Health Risks Lurking at the Nail Salon
Molly Dannenmaier, of Galveston, Texas, visits a local salon every three weeks. She regularly gets a pedicure and occasionally treats herself to a manicure -- but the pedicure is a staple. It wasn't until both she and a friend developed toe infections that she considered the health risks. "[My friend] got a terrible infection, and in fact had to have surgery to have her toe nail removed," Dannenmaier recalls. "It's never going to grow back."
While Dannenmaier's infection was not as bad, she says she now thinks differently about going to the salon. But because it's part of her longtime routine, she keeps going back.
"I never even imagined it was the nail salon," Dannenmaier says. "You know, it's been a month or two, and I keep going. I guess I'm in denial."
While there have been few reported cases of deaths due to a nail salon visit gone wrong, one California woman blames her daughter's death on an infection associated with bacteria she may have picked up during a pedicure in 2004. Little data has been collected in regards to salon-related deaths and illnesses across the country. U.S. News spoke to podiatrists, dermatologists and other health professionals to find out which health risks you should be aware of and how to protect yourself during your next manicure or pedicure.
[Read: Pedicure or Pedicurse? Proceed With Caution.]
Injury and Infection
Ouch! The nail technician clipped your cuticles a little too quickly and nicked the skin. She apologizes and rinses it off. It stopped bleeding, so you figure it's fine to continue your pedicure. But is that really a good idea?
Robert Spalding, a Tennessee podiatrist and author of "Death by Pedicure," says the most alarming health risk at a nail salon is injury that leads to infection.
About 75 percent of salons in the U.S. don't follow state protocol for disinfection, Spalding says. While it's impossible to be completely sterile, salons should sterilize their tools using an autoclave -- a machine used in medical environments that produces steam and pressure for disinfecting equipment.
Many nail salons use liquid disinfectants to clean tools, but this method is only effective if nail technicians soak the instruments for around 20 minutes. When shops get busy, tools are often removed early and used on the next client.
Also worrisome: Manicures and pedicures may cause microtraumas to the skin by nail filing or cuticle cutting, resulting in infection. "Those little micro-injuries that can be unseen are the ones that can lead to big problems," Spalding says. Hepatitis B, MRSA, and other bacterial infections are potentially life-threatening and can be picked up in salons. "There's a huge difference between a bacterial infection and a fungal infection," Spalding adds. "A huge number of people walk in with nail fungus, and most state laws prohibit them to be served, but they are served anyway. That then causes a bigger problem on the bacterial level."
Dennis Shavelson, a podiatrist in New York City, says infections can stem from dull nail files, but sharp instruments are especially concerning. "If [technicians are] cheating with sharp instruments or cutting corns or calluses instead of kind of grinding or shaving them, you can get infections, injuries, irritation," he says.
What you can do: People with poor circulation or diabetics are at a much higher risk of contracting an infection, and most diabetics should avoid going to a typical nail salon, Shavelson says. Check with your local podiatrist to see if the office offers a medical pedicure instead.
However, all salon-goers can protect themselves by bringing their own instruments or asking technicians about the salon's disinfecting procedures -- and requesting the technician use plastic gloves. Consider only going to salons that use autoclaves to disinfect instruments and tools. Never allow anyone to use a credo blade, which is a callus razor that resembles a vegetable peeler, or any other type of sharp instrument to remove skin. In fact, it's illegal for salons to use credo blades in most states. If you're injured in a salon or experience any pain or redness following a visit, see a physician as soon as possible.
[Read: Watch Out for Unproven Anti-Aging Treatments.]
Nail Fungus
Many of us love soaking our feet in the warm, bubbling water attached to a massage chair. But have you ever thought about the people who were soaking their feet before you?
Shavelson says a common misconception is that people can develop athlete's foot or similar fungal infections at nail salons. But typically, foot fungus develops in dark, moist enclosures -- not a nail salon foot bath.
Nail fungus, however, is another story. Shavelson says it can spread in a salon if foot baths and instruments aren't cleaned properly.
