Chapter 1:
PEDICURES, YESTERDAY AND TODAY:
BENEFITS OF NEW SALON SERVICES
2 CE Hours
By: JoAnn Stills
Learning objectives
After completion of this course, the participant will be able to:
ŠŠ Summarize how pedicure services have evolved through the ages.
ŠŠ List two (2) new services that have been introduced to the industry
since the 1980’s.
ŠŠ Identify at least three (3) benefits of providing clients with paraffin
wax treatments.
ŠŠ Differentiate between traditional nail salon and below-market salons.
ŠŠ List at least three (3) sanitary conditions consumers are now more
knowledgeable of in today’s age when receiving pedicures.
ŠŠ Explain the steps to take in order to prevent the incidence of
infection while providing pedicure services.
Introduction
Pedicuring – A long past
The pedicure is enjoying a recent surge of popularity in the United
States. It is a service that was generally left off the menu of most salons
until as recently as 1990. When it was on the service menu, most beauty
professionals performed the service reluctantly, when it was appointed.
When performed, pedicures were considered “a manicure on the feet,”
but even those who specialized in manicuring did few pedicures, if any,
before the mid-1990s. They did not want to touch feet, even those of
the people who were willing to pay well for the service. All feet were
considered unsanitary and foul smelling by these beauty professionals.
The history of manicuring is also the history of pedicuring, though its
“coming out” as a popular public service was delayed and more subtle
for pedicures. Both manicuring and pedicuring have a past, extending
thousands of years, and were offered in many cultures – including
India, China, Egypt and Rome – to the elite in their societies, and are
mentioned in ancient writings, such as hieroglyphics. Ancient cultural
writing, whatever the form, reflects that pedicures – more accurately
referred to as “foot care” – began being offered 5,000 years ago in
India, with henna used as nail polish.
In 3,000 BC, nail polish in China was used by the ruling class
to distinguish themselves from the general public. They used
ingredients such as beeswax, egg whites, and vegetable dyes. Petals
of flowers were added for varying shades of colour. It seems that no
matter what geographic region or culture, long ago nail polish was
strictly reserved for royalty.
In Ancient Egypt, nail polish signified a ranking of the classes:
●● Lower class: wore nude and light colours.
●● High society: wore red, the stronger the red, the more power held.
By the turn of the 19th Century, nail polish and colouring became
more common among the general population in France, England, Italy
and the United States. It still wasn’t until the 20th Century before
polish became “popular.” Manicure shops started appearing in France
in the 1920’s and 30’s.
Both women and men have enjoyed manicures for thousands of years,
but pedicures are believed to have been mostly a male service, long
ago. Pedicures were an important part of the grooming regimen of
many men, possibly to treat their calluses or to reduce the pain of sore
feet, and performed at home by servants, in a club or in a public bath.
In early times, manicures were performed for the beautification of
the hands, while most pedicures are believed to have been performed
primarily for cleansing. Women were slower to come to beautification
foot care. Until the very early 20th century, women wore long dresses
with their feet and ankles out of sight, so pedicures were not performed
for beautification. For wealthy women, it was a rare ritual of relaxation
and pampering, not performed especially for beautification, and
usually provided at home.
Pedicure development in the U.S.
The professional
license that is required
by state regulatory
agencies for
performing manicures
and pedicures in the
United States was
initially a
cosmetology license.
Known as “hair
designers” because of a preference for working with hair, many
cosmetologists would perform a manicure on a hair client, but
considered pedicures an unpleasant service to provide. Because few of
them suggested pedicures as a service, few clients knew the enjoyment
and beauty they offer. Until recently, pedicures were not considered a
highly demanded or profitable service for salons.
The history of the pedicure originated in Ancient Egypt as shown by
a carving (figure 1) created by an official of an Egyptian pharaoh,
who represents people receiving a manicure and pedicure. The word
pedicure comes from the Latin word, “pes,” which means “foot.” The
word “cura” means “care.” There you have it, foot care equals pedicure.
