Can You Get Toenail Fungus from a Pedicure at a Nail Salon?

If you get your nails done in a salon, you risk contracting a viral, bacterial, or fungal toenail infection. The level of risk that you face depends on how much your chosen nail salon values sanitation.

Most salon visits do not lead to toenail infections. However, it’s vital to be aware of the risks and minimize these. We’ll explain how to check that your salon pedicure is clean and hygienic. We’ll start off by exploring some of the medical problems that have arisen due to various failings.

Can Salon Pedicures Cause Toenail Infections?

In 2000, 102 customers contracted mycobacteria fortuitum from a nail salon in California. According to the CDC, some of these women developed life-changing scars on their legs and ankles.

In a separate case, Jessica Mears picked up mycobacteria fortuitum from a pedicure she received at a salon in 2004. As a result of her weakened immune system, she was unable to recover from the infection entirely and died two years later. In 2006, her mother filed a lawsuit against the salon, claiming their unsanitary practices had contributed towards her daughter’s death.

In 2002, the department of dermatology at Baylor College of Medicine randomly inspected five nail salons in Texas. They detected the presence of candida (yeast) and Rhizopus arrhizus (fungi) in four out of five of the salons. Candida can lead to some pretty unpleasant foot infections, such as athlete’s foot and onychomycosis (toenail fungus).

If you’re someone that likes to look after your nails, this probably sounds very worrying. The good news is that these incidents have prompted many businesses to improve their standards of cleanliness. Nonetheless, the onus is still on you to choose your salon wisely.

Potential Problems with Pedicures

Let’s explore the reasons why salon pedicures leave you vulnerable to fungal toenail infections:

Communal Facilities

Yeasts, molds, and bacteria proliferate in warm, damp, and communal environments. If the foot bath in your chosen salon is not decontaminated between each patron – you risk catching an infection.

Whirlpool Foot Baths

Many nail salons have jacuzzi-style foot baths. As we’ll explore, these foot baths are particularly tricky to keep clean. If an overgrowth of fungi does occur in the pipes or filter, the infection can spread quickly, because these systems re-circulate water continuously.

Poor Training

Some nail technicians lack adequate training in sanitization techniques. This issue affects some states more than others, as certain regulatory bodies are ‘overstretched’ when it comes to inspecting salons.

Invasive Methods

The pedicurist often pushes cuticles deep into the nail edge, to achieve a ‘clean’ finish. This technique increases the likelihood of fungi entering the nail bed. It could also lead to ingrown toenails and other toe injuries.

Strong Chemicals

Nail lacquers and nail polish removers can be very dehydrating for the nail. Over time, this can lead to weak and brittle nails – making us more susceptible to infections.

Single-Use Equipment

Porous equipment (i.e., nail files and sponge toe separators) cannot be effectively sterilized. As such, these items should be single-use items only. Some salons try to re-use porous equipment on new customers – putting them at risk of contamination.

Deep Cleaning

There’s the issue of biofilm. Biofilm can build up in foot baths and drainage systems if salons don’t perform regular deep cleans.

Biofilm is an accumulation of nails, hair, skin particles, and lotion residues. The problem is, bacteria and molds hide deep inside layers of biofilm, and multiply.

Some of these bacteria can become resistant to disinfectants. So, even if the foot basin looks ‘clean’ on the surface, it may be harboring a lot of harmful bacteria and fungi.

Are Cheap Nail Salons to Blame for Fungal Infections?

In 2017, U.S. residents spent 8.5 billion dollars on salon nail treatments. Salon nail treatments were traditionally reserved for the wealthiest people, but we’ve seen a rise in affordable “budget” nail salons in recent years.

Could this rise in cheap nail salons be to blame for the rise in customer infections? It’s true that employees in budget salons are often less experienced, or lack as many formal qualifications as those working in prestigious spas.

It’s also true that nail technicians in budget salons are often under pressure to get the job done quickly so that the salon can service as many clients as possible. So, is it fair to assume that we’re more likely to get nail fungus from a nail treatment at a cheap salon?

