However, not everyone with diabetes has the same risks and conditions in regard to pedicures. Many long-term studies show that some people with diabetes are at no greater risk of developing major foot problems (such as sores, infections and amputations) than the general population.
One key to successfully managing your life with diabetes is consulting with a podiatrist. Many people think that podiatrists do not like nail salons. However, your podiatrist can help identify and understand the potential risks and how they apply to you.
It is absolutely essential to take an active role in the care of your diabetes. See your doctor regularly to ensure that your blood glucose levels are appropriately managed. Maintain good blood glucose control. Be sure to see a podiatrist at least once a year. This visit identifies any changes to your feet and whether they indicate potential problems.
Whether you trim your nails, go to a salon or even to a medical professional, accidents do happen. The more experience and training that the person providing your care has, the less the risk is to you.
The concern with getting a pedicure is that you must be able to handle minor injuries to your feet. Even in the best of hands, accidents can and do happen. You want to be confident that your body can deal with a problem adequately. If something does happen, please seek medical attention as soon as possible – even if the injury seems unimportant to you. Timely medical treatment can save you from big problems down the road.
With an injury to your feet, many complications are possible. Some could result in a change in look or color, but others can be more dramatic. What puts you at greater risk for infections and sores? The two most important risks that your podiatrist will consider are circulation problems and nerve damage.
Circulation problems - People with diabetes have one of the highest risks for developing partial or complete blockages in the arteries that go to their feet. This lack of blood means that the body may not be able to deal with breaks in the skin or small cuts to the feet. An inability to heal wounds or fight infection can lead to serious problems.
Feet without good circulation can be compared to a dry forest in the midst of a hot summer when conditions are ripe for a fire. In the forest, all it takes is an innocent spark to start a blaze that destroys the whole forest. For someone with diabetes, something as small as an ingrown nail or even cracked heels can cause a problem. Having diabetes is the second biggest risk factor for developing poor circulation, after smoking.
Nerve damage - If people with diabetes have developed nerve damage, they may lose the ability to feel an injury or cut on their feet. (This condition is called peripheral neuropathy.) More importantly, they may not be able to feel an injury that is becoming severe. The longer that someone has had diabetes, and the poorer the blood glucose control, the more likely this condition becomes. In a recent study, it was found that up to 90 per cent of people with this condition were not aware that they had it.
Infections carried in the blood, such as hepatitis and HIV, can be transmitted through an open sore or cut. Do not go to the salon if you have any open sores, cuts or ingrown nails. Be sure to check areas of your feet that are hard to see, like your heels or the spaces between your toes. Do not shave or wax your legs in the 48 hours before going to the salon. Removing hairs can create small nicks that allow the entry of germs, causing infection.
Infections can also be passed through surface contact with hard-to-kill yeasts, viruses that cause warts, and fungus. These types of infections can be transmitted without having an open sore on your feet or legs.
Infections of the nails and skin with fungus or warts are quite common. They can be very difficult to treat. Fungal nail infections typically make the nail look yellow, flaky, thickened and misshapen. Using an instrument that hasn’t been properly sterilized can cause a fungal infection. If you have nail fungus or warts, you certainly do not want to pass this on to your technician or other clients. Take appropriate steps to prevent this from happening.
Selecting a nail salon or spa
If you have been told that it is safe to have a pedicure, be sure to select the right salon.
Provincial regulations vary across Canada. This means that the standards of practice and licensing can be different. Some provinces, such as BC, Ontario and PEI, regulate salons while others may leave it up to each municipality. Licensing and certification of nail technicians also varies across Canada. Some provinces require licensing, while others have no requirements at all.
When you consider a salon, ask questions. Does it have accepted standards of cleanliness and hygiene? Does the staff have enough experience to accommodate the special needs of people with diabetes?
Be proactive. Does the place look clean? Do they take pride in maintaining a clean work environment? Are disposable gloves used for each client?
Ask how they clean their instruments and chairs. These should be washed with soap and water to clean off any debris, and then sterilized. How is re-usable equipment sterilized? Liquid sterilizing can be done by soaking instruments for the recommended time with medical grade solution, generally for at least 15 to 30 minutes. Better yet is placing instruments in a high heat pressure cooker called an autoclave to kill all bacteria, viruses and fungus. Do not be afraid to ask to see the solutions and sterilizing process.
Many pedicures begin with a whirlpool bath or a foot soak. Whirlpool baths are difficult to clean properly. Many have traps in the bottom that can accumulate skin, hair and nail fragments. They can be a source of bacteria. Skip the whirlpool or choose a soaking tub. These tubs are easier to clean, properly wash and sterilize between clients. Better yet, they should be covered with an individual, disposable plastic liner.
Be sure the salon uses single-use, pre-packaged tools. Any instrument that is spongy or wooden, such as pumice stones and nail files, should be thrown away after each client. Metal instruments, such as foot paddles or nail clippers, should be made of non-porous metal. Non-porous metals are easier to clean and can be sterilized. Cleaning and sterilizing should take place after every use.
Ideally, instruments should be disposable or just for your own use. Many instruments are used on the nails and skin. Re-used instruments can carry bacteria, yeast or fungus on them. If they have not been scrubbed and sterilized properly, bacteria, yeast or fungus can be transferred to another person. If you go to a salon regularly, consider purchasing a set of tools that can be washed, cleaned and only used on you.
Do not allow technicians to cut your skin or use sharp blades or tools to remove calluses or thickened skin. For some people, it is safe for technicians to use a foot paddle or rough file. Talk to your podiatrist before allowing this kind of tool to be used. As mentioned, foot paddles should be either disposable or made of non-porous metal. They should be cleaned and sterilized after each use.
Nail salons have exploded in popularity over the past few years. Remember, having your feet examined regularly is an essential part of your foot care. If pedicures are appealing, talk to your podiatrist and understand the risks to help decide if they are safe for you.