Should I be worried about infections?
Our feet are sometimes more at risk of infections (particularly bacterial and fungal) than other parts of the body. That’s because feet are often cooped up in socks and shoes, get hot and may stay moist for longer. You won’t know whether other customers of a nail business have infections, so it’s important you know how to stay safe when getting a foot or nail treatment.
Infections can cause anything from annoying irritations through to more serious conditions where medical treatment is a necessity. For most of us these will not be medically serious, but those with diabetes need to be especially careful.
It’s better to avoid unnecessary infections (even if minor). Such infections include athlete’s foot and fungal infections which affects toenails. These cause discomfort, unsightly nails and can be a pain to get rid of.
How can I tell if a nail business is safe?
Unfortunately, some businesses offering nail and foot care and things like medi-pedis etc may not use proper equipment or safe, sterile procedures. There is little to no regulation of such businesses.
Hair and Beauty businesses
Due to concerns about unregulated businesses, the industry body for hair and beauty businesses (Habia) published a voluntary code of practice in 2007. This followed a period of rapid growth in such services. This covers good practice for cleaning, disinfection and sterilisation.
Unfortunately, there are some issues with this. We can no longer find that Code of Practice on Habia’s own web-site (and they have not replied to a question we asked about it) so it’s unclear if it’s even still in use.
The code also appears weak and not enough to help you stay safe. For example:
- For most services, the code just calls for cleaning and “disinfection” between customers.
- Nail technicians only need to “wash their hands with a liquid soap and water”.
- It shows pictures of ungloved hands giving treatments.
- It only talks about using gloves to protect the nail technician from potentially hazardous liquids – not to protect customers from cross infection.
- It says sterilisation is “unnecessary for nail services unless the nails are infected or the skin has been cut or pierced”. We question this:
- How do they know whether or not someone has an infection (which is often invisible)?
- Are you sure you don’t have any small breaks in your skin which could become infected?
- Fungal infections do not need broken skin to take hold – they grow on the skin surface and on and under nails.
- The code even admits that disinfection will not kill some spores. Unfortunately, since fungal infections are spread by…yep, spores and are common, that’s not very reassuring. Fungal infections can actually be very difficult to eradicate and are not to be treated lightly.
Cleaning is the physical removal of dust, grease or organic matter that will reduce the
Liverpool Heart and Chest Hospital – NHS Foundation Trust 2013.
number of micro-organisms present and remove medium supporting the growth of microorganisms.
Cleaning is necessary prior to disinfection and sterilisation.
Disinfection is the process of reducing the number of micro-organisms to a level at which
they are not harmful, with the exception of bacterial spores and prions.
Sterilisation is the process of removing or destroying all micro-organisms, including
spores.
How do we help you stay safe?
We need to be honest here….the situation on regulation of foot health practitioners is not much better than that for hair and beauty businesses. There is not a standard or a badge that you can quickly check to know that a practitioner follows safe practices.
But…there are a few things you can easily check so that you can stay safe.
Check what training and qualifications your foot care practitioner has. There are number of good training providers. The most common qualification is from the SMAE Institute which has been around since 1919.
There are other easily checked tell-tales. Below we run through what we do and what to look out for so that you can stay safe. We are also always happy to answer questions you may have.
Equipment
There are basically two ways that you can be sure that equipment is sterile:
- It’s single use/disposable
- It has been sterilised in a properly controlled autoclave.sterilisation vs
We use both approaches. For example, we use single use disposable emery surfaces (these are tips which are attached to reusable, sterilised instruments).
All of our metal instruments (e.g. clippers, files, etc) are sterilised by first washing with special cleaners and then undergoing a carefully controlled cycle at high temperature in a vacuum in an autoclave like the one here.
We record and print out each cycle so that we can check that it completed without errors. This is the same type of approach used for surgical instruments at hospitals, dentists etc.
Other Protective Measures
We clean surfaces (for example, the couch where you will sit for treatment) between clients using chlorhexidine gluconate solution. This is a solution which has been used for decades in hospitals for surface and skin cleaning to kill bacteria, viruses and fungal spores. We also use a hard surface plastic tray for feet which is easy to clean and disinfect effectively between clients and lined with paper.
We wear disposable gloves which are changed between clients or more often. More than this, we are also careful not to contaminate clean gloves by touching a non-sterile surface. That comes from decades of nursing expeirence. In our experience, this attention to detail is not widely used. That’s true even in some medical settings where infection control is of critical importance.
Controlling Dust
When drills are used to remove parts of nails and skin, this creates dust. This can spread easily in the air. You and the person doing your nails can be breathing it in if steps are not taken to avoid this.
At Footpal, we will treat your feet where appropriate with a purpose-made Berchtold podiatry drill. This is a precision instrument which operates at precisely computer controlled speeds
It also has a built in vacuum system so that dust is removed at the tip. This collects dust immediately and safely in a special three layer bag trapping bacteria, viruses and fungal spores.
This creates a safer, more pleasant treatment for you and protects us. If you receive treatment in a room with others, it’s particularly important to look out for this type of protection.
We also wear a disposable mask for additional protection because we are in this environment all day. We will happily provide you with a disposable mask if you like as well.
Some practitioners use tools which are not designed for podiatry. Others use portable podiatry drills which do not have a suction system. We do not believe in compromising. So even when we do home visits, our specialist drill comes with us in a special protective case.
Autoclaves and podiatry drills add up to thousands of pounds of investment. So it is easy to understand why some less established businesses may lack these.
What Else to Watch Out For
Unfortunately, some of the nail businesses which have sprung up in the UK in recent years, use unethical and illegal practices to keep prices unrealistically low. These include human trafficking and modern day slavery. Other workers may be being paid way, way below a minimum wage.
Some have also been linked to money laundering of other criminal activity including drugs and prostitution. This is because they can be used to handle large amounts of cash.
https://www.freedomunited.org/news/modern-slavery-lurks-behind-cheap-nail-bars-in-uk/
Of course, there are many reputable businesses as well. This article from Stylist magazine explains how you can check that you are not supporting exploitation and crime. By helping to protect others from exploitation, you will also be helping yourself to stay safe.
https://www.stylist.co.uk/beauty/ethical-nail-salons-issues-exploitation-workers/201334
Footpal is an owner-operated small business.
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