Well, not necessarily. According to a study on Jama Network, both budget salons and mid-to-high range salons had traces of fungi and bacteria on their tools and foot spas.

So, when choosing a safe place to have your pedicure, there are many factors to consider besides the cost of the treatment. With that in mind, let’s discuss the factors you should consider when choosing a nail salon.

1) Check Their Credentials

Before committing to a nail salon, check whether they have been approved by your state’s health department. Salons will usually display this information in clear view.

Also, check your pedicure is being performed by a certified nail technician. They study at an approved cosmetology school and complete between 500 and 1000+ hours of ‘practice.’ As part of their training, they’ll learn how to sanitize equipment and prevent infections.

You can check if your nail technician is certified by asking to see their ‘license to practice.’ This certificate is issued by the board of cosmetology. Most technicians will be proud to display their certificates in clear view of customers, so ask if you can’t see theirs.

In some states, technicians are required to take continuing education units (CEU’s) and renew their certificates periodically (usually every two years). Check your technician’s license is current, as this will ensure they have up-to-date knowledge and expertise.

If there are lots of nail staff working in the salon, and only one or two cosmetology certificates on display, this is a potential red flag. You should be sure that the person treating you is the person named on the certificate.

If your chosen salon has all of these credentials, this at least signals that they know how to care for your feet in a sanitary manner. It doesn’t guarantee that they will treat you effectively every time, so it’s good to do additional research if you can. For example, protect yourself by choosing a nail salon that has good online (or word-of-mouth) reviews.

2) Avoid Fish Spas

About 15 years ago, fish pedicure spas started to pop up in cities across the country. These spas were incredibly popular with customers as they offered such a unique pedicure experience.

These salons fill their foot baths with Garra rufa – a small fish from the Middle East. Garra rufa fish eat away at dead skin, leaving the skin feeling incredibly smooth. They have been used to treat psoriasis and other similar skin conditions.

Although these fish offer an excellent service to the feet, they can become a health risk to patrons. The fish are expensive, so salons are unlikely to change the fish very often. This means that the same fish will come into contact with hundreds of peoples’ feet. There is no way to control the spread of infection, so if you choose to have a fish pedicure, you risk contamination.

Furthermore, some unscrupulous salons have been known to use Chinchin fish, without informing patrons. These Chinese fish can puncture the skin and draw blood. This significantly increases the risk of infection.

What’s more, these fish are starved so that they eat human skin more efficiently. In many people’s eyes, this is a cruel practice. As of 2018, fish spas have been outlawed in 10 US states.

3) Ask Your Pedicurist How They Clean the Footbaths

As we’ve discussed, footbaths can harbor mold, bacteria, and fungi – leaving customers at risk of infection. For this reason, it’s essential to choose a salon that disinfects their footbaths between clients and deep cleans them at night.

Disinfecting Between Customers

Nail salons are required to use an EPA-registered disinfectant to clean their footbaths. This solution will be a hospital-grade disinfectant and should be labeled as such. If you see your technician cleaning the foot bath with a liquid from an unmarked bottle – this is a red flag.

Disinfectants take time to work (usually 8- 10 minutes). Between each customer, the pedicurist should be filling the foot bowl with a disinfectant solution and leaving it to stand. They should then rinse the foot bath with clean water. If you see your pedicurist wiping over the foot bath between customers, this suggests they have not disinfected it properly.

Deep Cleaning

In 2000, the CDC investigated an outbreak of Mycobacterium fortuitum in salons in California. The study found that 97% of foot spas contained mycobacteria. The salons’ failure to clean the foot spa filters contributed to the presence of bacteria.

Whirlpool foot spas are particularly challenging to keep clean because water is re-circulated through the pipes. Over time, biofilm can form in the pipes and the filters. Once the biofilm has formed, it can be very difficult to eradicate.

For your peace of mind, you should ask your salon if they disinfect their foot baths each night. If they have whirlpool foot spas (as opposed to foot tubs), they should be removing the filters nightly to disinfect these.