Pedicures are not a new service in United States, though they were ignored
by most salons until recently. An advertisement in the May 18, 1910,
issue of the Denver Evening Post mentions pedicure services, and ads for
them could be seen in large cities before that. But they were a service that:
1. Did not have special furnishings or implements.
2. Did not have a special location in salons.
3. Were not suggested during cross referrals of services.
4. Might have held a small, unnoticed place on the menu that
indicated “… and we also will do a pedicure, if you ask or insist.”
Artificial nail boom
Then, in the 1970s, artificial nails, known as “acrylic nails,” began to
develop as a serious service in salons and an important specialty in the
beauty business. They quickly became a fashion statement for women.
In just a few years, the services boomed, and they became officially
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the lifestyle of fashionable women. When the leading ladies of the
era’s popular TV shows “Dallas” and “Dynasty” wore these nails, the
popularity soared even more.
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With this new admiration, the nail table came out of the back room to
into the front of the salon, bringing the accompanying smells with it.
It became a featured service, providing significant money to salons’
bottom lines. This popularity brought artistic respectability for the
salons and professionals specializing in them.
The speedy development of the popularity of artificial nails quickly
moved natural nail services into the background of the beauty industry.
Many nail salons took them off their service menus because 1) the
salons viewed them as a low profit service, and 2) the cosmetologists
specializing in acrylic nails did not want to perform them; they made
more money performing artificial nail services.
Their acrylic nail clients became high-ticket “regulars” following their
first application, immediately scheduling standing appointments. The
services brought in the most money per service in the nail departments.
Soon, finding enough cosmetologists to meet the demand for these
new services became a problem, especially because few of them fully
specialized in the service. The industry’s answer was to develop a
specialty license, titled “manicurist,” and states added manicuring
licenses over time through their legislatures. This new specialty required
minimal education and was not restrictive in who could take the course.
All states now have a “manicuring” license except for Connecticut.
Originally, the educational hours required to become a manicurist
were as low as 50 hours; cosmetologists took that many hours in just
a single hair design course. Some states have maintained these low
hours, such as Delaware’s (300 clock hours), Ohio and Maine (200
clock hours), but most the states have raised the requirements over the
years to as high as 750 clock hours in Alabama and others.
The beauty industry began to change when the new nail specialty became
popular. The nail industry became defined and earned a listing in the U.S.
Bureau of Labor Statistics databases. As the industry grew, the smell of
the nail monomer that hair salons found offensive and the entrepreneurial
spirit of the new specialists, moved the services out of the hair salons into
their own locations. Because these services were in high demand, many
salons became dedicated to artificial nail services only; “nail salons” were
born, and became the first profitable inner specialty in the beauty industry.
By 1980, nail salons were opening in most cities.
For example, look at Columbus, Ohio: In 1980, three nail salons were in
business, soon to become four, and so on… Now, it is estimated that more
than 200 specialty salons in the Columbus area offer nail and pedicure
services, exclusively. In the years since, the phrase “a nail salon on every
corner” has become an accurate description of the nail business expansion
in almost every city. According to the Columbus Dispatch Newspaper, the
state of Ohio had 12,572 licensed manicurists in 2014, which is only down
1 percent from 10 years ago. The number of licensed nail salons in Ohio
decreased by 9 percent to 1,059 salons within the last decade.
In the very early 1990s, day spas became a quickly developing reality,
although initially, many did not offer nail services because they did
not want to have the acrylic odor in their spa environment. In fact,
the American Spa Association listed nail services as “optional” in
its definition of “day spa” in its early literature, and they were not
required to be in the facility to be called a day spa.
But clients wanted nail services, so spas added a few nail tables and
pampering natural nail services; a few added the artificial nail service
in a separate room because of the smell. In the early development of
spas, it appears that the few spas that offered acrylics in the formative
years of the spa concept, were those developed through expansion of
hair salons. These salons added spa-type services in a quiet area in the
salon, but wished to maintain their currently active and profitable hair
and nail departments. Pedicures were still not performed, even in the
spas that focused on relaxation.
Day spas eventually brought pedicures into the beauty industry in the
mid-1990s. Although European Touch had developed and put the spa
pedicure chair on the market in 1985, it wasn’t until day spas became
significant in the beauty world that the product and concept took off.
