Mary’s daughter was getting married. So as a last minute surprise she took her daughter and all of the bridesmaids out for an outing to get pampered at a nail salon. But just before the wedding, the bride, and all her attendants developed big black draining sores all over their lower legs and ankles. So how can you make sure your nail salon is safe and avoid this sort of pedicure disaster?
As a podiatrist, I get lots of questions about the relationship between pedicures, foot fungus, and infections. But the most passionate discussions seem to revolve around pedicures. I even remember one of my instructors in medical school telling all of us medical students to warn our patients to avoid salon pedicures. But we have to be realistic. Women love to be pampered and a pedicure is a great way to relax and feel special. You just have to know the risks associated with nail salon infections and follow some simple rules to keep your pedicure experience safe.
If you don’t think pedicures can be dangerous, you must not watch the news. In September of 2000, 110 people were infected during an outbreak in a nail salon in the San Francisco Bay Area. Within days of the soothing foot bath and pedicure, pimple-like bumps appeared. These little bumps got worse and turned into red or black pus-filled sores. Many of these women got permanent scarring on their legs as a result.
In 2004 there was another outbreak only miles south of San Francisco in which pedicure-related infections were identified in 143 pedicure customers linked to 33 different nail salons in Santa Clara County. In 2005 there was yet another outbreak of infections related to nail salons involving 17 people.
A pedicure lawsuit was born after a Mountain View California woman died after a bacterial infection allegedly contracted from a pedicure in 2004. A similar case in Fort Worth, TX involved a 46-year-old woman who allegedly contracted an antibiotic-resistant infection and eventually died from the staph infection. One shocking study conducted in Arizona in 2009 showed that 181 nail salon establishments agreed to pay fines to settle health code violations in the Tucson area alone.
Although the statistics and headlines can be alarming, you should know that not all pedicures lead to infections. There are laws and professional guidelines that help nail salon workers protect you from infections and the spread of disease during a pedicure.
The first thing you should do when you visit a nail salon is look around. Use a little common sense. If you go to a restaurant and see flies buzzing around the kitchen, would you still eat there? Does your nail salon look clean? Do you see health and safety rules posted in the waiting area? This is one of the most common reasons for citations in California nail salons during state inspections. Let’s face it if they can’t follow the simple rules, would you really trust them to sterilize instruments or meticulously clean the massage chair or foot bath?
Next, ask some questions. Are all of your nail technicians licensed? If they are licensed you can be sure they have at least taken a test about ways to decrease the spread of nail infections. Unsanitary practices are common but less likely in nail salons that follow the rules.
Ask them how they disinfect their instruments. Do they re-use any disposable instruments? This is a real no-no. Re-using disposable instruments is an easy way to spread fungus and bacteria from one foot to another.
How do they clean the foot bath? Most of the really contagious infections involved a germ called mycobacterium. It lives in water and can grown on the dead skin and hair that gets stuck in a little filter inside the foot bath motor. If the salon staff can’t tell you quickly the exact protocol for cleaning the foot bath, you may be soaking your feet in an alphabet soup of infection causing bacteria.
Look for labels and covers on all containers. If you don’t see clear labels such as “dirty,” “clean,” “water,” “disinfectant,” etc., don’t expect the workers to always grab the clean ones when working on your feet. Lids on the containers may not seem like a big deal, but all of those infection causing fungal spores and bacteria can float through the air from that nasty yellow toenail in the chair next to you and then settle right on the cuticle pusher the nail tech is about to use on you.
Watch for hand washing. Doctors and nurses wash hands before and after every patient contact. Simply washing hands is one of the best ways to prevent a contagious infection from spreading. Your nail tech should do the same. While you are waiting for your turn in the pedicure chair, just watch and see if the nail technician washes her hands or just changes gloves between clients.
Ask them if they ever fix ingrown toenails. If the answer is yes, you may be putting yourself at risk. Ingrown toenails are often teeming with infection-causing bacteria. And you don’t want to be sitting in the pedicure chair following a pus-filled ingrown nail. Only licensed podiatrists (foot doctors specializing in feet and toenail surgery) should be working on these. Just cutting out the corner or the ingrown nail has many risks and is illegal when performed during a nail salon pedicure. Once you have found a clean, reputable nail salon, don’t shave your legs before you get a pedicure. The one risk factor that links pedicures to horrific infections is open wounds. If you shave less than 48 hours before your pedicure, you create invisible little cuts in the skin that allow bacteria to get in. If you shaved your legs the morning of your pedicure, you can still get your toenails done, but you should avoid the foot soak.
Keep in mind that there are lots of safe, comfortable places for you to get a pedicure. You just need to ask a few questions so that you can feel sure you will leave the salon with pretty, soft, pampered feet… and not with a nasty infection.