Nail polish has been a part of human self-expression, and fashion since 3000 BCE. Pedicures are a common way that people, men, and women practice self-care, and choose to unwind.
As a foot doctor, this is one of the most common questions I get from my diabetic patients is, "Can diabetics get pedicures?" In a run-of-the-mill salon, is no. In a doctor's office, or medical spa with staff trained by a foot doctor, and even better with a foot doctor on-site, overseeing the pedicure on the diabetic patient, yes. This can be known as a medical pedicure.
Diabetes affects every part of your body, and your feet are no exception. There are certain changes seen in the feet of diabetics which increases their risk of having a foot amputation down the road.
My 5 reasons, as a board-certified foot doctor, that diabetics should not get pedicures in nail salons:
1. Diabetes affects blood flow to the feet
My top reason for diabetics not getting pedicures at nail salons is because of the circulation problems seen commonly in diabetic feet.
Diabetes can lower your circulation or blood flow to many parts of your body, your feet, and legs included. This is one reason why people with diabetes have a much higher risk of foot ulcers and foot amputation.
The amount of blood flow you are getting to any part of your body, feet included, is an important sign of being able to heal any kind of injury, from a cut in the skin to a bone break.
Any scrape, nick, or cut received from a nail tech in a salon can potentially be the reason for a toe or foot amputation in someone with diabetes. For me, all non-traumatic amputations (amputations not caused by a traumatic event, but by disease) in people with diabetes are tragic because they are largely preventable.
The most tragic amputations I have performed in my career were on people who were cut during a pedicure at a nail salon, or on someone who tried to trim their nails or calluses at home. This is a very real scenario and unfortunately, a reality for many people with diabetes.
2. Diabetes affects your immune system
Yes, diabetes impacts your immune system in a negative way, meaning that it is much harder to fight any kind of infection. Something like a minor skin infection from a cut or nick at a nail salon can turn into cellulitis (soft tissue infection), osteomyelitis (bone infection), or even sepsis (an infection that has reached your bloodstream and is life-threatening) very quickly in someone with diabetes. This is my 2nd reason why diabetes should not get pedicures from nail salons.
3. Diabetes can make it difficult to feel any injury to your feet
Diabetes can take a toll on the nerves of your feet, causing chronic pain, or numbness known as peripheral neuropathy, or specifically diabetic neuropathy. Because of this, someone with neuropathy in their feet would not be able to feel alone if they were accidentally cut during a pedicure at a nail salon.
They would not be able to tell if a callus was shaved down too far because they would not be able to feel any pain. Between the peripheral neuropathy commonly seen in diabetic feet as well as the circulation problems in the feet, and the weakened immune system. Due to peripheral neuropathy seen in many diabetic feet, this is another reason why diabetics should not get pedicures.
4. Nail salon workers are not doctors or trained medical staff
This an obvious statement, but one that needs to be made. 99% of nail salon workers are not trained to deal with the complexities of the diabetic foot.
I have heard personally from my patients, that nail techs in salons are removing ingrown nails, which is particularly dangerous for many reasons, in a healthy patient, but even more so in the diabetic patient, and can lead to disastrous consequences, including amputation.
Also, ingrown nail removal is technically a surgical procedure, and should only be performed by a doctor. Even shaving calluses by someone who is not a foot doctor, in someone with diabetes can lead to amputation in the worst-case scenario.
Due to nail salon workers not being trained by medical staff, changes to the feet like certain types of calluses, blisters, or redness due to pressure are not caught, or the patient just isn't told to see their foot doctor about these findings. All of these skin changes can eventually cause the skin to break open and a foot ulcer to develop.
One of the many important roles that we have as podiatrists is to treat disease in the diabetic feet, and prevent chronic wounds known as ulcers, as well as amputation. For this reason, it is critical for patients to be diligent about their foot health.
This includes not letting anyone who isn't a doctor or medical professional trim nails or calluses, remove ingrown nails, push back cuticles, or do anything to their feet that can cause a wound. Diabetics should be following up with a podiatrist on a regular basis for routine and preventative care.
5. Many salons don't autoclave their instruments
Unfortunately, many people don't know or understand the importance of autoclaving. An autoclave is a piece of equipment that looks similar to a toaster over, but with a heavy-duty metal door, and no glass.
Anything that is put inside an autoclave is heated to a certain temperature with added pressure to kill any and all things that can cause infection (bacteria, fungi, and viruses). Instruments are autoclaved to stop the spread of infection, especially if instruments have to be shared. Autoclaved instruments are what are used in surgery, in your doctor's office, and at tattoo or piercing parlors.
Properly autoclaved instruments will come in a sterile package. This pack should always be opened in front of you. If the pack is brought to you opened, or the instrument isn't in that pack at all, there is a chance that the instrument is not sterilized.
Any instrument or tool that is not processed in an autoclave, or placed in a cold sterilization solution (another option for sterilizing instruments), and then is used from person to person, is effectively dirty. Rubbing alcohol, and other cleaning solutions simply are not good enough at killing any and all germs. Sharing dirty tools from person to person increases the risk of contracting many infections including MRSA, Athletes Foot, HPV, E coli, and more.
In the diabetic foot, a wound that is created accidentally with a dirty tool can lead to life-altering consequences. This is my final reason why diabetics should not get pedicures at regular nail salons.
Ways to pamper your feet safely, as a diabetic:
If you are not ready to swear off the nail salon completely as a diabetic, there are some changes you can make to be certain that you are not increasing your risk of developing a foot ulcer or amputation.
1. Have a podiatrist or trained medical personnel trim your toenails, and calluses instead. You can then bring your own nail polish to the nail salon for them to apply.
A podiatrist/foot doctor, certified foot care nurse, or medical nail technician providing foot care including nail and callus trimming can also be known as a medical pedicure.
This I believe is the best middle ground for my diabetic patients who want to be safe, but still, want to receive some or all pedicure services.
This option is also the most accessible for many people since most cities and even small towns have podiatrists and foot doctors who perform diabetic foot care.
Follow up with your podiatrist regularly to be sure that your feet are in good shape, and then if you like, visit your local nail salon or a medical nail technician for nail trimmings and a polish change.
Applying nail polish requires no instruments, no cutting or trimming, and is safe. In order to lower your risk of catching a possible nail fungus from the shared polish bottles in salons, feel free to bring your own, and ask them to apply it for you!
2. Get foot or leg massages instead
Massages are a great way to unwind, relax, and release tension. Many nail salons do offer foot or leg massages. This is safe to do as long as there are no open wounds on your feet or legs.
3. Find a medspa, ideally with a podiatrist on-site to perform your pedicure.
This can be a more difficult thing to find, depending on where you live, but in certain major cities, there are medspas or podiatrist offices with medspas attached that perform dry pedicures on diabetics safely and in a sterile environment.
Overall, I as a foot doctor, do not recommend that diabetics get pedicures in nail salons due to certain potential changes seen in diabetic feet including poor blood flow, neuropathy, and weakened immunity.
If someone with diabetes chooses to visit a nail salon for a pedicure, regardless of the risk, please see a podiatrist immediately if you notice any injury or changes to your feet on your daily foot checks.
Schedule Your Appointment At Direct Podiatry Arizona Today
Looking for a podiatrist in Phoenix? My name is Dr. Tarr. and I am the owner of Direct Podiatry Arizona, located in Tempe, AZ. To view available appointment times, click the link here.