The risks of getting your nails done

Jane’s situation is typical of cases Wellington podiatrist Bronwyn Easterbrook-Smith sees “pretty much every day”.

In a particularly nasty case, one of Easterbrook-Smith’s clients had a nail infection, which developed into an ingrown toenail. Part of the nail had to be removed to treat the infection.

The woman’s cheap pedicure left her with a $350 medical bill.

Nail bars have been doing a roaring trade, springing up in malls and on high streets to offer customers perfectly polished tips. But as the industry has grown, so too have problems caused by lax hygiene.

Infection risks

Nail bars are a risky environment for infections to spread if hygiene practices aren’t up to scratch.

Bacteria, fungi and viruses can be transferred between customers when equipment isn’t disinfected and sterilised.

You can walk out with a case of athlete’s foot or warts, PodiatryNZ professional adviser Caron Orelowitz said. Blood-borne diseases, such as hepatitis B, can also be spread by dirty equipment.

Cutting cuticles – a practice done for cosmetic reasons – increases the risk of infection. Heel blades, used to remove calluses and dry skin, and footbaths that haven’t been disinfected also raise the risk.

“In the worst-case scenarios, life-threatening infections like cellulitis develop as a result of contracting a bacterial infection,” Orelowitz said.

A survey of 57 Wellington nail bars and beauty therapists lends support to Orelowitz’s concerns. Published in 2018 by the region’s public health agency, it found only 12 percent of operators had adequate disinfection and sterilisation practices.

Just 39 percent said they’d stop the manicure or pedicure if the customer started bleeding.

Less than half the salons had an adequately trained staff member. Many staff were trained on the job or by nail polish companies. The cheaper your manicure or pedicure (under $40), the less likely it was being carried out by a nail technician with a formal qualification, the survey found.

What are the rules?

There’s no national regulation of nail bars. Instead, the job is left up to councils and voluntary industry standards.

Just 12 councils have public health bylaws that apply to salons providing manicures and pedicures.

Existing rules cover 743 premises throughout the country, though requirements vary. Training requirements range from ensuring staff are ‘adequately trained’ to having formal qualifications.

Bylaws are intended to ensure services are carried out in a safe and hygienic manner. However, they don’t mean salons are problem-free. Last year, 30 complaints were reported. The main causes for complaint were unhygienic practices, including the use of rusty nail clippers.

Despite the bylaws, PodiatryNZ continues to see customers with infections after visiting salons.

“Unfortunately, we are not seeing a reduction in infections from pedicures at nail bars or beauty therapists,” PodiatryNZ chief executive Jennifer Pelvin said.

The only other hygiene standards in the industry are set by the New Zealand Association of Registered Beauty Professionals. However, membership is voluntary.

Both the association and Podiatry NZ want nail salons to be regulated by central government. However, that’s not likely to happen any time soon.

Chemical controls

Along with risks from poor hygiene practices, the products salons use also have health risks.

In 2017, two Auckland nail bars were prosecuted for using a banned substance – methyl methacrylate (MMA) – to apply acrylic nails. MMA can irritate the eyes and skin, and lead to allergic reactions or respiratory problems.

Kiwi Nails and Spa was fined $13,500 for using MMA after it was found using it in 2016. Another salon, Country Nails and Beauty, faced a higher fine of $15,750 because it not only used MMA on customers’ nails but decanted it into a container labelled “No MMA”. This meant staff had no way of knowing it was in the bottle.

Other chemicals used to attach acrylic nails are classified as hazardous substances and their use is capped by the Environmental Protection Authority.

What to ask

With limited regulation of nail salons how can you avoid getting fungus in your French manicure?

• Keep your eyes open for tell-tale signs your salon isn’t up to the job and don’t be shy about asking questions. Do the premises look clean and tidy? If the salon looks sloppy, chances are its hygiene practices are too.

• Before starting the treatment, salon staff should evaluate your skin, ask you about any health conditions and clean your hands (or ask you to wash them).

• If you’re inadvertently cut during treatment, the procedure should stop immediately. The salon shouldn’t cut your cuticles. Instead, the technician should use a rubber hoof stick to push back cuticles.

• If you’re getting acrylic nails, you should be told about the risks. The acrylate-based glues may cause an allergic reaction and lead to dermatitis.

• Benzoyl peroxide and hydroquinone (or hydroquinone methylether), ingredients used in fake nails, may also cause allergic reactions. Concentrations of benzoyl peroxide are limited to 0.7 percent in nail preparations. Hydroquinone is limited to 0.02 percent.