With winter coming to a close, the summery fashions are starting to emerge sending women everywhere in search of a pedicure pampering experience to prepare for spring sandal season. But every year there are more reports of horrible infections that result in athlete’s foot, toenail fungus and even repulsive draining sores resulting in permanent scarring. So how can you make sure your favorite nail salon is safe?

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. Back in 2005 there were reports of seventeen pedicure clients infected during another salon outbreak.

In California an emergency law was inacted after a lawsuit was filed when a Bay Area woman died from an alleged pedicure-caused infection. 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. In 2009 a study showed that 181 Tucson, AZ area nail salons agreed to pay fines for health code related violations.

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.

As soon as you get to the nail salon for your pedicure appointment, just take a god 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 be honest, if your pedicure place won't follow the simple rules like posting required signs, the almost certainly can't be trusted to carefully clean or sterilize your pedicure equipment?

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. Although anyone can make a mistake, you're just more likely to have sanitary conditions at a nail salon that follows all 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? The majority of dangerous foot infections after pedicures are caused by either staphylococous (tranferred from other people) or mycobacterium (which lives in the foot bath water). 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 your pedicurist doesn't seem to know the proper way to clean the footbath, you just might have all kinds of bugs doing the backstroke around your toes in that warm soothing foot soak.

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. When you go to the doctor you'll notice your doctor washes his hands before and after seeing you. This is a well-known simple way to decrease the spread of infection. You should expect no less from your pedicurist. If you sit in the waiting area and see a worker simply change gloves and not wash her hands, you might think twice about that pedicure.

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 must get a pedicure right after you shave your legs, skip the foot bath.

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 an nasty infection.

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