To give yourself the best level of protection, you could opt for a nail salon that uses simple foot tubs, as opposed to jet baths.

4) Ask How They Clean Their Tools

It’s not just the footbaths your salon should be decontaminated, it’s their tools, too. Metal tools must be sterilized between clients and porous tools that cannot be sterilized should be discarded after a single use.

According to a study by Baylor College, four out of the five salons tested had traces of candida on their nail clippers. Nail clippers come into very close contact with the hyponychium (the underside of the nail). They should never be re-used without sterilization, as fungal and bacterial spores are known to collect in the hyponychium.

Your salon should be using an EPA-approved liquid, an autoclave, or UV light system to sterilize their equipment.

Autoclaves

If you’re looking for a salon with the highest level of protection, opt for one that uses a medical-grade autoclave system. An autoclave uses very high temperature and pressure to sterilize equipment. Genuine autoclave systems can be expensive, so you’re less likely to find these in budget salons.

The tools are placed in a sealed pouch and then put into the autoclave for sterilization. The color of the bag changes once sterilization has been achieved. Your nail technician should open the seal in front of you, so you can see the tools are sterile.

UV Light and Liquid Sterilization

It is acceptable for salons to sterilize their equipment by UV light in most states – though laws are continually changing. The state of Texas had ruled (in 2006) that autoclaves would be the only acceptable method for sterilizing salon equipment. Since then, the law has been relaxed to include UV and liquid sterilization.

In any case, make sure your technician gets out a completely fresh set of tools when they treat you. These should come from a sealed bag, cassette, or be wrapped up in tissue. If you see your technician wiping over tools with a sanitizing spray between clients – this is a big no-no.

5) Observe How They Clean Between Clients

Before committing to your appointment, try to see how the nail technicians deal with the ‘changeover’ period between clients. As we’ve discussed, the technician should be decontaminating surfaces, to prevent the spread of infection.

The following behavior would be cause for concern:

• The nail technician reuses nail files, sponge toe separators, pumice stones, orange sticks or any other tools made of porous material.
• Metal tools (nail clippers, nippers, cuticle sticks) are reused without sterilization, or the nail technician wipes over them quickly. These should be placed in a container, away from the service area, to be sterilized at the end of the day.
• The nail technician rushes onto the next client without sanitizing their workstation or washing their hands.
• The technician tries to attend to more than one client at a time.
• The staff member fails to disinfect the foot bath or wipes over it with a cloth.
• Dirt and debris are allowed to collect on the floor, and no one is taking care of water spills.
• The nail technician ‘double dips’ their hands in lotions, creams, or scrubs. Instead, they should use products with a pump applicator, or spoon out some product into a sterile container.

If you notice any of the above, it’s time to make a quick exit!

6) Make Sure Your Technician Is Gentle

If the nail technician is too rough, they’ll damage your cuticles, nails, and skin, leaving you a prime target for infection.

To make the nails look smooth and healthy, pedicurists sometime adopt invasive methods. The problem is, these can damage the integrity of the nail. According to a review on NCBI, nail ‘drills’ should be avoided at all costs because these can thin the nail, causing it to become brittle.

Also, you should ask your pedicurist not to trim or push down the cuticles of your toenails. This procedure encourages dirt and bacteria to get lodged in the sides of your nails (periungual tissue). This could lead to a fungal toenail infection or an ingrown toenail.

Also, you should not allow your pedicurist to cut the dry skin away from the sides of your nails. Dry, flaking skin is treated more effectively by soaking the feet and buffing them with a single-use pumice stone.

Finally, if you are susceptible to weak or brittle nails, try to opt for a salon that uses very gentle or natural products. Harsh nail polish removers and nail primers can significantly dehydrate nails, leaving some people open to infections.

7) Check Your Nail Technician’s Hands

When you’re ready to sit down for your pedicure, you need to be sure to check your technicians’ hands and arms. If there are any wounds, sores, or scabs, you should not let them treat you.

Make sure your technician washes their hands before, and after, touching your feet. Often, pedicurists will wear gloves when performing treatment. This suggests their sanitization standards are high. Nonetheless, it’s acceptable for nail technicians to use their bare hands (some nail technicians feel it is more sanitary) as long as they are practicing good hygiene standards overall.

What If My Pedicure Goes Wrong?

Taking the time to find a professional and sanitary nail salon should help prevent infection. However, when you use communal facilities, there will always be a risk of infection. If your feet hurt after a pedicure, this is a sure sign something has gone wrong.

If you recognize any of the following symptoms after a pedicure, you’ll need to act quickly to prevent your condition worsening:

• A cut or graze to the foot – Due to the invasive nature of pedicures, this can occasionally happen. If it happened during your pedicure, the nail technician should have stopped the service immediately, as your risk of infection increases rapidly when you have an open wound. The best thing to do is clean the wound with a saline solution, pat the area dry, and apply a sterile bandage.
• Sore, tender or itchy soles –This is an early sign of athlete’s foot. If you develop it, you should treat your athlete’s foot it as soon as possible to prevent it from spreading to the nails. A very deep itch could also signal the arrival of a verruca. It would take a couple of months for a verruca to appear after catching the initial infection.
• Pain in the big toe – This could signal a fungal toenail infection or an ingrown toenail. An ingrown toenail could be caused by pushing the cuticles too far back during a pedicure.
• Ridges on the toenails – This is an early sign that a fungal toenail infection is developing, particularly if the nail starts to feel brittle.
• Boils on the feet and ankles – this is a sign of a bacterial infection, and you should visit your doctor immediately. Antibiotics may be required to treat this condition.

If you were to pick up an infection from a nail salon, it could be weeks or months before your symptoms develop. For this reason, many people do not connect the two things together, so their salon is not alerted to the problem.

Is It Safe for Me to Get a Pedicure?

Because of the risks associated with getting a pedicure, they are not necessarily suitable for everyone. Some groups of the population should take extra precautions when going to a nail salon, and some may need to avoid this procedure altogether. If you fall into one of the following categories, you may need to think twice before getting your salon pedicure.

• You have shaved in the last 24 hours – Official guidance from the CDC states that patrons should not shave before a pedicure as this can cause small scratches in the skin.
• You have cuts, wounds, scabs – Similarly, if you have open wounds on your feet, ankles or legs, steer clear of the salon until you’ve completely healed.
• A weakened immune system – People with a weakened immune system are generally advised against getting salon treatments because their body will find it very hard to fight an infection.
• Diabetics – Diabetics should take extra care if going for a pedicure, particularly if they have diabetic neuropathy. Moreover, if a diabetic person was to contract an infection, it may be difficult for them to fight it off. If you are diabetic, it would be better to go to a podiatrist to have your nails cleaned and trimmed.
• Take extra care during pregnancy – It’s widely believed that getting a pedicure in the late stages of pregnancy can bring on labor because manipulating certain nerves in the feet could encourage the uterus to begin contracting. There is very little evidence to support this claim beyond the anecdotal. Nevertheless, if you want to get a pedicure in pregnancy, you should be extra vigilant when choosing your salon, so you don’t put yourself at risk of infection.
• Athlete’s foot and toenail fungus – As we’ve explored, salons are ripe breeding grounds for fungal and bacterial infections, so its best not to add to the problem if you’ve already got one of these conditions. Having said that, you don’t need to ‘give up’ on your nails when you’ve got one of these infections. Let’s turn to this issue in a bit more detail.

Will Salons Do My Nails If I Have Nail Fungus?

Firstly, it’s important to be sure that you do have toenail fungus. Some people who regularly paint their nails develop weak and yellow toenails. This happens because the strong chemicals in the nail polish dehydrate and discolor the nail.

If this is the case, you shouldn’t be too embarrassed to get a pedicure. Most nail salons would not refuse to work with you and would even give you advice on how to prevent discoloration in the future.

If your yellow toenails have a strong smell, are crumbling and brittle, or you have sore toes – this is a sign you do have nail fungus. If you’re not sure whether you have fungus or not, it’s best to seek advice from a podiatrist who can diagnose onychomycosis.

