Visiting a salon and leaving with attractive, clean, and freshly polished finger and toenails can be a great way to kick off vacation, to celebrate a special event, or just to make you feel good. But there are definitely risks to a salon manicure or pedicure. At Pennsylvania Centre for Dermatology we often get questions from our patients about the safety of nail salons, and unfortunately we see the diseases that can result from improper manicure and pedicure practices. This blog post includes steps you can take to help make your finger and toenails beautiful and healthy while enjoying a salon.
- Avoid shaving your legs for at least 24 hours prior to getting a pedicure. Just a few weeks ago, I saw a healthy young woman who had an open sore on her ankle. Her primary care doctor had prescribed some oral antibiotics for a week, and she had been applying a topical over the counter medication without any improvement. When I asked her if she ever got pedicures, she said, “Of course!” and she was shocked when I told her the open sore was likely a pedicure-related infection. When we shave our legs, even if we don’t actually cut ourselves or see any blood, we create small tears in the skin known as micro traumas. These micro traumas can serve as a door for bacteria, viruses, and fungi to enter and cause infection. No matter how clean the salon or how careful we are, we are always exposed to bacteria and other microorganisms while at the nail salon. In particular, the foot baths that are used to give pedicures harbor bacteria. Salons should disinfect these baths after each customer, and many use disposable liners. However, even with excellent disinfection procedures and liners, a type of bacteria called Mycobacterium can grow in the water and in the jets at the sides of the foot baths, causing potentially serious skin infections. My recent patient, as well as many patients we have seen in Philadelphia over the last few years and who have been reported across the country, require months of oral antibiotics to treat these chronic, serious infections. So the best practice is to avoid shaving for 24 hours before a pedicure. But if you have shaved recently and find yourself at the salon, skip the foot bath!
- Do not get a manicure or pedicure if you have any open sores, including hangnails, blisters, warts that are being treated, nails that are painful or lifting off of the nail bed, or bug bites on your hands, feet or legs. Any places where your skin is not intact has the potential to allow bacteria, viruses, or fungi in, and we are always exposed to them at the salon. This is because most salons do not use an autoclave to sterilize their instruments. Autoclaves are oven-like machines that are in doctor’s offices and are used to truly sterilize any metal instrument. Most states do not require autoclaving at nail salons (as of this writing, only New York, Iowa and Texas do) and so even salons who are licensed and following the rules are not required to fully sterilize their instruments between customers. As a customer, you need to take the initiative to avoid salons if you have a break in your skin. If your nails or the skin around the nails are painful, or if the nails are lifting away from the nail beds, you should see a dermatologist to diagnose and treat that condition before having any salon services.
- Ask the nail technician to skip cuticle trimming. The cuticle is the dead skin that seals the edge of the skin to the nail plate. Sometimes that dead skin can be attached to more of the nail plate or can become ragged and can look unattractive. Part of a manicure or pedicure often involves the technician applying a cuticle softening cream and then using a tool to push or to cut some of the cuticle away. Applying the softening cream and using a tool to push the cuticle down is safe, as long as it is not painful or aggressive. However, using a sharp cuticle trimmer or clipper is not safe. It is likely to remove healthy skin along with the dead skin, leading to immediate pain, infection and possibly “hang nails” over the next few weeks as that damaged tissue grows back.
- Also skip the razor blade/sharp pumice stone to the feet during a pedicure. It is extremely difficult to clean these tools without autoclaving them and they are at high risk for cutting the skin. If you want to soften your heels and smooth out callouses, it is safer to do so over time, using an over the counter cream containing urea, alpha-hydroxy acids, or salicylic acid.
- BYO! Consider bringing your own tools to the salon with you. If you are at increased risk for infection, for example because you have diabetes, HIV, or are taking certain medications that can weaken your immune system, or if you just want to be extra careful, bring your own tools to the salon. Professional pedicure and manicure tools are relatively inexpensive online or at a beauty supply store. If you have your own tools, you are assured that no one else has used them and you control the disinfection process yourself.
- Give your nails some down time. Acrylic or gel manicures should be reserved for special occasions and used infrequently. Each time an artificial substance like acrylic or gel is applied and removed, a portion of the surface of your nail plate is filed down, thinning the nail. This is safe to do occasionally, but frequent (weekly or biweekly, or for some people even monthly) manicures will weaken your nails over time. Leaving your nails natural gives them a chance to regenerate, and you can see if you have any nail issues developing. Natural nails without any polish at all are also best when you come to the dermatologist’s office for your full skin exam! We want to examine your finger and toenails without any polish so we can look for skin cancers under the nails.
- Opt for a “pigment powder” gel manicure over a UV or LED-cured gel manicure. After a regular manicure or pedicure, turn off the light and just use the fan for drying your polish. Most salons use a UV (ultraviolet) or LED light source and a fan to speed up the drying time for polish, and most gel manicures require a light source to harden the gel. However, that UV light is the same light that causes photoaging (think wrinkles and brown spots on the backs of your hands) and contributes to skin cancers. Although some salons will say LED light is safer because it works faster, it does include some type of UV light and is not likely to be entirely safe. Avoid the extra light entirely when you can, or opt for wearing UV-protective gloves with the tips of the fingers removed. Several types of these gloves, specifically for this purpose, are available online. Remember to put the gloves on before your technician applies the nail polish.
- Communicate with your salon! On a first visit, consider saying, “I’m a new client. Can you show me around and tell me about the salon?” That opens the door to a comfortable conversation where you can ask questions about sterilization practices and understand exactly what the technician is doing and what you can expect. All states require that nail salons put their current licenses on display. Look for the license, ask your technician about her or his own licensing and training, and ask about the salon’s cleaning practices. Remember, you’re paying for the service and you have every right to understand and feel comfortable with each step.
Keeping in mind the above tips will help you enjoy a summer filled with sandals and healthy skin and nails. If you have any additional questions, or concerns about the health of your skin or nails, don’t hesitate to contact your Pennsylvania Centre for Dermatology provider or to contact us to make a new patient appointment.