The day spas loved them. These heating and massaging chairs with
bubbling whirlpools for the feet were perfect for spas and met their
focus of pampering services; they swirled and soaked, massaged and
vibrated, bringing ultimate relaxation to clients, who discovered
pedicures when they were offered in these wonderful chairs. About the
same time, Creative Nail Design (CND) of Vista, Calif., developed the
first Spa Pedicure Kit and protocol, bringing more attention
to pedicures. The pedicure industry
began to grow quickly, and by 1995,
only a few spas did not have a pedicure
whirlpool chair to offer the service.
From these developments, pedicures
became the service to have in a spa
package. The monthly pedicure, routine
foot care and beautification were soon
accepted as a ritual for many women in the large cities, where more
spas were available. The services sold themselves, and once a client
experienced the pedicure service, the spas knew they would be back
for the service again.
When pedicures became popular in spas, nail salons began to look for
the dollars to invest in a pedicure chair so they could add them to their
menus. Because the prices for pedicures were established by day spas –
which meant they were higher – salons found they could bring in nice
profits, despite the high cost of the new throne-type chair. Suddenly, nail
professionals wanted to add pedicures to their service talents, and soon,
pedicure areas that were private and the ultimate in relaxation were
added, making the service even more pampering, popular and profitable.
Many large salons and spas added multiple chair rooms, called
“pedicure lounges,” bringing the comparative square footage cost
per chair lower in a setting that was still luxurious and inviting. The
additional pedicure chairs in these lounges attracted groups and
couples to enjoy the services together, with the number of people who
could be accommodated with comfort and exceptional pampering
restricted by the number of professionals to provide the services and
the number of chairs available. Pedicure parties, including girls’ nights
out, bridal celebrations and any other excuse to party, encouraged the
development of even larger pedicure lounges. By 1999, pedicures were
the fastest growing service in the global beauty industry.
A new world for manicurists
Spas and salons were soon expanding their pedicure menus to
include pedicures that exhibited the spa’s theme, or were a specialty
pedicure with the spa’s name in the title. These pedicures were
high-end, stress-relieving treatments that provided relaxation and
rejuvenation, even beyond the normally luxurious spa pedicure
service. Clients experienced softer feet and many felt even more
revitalized post-treatment. They brought in top dollar to both the
spa and the professional, providing the service. Many manicurists
and cosmetologists wanted to perform pedicures and to become a
“pedicurist,” the new name for those who specialized in pedicures, and
many performed them, exclusively.
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The average price for a basic pedicure in a spa in 2000 was $35-50 for a
30-45-minute service, depending on the salon or spa. This pedicure was
called a “basic,” without bells and whistles, and was a service performed
only on the feet and not the legs. It included all the basic pedicure
service segments: soak, nail trim, scrub, short massage, minor callus
smoothing, cuticle softening and polish. This service is still on menus
today. The longer and more luxurious pedicures treating the client with
special treatments, such as masques, were called “spa pedicures” and
went up in price to $50-65, with some luxury pedicures even higher in
especially high-end resorts and spas. This new spa pedicure developed
by CND included the skin of the legs and focused on exceptional
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relaxation techniques, with a longer massage, pleasant aromas and a skin
softening masque. This service is still on spa menus; clients leave the
pedicure room very rejuvenated and relaxed when the service is over.
Ambiance and added features are important to these pedicures and
their pricing. For example, some pedicure lounges, with many chairs
designed to provide exceptional ambiance and luxury, have curtains
for individual chair privacy, if the client prefers it. A number of special
features and add-ons have gained in popularity and can be added to a
salon’s services. Some of these special services we will now discuss.
Paraffin service
Paraffin treatments have a long history of use in the medical industry
for reducing pain from rheumatism. They are used in manicures and
pedicures in the beauty industry to soften skin. Originally, they were
performed by dipping the hand or foot in a temperature-regulated
tub, called a “paraffin bath.” These units keep paraffin wax heated to
above its melting point to maintain a liquid form, in most units at a
comfortable 120 degrees to 130 degrees Fahrenheit. But other methods
of application of paraffin wax have been developed, including sprayon techniques, paraffin-dipped gauze strips, one-time gloves or foot
mitts, and dipped gauze sheets wrapped over the hands or feet.
