Dr. Scheffler: A person who has diabetes should think about the following before getting a pedicure:
• Serious foot and leg infections have been contracted in nail salons and spas from coast to coast. Fungi, viruses, and bacteria lurk in the soaking tubs and on the instruments of pedicurists, waiting for your unsuspecting toes.
• Toenail infections such as onychomycosis (a fungus) can be contracted at nail salons. This type of infection makes your toenails look discolored, and they may become thick, brittle, or flaky. The same fungi may also infect the skin, causing athlete’s foot. The skin may form blisters, itch, or be dry and scaly. If the infection is between the toes, the skin may be moist.
• Viruses are another possible source of infection. A common viral infection is a wart. More serious viral infections, such as hepatitis C and HIV/AIDS, can be potentially transmitted by careless pedicurists. Yes, if the skin is broken, even these deadly bloodborne pathogens can be caught during a pedicure!
• Bacterial infections from Mycobacterium fortuitum as well as the drug-resistant bacteria MRSA (methicillin-resistant Staphylococcus aureus) have been reported following pedicures. MRSA causes serious infections that can even lead to death. Some infections can start out looking like small insect bites but may enlarge into pus-filled boils, requiring strong antibiotics. These infections may leave permanent scars.
Does this mean you should never get a pedicure? That is up to you. This is a decision only you can make. I just want you to know what you might be getting yourself into. I am really not a fan of pedicures. As a foot specialist, I have seen many foot infections that were caused by pedicures. There are many people who get pedicures regularly who have not experienced problems.
If you do choose to have a pedicure, consider these tips:
• Become your own investigator. Check for licenses and recent inspection certificates. Insist on cleanliness. Are they disposing of items that cannot be sterilized, such as emery boards, nail buffers, and toe separators? Do they use sharp instruments to shave corns and calluses? In most localities, this is not allowed by law. Besides, your podiatrist should advise you about the causes of these areas of hard skin and what should be done to prevent them or treat them properly.
• What is used for bathing your feet? It should be a plain tub of water that is soaked with disinfectant for at least 15 minutes between clients. Better yet, you should purchase disposable tub liners that separate you from the tub. Also, there should be no moving water. Any tub that has jets or bubbles cannot be adequately cleaned in the time between you and the customer who was in the tub before you. Bacteria can flourish in the plumbing and filter screen.
• Do not shave your legs before your pedicure. Shaving opens hair follicles and may cause tiny nicks in your skin that are openings for bacteria to invade.
• Buy your own instruments and bring them with you. Complete kits are available, some even in attractive carrying cases, which should be yours alone. This kit, in addition to the disposable tub liner, would effectively isolate you from harmful bacteria, viruses, and fungi. Your podiatrist may have these items available for sale.
• If you discover a problem such as a change in color or thickening of a toenail, or a strange spot that wasn’t there before, call your podiatrist for an appointment. It’s much easier to treat a condition early in its course rather than later.
Editor’s note: Dr. Scheffler’s comment was adapted from his article “Pedicures — Hazardous to Your Feet?” published in inMotion (a publication of the Amputee Coalition), July/August 2008.