A Manhattan podiatrist on the salon habits that send women to her office, and the five questions that keep your toes pretty and healthy.

The short version: Pedicures can spread fungus, warts and bacteria through footbath jets, shared tools and tiny nicks in the skin. Manhattan podiatrist Dr. Rebecca Pruthi advises asking how footbaths and tools are cleaned, choosing salons that sterilize instruments, going early on weekdays, skipping leg shaving for 24 hours beforehand, and checking your feet afterward.

The Saturday pedicure is one of New York’s great democratic rituals. The hedge fund partner and her assistant sit side by side in identical vinyl thrones, feet in identical swirling tubs, scrolling identical phones. For forty minutes, everyone gets treated like a client of note. It is the cheapest luxury in Manhattan, and one of the most beloved.

The swirling tub is the problem. In one study cited by the Centers for Disease Control, researchers found a bacterium that can cause skin boils in 97 percent of the salon footbaths they tested. That number measures contamination in the tubs, not how often clients get infected. Most pedicures end with nothing worse than pretty toes, but the finding is a good reason to ask questions about the tub.

Dr. Rebecca Pruthi, who owns Foot Care of Manhattan on Madison Avenue, has written on the Dr. Oz blog that she often sees salon-related infections in her office, from fungus to plantar warts. She isn’t against pedicures. She wants you to have the good kind.

What hides in the jets

A salon can look spotless and still be dirty in the ways that matter. You cannot see a bacterium, a virus or a fungal spore, Pruthi has pointed out, and microorganisms cling to moist surfaces and to the insides of whirlpool jets even after the tub is cleaned. Switch the jets on and you help them travel from the pipes to your feet.

Think of a jetted footbath as a beautiful piece of plumbing that never fully dries. Warm water, organic material and dark pipes are exactly the conditions microorganisms prefer. Wiping the visible basin between clients doesn’t reach what lives behind the nozzles.

What patients bring home

The usual results are unglamorous:

  • Athlete’s foot, a fungal skin infection that can show up as peeling, itching or cracking between the toes.
  • Fungal toenails, which Pruthi warns can be very hard to get rid of once they take hold.
  • Plantar warts, caused by a virus, which grow inward on the sole, can become painful and can spread.
  • Bacterial infections, which the American Academy of Dermatology notes can include antibiotic-resistant staph.

Most of these start the same way: a microorganism meets a tiny opening in the skin. That opening is usually something the client or the technician created without noticing.

A composite regular

Call her Dani, a composite: 39, a restaurant group’s head of marketing, with a standing Saturday 11 a.m. at a busy salon near Union Square. It is her one hour a week without a phone call about a walk-in refrigerator. She shaves her legs Saturday morning so the whole look is done at once. She asks for her cuticles cut and her calluses shaved because she likes the clean line. She has never asked a single question about the tub.

Then a thickened, yellowing big toenail appears, the kind she paints a darker shade every week until she runs out of darker shades.

The five questions Pruthi would have you ask

What kind of footbath is this? Pruthi told SELF to ask the supervisor directly. Pipe-free basins are better than piped whirlpools, and a disposable liner, changed between every client, is better still. Or simply ask them to turn off the bubbles.

How are the tools cleaned? This is the question most people never ask. Pruthi’s point to SELF was precise: “disinfection and sterilization are not the same.” The blue liquid in the jar disinfects. An autoclave, the heat-and-pressure sterilizer used in medical offices, actually sterilizes. Better salons have one, and are happy to tell you so.

Are the files and buffers new? Disposable tools should be opened in front of you and thrown away after. Pruthi goes one step further: bring your own surgical-steel instruments, and even your own polish, since bottles get dipped from client to client.

When is the salon least busy? Go on a weekday morning, she advises, when footbaths are typically cleanest, before a day of heavy use. Overcrowded salons have less time to clean between clients.

Are you cutting my cuticles? Ask them not to. Cuticles are a protective barrier against infection. Calluses should be smoothed with a pumice stone or foot file, never a blade or razor.

One more rule, for Dani in particular: don’t shave, wax or use hair-removal cream on your legs in the 24 hours before a pedicure. Microscopic nicks are open doors. If you must shave, do it after.

Red flags at a glance

Walk out, politely, if you see:

  • Tools pulled from a drawer rather than a sealed pouch or sterilizer
  • Files and buffers reused from the last client
  • A razor blade or callus shaver coming toward your heel
  • A footbath that isn’t drained and cleaned while you watch, or a missing liner
  • Technicians who skip handwashing between clients

New York State licenses nail technicians, and licenses should be posted where you can see them. A salon that takes its paperwork seriously usually takes its hygiene seriously too.

The habit after the polish

Pruthi’s last instruction is the one almost nobody follows. Look at your feet after a pedicure. Any irritation, redness, wound or skin change, see your podiatrist. People with diabetes, smokers, and anyone with poor circulation or a weakened immune system should be especially careful, because a small cut on the foot can become a serious wound.

There is also a middle path many women don’t know exists. Thick nails, corns, calluses and ingrown toenails can be handled in a medical setting. Pruthi’s practice lists routine foot care, corns and calluses, and ingrown toenails among the reasons patients visit. Let the salon handle the color and the doctor handle the problems.

Between appointments, her at-home routine is simple: a pumice stone in the shower to slough off dead skin, daily moisturizer on the heels, and nails cut straight across to avoid ingrown corners.

Dani’s new Saturday

Dani moved her appointment to Thursday at 9 a.m., before the restaurant’s lunch rush. She brought a small zippered case with her own clippers and file, asked for the jets off, kept her cuticles, and shaved her legs that evening instead of that morning.

The yellow toenail turned out to be fungus. She started treatment, gave the nail a long break from polish, and by Memorial Day her feet were back in sandals, unpainted and unbothered. She still takes her hour without the phone. She just spends it in a cleaner chair.

Frequently asked questions

Can you get an infection from a pedicure? Yes, though most pedicures are uneventful. Footbaths and shared tools can spread fungal infections, plantar warts and bacterial infections, especially through small cuts or nicks in the skin.

How do I know if a nail salon is clean? Ask how footbaths are cleaned and whether they use liners or pipe-free basins, whether metal tools are sterilized in an autoclave, and whether files and buffers are new for each client. Look for posted licenses and tools opened from sealed packages.

Should people with diabetes get pedicures? People with diabetes or poor circulation should be especially cautious, because small foot injuries can become serious wounds. Many choose to have nails, corns and calluses cared for by a podiatrist instead.

What should I do if my toe is red or sore after a pedicure? Keep it clean and watch it closely. Increasing redness, swelling, warmth, drainage or pain are signs to see a podiatrist or doctor promptly.

Back to the series pillar: Manhattan’s Most Glamorous Women Walk Miles in Heels. Related: What Your Toenails Are Telling You That Your Pedicurist Won’t.

Dani is a composite. This article is for general information, not medical advice.