Paraffin is made from hydrocarbons of the paraffin distillate portion of
crude petroleum. It is able to absorb and retain a high amount of heat.
As it melts, the paraffin becomes a liquid and is easily applied by the
above methods to the hands, feet, even faces. It is in the solid state at
room temperature and begins to enter the liquid phase when heated
past approximately 98.6 degrees (37°C).
Three treatment benefits occur in a paraffin treatment. First, the paraffin
serves as a barrier holding the treatment lotion to the surface of the skin
while its heat opens the pores to enable greater penetration of the product
ingredients into the skin. Second, the elastin and collagen fibers, in the
dermal layers of the skin, are stimulated to regenerate by the heat and
the product that is absorbed. Third, hydration of the skin occurs as the
heat from the paraffin produces perspiration, which cannot escape the
surface of the skin because of the paraffin barrier and so, is forced into the
surrounding layers of the skin, plumping it up and providing hydration
to dehydrated cells. With all this in mind, paraffin is a perfect add-on for
a client wanting to improve her skin, or it can be included in a luxury
pedicure to enhance the perceived value of the service. The add-on price
for a paraffin treatment in a pedicure ranges from $10-25, according to
whether there is an additional masque or skin treatment applied before the
paraffin and to the luxury of the facility where it is performed.
One advantage to this treatment is that it can be performed during a
pedicure without added time; the nail technician can apply it to one
foot while working on the other foot, or it can be just applied over a
masque, so it will be included in the set time for the masque. Consider
providing this treatment on the hands during the pedicure for an
additional add-on price, or as a part of a luxury pedicure.
Some technicians have problems introducing paraffin treatments to their
clients, and no matter how effective the treatment is, it will not become
a staple for their clients if they don’t first experience the service. One
method to stimulate demand for this service is to offer a free paraffin
treatment on one hand or foot to clients, regardless of whether they are
in the salon for new sets, fills, manicures or pedicures.
Prepping the skin on the foot before the paraffin application is important
to the results of the treatment. Cleanse with an exfoliating lotion, then
remove the product thoroughly with a warm, wet towel and dry it. Apply a
hydrating lotion, then apply paraffin to the hand or foot according to your
salon’s policy; place it in a plastic cover and then into a terry mitt cover.
During the set time (the time the paraffin is on the hand or foot,
usually 10 minutes) and while working on the other foot, explain the
benefits of the service and mention the price. Then, after the paraffin
has been removed, compare the treated and untreated hands or feet.
The difference in appearance is usually dramatic; once clients see it,
many ask for the other one to have the service, too, or at least set an
appointment for the treatment with their next service.
Free treatments of both hands or both feet aren’t recommended because
clients might not see the difference the service provides, without the
comparison. If the free treatment is only on one foot, the difference will
be noted following the pedicure and even later, and clients are much
more likely to schedule the treatment during their next pedicure.
Paraffin can be used in many ways to expand profits in a pedicure
business and is a great way to get clients back into the salon. Enclose a
gift certificate for a paraffin treatment when sending birthday cards, a new
client thank-you card, or on the anniversary card when the client started
with the salon. There are many ways to expand this simple but profitable
add-on treatment. Ask other salon and spa owners and professionals in
the industry how they market their paraffin treatments, and you will find a
myriad of ways it can bring in clients and expand tickets.
Aromatherapy
Essential oils, the active ingredient in aromatherapy treatments,
have been used since antiquity in the art and science of healing and
to soothe the body, mind and spirit. These precious oils are highly
concentrated, non-oily, volatile extracts distilled from the aromatic
roots, stalks, flowers, leaves or fruit of plants. Each oil contains its
own unique, beneficial properties for use in aromatherapy treatment
and product formulations. They contain vitamins, minerals and natural
antiseptics and have hormone-like qualities that can be highly active
– and even dangerous in the hands of the uninformed. These qualities
make them complex in their choice for treatments; safe use of pure
essential oils is a matter of training and experience.
