons such as nail care tools, sharpeners, sponges,
combs, makeup brushes, hair stretchers, rollers, and hair-
pins (Table 1).
6,30
Researchers collected samples from
clippers, clipper steps, combs, and brushes from 40 differ-
ent beauty salons in Taraba State, Nigeria, in 2020. The
samples were cultured on nutrient agar, mannitol salt agar,
MacConkey agar, and Sabouraud dextrose agar. All sam-
ples contained pathogenic bacteria, including species of
Staphylococcus, Bacillus, and Streptococcus. In addition to
bacteria, pathogenic fungi in the following genera were
also found: Aspergillus, Trichophyton, Malassezia, Mucor,
and Microsporum. The highest microbial content in this
study was measured on clippers, as these tools received the
lowest level of sterilization practice among all of the tested
tools.
31
In 2019, at the University of Al-Qadisiyah,
College of Biotechnology in Iraq, six bacterial species
were isolated from combs, brushes, rollers, hairpins, scis-
sors, razors, dryers, and laundry tools from beauty salons
in the campus. Based on the molecular and biochemical
Table 1 The Most Common Microbes That Have Been Isolated in Beauty Salons
Microbes Source of Isolation Reference
Staphylococcus sp., Streptococcus sp., Bacillus sp., Aspergillus sp., Trichophyton sp., Malassezia
sp., Mucor sp., and Microsporum sp.
Cosmetic tools [31]
Staphylococcus, Bacillus, Aspergillus, Penicillium, Microsporum Brushes and combs [23]
Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus sp., Micrococcus sp.,
Enterococcus and Enterobacter
Cosmetic tools [6]
Staphylococcus sp., Streptococcus sp., Enterococcus, Candida albicans Wax, lipstick, eyeliner, mascara, and
foundation
[36]
Staphylococcus aureus, Candida albicans Lipstick, mascara, and eyeliner [37]
Escherichia coli, Proteus vulgaris, Streptococcus viridans, Corynebacterium sp. Brushes and combs [32]
Bacillus, Staphylococcus, Escherichia coli, Aspergillus, Penicillium, Salmonella, Cosmetic powders and eyeliners [5]
Staphylococcus, Pseudomonas, Bacillus, Enterococcus, Aspergillus, Cladosporium, Rhizopus Hairdryers, combs, and brushes [33]
Staphylococcus, Aspergillus, Streptococcus Combs, Brushes, and Hairdryers [3]
Bacillus, Staphylococcus, Escherichia coli, Aspergillus, Penicillium, Salmonella Brushes and combs [39]
Saprophytic fungi, dermatophytes Hairbrushes [10]
Streptococcus, Staphylococcus, Escherichia coli, Enterobacter, Pseudomonas, Aspergillus,
Penicillium
Combs, brushes, hair stretchers,
rollers, and hairpins
[2]
Staphylococcus aureus, Pseudomonas aeruginosa, yeast, and fungus Cosmetics products and tools [35]
Bacillus, Staphylococcus aureus, Escherichia coli Cosmetic creams [15]
Candida, Penicillium, Micrococcus, Staphylococcus Nail care tools [40]
Pseudomonas aeruginosa, Enterobacter gergoviae, Candida parapsilosis, Aspergillus avus, mould Facial creams and hand and body
lotions
[25]
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characteristics of the isolated bacteria, they were identied
as S. aureus, which was the most dominant species in all
samples, S. epidermidis, Streptococcus spp., Micrococcus
spp., Enterococcus spp., and Enterobacter spp.
6
In the
same year at the university, bacteria and fungi were iso-
lated on nutrient agar and potato dextrose agar from combs
and brushes used in public beauty salons in three cam-
puses in Nigeria. The bacterial isolates were identied as
Staphylococcus aureus, and species of Bacillus,
Micrococcus, Serratia, Citrobacter, Proteus, and Shigella,
and fungi such as Aspergillus avus, Penicillium spp.,
Trichophyton spp., and Microsporum spp.
23
It can be con-
cluded from this study that beauty salons can be consid-
ered a hazard when the hygiene standard is far from the
expected, especially when it is combined with high moist-
ure and dust content. Another study investigated the
microbial content in a beauty blender when it was not
cleaned at all or when it was dropped on the oor and
reused without cleaning. The results revealed the presence
of both S. aureus and E. coli.
30
In 2018, hair samples were collected from salon tools
from ten different salons within the Benin metropolis, Edo
State, Nigeria. All samples were inoculated on nutrient agar.
The bacterial isolates obtained from salon tools included
E. coli, Proteus vulgaris, Streptococcus viridian, and
Corynebacterium sp.
