Pedicures: Safe or Sorry?
Pedicures have become quite popular over the past several years – anyone who has had one knows why. They feel good and keep your feet presentable, especially in the summertime. We think of pedicures being a “girl thing.” But, as you will learn in this article, men benefit from pedicures as well. In addition to the many benefits from pedicures, be aware of serious risks.
Many people get pedicures simply to have prettier feet, painted toenails, and to relax at the salon. Pedicures provide needed foot care for those that cannot provide it for themselves. People with stiffness from normal aging, arthritis, and back problems seek help with foot care because they cannot reach their feet. Even an agile person with poor vision needs help with foot care. Not seeing what you are cutting is dangerous and risks cutting into the skin. People with medical problems such as diabetes, peripheral vascular disease, and poor immune systems are at high risk for infection and even limb loss (amputation) if a cut or abrasion occurs while clipping the nails or managing calluses.
Health benefits of getting a pedicure:
- Nail Care – Proper trimming of the nails prevents ingrown toenails. Proper nail care is extremely important for diabetics as well as people with peripheral vascular disease because infection can result in amputation or worse. People with a total joint replacement are at risk of ingrown toenail infection spreading into the replaced joint, resulting in multiple surgeries to eliminate the infection.
- Callus Management – The more work our feet do, the faster they build calluses. Calluses may result in blisters and skin cracks, especially around the heel. The result of a skin crack is the same as a blister – pain and an entry portal for bacteria to cause a skin infection (cellulitis).
- Blood Flow – Most pedicures include a massage of the feet and legs. As the legs are massaged, stroking from the foot to the knee promotes the flow of venous blood and lymph (clear fluid that can accumulate in the feet and legs) back to the heart. For people who have severe swelling, a pedicure should not be the first line of therapy – if severe swelling is present, it is best evaluated by a doctor before having a pedicure.
- Moisturize – Dry skin is uncomfortable, fragile, and prone to developing an itchy rash (xerodermatitis). While scratching for relief is almost irresistible, it results in abrasions that provide bacteria entry threatening infection. The oils and lotions used by the pedicurist rehydrates the skin and helps the skin retain its own moisture providing a healthy barrier to infection.
- Early Detection of Problems – The pedicurist working directly with your feet can point out abnormalities such as bunions, hammertoes, and skin changes. Beware of two types of dark discoloration of the skin: 1. Dark callus and 2. Dark freckle or mole. Dark maroon or almost black discoloration under a callus indicates bleeding between the callus and the deep layer of skin (dermis). This occurs in diabetics who have neuropathy and needs swift medical care to prevent a limb threatening ulcer. A dark freckle or mole is a warning sign for melanoma, a life threatening skin cancer that can be cured if treated early.
- Prevention of infection – As noted above, good nail, callus, and general skin care decreases the risk of infection by maintaining a healthy barrier to infection and preventing trauma from normal use of the feet.
With all those benefits, what are the risks? Infection, infection, infection! If proper procedures are not followed, the risk for infection from a pedicure is high. There are many types of infection including bacterial, mycobacterial, fungal, and viral. The most dangerous skin infections that can occur are MRSA (methicillin resistant staph aureus) and mycobacterium fortituitum (an aggressive dangerous cousin to tuberculosis). Both can get very serious very quickly and they are difficult to impossible to treat with normal antibiotics. In addition, they cause infected wounds resulting in unsightly scars and the need for surgical treatment. Fungal infections of the skin can also be very difficult to resolve and may require months of treatment. Fungal toenail infections are not as dangerous for healthy people, but are unsightly, cause embarrassment, and sometimes are painful. Fungal toenails are difficult to treat. Topical treatments don’t work well. Pills have unpleasant side effects and stress the liver. Laser treatment of fungal nails has the best success rate, but is expensive and medical insurance does not pay for it.
The most important way to prevent infection is to go to a pedicurist in a reputable salon. All of the organisms that cause infection live in the whirlpool basin and its tubes. The surfaces of the implements used to cut and file nails and calluses are also homes for germs. The whirlpool foot bath should be cleaned with a hospital grade disinfectant solution that fills the basin and tubes for at least 10 minutes. It should be treated after each client, not just at the end of the day. A de-cleating agent needs to be used to remove oils and lotions that contribute to biofilm that protects the bacteria from chemicals. Metal implements need to be disinfected, too. They must be cleaned with a brush to remove all visible debris. A salon that is fastidious about cleanliness also uses an ultrasonic treatment to remove particles too small to see. After cleaning, the instruments must be soaked in a hospital grade disinfectant for a minimum of 10 minutes. UV light treatment alone is not sufficient.
So how do you know you are at a salon with proper sanitation and safety practices?
- Evaluate the salon – Know your place of business.
- Look for state license certificates – Most states have laws requiring them to be posted in plain view.
- Ask to see the sanitation record or pedicure cleaning log – If it cannot be produced, walk out!
- Observe practices in the salon – Are non-metal, single-use files and pumice stones being thrown out? Are metal implements disinfected? Are whirlpools being disinfected properly after each client? Are the workstations clean?
What can you do to minimize the risk of having a pedicure?
- Don’t shave your legs before you go – Shaving causes microtrauma to the skin that allows bacteria and fungus to penetrate the protective layer of skin.
- Don’t get the whirlpool foot bath – Or choose a salon that has a “pipe-less” foot bath with a throwaway liner that is changed after each client.
- Don’t cut your cuticles, or let the pedicurist cut them – The cuticle is a protective barrier to germs. Soften the cuticles with cuticle softener or by soaking in warm soapy water. After it is softened, push the cuticle back instead of cutting it.
- Don’t allow callus to be shaved with a blade instrument – It is not legal in most states.
- Bring your own tools and polish – That way you know they are not contaminated. Be sure to clean your tools in 91% alcohol after each use.
A pedicure is an easy, enjoyable way to prevent foot problems …go have a safe one!
Published: QC Times “Staying Well” September 2014