Training for the use of essential oils in aromatherapy is a specialty and
may be difficult to find. Always investigate the experience and reputation
of every trainer or institute that specializes in this training. The use of
pure oils is a responsibility professionals must understand; good training
reduces their complexity and enhances their safety during their use, within
a service. For example, a user of pure oils must know essential oil of
rosemary should not be used on persons with high blood pressure.
Essential oils work in two different ways. Each unique oil affects the
body through the sense of smell to the limbic system of the brain, and
can work additionally through absorption into the skin from specially
formulated products. Many of the products used in manicures and
pedicures can provide these benefits through their inclusion in products
in the services. In a pedicure, aroma can be in products for the soak,
the massage product, lotions, in aerosols for aroma on the towels,
even in candles. These products enhance enjoyment of services, some
through the aroma and some through a combination of the aroma and
the product absorbed through the skin, providing benefits.
These lotions, oils, aromasols and soaks are formulated with identical
aromas in product systems that contain a blend of oils that are safe for
general use while enhancing the benefits – such as relaxation or energy
enhancement – that are noted on their labels. Each blend is formulated
into products for use in each step within the service, such as the soak,
massage, lotions and aerosols for spraying on towels. Other companies
build entire lines around a single aroma, building several single aroma
lines to provide choices. Clients relax into the subtle aromas – they
often purchase retail products from the line to use at home, too.
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It is also generally believed that carefully blended products are best
in the beauty industry. To prevent problems and support safe use of
aromatherapy products, several companies have prepared blends of
oils in synergistic products for safe use in manicures and pedicures.
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Nail art
Nail art has been an established add-on in the industry for many years
to bring attention to natural and enhanced fingernails. Only in recent
years has it begun to be applied to toenails. The art on the toenails is
usually simpler than the sometimes complex art on the fingernails, but it
attracts just as much attention when applied to toenails when the client is
wearing open toed shoes or sandals – perhaps even more attention.
The latest in nail art fashion are “nail
wraps.” These wraps are pre-printed
designs from a digital printer, allowing
for complex pattern and reflective
metallic finishes that are just not
possible through traditional means.
They are applied with heat and protect
the nails from scratches and chips while
lasting over a month.
Stamping nail art is probably the most
popular nail art method in today’s
times. The nail artist applies nail polish
on a metal plate which is engraved
in various styles and designs. Then,
using a scraper, the artist is removing
any excess of nail polish in order to leave it only within the stencil
material. Using a stamp, the nail artist is transferring the design from
the metal plate to the stamper and then onto the client’s nail. This is
a very detailed, eye-catching service, impossible to replicate with any
other method.
Artificial toenails
Until recently, most nail technicians did not apply artificial toenails
because of the ergonomics of it and the unique sizes of the nail plates.
Despite what some technicians say, it is a different application. Many
nail technicians apply them now, and the clients who need them are very
pleased. But three conditions must be considered before their application:
1. The nail technician must be certain the nail is not fungal or
pseudomonal. It is illegal for a nail technician to work on or apply
a nail to a toe that is not healthy.
2. It is recommended that the product applied to the toenail be a flexible
gel. Acrylic nails are extremely hard and inflexible, and if the toenail
gets caught on something, it can rip off the underlying nail plate with
the artificial nail, leaving a bloody and painful nail bed. Gels are more
flexible and less likely to remove the nail plate in this instance.
3. The artificial toenail must be shorter than the tip of the toe to
prevent pressure on the toe from shoes and to prevent violently
pushing the less-flexible-than-a-natural-nail product back into
the nail matrix, if it is stubbed. It also may prevent the nail from
catching on something, on those rare occasions.
Changes in the nail industry
The nail industry enjoyed a time of high profits, and that always attracts
competition. The climate began to change dramatically in the mid-1990s
with the entrance of immigrants, primarily Vietnamese, into the nail
industry. Many of these immigrants were highly educated and looking
to improve their livelihood, according to the Vietnamese Nail Care
Professional Association (VNCPA), and they recognized the opportunities
in a niche of nail care. Now called below-market salons, the businesses
attracted and were welcomed by consumers who could not afford services
from traditional nail salons. These salons quickly became profitable.
