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Glenn D. Braunstein, M.D. Headshot

Prudent Pampering: How to Choose a Healthy Nail Salon

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Sandal season is nearly upon us in Los Angeles. Fashion advice is clearly not my forte (just ask my wife) - but I'm willing to bet that no matter what kind of sandals are in vogue this summer, they will be accompanied by pedicures.

For many women, the manicure and pedicure is a relaxing treat. Just be sure that you don't get more than you bargained for. An infection or nail fungus - and in more extreme cases more serious diseases including Hepatitis B and methacillin-resistant staph infections - could result from being groomed with dirty tools or in a dirty footbath.

While there have been some incidents of infections being spread through salons, particularly through contaminated footbaths, on the whole manicures and pedicures are a safe and soothing ritual. A manicure or a pedicure should never be painful - and if they are, alert your cosmetologist immediately as she may be opening a portal in your skin that will allow bacteria to take up residence.

Here are a few more tips to consider before going to the nail salon:

Look before you leap into a salon. Before you dash to the shelf to pick out your nail color, peruse the walls for a license for the salon, and also a license for each technician. If you don't see one for your manicurist or pedicurist, ask.

Also note if it seems to be clean. Are the footbaths being drained and cleaned with disinfectant between clients? Many salons use spa chairs with built-in foot spas. If they're cleaned regularly, they're perfectly safe. However, you might consider a salon that uses portable foot spas that are lined with plastic that is changed after each pedicure.

In 2000, the California Department of Health Services and Centers for Disease Control investigated the first known outbreaks of Mycobacterium fortuitum, which were acquired from footspas at a Northern California nail salon. More than 100 pedicure customers had prolonged boils on their lower legs that left scars. Making sure that spa chairs with built-in footbaths are regularly sterilized, and have the necessary filters changed - or opting for portable footbaths - could avoid this kind of infection.

Don't be shy about tools and sanitation practices. To be 100 percent safe, bring your own tools - that way you know they're clean. Alternately, find a salon that uses new tools on each client.

Many salons in Los Angeles will send you home with a kit that includes the buffer, file, and other wood- or cardboard-based tools used on you. These porous materials cannot be sterilized, and under the rules of the California Board of Barbering and Cosmetology, should be used only once by the salon. Sending the kit home with you isn't only for your convenience for touch-ups - it also reassures you that those tools will be discarded and fresh ones used for each customer.

If the salon uses a mix of those items and stainless steel tools, ask how they are sterilized. The best means of sterilization is through heat - called autoclaving. Note that some salons use UV light - but that's not an effective means of killing bacteria, while others will use liquid disinfectants that can work if the tools are immersed long enough. Call the salon ahead of time, and ask how they sanitize their tools before booking an appointment.

Other salons have moved to a system of storing personalized kits for clients on site - kind of like some sushi restaurants that store your personal chopsticks.

Speak up if your technician is using an illegal tool, like razor callus shavers, also known as Credo Blades. These can cause serious injuries requiring medical attention.

Reputable salons should be comfortable answering any of your questions about sanitation practices. Chances are, you aren't the only one asking.

Know the first step in a manicure. All manicures and pedicures should start with a scrub. Both you and your technician should wash your hands with antibacterial soap before the service begins.

Does the salon pass the smell test? You should not be overwhelmed with the powerful odors of the various polishes, solutions and other chemicals used in a nail salon. If you are, that's a sign of poor ventilation. Prolonged exposure to the fumes from a nail salon should be avoided.

Careful with those cuticles. Cuticles are a natural defense for your nail bed from bacteria. It's best not to have them cut. Ask your technician to leave them alone, or to gently push them back with a cotton-covered stick.

Delay your manicure or pedicure if you have a cut or infection. If you have a cut around your fingernails or on your feet, put off your appointment. Open cuts invite infection, especially if you're going to be indulging in a foot soak. If you have any inflammation or a skin rash, the technician is expected to refuse service to you to prevent the spread of disease to other customers.

In fact, if you plan to use the foot soaking tubs, do not shave or wax your legs for two days before your appointment to decrease the chances of bacteria entering nicks or cuts.

Tell your technician about any relevant medical conditions. If you are diabetic, have peripheral vascular disease or are taking any blood-thinning medications, including daily aspirin, tell your technician. This will alert your cosmetologist to take special precautions.

As you trade socks and shoes for sandals, give your feet some extra pampering. Just keep in mind that these are licensed professionals using sharp tools - it's OK to be picky about how they treat your hands and feet. Choose a salon that you have 100 percent confidence in - even if that means spending a little extra.

You - and your health - are worth it.