Beware of the pedicure

I watched a news report on CNN two nights ago about a group of women who are suing a few pedicure salons in the US. These women claim that they had scarring on their legs after their pedicure visits. This is actually a microbacterial infection called Fortuitum which causes boils on the legs. In some instances, they even cause permanent scarring.

Mycobacterium fortuitum is found commonly in contaminated whirlpool footbaths used by salons to relax customers and soften their skin before a pedicure. Fortuitum is found everywhere on earth. It only causes a problem to humans when nutrient content and temperatures get to the right level, allowing them to multiply in large amounts. The bacterium is not spread from person to person. A person can only acquire it from the environment. In this case, whirpool footbaths.

So what happens when you get infected by it? Usually after getting a pedicure, one that is infected will start noticing small sores developing on her lower legs. These small pores will then become larger and will developed into tender boils and skin ulders. A dose of antibiotics will usually make the infection go away but scarring on the legs will usually remain. These scars will require skin grafting.

How does a whirpool footbath get contaminated by Fortuitum? The answer is footbath screens. Chairs designed for pedicures have foot baths attached with individual filtering systems. These footbath screens if not cleaned, will accumulate hair, skin and toenails. This makes an ideal environment for fortuitum to breed. So when the water swirled around your feet, Fortuitum swims all over your feet too.

The International Nail Technicians Association (INTA) says that consumers should follow certain guidelines when having pedicure. You must not shave your legs for at least 24 hours before a pedicure. Do not do pedicure if you have open sores or nicks on your feet or legs. All equipment including basins and bowls must be clean and disinfected, before a pedicure. Before a whirlpool footbath, ask if the screen is removed, cleaned and disinfected every day. Disinfectant must to be circulated and flushed through the whirlpool system for at least 10 minutes. If the salon rejects your questions, then it is better that you move to another salon to be safe.

So is having a pedicure in Singapore safe? Today, I asked 10 salons offering pedicure services and this is what I found out. None of them know anything about Mycobacterium fortuitum. Only 3 out of the 10 that I spoke to told me that they heard of possible bacteria infections caused by pedicure. Only 1 salon stopped using the whirlpool footbath and now uses buckets that are cleaned with baricide instead. The other 9 salons do not clean their footbath screens daily. Only 1 out of these 9 salons cleans them once every three days. 5 of them don't even know that the screens have to cleaned in the first place! The other 3 haven't been cleaning the screens for weeks and months.

A doctor that I talked to says that fortuitum infections from contaminated footbaths may occur quite regularly here in Singapore but he says the authorities do not track the disease. "I have heard of it from other doctors too but I would say there are more people that don't seek treatment," he said. A person who is in the nail/pedicure industry told me that there is no law or code of conduct in Singapore for nail practitioners to adhere to. The person told me that some in the industry are discussing about forming an association where proper education and practice can be taught to the nail practitioners.

So the next time you step into a salon for a pedicure, remember to ask them about their footbath screens. You do not want to get Fortuitum.