The onslaught of below-market salons hit the nail industry hard. The
Vietnamese nail technicians developed their skills quickly and well, and
traditional salons did not keep up. The prices plummeted, and many
multi-service salons abandoned the performance of nails as a service,
because they could not compete at a profitable level; their facilities were
too expensive, and the prices needed to support them were no longer
feasible. The incomes of nail technicians in the traditional salons lowered
dramatically, and fewer were able to make a good living at their craft.
While the industry was enjoying the development of acrylic nails,
salons offering nail services were offering predominantly acrylic
services, with occasional manicures. Then, spas added pedicures and
the pedicure hit the mainstream. Clients who went to nail salons, not
spas, began wanting pedicures, and nail salons began performing
pedicures. Then, the below-market salons noted the profitability
of pedicures and also entered the market. Pedicures were now big
business in both spectrums of the nail business; spa clients were, many
times, having their pedicures more often, than their haircuts.
For many years, a huge chasm existed between the two segments
of the market, the below-market nail salons and the traditional nail
salons, even though they usually did not attract the same clients.
●● The below-market salons attract clients who focus on price and speed.
●● The traditional salons and spas focus on the clients who want ultimate
pampering and high-end customer service with their services.
●● The below-market salons charge by the increment of the service
– an amount for the basic service plus added dollars for any
additional part of the service, such as polishing, topcoat, etc.
Clients have a choice with this concept of how much they want to
pay through the elimination of some of the traditional pedicure.
●● The traditional salons charge for the full service, not by the
incremental units of the service. The clients of these salons or spas
do not care to price-pick their service and often are irritated by this
type of pricing.
●● Below-market salons do not require an appointment, which is very
attractive to busy people.
●● Traditional salons adhere to an appointment system and their clients
want their specific time. They become irritated if they have to wait.
Many times these salons or spas will take walk-in clients if they have
an opening, but usually they are not set up for this type of client.
●● The pedicure chairs in a below-market salon are lined up out in the
open main room of the salon.
●● The pedicure chairs in a traditional salon or spa usually are in a
separate room, individually or in a pedicure lounge, providing the
privacy their clients prefer.
Many second-generation owners of the below-market salons are now
stepping into the traditional market, with upscale and luxury salons
and appointment policies. Every market evolves, and this one has
also. They bring with them their solid business savvy, and many are
enjoying their new niche for their businesses.
Ohio consumer awareness
As the market has grown, so has the need for legislative rules in order to
regulate the profession and expel those practicing illegally, endangering
the health of consumers and themselves. The Ohio State Board of
Cosmetology oversees and enforces the state laws that govern the nail
industry to ensure the health and safety of the consumer.
Each year, we keep hearing more news regarding nail salons and
unsanitary conditions. As a licensed professional, it is important
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to understand that your clients, now know, what to look for when it
comes to “cleanliness and sanitation” in the salon and while providing
manicure and pedicure services. Clients are now informed to look
for the technician’s license and for the most recent inspection report.
Chapter 4713-1-10 of the Ohio Administrative Code (OAC), states
“Every salon shall display all licenses and most recent inspection
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report in a publicly visible place. Licensees shall post their license and
a board approved photo less than 5 years old.
Consumers are also more
aware of the chemical
substances used in providing
nail services. There have
been quite a few articles in
the news stating the harm
these chemicals may cause.
More research is currently
being conducted to assess
how great the exposure risk
actually is, to both clients
and workers. A salon has to have proper ventilation to help ensure the
quality of the air. Some consumers believe that ventilation is needed
for the strong odors coming from the chemical products in a salon, but
that is incorrect, the ventilation is necessary to control vapors and
dusts. In Ohio, Chapter 4713-11-09 of the administrative code explains
that all licensed salons are to have properly maintained exhaust fans or
air filtration equipment that meets local and state building codes.
Another element of sanitation consumers are very aware of is the
cleanliness of the manicure and pedicure stations, especially the
pedicure whirlpools. Chapter 4713-15-15 entitled, Equipment
Sanitation explains that electrical equipment which provides
circulating, whirlpool or vacuum effects shall be cleaned and
disinfected after each use and shall be maintained as recommended
by the manufacturer. All cloth items shall be laundered with laundry
detergent and chlorine bleach. Salons must have closed dust proof
cabinets with solid sides and a top for clean towels. Soiled towels
and linens shall be kept in a hamper or container with solid sides.