32
In Kamyaran city, Iran, in the sum-
mer of 2015, bacteria and fungi were isolated from hair
dressings used in beauty salons using a variety of selective
microbial media. The contaminating microorganisms were
identied as Staphylococcus aureus, S. epidermis,
Klebsiella pneumoniae, Pseudomonas aeruginosa, and spe-
cies of Bacillus, Micrococcus, Enterococcus, and
Enterobacter, and the fungal species Aspergillus avus,
A. fumigates, Alternaria spp., Cladosporium spp.,
Geotrichum candidum, Rhizopus nigricans, R. arrhizus,
Trichophyton spp., Mucor spp., Candida albicans, and
Penicillium spp.
33
In Michael Okpara University of Agriculture,
Umudike, Abia State, Nigeria, samples from combs,
brushes, and hairdryers were collected from two hairdres-
sing salons inside the campus to investigate the role of
salons in spreading diseases. The samples were inoculated
on nutrient agar, MacConkey agar, and mannitol agar and
showed the presence of bacterial species in the genera
Streptococcus and Micrococcus, as well as
Staphylococcus aureus, and a few species of fungi in the
genera Aspergillus, Mucor, and Rhizopus.
3
The same the-
ory, the role of salons in spreading diseases, was tested by
Enemuor and colleague at Kogi State University, Anyigba.
They collected samples from combs, brushes, hair stretch-
ers, rollers, and hairpins from six hairdressing salons. The
samples were then cultured on a variety of selective and
general media, revealing the presence of ve bacterial and
six possible pathogenic fungal species. The dominant bac-
terial species across all six salons was S. aureus, followed
by S. epidermidis. This study considered the presence of
the pathogenic fungus Trichophyton as an indicator of the
probability of contamination by more risky
microorganisms.
2
Even though the sample size in this
study was very small, it highlighted a series of problems
regarding the acceptable hygiene level that needs to be
enforced in salons.
In another interesting study by Baqer et al (2014),
sponges and mascara were tested to evaluate microbial
contamination. The results revealed the existence of nor-
mal ora, such as S. epidermidis, and the dominance of
S. aureus and other Enterobacteriaceae family members
including E. coli, Shigella, and P. aeruginosa. Each of
these species is known for their ability to cause nosoco-
mial infections in health centers and the community. This
study also employed a natural sterilization method using
the supernatant of Lactobacillus, which has antimicrobial
activity and can control the growth of microbes living in
beauty sponges and eyelash mascara.
34
In 2015, fungal species were detected in hair brush
samples from beauty salons in Jatinangor, Indonesia,
using two different culture media, Sabouraud agar with
chloramphenicol and Sabouraud agar with chloramphenicol
and cycloheximide. The majority of fungi in this study was
saprophytic fungi, including species in the following gen-
era: Aspergillus, Fonsecaea, Penicillium, Cephalosporium,
Mucor, Rhodotorula, Gliocaldium, Phialophora, Rhizopus,
and the species Mycelia sterilia. The existing fungi were
highly affected by the salon practice used in washing
brushes. When required care was neglected, examination
revealed the presence of a small percentage of dermato-
phyte species. When brushes were cleaned once a week
with a common detergent, Candida spp. were detected,
and when the brushes were never washed, Trichophyton
spp. and Malassezia spp. were detected.
10
In 2012, Naz isolated and detected numerous human
pathogens from 100 samples of beauty salon tools includ-
ing blusher brushes, face sponges, and wax. The samples
were inoculated on mannitol salt agar, cetrimide agar for
bacterial detection, and potato dextrose agar for fungal
tests. Most of the wax samples, all brushes, and beauty
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sponges were contaminated with S. aureus. Pseudomonas
aeruginosa contaminated 75% of the samples, while less
than 50% of the samples were contaminated by yeast and
other fungi.
35
Most of the research on assessing the role of salon
tools in the spread of diseases found that these tools either
were never stylized or were not cleaned between custo-
mers. Even when hygienic practices were employed,
acceptable levels of sterilization were rarely applied.
Microorganisms Isolated from Cosmetics
Products
In addition to all of the studies investigating pathogenic
microorganisms contaminating cosmetic tools, the litera-
ture is replete with reports on the isolation of microbes
from cosmetic products in beauty salons, including lip-
stick, mascara, eye shadow, foundation, blusher, eyeliner,
facial creams, and hand and body lotions (Table 1). All of
these products are considered an ideal environment for
microbial proliferation due to their rich favorable
ingredients.
In one study in 2018 at the University of Raparin, Iraq,
over 120 moistened cotton swab samples were collected
from ten different hair and beauty salons to dene the
presence of microorganisms in lipstick, eyeliner, mascara,
and foundation. The study found more bacterial growth
than fungal growth. The bacterial species included
Staphylococcus spp., Streptococcus spp., and
Enterococcus spp. The fungal specie was Candida albi-
cans, which is considered a natural constituent of gut ora,
but when it transforms far from its original site it can
cause several chronic infections.
