By Heather Aspinall

Summer is here and nail salons and spas are buzzing with people anxiously about the business of getting well groomed hands and feet. But along with the process of getting well-groomed or perhaps just a relaxing foot soak or rub, may come infection risks of which consumers need to be aware.  In addition to causing unintended nicks and cuts, manicures and pedicures may cause micro trauma to the skin which may present an opportunity for germs to enter the body and cause infections.   Furthermore, blood-borne viruses such as, hepatitis B or C, and HIV, or Mycobacteria and other bacteria, and fungi (yeast and moulds) can contaminate manicure and pedicure tools, resulting in potentially life-threatening viral, bacterial and fungal infections of the skin and nails.

The good news is that there are precautions that  people can take before, during and after a nail service to reduce the chances of infection to themselves, as well as to service providers and other consumers.

Before Your Service

• When selecting a nail salon, choose one that has been licensed and inspected by the local public health unit to ensure that proper steps are being carried out to prevent the spread of infections. Some health departments provide online searchable databases of inspection history of salons, while others may provide you with an inspection history report if you contact them directly.
• Postpone your service if you have any cuts, bruises, abrasions, scabs, open sores or bug bites on your hands or feet, or if you have a nail or skin infection such as athlete’s foot or warts.
• If you are diabetic, have poor circulation, vascular disease or any condition that affects your immune system, consult your healthcare provider before getting the service, as you may be at a much higher risk for infections.
• Avoid shaving, using hair removal creams, or waxing your lower legs for at least 24 hours before getting a pedicure. Any nicks on the skin will increase your chances of infection.
• If you get frequent manicures and pedicures, consider purchasing and bringing your own tools to be used at the salon.

At the salon

The salon should be visibly clean, tidy and well-lit, with no dirt, dust, nail clipping on surfaces or floors. This may give an indication of the overall sanitation of the instruments and tools that may become contaminated with germs that may cause infection.

The nail technician should clean his or her hands, and ask customers to clean their hands using soap and water, or a 70 per cent alcohol hand sanitizer before starting service.

Tools such as scissors, clippers, cuticle cutters, glass/diamond nail files, and tweezers should be cleaned and then disinfected before starting a nail service.

Tools that cannot be properly cleaned and disinfected, such as buffing blocks and pumice stones are single-use items and therefore should not be used on more than one person.  These items should be thrown away after each customer.

Pedicure razor blades are also single-use items and must therefore be properly discarded after each customer.

Pedicure footbaths, tubes and filters can collect germs and cause them to grow and multiply to cause infections.  Footbaths must therefore must be thoroughly drained, cleaned and properly disinfected between each use to prevent harbouring germs.  Do not use a footbath if you are not sure it is disinfected and safe to use. If in doubt, choose a salon that uses footbaths without drains or footbath liners that are changed between customers.

Lotions, oils and creams should be used in a manner that does not contaminate the remaining product.  The technician should use a disposable applicator that should not be “double dipped” into the remaining product.

Ask the technician how cleaning and disinfection procedures are carried out, if in doubt.

After your service

If you notice signs of infection during the weeks following a nail service, contact your healthcare provider immediately.  Signs of a fungal infection may include discoloration (yellow, brown or white) or flaking, thickened or cracking nails or red, itchy, peeling skin between the toes (athlete’s foot).  Red, swollen, throbbing or tender skin may indicate a bacterial infection which requires immediate medical attention.

Report any complaints regarding improper cleaning and disinfection practices in a nail salon to your local health department.

(Heather Aspinall is a communicable disease control specialist.)