With spring right around the corner, chances are pretty good that nailcare services, pedicures in particular, will soon become a priority for many of your clients. Unfortunately, when it comes to nailcare sanitation, we've all heard the horror stories. It wasn't all that long ago that "American Idol" judge Paula Abdul appeared before a California Senate Committee lobbying for new state regulations establishing safety standards for manicure and pedicure equipment and a mandate that nail establishments clean up their act. This came on the heels of her contracting a staph infection from unsanitary tools used during a routine manicure. While such stories serve a useful purpose in motivating many spa and salon owners to heed the warnings and make sanitation a priority, far too many have yet to devote the time and attention the issue deserves. "It may take only one bad nail infection to ruin a spa's reputation," says Doug Schoon, chief scientific advisor for the International Nail Technicians Association and co-chair of the Nail Manufacturers Council (NMC). With that in mind, can you say with certainty that your spa is above reproach?
According to Johanna Youner, M.D., an attending podiatric surgeon at New York Downtown Hospital and a spokesperson for the American Podiatric Medical Association, dirty tools and soaking tubs are just some of the sanitation issues affecting spas and nail salons today. Ji Baek, owner of Rescue Beauty Lounge (New York City) and author of Rescue Your Nails: A Do-It-Yourself Guide to Perfect Fingers and Toes (Workman Publishing Company, 2008), has also witnessed nail technicians reusing disposable non-metal items, such as nail files, orange sticks, buffing blocks, and foot files, as well as not properly sterilizing metal implements. Needless to say, these are just a few of the ways infections can spread.
Some spas provide clients with their own bottle of polish to keep for the sake of hygiene.
"I once watched a nail tech perform a pedicure, and during the cuticle-trimming and nail-cleaning process, she would wipe the trimmings off the implements with a towel," says William H. Berger, Ph.D., president of Sensuous Solutions, a manufacturer of foot spa sanitizing agents and additives. "Once she completed the pedicure and drained the tub, she used the same towel to wipe the inside of the tub. Never bothering to disinfect, she then called the next client and filled the tub." Unfortunately, such scenarios are all-too common, and if it happens in your spa, you and your unsuspecting clients are the ones who may pay the price.
It should come as no surprise that nailcare sanitation is often called into question when you consider the lack of knowledge that still exists on the topic. "It's the spa and salon owners' responsibility to make certain sanitation is a part of the nail professional's ongoing training," says Tia Hildabrand, regional account manager for SpaRitual and a licensed nail technician. According to Schoon, many nail technicians either don't understand what they're supposed to be doing in terms of cleaning and disinfecting utensils and are doing it incorrectly, or they're not doing it at all. "The majority of technicians are probably doing something and thinking they're taking the appropriate steps, but those steps are either based on misinformation or misunderstandings of what they learned in school, read in trade magazines, or took from the state regulation," says Schoon. "The majority of state regulations are either written so poorly or are so difficult to understand that nail technicians don't know what their responsibilities are."
Part of the problem can be traced back to the classroom and to the textbooks and tests being used. According to Schoon, many of the books contain misinformation. "To make it worse, in many cases, the instructors know it's wrong information, but they know the certification tests are inaccurate and they want their students to pass," says Schoon. "Some questions on the tests are wrong, but the teacher has to teach the students how to answer them." Needless to say, this creates a fair amount of confusion for students who are sometimes learning two answers to the same question. It's no wonder then that many have no idea what sanitation steps need to be taken. That's why it's imperative that spa owners and directors step up to the plate.
You may be asking yourself, "Why not just update the books and tests?" Unfortunately, it's not a simple process when you factor in the competing interests of the book manufacturers, exam-writing companies, and national and state councils, who are also responsible for writing some of the tests. "I've changed things in textbooks and had the people writing the exams come back and say 'you can't change that because this is what it says on our test'," says Schoon. "To change a question is not as simple as going in and changing the question. It is costly and time-consuming, which is why they don't want to do it."
Sharing a Common Language
What types of misinformation are students learning? "I would say the vast majority of people in our industry do not know what the word sanitize means, because it is used incorrectly in the books, in trade magazines, in marketing literature, and on the state examinations," says Schoon. "Sanitize simply means to clean. People think if they just sanitized something, then it's okay. The law requires cleaning and disinfection."
