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Safety and Fitness for All
Hazardous To Your Feet?by Neil M. Scheffler, DPM, FACFAS
bubbles soothing away the day’s sometimes painful calluses that troubles. The pedicurist applies
Plenty!Just search the Internet and you wil see many reports of serious foot and leg infections con-tracted in nail salons and spas from coast to coast. From Beverly Hil s, California, to Boca Raton, Florida, and right in your neighbor-hood, fungi, viruses and bacteria lurk in the soaking tubs and on the instruments of pedi-curists, waiting for your unsuspecting toes.
The Usual SuspectsThere are a number of kinds of infections that may be contracted at nail salons. One common infection is onychomycosis, a fungal infection of the toenail. This infection was made famous by “Digger the Dermatophyte,” seen in TV commercials for Lamisil, one of the medications used to treat onychomyco-sis. Toenails infected with these fungi look discolored and may become thick, brit le or flaky. The same fungi may also infect the skin, causing athlete’s foot. The skin may form blis-ters, itch or be dry and scaly. If the infection is between the toes, the skin may be moist.
Viruses are another possible source of infec-tion. A common viral infection is a wart. More serious viral infections, such as hepatitis C and HIV/AIDS, can be potential y transmit ed by careless pedicurists. Yes, if the skin is broken, even these deadly blood-borne pathogens can be caught during a pedicure!
There are many reports of infections from Mycobacterium fortuitum
as well as the drug-resistant bacteria MRSA (methicil in-resistant
Volume 18, Issue 5 July/August 2008
between you and the customer who was in the tub 10 minutes ago. Bacteria can flourish in the plumbing and filter screen.
Don’t shave your legs before your appointment. Shaving opens hair follicles and may cause tiny nicks in your skin that are openings for bacteria to invade.
Buy your own instruments and bring them with you. Complete kits are available, some even in at ractive carrying cases, which would be yours alone. This kit, in addition to the disposable tub liner, would ef ectively isolate you from harmful bacteria, viruses and fungi. Your podiatrist may have these available for sale on his/her Web site.
Finally, if you discover a problem such as a change in color or thicken-
) following pedicures. MRSA causes serious
ing of a toenail, or a strange spot that wasn’t there before, cal your
infections and can even lead to death. Some infections can start out
podiatrist for an appointment. It’s much easier to treat a condition early
looking like small insect bites but may enlarge into pus-filled boils,
requiring strong antibiotics. These infections may leave permanent scars.
Neil M. Scheffler is a podiatrist in private practice in
Baltimore, Maryland. He is a fel ow of the American
Some people are at greater risk than others of get ing infections from
College of Foot and Ankle Surgeons and is board-
pedicures. People who have diabetes, neuropathy (numb feet) or
certified in foot and ankle surgery. Dr. Scheffler is a
peripheral arterial disease (PAD – poor circulation) have a much
past president, Health Care & Education, Mid-Atlantic
greater chance of serious problems if their feet get infected. People
Region, American Diabetes Association. He is the
who do not have these ailments will generally heal with good medical
attending podiatrist for the Prosthetics Clinic, Sinai Hospital of Balti-
care. People with neuropathy may not feel the pain of the infection,
more. Visit him at www.baltimorepodiatrygroup.com
leaving them unaware of the problem until it’s too late. Those with diabetes or PAD may simply not heal at all. These nonhealing infec-tions al too often result in amputation.
Does this mean that you should never get a pedicure? That’s a personal decision that should be made on the basis of how satisfied you are with your pedicurist’s practices. As you might have guessed by now, I’m really not a fan of pedicures. In my profession as a foot specialist, I’ve seen many women with infections that were contracted while get ing a pedicure. However, there are certainly many women who go regularly without experiencing any problems. So, if you do choose to have a pedicure, here are some tips to consider, including clues as to whether your pedicurist operates safely and responsibly.
The Game’s AfootFirst of all, become your own investigator at the spa. Check the facility for licenses and recent inspection certificates. Insist on cleanliness. Are items that cannot be sterilized (such as emery boards, nail buffers and toe separators) disposed of after each use? Does the pedicurist use a bladed instrument to shave corns or cal uses? (In most localities, this is not allowed by law!) Your podiatrist should advise you about the causes of these areas of hard skin and what should be done to prevent them or treat them properly.
What does the pedicurist use to bathe your feet? This should be a plain tub of water that is soaked with disinfectant at least 15 minutes between clients. Better yet, purchase disposable tub liners that sepa-rate you from the tub. Also, there should be no moving water. Any tub that has jets or bubbles cannot be adequately cleaned in the time
Contact the ACA at 888/267-5669 or www.amputee-coalition.org 29
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22 september 2006 • Pharmaceutisch Weekblad nr. 38Farmakundigen passen in een maatschapApothekers moeten investeren in ondernemerschap. Volgens minister Hoogervorst kan de farmakundige daarbij ondersteunen. Veertig farmakundigen zijn inmiddels afgestudeerd. Ze werken bij apotheekketens, zorgverzekeraars en in de industrie, maar niet in de apotheek. De gemiddelde apotheek blijkt te klein, maar