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Rise of pedicures and risks of infection

Discussion in 'General Issues and Discussion Forum' started by Cameron, Oct 11, 2005.

  1. Cameron

    Cameron Well-Known Member

  2. John Spina

    John Spina Active Member

    Nail salon syndrome is quite common.I have seen pts who developed fungal nails or tinea pedis after a pedicure.I even had a young lady who went for a pedicure and developed onycholysis.I have not seen too many studies on it,however,I am familiar with an article written on it.
  3. williac

    williac Active Member

    Patient of mine was given a session at a pedicure salon for her birthday. 20 years type 1 (poorly controlled) - both neuro and vasc status compromised. Technician 'buffed' off medial heel with pulmice stone until bleeding - lesion rapidly progressed to an infected ulcer. I'm still managing her wound 4 months post. Silly thing is she new the risks of accessing a place like this, however she did not want to upset her daughter by rejecting the 'gift'.
  4. Angus

    Angus Member

    I have seen two patients recently with fungal infection of the finger nails following manicures.
  5. pgcarter

    pgcarter Well-Known Member

    Are we really pretending that our patients are totally proof against cross infection with all the uglies lurking around in our treatment rooms? And if you don't have any in your room ..how are you achieving that?
    Regards Phill
  6. Alan

    Alan Member

    Airborne contamination

    I read a lot about surface to surface contact, but I am looking into airborne contamination. A number of people have concerns but there seems to be little action. I am interested in your concerns as I have some answers.
  7. pgcarter

    pgcarter Well-Known Member

    I have had subjective concerns about the airborne particles generated by use of pod drills...bacteria, viruses and protein particles, all of which can/may impact on the health of us and our patients....many pods just don't use drills and blame their slackness on these issues and tell themslves that doing a less complete job is OK because of this stuff. Everyone make their own choice and has their own reasons, more or less valid ones...
    For years I have used HEPA room filters...which may be purely placebo... but the living result feels better. There are also some Italian podiatry suckers (Cattani Dental co. I think )that look a little like a Dalek that would probably help but nobody brings them to Australia...I tried a few years ago. What do you know?
    Regards Phill
  8. Angus

    Angus Member

    I think point made about 'salon syndrome' was mainly about cross infection due to unclean and non-sterile instruments. I share your concerns over airborne particles in practice, the potential for cross infection, and especially their effect on the practitioner's health. I too use a room filter, dust extract drill and a 'dust' face mask, but the accumilation on surfaces in the room demonstrates you can't remove it all. I am interested in ideas on how to improve things.
  9. David Smith

    David Smith Well-Known Member

    Hi All

    Since buying a new (2nd hand) Autoclave I have been looking at what is meant when we use the term sterile.
    The Health and Safety Executive state that,

    autoclaving, effectively 100% kill;
    incineration, effectively 100% kill;
    chemical disinfectant [state which] used according to manufacturers instructions and under conditions similar to those used by the manufacturer when validating the disinfectant against the host micro-organism. Under these circumstances it is acceptable to rely on validation data provided by the manufacturer e.g. the log reduction in viability may be stated by the manufacturer or there may be an alternative statement of effectiveness;
    chemical disinfectant [state which] used under non-standard conditions that do not conform with the manufacturer's instructions, or non-standard heat treatments etc. In these circumstances it will be necessary to undertake measurements to validate the procedure. This will enable the actual percentage kill, log reduction in viability, or similar to be stated.

    The CDCP Centre for Disease Control and Prevention, Atlanta, states that a 12 log reducion in microbe/pathogen load is the highest reduction feasible, ref: Esty JR, Meyer KF. The heat resistance of spores of B. botulinus and allied anaerobes, XI. J Infect Dis 1992;31:650-63.

    Does anyone have a refference or know the typical log reduction of a clinical non vacuum autoclave. The HSE state Effectively 100% but is a 6 log reduction in load Efectively 100%.

    A 1 log reduction in the microbial/pathogen load, usualy expressed as CFU/ml (colony forming units eg 1 bacteria), reduces by 10 times so 1million become 100,000.In a 6 log reduction 1 million (1000,000) become 1 ie 99.9999% reduction. Is this Efectivelly 100%?

    What log reduction would you consider acceptable for podiatry/chiropody but not podiatric surgery.

    What would be a typical load in CFU/ml for an autoclave in clinical practice?

    Cheers Dave Smith
  10. pgcarter

    pgcarter Well-Known Member

    What we do with surfaces and liquid treatments is also about contact times....a substance may well be effective against a good range of bugs...but over 10-15 minutes etc....I tend to spray the old alcohol with pink additive around and leave it in place a bit to extend the time....not as good as alcohol taken internally but it can't hurt.

    Regards Phill
  11. Greg Coyle

    Greg Coyle Welcome New Poster

    What evidence is there that pedicurists are any worse than podiatrists when it comes to infections folowing pedicures? There was precious little evidence in that article of any kind.

    Too many podiatrists are threatened by pedicurists because they have no greater skills or knowledge than pedicurists. They ought to be worried.

