Getting A Safe Manicure/Pedicure
In the interest of researching how thoroughly mani-pedi establishments sterilize their instruments, I donned my very best undercover-I-am-not-a-foot-care-nurse disguise and conducted an informal survey. I walked a distance of about 1.5km on a busy Toronto street and counted 12 mani-pedi places and 2 more that had closed down.
Bacterial, viral and fungal infection risks are present with any procedure that can potentially break skin, such as accidentally cutting a client with improperly sterilized nail or cuticle nippers. Transmission may also occur between client-technician through improper glove use by the technician. Infection risks are even greater and have more serious effects for diabetics and anyone with lower immunity or circulation issues.
At all 12 places, staff were happy to answer my questions about how they clean their instruments and soaking tubs. Each place said they use bleach or isopropyl alcohol to soak instruments and soaking tubs. About half use a UV light machine after chemical soak, a couple of places have an ultrasonic machine to soak instruments, a few just use soaking, and only one establishment has an autoclave sterilizer.
All establishments claim to have been passed by the Toronto Public Health. Although I didn’t ask to see documented proof of this, no one voluntarily showed me any documentation and no one has a certificate of approval on display.
In preparation for this survey, I did some preliminary reading of Canadian sources. The first study I read was the Survey of Infection Control Procedures at Manicure and Pedicure Establishments in North York, published in the Canadian Journal of Public Health, March – April, 2001. The second study was Personal Service Establishments: Looking at Infections Risks, by Prabjil Barn and Tina Chen at the National Collaborating Centre for Environmental Health Seminar, October 27, 2011 for the British Columbia Centre for Disease Control.
Disinfection is not the same as sterilizing. Disinfection eliminates all pathogenic organisms except bacterial spores. Bacterial spores may revert back to the multiplying form of the bacteria and cause infection.
Sterilizing destroys all pathogenic organisms, including spores.
Isopropyl alcohol and solutions that contain quaternary ammonium materials are used in mani-pedi places as a chemical cleaner. According to both studies, they are all classified as low-level disinfectants and should not be the only method of cleaning instruments which can pierce the skin, such as nail and cuticle nippers. Their efficacy also depends on the amount of time instruments are soaked or how well tubs are wiped down.
UV light machines and a glass bead sterilizers are not approved methods of sterilization and should be discouraged, according to the North York survey of mani-pedi establishments, and seconded by the Barn and Chen study.
The only establishment that properly sterilizes their tools is the one with the autoclave sterilizer. At McDermott Footcare, autoclave sterilization is the method we use as well.
Each place claimed that the method they use thoroughly sterilizes their instruments and soaking tubs. It seems that the people I spoke with don’t know the difference between disinfecting and sterilizing, which indicates a lack of knowledge in this area.
How can we be assured of a safe manicure/pedicure?
- find a place that uses an autoclave sterilizer, not a UV light machine or glass bead sterilizer and not an ultrasonic machine for soaking. Only an autoclave will eliminate all pathogenic organisms including spores.
- find out if all tools, files and sponges used on you are autoclaved between clients
- make sure the technician uses gloves while working with you. If he/she attends to another client at the same time, make sure the gloves get changed between clients.
- Do not let the technician push back your cuticles or cut them. Cuticles are the main line of defense that prevent bacteria and fungus from infecting the nail bed. Read about fungal infections, here.
- ask if you can bring your own tools to use. If using your own personal tools, there is no need to autoclave because you are not sharing them with anyone else.
In Toronto, Canada, mani-pedi establishments are not regulated; there is no set protocol or best practice guideline for disinfecting and sterilizing. It might be the same where you live. Check with your Department of Health.
I went back to the only establishment that had an autoclave sterilizer and got a pedicure. It was the one place where I felt that I could get a safe pedicure. The technician honoured my request to not push back or cut my cuticles after I explained that cuticles protect the nails from bacterial and fungal infections. I never did tell them that I’m a certified foot care nurse.
Buyer beware. A representative from Toronto Public Health told me that since they do not regulate mani-pedi establishments, the onus is on the consumer to ensure their health and safety. Know the risks. Ask questions. Protect yourself.