Infections in Nail Salons

Abstract 

The spa pedicure has come into its own in the 21st century. Before that, people cut their toenails at home or had pedicures in hair salons, where technicians used small plastic foot spas to soften the nails and surrounding skin. Today, there seems to be a nail salon on every corner; in fact, in the beginning of this century, there were 51,571 nail salons in the U.S. and 368,818 licensed nail technicians (Gira, A.K. et al., J. Clin. Microbiol. 42:1813-1817, 2004). Each nail salon contains a row of pedicure footbath spas, which are actually circulating whirlpool footbaths that are used to soften the toenails and skin. Prior to 2000, when an outbreak of mycobacterial furunculosis was first reported in northern California, most salons did not regularly clean the screens and filters that trap skin debris in these whirlpool baths. This omission resulted in both large and small sporadic outbreaks of mycobacterial infections on the shins of individuals who had had a pedicure in the preceding 2 weeks. We review what we have learned in the past 7 years about treating and preventing infections from nail salons.