  12. John Spina

    John Spina Active Member

    Greg:While it is true that some podiatrists are stupidly in competition with pedicurists,and that some podiatrists are rather incompetent,to say that "Too many podiatrists....have no greater knowledge or skill than pedicurists" is nonsense on stilts.Podiatrists have to go to college,med school,sit for boards,etc.Again,it is true that a few members of this profession are not that great and elitist as well.However ,I cannot swallow an asinine comment like the one made by yourself(with all due respect,I may add).
    Last edited: Oct 30, 2005
  13. admin

    admin Administrator Staff Member

    Before this blows up into an international incident .... John is talking about the situation and educational requirements in the USA and Greg is talking about the situation and educational requirements in New Zealand ....worlds apart in the context of this discussion.
  14. Greg Coyle

    Greg Coyle Welcome New Poster

    John, I wish you were right. But in England, Australia and New Zealand many Podiatrists trained a long time ago and have done nothing to keep up, advance thier skills or knowledge. They spend their days cutting peoples toenails and chipping off corns and calluses. I can't see a great difference between them and well trained pedicurists.Nothing elitist about it, just the sad truth.

    regards, Greg


  15. John Spina

    John Spina Active Member

    Greg:I see what you see right here in America!I have a colleague who is not sure what needle you use for a heel spur injection.Another banana(sorry,he is) will do nothing except cut toenails as he is afraid he will be sued if he does a thing above and beyond that.So I see my share of flotsam and jetsam right here.I myself am no Dr.Welby.I am,however,competent.My point is there are some lemons,but there are also some fine podiatrists here and elsewhere.I do appreciate your opinion.Indeed,many pods need to hear it.I just said what I said because I do enjoy what I do,and I simply do not like to see this profession criticized.thank you for a spirited discussion.
  16. C Bain

    C Bain Active Member

    Market Demand!

    Hi All,

    Just to help this Thread on a little bit, are we back to Supply and Demand again? What is it really about here? Should it be what the customer wants or what the Podiatrists wants?

    If he/she is prepared to put their hand in their pocket and pay for nail, corn or callus cutting that is what they will get from me!

    If on the other hand they are prepared to pay for expensive, sometimes in their eyes, what they don't want or need, that's how it will be in the private sector!

    Who is more important the Patient or the Podiatrist?

    Just maybe the Patient might want a Chiropodist, whose grades have just been removed from our NHS. so they cannot have him/her? In a free market place this should resolve itself but here in the UK. the NHS. is just about the only Nationalised institution/industry left. But don't worry the Government is working on it!



    PS. Now there is a thought Greg, how about trained Pedicurists for the NHS? But would they work for such low wages?
  17. NewsBot

    NewsBot The Admin that posts the news.

    Atypical Mycobacterium furunculosis occurring after pedicures.
    J Am Acad Dermatol. 2006 Mar;54(3):520-4
  18. nailsaloninfectionsurvey

    nailsaloninfectionsurvey Welcome New Poster

    The only real way we are going to stand tall on the subject of nail salon infections is to gather our own log of nail infections/foot infections from pedicures. Please participate in the NAILSALONINFECTIONSURVEY.com site. The site is password protected for doctors. Email for the user name/ password. Nail techs, pedicurists can complete the second non password protected survey and consumers who may never report these issues may report to the third survey. The Journal of Dermatology article Mar 2006 reports 4 cases to the board of cosmetology in Ohio/Kentucky recently. Unfortunately, not all cases are reported or even seen by physicians.
    I would urge all Pods, MDs, DOs, NP and others to complete this survey. The same is true of all consumers and nail techs and international pedicurists. Boards of cosmetology are sometimes hampered by politics, lack of medical oversight, and a tremendous issue of language barrier when a high percentage of US salons are now serviced by recent arrivals from non-english speaking counties. When I testified before the board of Cosmetology in Tennnessee in 2002 most of the violators were Asian and brought there own interpreters. THey were cited for issues like attempting taking each others test or no certificate to operate. None of the violators acknowledged to the board why they were being cited even with the interpreters.
    My book, Death by Pedicure discusses this in detail.
    If you want to do something about this. Take the survey NAILSALONINFECTIONSURVEY.com and then call find out about your state's board of cosmetology in your state. It will surprize you. Call them and get a rule book so you can see if your state uses callus cutters or what constitutes sanitiation in a nail salon. Inspect your own practices as well. There are good nail techs and there are good pods. There is also the opposite spectrum of both. Learn to identify both. My book, which will be sold wholesale to pods in quantity for resale in your offices, will help your patient population to know how to select the good ones.. See Justfortoenails.com for when the book is released.

    Bob Spalding
    Last edited by a moderator: Apr 14, 2006
  19. NewsBot

    NewsBot The Admin that posts the news.

