Is Your Pedicure Killing you?

Is your pedicure killing you?

I have to admit that I find it amusing that our last blog was titled "Are your feet at risk in the water?" and it was about shark attacks, and the word killing was not in the title of our blog or podcast.  Then we shift gears this week to, "Is your pedicure killing you?". A topic I know most women and some men do not want to hear about.  But just like many of statistics with shark attacks versus things like sink holes and dog attacks, I wanted to explore if we could put together some hard and fast, and more importantly understandable to the listener, facts that can support and maybe shift our thinking that putting our feet in the water of the nail salon may not be such a great idea!

Of course there are a thousand stories in the naked city. Everyone knows someone who has had some kind of problem after a pedicure. Dr. Henne and I see it everyday first hand. 
Anecdotally, in the last 13 years in private practice, I would say we see anywhere from 2 to 5 people daily that have fungus, infected ingrown nail or infection in the skin or soft tissue due to a pedicure. We spend time explaining to the affected, that getting a pedicure is a high risk activity and is really only a couple steps down from having unprotected sex. 

You might be thinking I have gone too far with that last comment but hear me out. Non-tuberculosis mycobacterium, Hepatitis, MRSA and many others including the very common fungal nail infection are very possible to get when sitting in the comfy nail salon chair.  I always try to comfort patients that come in with a fungal nail infection, that fungus is one of the better problems to walk away from a nail salon with. Though nail fungus is very difficult to treat, it does not typically end up with a hospital stay or potential loss of limb like some of these other problems.

One of the crusaders of informing the public about the dangers that lurk in a nail salon is

Dr. Robert Spalding Jr. As a foot doctor, Dr. Spalding is no stranger to the hidden problems of the nail salon industry and in his book, "Death by Pedicure, the dirty secrets of nail salons" he dedicates a chapter in his book to the death of two women, Kimberly Jackson and Jessica Mears, whose unfortunate deaths were after having pedicures performed.  In 2005, Kimberly Jackson, a paraplegic that was wheelchair bound due to damage of her lower extremities was unable to trim her own toenails. She sought the aid of a nail technician instead of a podiatrist for care of keeping her nails trimmed.  When Kimberly left the nail salon that day in 2005, she left with more than her toenails trimmed and painted.  She left with an open cut from the pumice stone that the nail tech had used on her foot, according her friend and neighbor, Patricia Mathis. This open cut, in addition to the soaking in the questionable spa whirlpool was the perfect storm for this unfortunate woman to develop a MRSA staph infection.  After a 7 month battle and intense medical care, Kimberly Jackson lost her battle and died.  Her cause of death was heart attack from blood infection from a staph infection from her foot.

I will now interject a story from one of the many from my own practice over the last 13 years.  About 7 years ago, a 36 year old female presented to my office with a history of a pedicure 4 days before the visit. Her past medical history, none, meaning she was healthy, on no medications and a recent physical and blood work that concurred with her very clean bill of health.  She was seen in a local nail salon in Clermont, Florida.  She was complaining of rough skin on  her foot and on her big toe near her nail.  The technician decided to use a tool, that she had used on someone else earlier in the day on my patient. The tool caused a small cut on the bottom of my patients foot and she presented 4 days after her pedicure with a swollen red and hot foot.  Her pain was excruciating, because she, unlike Kimberly Jackson, did not have neuropathy.  What this means in layman's terms, she could feel the painful presence of the bacteria eating away at her deep tissue and causing serious injury to her foot.  I explained to the patient that it would be in her best interest to be admitted to the hospital and placed on IV antibiotics and scheduled for an incision and drainage of her foot. 

An incision and drainage is a term foot and ankle surgeons use for our patients that implies that we will attempt maximal limb salvage.  In this scenario, we remove all infected dead tissue take deep cultures and leave the wound open.  We have the patient in the hospital for anywhere from 5 to 14 days depending on how the tissue looks daily. We may have to bring them back to the operating room upwards of 5 times before closing a wound. You heard me right folks, a completely healthy person could be subjected to 6 weeks of IV antibiotics, 5 am blood work daily, multiple surgeries, permanent nerve damage, functional damage to the foot, possible limb loss and death, worst case scenario, from a pedicure!

My lovely 36 year old patient, spent 2 weeks in the hospital and had 3 surgeries.  The third surgery was the final cleaning and closure of her wound.  She is someone I see now and again, at the store or for different reasons in  our small town.  She has all 10 toes and is very happy cutting and painting her own toenails. And the other woman I mentioned from Dr. Spalding's book, Jessica Mears received a pedicure on November 24, 2004 in California. She died June 20, 2005 after complications after pedicure.

If you are healthy, there is a lesson to be learned here and if you have any immune compromised illness the same lesson exists. The nail salon industry is dirty and you are putting yourself at risk not knowing all of the facts. In Dr. Spalding's book, he states that he believes that Kimberly Jackson should not have been able to have had a pedicure without a note from her doctor. I challenge that notion, as it is well documented that the nail spa industry is not clean.  Like my healthy patient, you put yourself at risk no matter what your health status may be.  If the person they used the whirlpool spa or instruments before you had an easily transferrable disease, guess what? YOU ARE NEXT!

What you need to know:
1.  Only two states currently require that a nail salon autoclave or sterilize their instruments: Texas (after poor Kimberly Jackson died) and Iowa(where Dr. Henne and I went to podiatry school, met and fell in love, but that's a different story).
2.  Shaving before a pedicure is a HUGE mistake!  Google Image the term Mycobacterium Tuberculosis feet or legs and you will never want to even soak your feet and legs in your own bath tub!
3.  I always say BEWARE of the mysterious file that a nail tech does not take out of a sterile package as well as the nail polish you have selected from the wall of colors that has been used on several clients before you.
4.  Do not always believe what you see, just because the nail technician takes nail implements from a plastic sterile looking package does not mean that those implements were sterilized.
5.  You should not let your overwhelming need to feel pretty outweigh your better judgment!

As promised in our Podcast Pictures of Credo Blade: What not to let them use on your foot during a pedicure!!!

And what Mycobacterium Tuberculosis on the legs after a pedicure looks like:

The dirty secrets of nail salons

02:52

Close X

Embed Video Code:

Link to Video: