Getting a manicure and/or pedicure is arguably the most relaxing ways to pamper yourself. But, in the case of one Florida woman, a trip to a local salon ended became a life-altering experience.
Back in September 2018, Clara Shellman visited Tammy's Nails 2 in Tampa, where her toe was cut during a pedicure. The small nick on her toe lead to an infection that quickly spread from to her lower leg, requiring part of her leg to be amputated, according to local Tampa outlet WFLA — a situation which was reportedly exacerbated by a preexisting health condition. (More on that down below.) Shellman's attorney told Newsweek that she first thought the infection was "typical," but when someone at work stepped on her foot 22 days later, she "doubled over" in pain. ER doctors told her she had a serious infection, requiring three separate amputations of multiple toes and, ultimately, part of her leg.
Shellman filed a lawsuit against the salon in May 2020, with her lawyers alleging the employee "used tools and equipment that were so dirty they posed a danger to customers," according to the Tampa Bay Times, noting that Shellman's life was flipped upside down due to medical expenses and the inability to walk and care for her young daughter. The salon denied Shellman's claims and even placed blame on her for not immediately seeking medical care or taking "reasonable efforts to prevent the development of infection." In the end, Shellman received a settlement of $1.75 million.
You may have never given a second thought to the state of the tolls and equipment during your nail appointments, but New York-based podiatrist Hillary Brenner, D.P.M tells Shape that salon-induced infections are "more common than you would think." Eek.
Keep reading for everything you need to know about how common a salon-induced infection is, and what you can do to keep yourself safe during your next appointment.
How common are post-salon infections?
"Throughout my years in practice, I have seen my fair share of skin and nail infections secondary to my patients going to nail salons," says Dr. Brenner. She points out a 2017 study from the Journal of Chemical Health and Safety that looked at the potential for health and safety risks among salons in New Jersey with some alarming stats. "Of the 90 participants in the study, 52 percent reported having dermal (i.e. skin or nail), respiratory, and/or fungal infection symptoms, and they were the most common among people who had been to a salon three times in the past year," according to Dr. Brenner. Researchers noted that — perhaps unsurprisingly — those who visited salons more frequently had "increased occurrence of dermal and fungal symptoms." That means going for regular mani/pedis may up your chances for infection. (Don't worry, you can totally treat yourself to a salon-worthy pedicure at home.)
What causes an infection during a manicure or pedicure?
"There are a multitude of fungi and a multitude of ways of contracting them," as board-certified dermatologist Joel Schlessinger, M.D., previously told Shape. Coming in contact with harmful fungi in your environment (e.g. the nail salon), can result in infection, especially if you're already immunocompromised and/or have pre-existing health conditions (like HIV/AIDS, cancer, diabetes, and other autoimmune diseases) that boost your chances of catching bacterial, fungal, viral, and/or parasitic infections in the first place.
While a bacterial infection can show up within days after exposure, both viral and fungal infections (which cause plantar warts on your feet and toenail fungus, respectively) can sometimes show up several months after exposure, which could make it tricky to pinpoint exactly when and where you became infected, adds Chicago-based internal medicine physician Vivek Cherian, M.D.
Unfortunately, there are multiple different types of health issues that can arise as a result of a salon visit, according to Dr. Brenner. Some examples: A fungal infection called athlete's foot (aka tinea pedis), and a bacteria called mycobacterium fortuitum that can develop due to moisture in an unsanitized foot bath can occur, she says. Your risk will be higher if you hit the salon with freshly-shaven legs, she says. Even though it might be tempting to remove your hair, waiting at least 24 hours will help reduce the risk of illness-causing microorganisms making their way through teeny tiny abrasions and cuts. You'll also want to skip the foot spa if you've got any open wounds including bug bites, bruises, scratches, cuts, scabs, and poison ivy, according to the U.S. Environmental Protection Agency.
You can also develop warts (a skin infection caused by the human papillomavirus, aka HPV), a virus that infects people with a cut in their skin, by way of, say, an unclean filing tool. There's also the chance of developing MRSA (methicillin-resistant staphylococcus aureus) which is a bacteria resistant to antibiotics that leads to a staph infection, typically from unsanitized tools. Lastly, there's a "low risk," of developing HIV and/or Hepatitis C (a liver infection), which are viruses that can occur when blood is present on an instrument and used from one client to the next, says Dr. Brenner. Even though the chances of developing either condition at a nail salon are minimal, "you still need to be cautious any time you're sharing personal instruments or equipment with others," which is why nail tools should always be new or sterile, says Dr. Brenner. (Related: Woman Nearly Loses Her Leg After a Salon Used a Banned Pedicure Tool)
As for Shellman, she had a previous health condition (peripheral arterial disease, or PAD) that reportedly resulted in the infection spreading rapidly from her toe to her lower leg. Her attorneys have stated that Shellman had a severe form of this common circulatory disorder in which narrowed arteries reduce blood flow to the limbs. Dr. Brenner notes that people with predisposing conditions, such as diabetes, neuropathy, peripheral vascular disease, or other immune-based illnesses, should not get a salon mani/pedi. Instead, you'll want to visit a podiatrist for a medical-grade manicure/pedicure, which is done with special care to avoid infection — e.g., without water and potentially invasive scrubbing, and with sterile, safe, medical-grade tools.
How can you prevent an infection and when should you seek medical care?
"The best way to prevent infection is to go to a reputable nail salon where the nail technicians wear gloves and sterilize and clean all tools and equipment with a strong antiseptic (aka a solution that kills germs)," says Dr. Brenner. "Prior to getting a pedicure for example, you should make sure that the bowls are disinfected and cleaned after each patron," adds Dr. Cherian. "It is also extremely important that the instruments used are completely disinfected after each client — ideally they should be autoclaved, a disinfecting method hospitals use for sterilizing surgical tools, that completely sterilizes the tools. Usually when they open a new case from a bag this likely is the case, but it is still definitely prudent to ask to have that assurance," he notes.
There are other ways you can be extra sure you're helping to prevent infection, adds Dr. Brenner, who suggests getting a dry pedicure (i.e., skipping the foot bath), avoiding hair removal on your legs and feet a week before your treatment, and bringing your own instruments — all of which can help you enjoy your experience while minimizing risk. (Related: Exactly How to Get a Salon-Quality Manicure at Home)
If you do have a pre-existing health condition and you get nicked or cut during a spa treatment, you'll want to seek medical care ASAP even if you don't yet show any troublesome symptoms, says Dr. Brenner. If you don't have a pre-existing health condition, just monitoring the area will suffice, she says. Watch for the area around a cut or bump becoming red, hot, or swollen, or the development of a boil, pus, or red streaking up the leg. Seek immediate medical attention if you develop a fever, chills, night sweats, nausea, or vomiting, which could mean your infection is spreading. All in all, you don't want to mess around with any of the above, so it's always better to err on the side of caution and check in with a podiatrist or physician with any mani/pedi-related concerns.