    KSL Utah are reporting:
    How Safe Are Pedicures?
    May 1st, 2006 @ 10:06pm
  20. Alan

    Alan Member

    Aiborne contamination

    I have been looking at the collection efficiency of collecting at the source (a collection stool just below the foot for general work, and an over the foot hood for use with drills). Anything collected is passed through a HEPA filter so that air recirculated is free of all sub micron particles. Even if the collection efficiency is only 30-50%, continually recirculating the room air will reduce all particles over a period of time. This principle is used in electronics, pharmaceutical manufacturing, and fine engineering, so why not in Podiatrists rooms?
  21. EdYip

    EdYip Active Member

    Our local news here in Toronto has been running a "consumer health alert" warning of "dirty" nail salons. It's definitely good to see them reporting on such matters.
    Click here for video clip
  22. NewsBot

    NewsBot The Admin that posts the news.

    Now there has been some media coverage in Australia:
    The Sydney Morning Herald are reporting:
    Warnings over nail salons health risk
    Full story
  23. NewsBot

    NewsBot The Admin that posts the news.

    Here is another:
    Nasty Nails? Woman claims infection from nail salon

  24. DAVOhorn

    DAVOhorn Well-Known Member

    The dangers of Nail Bars/Salons

    Dear all,

    On the front page of Yahoo UK is an article on the dangers of nail bars and the poor standards of infection control used by them.

    So what is new????:empathy:

    I thought this had been debated for a very long time.

    Now you can even have your callus removed by fish!!!!:craig:

    Still it was an interesting couple of minutes read.

    Oh look the sun has come out, time to go out and enjoy it.

  25. SandraSmith79

    SandraSmith79 Welcome New Poster

    Yes, I can confirm this trend. Many people think pedicurists can cure all their foot disesaes... I hear it every day in my office... then they wonder about the difference.
  26. NewsBot

    NewsBot The Admin that posts the news.

    Mycobacterium bolletii/Mycobacterium massiliense furunculosis associated with pedicure footbaths: a report of 3 cases.
    Wertman R, Miller M, Groben P, Morrell DS, Culton DA.
    Arch Dermatol. 2011 Apr;147(4):454-8.
  27. peace

    peace Member

    That is shocking. I have a nail business and infection control is paramount - wash, fluid, ultrasonic and then autoclave. If it can't be autoclaved it is thrown away (eg nail files). For pedicures we use disposable liners for the spa.

    Also in the UK client consultation forms are kept and all medical problems notes. In the case of diabetes, epilepsy, heart problems and many more conditions you are not allowed to perform the service - not even allowed to just apply nail polish.

    Regarding pedicures, toe nail cutting and callus reduction is included. Callus is treated with an AHA acid treatment. So it makes you wonder what the point of becoming an FHP is. I am half way through my training and wish I hadnt bothered really. Incidentally depending on whether they are basic or luxury, pedicures can cost from £12 to £30.

    There is no excuse for lack of hygene in any treatment whether if be by a pedicurist, FHP or podiatrist.
  28. Catfoot

    Catfoot Well-Known Member

    Well i think that sums it all up doesn't it?

    When you (probably) have a good business in beauty therapy why muddy the waters by getting involved in something else more complex?

    I suggest some of my patients see beauty therapists because they can give them the time and the pampering that I can't. I wouldn't refer to an FHP.


  29. NewsBot

    NewsBot The Admin that posts the news.

  30. Claire72

    Claire72 Active Member

    Hi Catfoot

    Would you suggest to some of your patients that they visit a beautician because a FHP doesn't necessarily offer pampering either, or for any other reason?

  31. Admin2

    Admin2 Administrator Staff Member

  32. NewsBot

    NewsBot The Admin that posts the news.

    Do Educational Interventions Targeted to Nail Salon Workers and Customers Improve Infection Control Practices in These Salons?
    Lois Lux , MSN, RN, James Marshall , MPH, Shannon Parker , BS, CHES, Susan Collard, Benjamin Rogers , BA, and Stephen Fuson , DPM
    Journal of the American Podiatric Medical Association: March 2014, Vol. 104, No. 2, pp. 174-176.
  33. NewsBot

    NewsBot The Admin that posts the news.

    Adherence to and knowledge of best practices and occupational biohazards among manicurists/pedicurists.
    Garbaccio JL, de Oliveira AC.
    Am J Infect Control. 2014 May 2
  34. turkey

    turkey Welcome New Poster

    I have at least one pt each week that has contracted a fungal infection after having a pedicure. In one instance, a lady contracted herpes on her arm. This was following a manicure. GROSS!
  35. NewsBot

    NewsBot The Admin that posts the news.

  36. NewsBot

    NewsBot The Admin that posts the news.

  37. NewsBot

    NewsBot The Admin that posts the news.

    These nail salons’ dirty secret will make you sick to your stomach.
  38. NewsBot

    NewsBot The Admin that posts the news.

  39. NewsBot

    NewsBot The Admin that posts the news.

    Instrument processing: knowledge and practice among

    Juliana Ladeira Garbaccio et al
    Vigil. sanit. debate 2016;4(1):64-69 | 64
  40. NewsBot

    NewsBot The Admin that posts the news.

    Beauty salons cited over razor use

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