There are several downsides a diabetic needs to be particularly careful about. "People with diabetes are at risk for a number of complications. Foot infections are common. If they develop a break in the skin, it can be a life-threatening complication," says Lee J. Sanders, DPM, chief of podiatry at VA Medical Center in Lebanon, PA. "I would caution individuals with diabetes not to receive a pedicure because of the sanitary conditions of the salon, the skills of the individual performing the procedure, and the cleanliness of the instruments used."
If you are healthy and complication-free, getting a pedicure doesn't pose a threat the way it does for people with foot complications of diabetes. But if you have an infection, ulcer, cut, or neuropathy, don't book an appointment. An open wound is an open door for any bacteria that may be in the foot basin's water, and nerve damage will make it harder for you to tell if you've been cut or if the bath's water is too hot.
Scheduling a pedicure at any old nail salon is a bad idea. "The most important thing is that wherever people go, they need to make sure they're using clean practices," says Donna Perillo, owner of Sweet Lily Spa in New York City. As podiatrist Sanders puts it: "We don't know how clean the basin is. We don't know how clean the water is." He urges women to look into the places sanitation practices, the technician's training- make sure she's licensed- and how the tools are cleaned. "If a woman is going to seek out this service, it is important she addresses these issues," he says.
If the water looks clean, but you're still unsure about the sanitation process, don't be afraid to ask. "Ask them how they clean their things," says Perillo. "We get asked all the time and I'm happy to answer." According to Lisa Tep, owner of Sesen Spa in Vienna, VA, after each service, foot baths should be cleaned with a hospital-grade, EPA-registered disinfectant made specifically for pedicure chairs. If the spa doesn't clean as often or with the proper chemicals, walk away. "I wouldn't take a chance," says Perillo. "There are so many things you can catch. Fungus is the number one thing you see."
Carroll Kingbile of Damascus, Oregon, who was diagnosed with Type 2 diabetes 3 years ago, inspects new nail places by getting a manicure first before leaping into the pedicure chair. "I've walked in and sat around and waited" in order to check a salon out, she says. "There are a couple places I've walked out of."
Sure, sinking your feet into a pool of warm, bubbly water is relaxing. But did you know bacteria may be introduced into your bath thanks to the pipes that carry the water? Avoid soaking in someone else's bacteria by being picky about your foot bath. Some spas, such as Sesen, use "pipeless" pedicure chairs, which reduce the area in which bacteria can hide. Others, like Sweet Lily, opt for easy-to-clean individual buckets or bowls. Before you book your service, ask the spa which type of basin it uses. And remember, regardless of basin type, the technician should clean between each client.
Before you let a pedicurist touch your feet, find out how her tools are sanitized. Like foot baths, implements should be cleaned between each use. But, be warned: Just because tools were pulled from a sterilization pouch or drawn from a jar of blue liquid doesn't mean they are safe, says Tep. Dirty instruments used on past customers may soak in unchanged fluid or open containers. Ask if the salon operates an autoclave (a hot, pressurized chamber used to sterilize medical instruments), and make sure packages of uncontaminated tools aren't opened until the minute you sit down- otherwise they may have been compromised, she says.
Another tip: Pick a salon that uses stainless steel instruments, which are easier to clean than porous nail files and those wooden sticks used to push back cuticles. If emery boards or nail buffers are used, they should be thrown out after each client to prevent the spread of bacteria.
Some people even tote their own tools as an extra precaution. But then cleanliness becomes your responsibility: "You have to, as an individual, make sure you wash your tools," says Perillo. "You can infect yourself. As long as you go home and wash them really good... that's a great solution."
"I always tell people: If they have diabetes they should let us know," says Perillo. "The massage should be gentler." Although you may feel nervous about saying something, nail technicians actually want you to speak up. "I tell my pedicurist, 'You know, I can't have the water too hot,'" says Kingbile. "I have never found anyone to be nonresponsive to that. They've always been very, very nice."
Request that the technician not clip your cuticles or file heels or calluses. Make sure the basin's water is warm, not hot, and that your toenails are being cut straight across. Ensure that moisturizing lotions are thoroughly massaged into your feet to prevent excess lotion collecting between the toes. And insist the pedicurist avoid a credo blade- that's one that looks like a razor- on your feet. The tool is illegal in many states.
As lovely as fresh shaven legs are, in this case they can do more harm than good. Stop shaving your legs two days before your scheduled pedicure to prevent skin from getting irritated or bacteria from entering any tiny nicks or cuts.
These measures may sound extreme, but consider the alternative: Unsterilized instruments can pass bacteria and infections between clients. So, what do you do if you suspect a salon isn't practicing safe sanitation? "I would say get up and leave," says Tep. "You're risking a lot for a pedicure. If you're not sure, and you're not comfortable, it's better to be safe than sorry."
If you have diabetes and do not currently see a podiatrist please call our Bristol office today to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
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