If you do have a fungal toenail infection, it’s best to avoid standard nail salons until your infection has cleared up. As we’ve discussed, it would be hard for the salon to protect the health of other customers. Not only that, standard salon treatments can worsen a fungal nail infection– causing it to spread to other nails.

If your nail technician suspects a fungal nail infection, they will usually suggest terminating the treatment and will refer you to a doctor.

Not all polishes were created the same. There are specialist antifungal polishes available, such as Dr.’s Remedy Enriched Nail Polish. They’re not an alternative to a treatment, but they can help to kill fungus that gets on your nails.

Are There Any Alternatives?

Toenail infections can cause problems for self-esteem because sufferers feel as if they must hide their feet at all times. Studies have shown that people who take the time to indulge in foot treatments are less likely to be bothered by their fungal nail infection.

As we know, toenail fungus can take a while to heal, so it makes sense to continue with your beauty regime while you’re waiting for your toes to get better. So, if typical nail salons are out of bounds, are there any other alternatives?

A Pedicure at Home

Carrying out a simple pedicure at home is a safe and affordable way to treat your feet. The good thing about doing a self-pedicure is that you can control how much pressure you put on your nails. A pedicure at home (in the right way) could speed up your recovery.

Consider the following tips:

• Start your pedicure with a warm foot soak. Try adding a few drops of an anti-fungal essential oil such as tea tree oil or lemon oil. This will also help fight foot odor.
• Pat the feet dry after soaking and never let them stay wet longer than necessary as this could cause a fungal infection to spread.
• Trim toenails short so they look neat but try not to cause any damage to the nail bed.
• Use a nail file to file away brittle parts of the toenails.

Try A Medi-Pedi

If you have toenail fungus (or you are worried about poor hygiene in conventional nail salons), you could consider trying a Medi-Pedi salon. These salons offer medical-grade pedicures to patrons; they combine spa-treatments with podiatry.

Treatments at Medi-Pedi’s can be expensive. However, because they are focused on treating the nail fungus, they are a good long-term investment.

Medi-Pedi’s are generally less busy than nail salons so that they can keep a close eye on their hygiene standards. What’s more, they often use specialized creams, lotions, and lacquers that you wouldn’t find in a cosmetic nail salon.

What About ‘Cover Up’ Fungal Nail Treatments?

Some cosmetic nail salons offer ‘cover up’ nail fungal treatments. The nail technician will apply an acrylic nail over the infected toenail to make it look healthy.

Although these treatments will improve the appearance of your nail, they’re likely to prolong healing time. According to some studies, bacterial and fungal infections are more likely to develop in acrylic rather than ‘native’ nails. This may be because it is harder to wash acrylic nails thoroughly.

In recent years, there have also been some high-profile cases of infections caused by acrylic manicures.

‘Cover-up’ toenail treatments should be avoided where possible as these are not ‘treatments’ in the true sense of the word. Instead, opt to see a podiatrist, or visit a Medi-Pedi salon for a long-term treatment that will help.

How to Get a Safe Pedicure

Although pedicures have their risks, they can be a great treat for many people. Not only do they help you relax, but they can also help improve circulation in the feet and help keep the skin exfoliated.

To ensure your pedicure is benefiting rather than jeopardizing your health, follow these key steps:

1. Check your suitability – use the information in this article to check you are a suitable candidate.
2. Search for a nail salon that displays their state license (and check it is in date).
3. Check your pedicurist is professionally trained. If it is not already on display, ask to see their certificate (issued by the board of cosmetology).
4. Ask your nail technician how things are cleaned in the salon. If they can’t answer you straight away – this is a red flag!
5. See for yourself – make sure the salon is disposing of single-use items, and disinfecting footbaths between patrons.
6. Don’t let your nail technician use any invasive methods and ask them not to cut the cuticles.
7. If your skin becomes broken during the pedicure, terminate the treatment and make sure the wound is cleaned.

Finally, if there are any signs of dirt in the salon – leave! It’s better not to risk your health for the sake of a pedicure.