What you can do: If you think you may have a fungus, never go to a nail salon to have the problem treated. Nail fungus is often treatable at home, but you should see a podiatrist if it continues to grow after the initial removal, Shavelson advises. "If they just see an area that's turning white, I would take a nail clipper and remove that part of the nail, and if it keeps getting white or grows back white then they should get some help," he says.
Unlike over-the-counter athlete's foot medication, over-the-counter nail fungus medication is rarely effective, he adds. If the fungus needs medication, it's important to use a prescribed treatment.
[Read: 9 Footwear Do's and Don'ts.]
UV Ray Exposure
You're admiring your freshly painted fingers as you sit down at the drying station -- ready to settle in and wait for the polish to harden. But have you considered what that lamp is doing to dry your nail polish? It turns out these light stations emit UVA rays -- the same rays emitted by the sun and tanning beds, which have skin-damaging effects and can lead to cancer.
Jenny Kim, a dermatology professor at the University of California-Los Angeles School of Medicine and practicing dermatologist, cites a 2009 report by a dermatologist with two patients who had skin cancer on their hands. Because the women frequented nail salons, the physician attributed the cancer to the salon's drying devices. However, Kim cautions that while it's possible the dryers were a contributing factor, there's no evidence the cancer was a direct effect.
In a study published in JAMA Dermatology this year, researchers tested 17 different UV lamps and found that the risk of cancer is very small from exposure. However, the study revealed that significant DNA damage to the skin could occur in eight to 14 visits over a time period between 24 and 42 months. Kim attributes this to the UVA from the lamps. "We know UVA exposure is harmful and that that could lead to photo aging and eventually skin cancer," Kim says.
She adds that your skin pigmentation affects your risk level -- those who have fair skin have a higher risk of damage than those who are dark-skinned.
To put the risks in perspective, consider that while nail drying lamps emit UVA rays, tanning beds will cause more damage. "The light that is coming out to give one a tan at a tanning salon has been shown to be very dangerous, and so I don't think it is fair for the salon owners to say that is comparable," Kim says.
Michael Greenberg, a dermatologist at the Illinois Dermatology Institute, says even if the effects are small, people need to weigh the risks with the benefits. "We're so obsessed with all these beauty processes, and there are always side effects to everything we do. Any UVA exposure is still UVA," Greenberg says.
What you can do: While people should not be too alarmed by the UVA exposure of drying lamps, Kim says, it is important to recognize damage is occurring with any exposure. She, as well as the American Academy of Dermatology, encourages salon-goers to wear a broad-spectrum sunscreen that protects against UVA and UVB rays on the hands to minimize damage.
[Read: What to Know Before You Glow.]
Respiratory Irritation
When you walk into the nail salon, it's difficult not to notice the strong smell of acetone and other chemicals. But have you ever wondered exactly what you're breathing in and how it could affect your body?
"Basically, they are organic solvents. And organic solvents, in general, have a high potential for two things: carcinogenesis-causing cancer, and in sensitive people, irritation of the airways," says Norman Edelman, a pulmonologist, senior medical consultant with the American Lung Association and professor at Stoneybrook University's School of Medicine.
More research is necessary to determine if breathing these chemicals causes cancer, Edelman adds. "What we know for sure is that these things will trigger asthma," he says. Those who inhale the chemicals daily are at the greatest risk of health complications. If they suffer from asthma, it will likely get worse, Edelman says.
What you can do: Nail salons should avoid using products with the "toxic trio:" toluene, formaldehyde and dibutyl phthalate, according to the U.S. Department of Labor. Staff should also consider using a respirator when working, as surgical masks only protect from loose particles and make no difference when inhaling toxic fumes.
If you don't work in a salon and merely visit for appointments, such chemicals likely won't be detrimental to your health. However, if you have asthma or are particularly sensitive to irritants, experts recommend avoiding salons with poor ventilation.
[Read: 8 Beauty Emergency Bailouts.]
