Client Consultation, Contraindications, and Patch Testing
This domain tests the conversation before the tweezers come out: how you gather history, decide whether a client can be treated, document consent, and run a patch test that actually means something. Exam items often present a client scenario and ask whether to proceed, modify the service or refer.
Consultation structure
Collect a written intake covering eye health, allergies, medications, prior lash services, contact lens use, pregnancy, and skin conditions. Ask specifically about cyanoacrylate reactions, latex allergy, recent eye surgery, and any active infection. Take baseline photographs with consent, explain realistic retention expectations, and record everything. Set expectations that 40 to 60 percent retention at two to three weeks is normal.
Absolute and relative contraindications
Absolute: active conjunctivitis, blepharitis flare, stye, or any contagious eye condition; known cyanoacrylate allergy; recent eye surgery without physician clearance. Relative, requiring physician clearance or modification: pregnancy and breastfeeding, chemotherapy, uncontrolled diabetes, thyroid medication and other drugs that drive lash shedding, isotretinoin within the past six months, blood thinners, dry eye disease, and contact lens wear, where lenses are removed for the service.
Patch testing
Apply a small amount of the actual adhesive 24 to 48 hours before the first appointment, behind the ear or on the inner elbow, and document the result. A negative test does not guarantee safety: cyanoacrylate allergy is acquired through repeated exposure, so a client can react after months of uneventful sets. Retest when the adhesive brand or formula changes.
Worked example
A client who has worn extensions for eight months arrives with itching, redness and swelling of both lids within hours of her last fill. Reasoning: this pattern is delayed hypersensitivity, not poor hygiene or a bad batch. The correct action is to remove the extensions professionally, not perform a fill, refer her to an eye care professional, and record the reaction. She should not resume cyanoacrylate-based extensions.
Traps that cost marks
Patch testing on the day of service; treating "hypoallergenic" as a guarantee; ignoring the possibility of sensitization over time; proceeding during an active eye infection; and diagnosing a condition instead of referring.