There is always the risk to your health if proper infection prevention principles are not applied
Enjoying a pedi-manicure is a self-pampering moment for all ladies, even for men. They would head off to the nearest cheapest nail salon and indulge themselves with the 45 min princess-like treatment. While indulging, we expose ourselves to the risk of infection and worse, losing our finger or limbs!
Personal Service Establishments (PSEs) consist of businesses offering services such as aesthetics which range from non-invasive nails and hair services to more invasive procedures such as tattooing and body modifications. Any personal service with the potential to break the skin, our body’s defence, exposing it to skin-skin or skin-surface contact poses a risk of infection to the PSE workers and us. Infection can even be transmitted to other clients if proper infection prevention principles are not applied properly.


How can we get an infection from pedi-manicure?
1. The sterilisation or sanitation of tools is not adequate such as nail clippers or whirlpool footbaths between clients.
2. The use of metal files/grater overzealously to remove dead, dry skin and calluses.
3. To cut the toenails too short which may result in an ingrown toenail or infection.
4. To clip the cuticles. The cuticles are a protector and barrier from infection.
5. While shaving the legs before a pedicure, the infection transmits through scratches, and tiny nicks result from the pedicure.

Ingrown toenail infection.
Any personal service with the potential to break the skin, our body’s defence, exposing it to skin-skin or skin-surface contact poses a risk of infection to the PSE workers and us. Infection can even be transmitted to other clients if proper infection prevention principles are not applied properly.
How do we know when a manicure and pedicure has gone wrong and infection has occurred?
The telltale signs of infection may occur immediately or even months later.
1. In a bacterial infection, the skin around the toenail will be red, swollen, hot, painful, and tender to touch a few days after the pedicure. Please visit your General Practitioner (GP) for advice, especially if there is an abscess (a pus-filled area in the skin). Do not try to puncture yourself, which may lead to a more severe infection or other complications. The GP would usually start you on a course of antibiotics and may perform a small incision to drain the area.
2. If you notice that your nail is lifted, nails getting more brittle, thickened and distorted, or and presence of odor, this means that you may be dealing with a fungal infection. It may not appear for months after the pedicure. The GP may prescribe oral antifungal medication or antifungal nail lacquer or topical solutions or even take a nail scrap and send the sample for analysis and identification.
3. A “plantar wart” is typically similar in colour to the skin, occurring on the bottom of the foot or toes caused by the human papillomavirus. There might be even more than one wart in an area and may result in pain with pressure, making walking difficult. Treatment is to alleviate symptoms and may include applying a salicylic acid solution to the wart, cryotherapy or surgical removal.
How can we reduce the risk of infection?
Please be always vigilant. Do follow these simple rules and tips.
1. Be a detective and pre-screen your nail salon. Visit the nail salon and find out how they sterilise their tools and instruments.
2. Before your manicure and pedicure, do not be shy to request for tools sanitisation.
3. Request the worker to be gentle and speak up if any of the procedure hurts.
4. Steer clear of metal files and opt for a gentler tool like stone pumice.
5. Skip the cuticle pushing and clipping.
6. Shave your legs after you get a pedicure and not before.
As always, prevention is better than cure. — The Health
Dr Dian Nasriana Nasuruddin is Senior Lecturer and Chemical Pathologist Consultant, UKM Medical Center, Universiti Kebangsaan Malaysia (UKM) and Treasurer of Malaysian Sepsis Alliance while Assoc Professor Dr Tan Toh Leong is Senior Lecturer and Emergency Medical Consultant, UKM Medical Center, UKM and President and Founder of Malaysian Sepsis Alliance