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Wednesday, September 28, 2011

In for a Manicure, Out With an Infection

By Debra Jaliman, MD

Last week I wrote about nail tips and how people who use them regularly are risking serious fungal infections. This week I’d like to discuss how to get a safe manicure or pedicure at your favorite salon.

First of all, always – and I do mean always – bring your own instruments to the salon. Several states have laws prohibiting the use of manicure implements that others have used, but just in case, the smart thing to do is to always bring your own. This includes nail files, too. I regularly see patients who take their own clippers and nail scissors to salons, yet still end up with nail infections. “Did you bring your file, too?” I ask. The answer is always no.

Paronychia is the medical term for an infection around the nail; symptoms include pain and red, swollen skin. The usual causes? Excessive cutting of the cuticle or the use of an infected manicure instrument, including the stick used to push the cuticle back. Treatment of paronychia depends on whether it is bacterial or fungal; usually it is treated with topical antibiotics, but severe cases may require oral antibiotics or injections into the nail fold (very painful, I’m afraid). People can also get herpetic infections of the skin around the nail, known as whitlows,from infected tools.

Second, even if you are the only person using them, clean your manicure implements with rubbing alcohol after every use.

Third, never trust appearances. No matter how beautiful, expensive or clean a salon appears,it’s no guarantee that its facilities and instruments are free of fungi and bacteria. If the manicurist beckons you to a newly vacated pedicure chair where the basin has not been cleaned with bleach, do not sit there. A swish of water and soap will not do; only bleach kills bacteria and fungi.

Pedicures present their own challenges. Never, ever let the manicurist use a razor or a callus remover that slices dead skin. Those are dangerous to use, because it is very easy to cut too deep and slice into flesh, leaving the area vulnerable to infection. Buffers and pumice stones are safer, but should not be used too enthusiastically. It’s actually better to use a pumice stone or file regularly on your feet at home, rather than have it done to excess every few weeks at a nail salon.

On a different, but important, note about nail salons, I’m regularly asked if the ultraviolet drying lamps will age skin as much as sunlight. The answer is yes, especially if you have manicures regularly. Letting nails dry naturally may take longer, but you are not exposing your hands to damaging rays.

Bottom line: Take charge of your experience at your nail salon – always bring your own implements and decrease your chances of infection.

Posted by: Debra Jaliman, MD at 10:06 am

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