All salons should have a cabinet of adequate size to safely store
chemicals (OAC 4713-11-06).
With the Internet, consumers are much more knowledgeable than in
previous years, and this is illustrated by news articles, e-magazine articles,
and blogs, describing for the consumer, what to watch out for, when
obtaining services in a salon. Out of these pre- cautionary measures, clients
are most worried about acquiring an infection when receiving a manicure
or pedicure. As a licensed Ohio professional, it is your responsibility
to ensure the risk of infection is reduced by using appropriate sanitation
procedures. Let’s discuss the basics of these procedures for the foot spas.
Preventing pedicure foot spa infections
First, let us look at the guidance provided by the Environmental
Protection Agency (EPA) and the Center for Disease Control and
Prevention (CDC) in preventing infections in foot spas. Then, we
will tie in Ohio’s administrative and revised rulings on the matter
Microorganisms in foot spas can enter through the skin; so broken skin
on a client (cuts, abrasions) should not come into contact with foot spa
water. The same is true if a client’s skin has any open wounds such as
bug bites, bruises, scratches, cuts, scabs, and poison ivy.
Ohio’s Administrative Code, Chapter 4713-15-13, Contagious/
Communicable Diseases, protects workers and clients by strictly
stating the following:
No patron with definite open sores, who is exhibiting symptoms
of an infectious or contagious disease, a disorder of the skin, or
parasitic infestations shall be served without written permission
from a physician. A salon shall have a written policy describing
the process licensees working in the salon shall follow should
a client exhibit the above mentioned symptoms. The policy
shall direct the licensee as to how to follow this rule and how
to minimize embarrassment to the client in the process. An
independent contractor shall also develop a policy as to how to
serve a patron exhibiting the above mentioned symptoms.
When a salon owner, manager or individual assigned responsibility
by the owner suspects a licensee or any individual working in the
salon has open sores, or is exhibiting symptoms of an infectious or
contagious disease, a disorder of the skin or a parasitic infestation,
the salon shall have the individual provide a doctor’s statement
that there is no danger of infection. The salon may request the
licensee or other individual not work unless the licensee has
written permission from a physician.
So, the rule is if clients or workers have any type of open cuts or
sores, etc… a physician’s written permission to work or receive
services is needed.
Some incidents of foot spa infections
have been caused by Mycobacterium
fortuitum. This organism can occur
naturally in water and soil. Other
organisms have also been found in
footbath systems. The screens and
tubes of foot spas are particularly good
places for the bacteria to collect and
grow, often forming dense layers of
cells and proteins called biofilms, which can be very hard to remove.
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Methicillin-resistant Staphylococcus aureus (MRSA) is known to
be spread at nail salons leading to infections. MRSA can be spread
through the sharing of nail files and other implements that have not
been sanitized. To prevent the incidence of infection, foot spas should
be disinfected between each customer, and nightly. The disinfectant
needs to work for the full time listed on its label, typically 10
minutes, depending on the type of disinfectant. Foot baths should be
vigorously cleaned and sanitized between clients! Proper cleaning and
disinfection can greatly reduce the risk of a client getting an infection
by reducing the bacteria that can build up in the foot spa system.
In OAC, Chapter 4713-15-02, Methods of Disinfection, it is stated that
any implements used on any patrons shall be properly sanitized and
then disinfected. All chemicals used for infection control (sanitation
and disinfection) shall be EPA registered, bacteriologically effective
and commercially prepared disinfection agents and shall be used in
accordance with manufacturer’s instructions. Chapter 4713-15-03(A)
(3) also ensures an item is disinfected so that the HIV/HBV and other
viruses, bacteria, fungi and molds are destroyed or safely disarmed,
the individual disinfecting the surface shall strictly follow the contact
time suggested as appropriate by the manufacturer of the disinfectant.
“Contact time” is the time the surface of the equipment or implement
must stay visibly moist with disinfectant to be effective against the
pathogens listed on the label of the product.