36
Similar microbes were found in studies conducted in
the same year at Benghazi University, Libya. That study
analyzed microbial contamination of 25 facial cosmetics
including samples of kohl, eyeliners, and lipsticks.
Bacterial and fungal contaminants, such as
Staphylococcus aureus and Candida albicans, respec-
tively, were found.
37
More cosmetic products have inves-
tigated earlier in ten beauty salons in different regions of
Tabriz city, Iran. Scientists collected 52 samples from skin
and eye cosmetics, such as cream, mascara, powder, and
eyeliner from All samples were inoculated on cetrimide
agar, Levine eosin methylene blue agar, Baird Parker agar,
and Sabouraud dextrose chloramphenicol agar. All cos-
metics were found to be contaminated with bacteria,
fungi, and yeast, and the most dominant species were
associated with the following genera: Streptococcus,
Pseudomonas, Bacillus, Staphylococcus, Acinetobacter,
Salmonella, Klebsiella, Citrobacter, Rhodotorul, and
Candida, as well as E. coli.
5
Among all of the samples
used in this study, the powder had the highest contamina-
tion level, which might be due to exposure to air and the
frequent use of the same powder pad. Besides powder,
mascara also had a high contamination level, most likely
due to its high moisture content, which contributes to
ocular infection.
22
The number of people who use and share a cosmetic
product greatly affects the microbial contamination rate. In
a study by Skowron et al,
38
samples including cream,
lotion, and face and hair masks were divided into three
groups. The rst group of products were used by one
person, the second group was used by a group of people,
and the last group of products was expired and utilized by
public. The microbial content in personally used products
was much lower than that of publicly used products, and
the expired products exhibited the highest microbial con-
tamination. The majority of microorganisms detected in
this study were considered microora and few pathogenic
organisms were detected, such as P. aeruginosa and
C. albicans.
38
Although many microbes detected in cosmetic products
are not necessarily pathogenic, they may still pose a risk
when considering the overall microbiome. It has been
shown that organisms in the normal ora can threaten
human life when they transfer from one person to another,
which is common in salons. It was found that the higher
the moisture percentage in the beauty product, the higher
the microbial count. In addition, leaving the cosmetics
tools or products uncovered, exposed them to the air,
dust, and airborne microorganisms, which may increase
microbial contamination.
Closing
A review of several studies clearly showed that more
bacterial species, especially Gram-negative bacteria, were
isolated from cosmetic products in beauty salons. The
main reason for this is likely due to the preservative used
in cosmetic product being more effective in inhibiting
fungal growth than bacterial growth.
41
Some microbes isolated from cosmetic products and
tools are considered as signicant threats to public health.
S. aureus, P. aeruginosa and K. pneumoniae are ubiqui-
tous in the environment, and are related to nosocomial
infections, causing severe infections in plants, humans,
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1251
Dovepress Alharbi and Alhashim
and other animals. Bacteria related to nosocomial infec-
tion microbes are rarely and poorly controlled by
antibiotics.
42
In addition to infections acquired from hos-
pitals, food-borne diseases are another issue caused by
microbes found on salon instruments and products. The
most common food-borne microorganisms, such as
E. coli, Bacillus sp., Salmonella sp., and Yersinia sp. are
widely found in salons. Both Bacillus cereus and E. coli
can cause food poisoning, as they are agents that secrete
toxins into food, triggering gastrointestinal illness.
Salmonella spp. and Shigella dysenteriae spread via con-
taminated food and food handlers, are known to cause
food-borne sickness, and are highly resistant to certain
antibiotics.
43
The ndings of these studies may have been limited by
the variable types of microorganisms present in the collected
samples. In addition, the approaches used may not have been
conducive to isolating all types of contaminating organisms;
some organisms may require special conditions to grow on
agar plates, or tissue culture propagation in the case of
viruses and other parasites.
There is a need to increase the public’s awareness of
the potential for disease transmission through the common
tools and products used in beauty salons. Accordingly,
based on the ndings and recommendations of the studies
reviewed here, we aim to heighten salon standards of care
used in sterilizing beauty tools and products, and storing
them properly. In addition, we highly recommend the use
of individual cosmetic kits. All of these recommendations,
if employed, should contribute signicantly to a reduction
in the spread of infection and disease through beauty
salons. In term of awareness, the International
Organization for Standardization provided guidelines that
should be taken into account in the eld of cosmetic
manufacturing, from manufacturing to the usage by custo-
mers, until waste disposal.
Disclosure
The authors report no conicts of interest for this work.
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