It's important to use new non-metal implements for each client so as not to risk spreading infection.
"Because terminology is not understood in our industry, and we don't have a common set of words that we agree upon, it's creating chaos," says Schoon. "If we can't agree on what the words mean, how can we communicate, and how can we tell people what they should and shouldn't be doing?" The word cuticle is another prime example. "The term cuticle is used to mean so many different things," says Schoon. "Why are there both cuticle removers and cuticle conditioners? Are we supposed to condition the cuticle before removing it from the nail plate, or do we not understand what the cuticle really is?" This is especially relevant when it comes to education and legislation.
Understanding State Regulations
As an owner, it is your responsibility to ensure that your spa is complying with all state regulations. That can be easier said than done, considering some regulations rely on verbiage from 10 or 20 years ago. "You get regulations that say don't cut the cuticle, for instance," says Schoon. "The cuticle is dead skin on the nail plate that has to be removed to avoid product lifting. What they really mean is don't cut the eponychium, which is the living skin around the base of the nail plate." According to him, this becomes cause for concern because nail technicians then cut something they shouldn't and leave the dead skin, which is something that should be removed. "Again, the word cuticle has caused a tremendous amount of confusion and led people to think that it's okay to cut the living skin around the base of the nail plate, which is a huge violation," says Schoon. "That's against federal law, not just state law."
It's also important to remember that not all state regulations are created equal. Although California and Texas lead the way in terms of providing the strictest regulations, some states have yet to enact any at all. However, that doesn't mean you needn't be concerned. On the contrary, it means you need to be even more proactive in establishing a clear set of guidelines for your staff to follow. A great place to start is www.probeauty.org/nmc or www.americasbeautynetwork.com, which feature a set of guidelines on nailcare sanitation. "Owners really need to make sure nail technicians are adhering to their state regulations, and these guidelines can help," says Schoon, noting that California actually based its pedicure cleaning and disinfection rules on the NMC guidelines. "You'll find that these guidelines usually exceed state board regulations, so if you're following them, then you're probably also meeting your state regulations. But make sure you check your local rules and regulations and adhere to them."
Stepping on Doctors' Toes
Because there is such confusion about what is and isn't allowed, nailcare services often cross over into the medical arena. "The reason there is the level of infections in spas and salons that is going on right now is due, in part, to nail technicians trying to treat medical conditions," says Schoon. "Nail technicians are only licensed to work on healthy nails and intact skin. It is outside the scope of their licensing to diagnose, treat, or prescribe treatment for any medical condition, including nail and foot infections." For instance, removing a callus can be considered a medical procedure and goes against federal regulations. Yet, many nail technicians don't even hesitate when faced with a client's unsightly calluses. "It is illegal in the state of New York to use a blade on a client for calluses," says Youner. "I have treated several patients for lacerations from these blades."
According to Youner, even sterile tools can cause infection. "You can't sterilize fingernails and toenails," says Youner. "A tool that trims cuticles can inoculate a client with his or her own normal skin bacteria, which can create an infection." Of course, this wouldn't be a problem if more nail technicians understood what they should and shouldn't be cutting. "As a podiatrist, I see cases of nail fungus, athlete's foot, and warts being transmitted from spas to patients," says Youner. "The most important thing spa owners can do is put their spa's practices in line with any sanitation guidelines they can get their hands on."
At Rescue Beauty Lounge, Baek is adamant that her staff follows proper procedures. "Our rules are simple," says Baek. "Non-metal gets tossed after each use, and all metal implements are sterilized in an autoclave with a built-in timer that is used in the medical profession." According to her, metal implements, although reusable, are often not sterilized properly. "If they are using a UV-ray, then implements must lay flat and free of moisture for at least 25 minutes, undisturbed," says Baek. "I have never seen a timer next to a UV box." Other common sanitation issues she won't tolerate are technicians not washing their hands before touching clients or dipping their hands into products instead of using disposable wooden sticks.
Today's spa-goers are savvier than ever when it comes to cleanliness. It takes only one questionable act—like the use of a dirty file—to have them running for the door. When it comes down to it, you are accountable for what happens in your spa. The best way to guarantee that your clients return time and time again is to ensure that your nail technicians are obeying the law and following the proper procedures to guarantee a safe and hygienic experience. Isn't your clients' health and that of your business worth it? —Heather Mikesell