A Stye, an Old Patch Test and a Request for the Longest Lashes
A 31-year-old regular client books a full set of classic lash extensions plus a lash tint. She mentions that a lash lift at another salon two weeks ago left her lids red and itchy, and that her GP treated a stye on the right upper lid with chloramphenicol ointment; the lid is still slightly swollen and tender. She had a patch test at your salon six weeks ago, which was negative, and assumes it still counts. She wears monthly contact lenses, works night shifts as a nurse and wants 'the longest, thickest 0.07 mm lashes you stock, with a tint so I don't need mascara'. She has had no previous extensions. She is not pregnant, takes no medication and has no known allergies, although she reacts to some plasters. The salon uses cyanoacrylate adhesive and a tint containing PPD derivatives.
1. Is this client suitable for lash extensions and a lash tint today? Explain your reasoning.
Read the worked answer
No - neither service should go ahead today.
- The stye and lid inflammation: a stye is an acute bacterial infection of the lid margin, and the lid is still swollen and tender. That is an active local infection and an absolute contraindication to eyelash extensions, lash tint, lash lift and any eye-area work. Extensions would trap bacteria and adhesive near the lid margin, and tint chemicals would irritate and potentially infect the area.
- The reaction to the lash lift two weeks ago - redness and itching - may be irritant or allergic contact dermatitis to thioglycolate or the adhesive used. A sensitised client is at higher risk of reacting to cyanoacrylate or PPD.
- The lift itself: only two weeks ago, lashes may still be settling from the chemical process.
- Contact lenses: remove before any eye-area treatment and reinsert only after the recommended period.
- Night shifts: not a contraindication, but poor lash hygiene and blepharitis risk are relevant to aftercare.
The correct action is to postpone until the lid has been symptom-free for at least one to two weeks, or the GP confirms resolution, then reassess.
2. How does the patch-test requirement apply here, and what does her plaster reaction tell you?
Read the worked answer
Six weeks is too old. The industry standard, and most manufacturers' instructions, is a patch test 24–48 hours before every tint application, or at least before the first appointment and after any gap or product change. Six weeks does not meet that requirement, and a previous negative result does not cover a new product, a change in client status or a newly sensitised client.
The plaster reaction matters. Adhesive plasters typically contain acrylates and colophony. A reaction suggests possible sensitisation to acrylate chemistry - the same family as cyanoacrylate lash adhesive. That raises the risk of allergic contact dermatitis, and once sensitised the reaction tends to worsen with each exposure.
Tint contains PPD derivatives. PPD is a strong sensitiser; a previous positive reaction or known sensitivity means no tint, ever.
So: patch test the adhesive (behind the ear or inner elbow) and the tint separately, 24–48 hours before, with a written record and the client's signature, and only once the lid is healthy. A negative test reduces but does not eliminate risk, so keep monitoring during application.
3. She insists and says she cannot come back for weeks because of night shifts. How do you handle the conversation, and what can you offer instead?
Read the worked answer
Hold the boundary, warmly but firmly.
- Acknowledge her: 'I understand - you want low-maintenance eyes for night shifts.'
- Explain the specific risk: 'Your lid is still infected, and you have reacted to a lash product before. Putting adhesive and tint near an active infection could spread it, and if you are sensitised the next reaction can be worse - swelling, blistering, and in rare cases a severe reaction. That is not a risk I will take.'
- Do not offer a 'small set' or 'just the tint' as a compromise - the contraindication applies to the eye area.
- Document the refusal, the reasons, the advice to see her GP or pharmacist, and her signature; note that the deposit was transferred.
Offer instead:
- Brow shaping and a brow pencil - but not brow tint, because of PPD cross-risk.
- Strip lashes with a patch-tested adhesive once the lid is clear - not today.
- Lid hygiene advice (warm compresses, lid wipes) once the GP agrees.
- A patch test appointment symptom-free, then rebook.
Also discuss length: even when suitable, the extension should not exceed about one-third beyond the natural lash, and 0.07 mm is a fine diameter but length must match lash strength to avoid traction damage.