Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
317A.130
NECESSITY, FUNCTION AND CONFORMITY:
KRS
317A.060 requires the board to establish
appropriate standards of practice for individuals licensed by the board. This
administrative regulation establishes the required restrictions and limitations
placed on esthetic practices.
Section
1. Definitions.
(1) "Basic
exfoliation during dermaplane techniques" means only the uppermost layer of the
stratum corneum may be removed.
(2)
"Cosmetic resurfacing exfoliating procedures" means the application of cosmetic
resurfacing exfoliating substances by a licensed health care practitioner for
the purpose of improving the aesthetic appearance of the skin. This includes
services such as acid or chemical peels, microdermabrasion, and other forms of
exfoliation or resurfacing of a cosmetic nature.
(3) "Direct supervision" means to be within
immediate distance, such as on the same floor, and available to respond when
needed.
(4) "Health care
practitioner" means any individual certified by the Kentucky Board of Nursing,
or the Kentucky Board of Medical Licensure to perform esthetic
specialties.
(5) "Immediate
supervision" means a licensed physician is physically present in the same room
and overseeing the activities of the esthetician at all times.
(6) "Microdermabrasion" means a gentle,
progressive, superficial, mechanical exfoliation of the uppermost layers of the
stratum corneum using a closed-loop vacuum system.
(7) "Microneedling" means the use of multiple
tiny solid needles designed to pierce the skin for the purpose of stimulating
collagen production or cellular renewal. Devices used may be in the form of
rollers, stamps, or electronic "pens". Microneedling is also known as:
(a) Dermal needling;
(b) Collagen Induction Therapy
(CIT);
(c) Dermal
rolling;
(d) Cosmetic dry
needling;
(e) Multitrepannic
collagen actuation; or
(f)
Percutaneous collagen induction.
(8) "Physician" means a medical doctor
licensed by the Kentucky Board of Medical Licensure to perform services within
his or her scope of practice.
Section
2. Supervision of Restricted Practices. An esthetician licensed by
the board shall not perform any of the activities listed in
KRS
317A.130(2) unless under the
immediate supervision of a licensed physician. Medical procedures shall not be
performed by an esthetics or cosmetology licensee. Services under the direct
supervision of a licensed health care practitioner shall fall within the
category of cosmetic resurfacing exfoliating procedures.
Section 3. Microdemabrasion.
(1) To be approved for use, a
microdermabrasion device shall:
(a) Be
specifically labeled for cosmetic or esthetic purposes;
(b) Be a closed-loop vacuum system that uses
a tissue retention device; and
(c)
Not result in the removal of the epidermis beyond the stratum corneum from the
normal and customary use of the device.
(2) Loose particle microdermabrasion systems
shall not be used.
Section
4. Acids and Chemical Exfoliations.
(1) The use of any acid or acid solution,
which would exfoliate the skin below the stratum corneum, including those
listed in subsection (2) of this section shall not be used unless under the
direct supervision of a licensed health care practitioner.
(2) The following acids or acid solutions
shall not be used unless under the direct supervision of a licensed health care
practitioner:
(a) Phenol;
(b) Bichloroacetic acid;
(c) Resorcinol;
(d) Any acid in any concentration level that
requires a prescription;
(e)
Modified jessner solution on the face and the tissue immediately adjacent to
the jaw line;
(f) Alpha hydroxy
acids with a pH of not less than one (1.0) and at a concentration of fifty (50)
percent shall include partially neutralized acids, and any acid above the
concentration of fifty (50) percent is prohibited;
(g) Beta hydroxy acids with a concentration
of not more than thirty (30) percent;
(h) Trichloroacetic acid (TCA), in a
concentration of not more than fifteen (15) percent, but no manual, mechanical,
or acid exfoliation may be used prior to treatment unless under the direct
supervision of a licensed health care practitioner; and
(i) Vitamin-based acids.
(3) Limited chemical exfoliation for a basic
esthetician shall not include the mixing, combining, or layering of skin
exfoliation products or services, but shall include:
(a) Alpha hydroxy acids of thirty (30)
percent or less, with a pH of not less than three (3.0); and
(b) Salicylic acid of fifteen (15) percent or
less.
(4) A licensee may
not apply any exfoliating acid to a client's skin that has undergone
microdermabrasion or microneedling within the previous seven (7) days, unless
under the direct supervision of a licensed physician.
(5) A licensee shall prepare and maintain
current documentation of the licensee's cumulative experience in chemical
exfoliation, including:
(a) Courses of
instruction;
(b) Specialized
training;
(c) On-the-job
experience; and
(d) The approximate
percentage that chemical exfoliation represents in the licensee's overall
business.
(6) A licensee
shall provide the documentation required by subsection (5) of this section to
the board upon request.
(7) A
licensee shall not use an acid or perform a chemical exfoliation that the
licensee is not competent to use or perform through training and experience,
and as documented in accordance with subsection (5) of this section.
(8) Only commercially available products
utilized in accordance with manufacturers' instructions shall be used for
chemical exfoliation purposes.
(9)
A patch test shall be administered to each client prior to beginning any
chemical exfoliation series.
Section
5. Devices. No mechanical or electrical apparatus that is
considered a prescription medical device by the FDA may be used by a licensee,
unless such use is under the immediate supervision by a licensed physician and
within that licensed physician's appropriate scope of practice.
Section 6. Disclosure. Before applying a
chemical exfoliant or using a microdermabrasion machine, a licensee shall
inform a client that:
(1) The procedure shall
only be performed for cosmetic and not medical purposes; and
(2) The benefits and risks of the all
procedures shall be disclosed prior to application.
Section 7. Prohibited Practices.
(1) A licensee shall never use any
preparation, product, device, or procedure that pierces or penetrates the skin
beyond the stratum germinativum layer, also known as the basal layer of the
epidermis.
(2) Dermaplane
procedures, dermabrasion procedures, microneedling procedures, blades, knives,
and lancets are prohibited, except for:
(a)
Advanced extraction of impurities from the skin shall use a lancet of 2mm or
less; and
(b) Dermaplane procedures
for advanced exfoliation under direct supervision of a licensed
physician.
(3)
Dermaplane procedures for basic exfoliation may be practiced without the direct
supervision of a licensed physician only if the following apply. A licensee
shall maintain current documentation of the licensee's training in
dermaplaning, including:
(a) Courses of
instruction; and
(b) Specialized
training.
(4) A licensee
shall provide the documentation required by subsection (3) of this section to
the board upon request.
(5) A
licensee shall not use any procedure in which human tissue is cut or altered by
laser energy or ionizing radiation.
STATUTORY AUTHORITY:
KRS
317A.060,
317A.130