As the sun makes less of a cameo appearance and enjoys more of a starring role these days, and as we start shedding layers of clothes, our thoughts have taken a downward turn—to our feet! Are we really ready to bare these things? Shouldn’t we do something to spiffy them up? But wait—what was that we heard about spa pedicures and their association with infection?
To help you weigh wisely whether that hot pink pedicure is worth the risk, we got together with Ann Marie Pettis, director of Infection Prevention at Strong Memorial and Highland hospitals.
Scripts: We have our fingers (and toes!) crossed that warmer weather is afoot—which equals bare and sandaled feet. We’ve heard, however, that spa pedicures might be linked to some risks for infection. Can you elaborate?
Pettis: There’s potential for exposure to and subsequent infection from fungi and blood borne pathogens, such as hepatitis B and C, as well as HIV. This is because there’s a slight risk of a small amount of bleeding if pedicurists use instruments too aggressively and then don’t sanitize them adequately. Another common germ which is often found on the skin of healthy individuals is Staph aureus, which could make its way into the spa. Germs commonly found in water, such as Pseudomonas, might potentially be found at the spa as well.
Really, the pedicure instruments and the foot bath present the greatest risk. If you get a pedicure when you have a rash, cut, or even bug bites, you could make yourself more vulnerable to infection—and you also increase the chance of sharing an infection with the next customer. Another recommendation along these lines is to avoid waxing or shaving your legs for at least 24 hours before your treatment, since doing so can create tiny skin abrasions, opening you up to the possibility of infection.
Scripts: So are there ways to prevent infection at the spa? Can we still schedule our pedicures if we take certain precautions, or should tootsies never be handed over for treatment?
Pettis: I actually get a spa pedicure myself occasionally. My advice is to take a look around, and inquire about the spa’s sanitation practices before you kick off your shoes and socks. Feel free to ask the owner how they disinfect the instruments and foot bath between each customer. Make sure that they use an Environmental Protection Agency-approved disinfectant. Technically, the Department of Health is responsible for ensuring that spas meet sanitary standards, but with the large number of spas out there, this is a tall order—so, ultimately, you need to do your own “due diligence.” Since they’re at increased risk for infection as well as serious complications if an infection does occur, people with diabetes should be particularly cautious in evaluating the hygienic conditions of their go-to spa.
Some spas encourage customers to bring their own instruments, which they then store for your next visit. Not sharing instruments definitely decreases the risk of exposure to anyone else’s germs. And speaking of tools, your pedicurist should never trim any callous on your feet with a razor. Instead, they should carefully use a pumice stone (to avoid abrasions or bleeding).
Finally, try to be the first customer of the day. A spa is likely to be cleanest before all the “foot traffic” tromps through.
Scripts: Makes perfect sense. How can we tell, after returning home from the spa, if we might have picked something up?
Pettis: Keep an eye out for redness, tenderness, or rash in the area. If any of these show up post-pedicure, consider contacting your care provider.
Ann Marie Pettis directs Infection Prevention at both the University of Rochester Medical Center (Strong Memorial Hospital and Golisano Children’s Hospital) and affiliate Highland Hospital. An infection preventionist with more than 30 years’ experience, she’s published articles in peer-reviewed journals and trade publications, and lectures locally, nationally, and internationally. Leadership roles include serving as past president of Western New York Infection Control Organization and the Association for Professionals in Infection Control and Epidemiology (APIC) Finger Lakes Chapter. She recently completed her term as chair of the APIC Communications Committee.
A couple years back, she spoke to Scripts with some smart advice on whether or not handshakes should be taboo during cold and flu season. You can see that “Let’s (Not) Shake on It” video post here. Just a couple months ago, she talked with us again about finding a balance between cleanliness and germs (see here).