Disinfectants used in the foot spa should indicate on the label that they
are approved for hospital use, according to the EPA. A disinfectant
label should clearly show its uses and that it is EPA-approved. The
label (at right) should list relevant product information, including:
●● The terms “Disinfectant” and also “Hospital” or “Medical”
or “Health Care.” This indicates the product can be used as a
disinfectant on surfaces in these environments.
●● The EPA registration number.
●● The label may also list the following organisms:
○○ Staphylococcus aureus.
○○ Salmonella enterica (formerly S. choleraesuis).
○○ Pseudomonas aeruginosa.
●● Some products may have instructions for both sanitizing and
disinfecting footbaths. Pedicurists should follow disinfecting
directions.
Household bleach is an effective disinfectant for all purposes in a
salon. Bleach solutions shall be mixed daily and used in a nine to one
solution (nine parts tap water and one part bleach). Bleach must be
kept in a closed covered container and not exposed to sunlight.
Page 5
Bleach may produce eye irritation or mouth, esophageal, and gastric
The table that follows contains information on ingredients used in nail
burns. Bleach is corrosive to metals and bleach vapors might react
salon products and the potential health effects that could be associated
with vapors from other chemicals, and therefore should not be placed,
with overexposure. The quantities of these ingredients in nail care
disposed of or stored near other chemicals used in salons (i.e. acrylic
products are typically small, and with proper usage and application
monomers, alcohol, other disinfecting products, or near flame). Used
techniques, exposure levels can be further minimized.
or soiled bleach solution shall be discarded at least every day by
pouring the solution down a sink basin or toilet bowl.
INGREDIENTS TABLE
POTENTIAL SYMPTOMS & HEALTH EFFECTS OF OVEREXPOSURE TO INGREDIENTS USED IN NAIL CARE PRODUCTS
INGREDIENT
USAGE
SYMPTOMS OF OVEREXPOSURE*
Acetone
Nail polish remover,
fingernail glue removerA
Overexposure may cause headache, dizziness, irritation to skin, eyes, and throat, and
central nervous system depression.1
Benzoyl Peroxide
Powder additive for
artificial nailsA,B,E
Overexposure may cause irritation to eyes, skin, nose, mouth, throat, and lungs, and skin rash.2
Butyl acetate
Nail polishA,D,F
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, headache,
drowsiness, skin rash, confusion and/or haziness.1,2
Butyl methacrylate
Artificial nailsA
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, shortness of
breath, and skin rash.2
Camphor**
Nail polishD
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, nausea,
vomiting, diarrhea, headache, dizziness, and in extreme cases of overexposure,
uncontrollable muscle contractions.1,2
Dibutyl phthalate**
Overexposure may cause irritation to eyes, stomach, and upper respiratory system. Prolonged
Nail polish, nail hardenerC exposure to high concentrations may be hazardous to human reproduction and development.
1,2,3
Ethyl acetate
Nail polish, fingernail
glueF
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, skin rash,
confusion and/or haziness.1,2
Ethyl cyanoacrylate
Fingernail glueA,C,D,G
Overexposure may cause irritation to eyes, mucous membranes, and skin, and skin sensitization.2,4
Ethyl methacrylate
Artificial nailsA,E,F,G
Overexposure may cause irritation to eyes, skin, and respiratory track, and skin sensitization.2,4
Formalin**†
Nail hardenerA
Overexposure may cause irritation to eyes, nose, skin, throat and respiratory system, and
wheezing. Prolonged exposure may cause asthma-like respiratory problems.5 Substance
may be a carcinogen if inhaled in high concentrations or for long.
Hydroquinone**
Artificial nailsA
DE
Overexposure may cause irritation and inflammation to eyes, irritation to skin, skin
rash, and in more serious cases of overexposure, colored urine, nausea, dizziness, rapid
breathing, muscle contraction, and central nervous system excitement. 1,2
POTENTIAL SYMPTOMS & HEALTH EFFECTS OF OVEREXPOSURE TO INGREDIENTS USED IN NAIL CARE PRODUCTS
INGREDIENT
Isobutyl methacrylate
USAGE
SYMPTOMS OF OVEREXPOSURE*
Artificial nails
A
Overexposure may cause irritation to eyes, skin, nose, mouth, throat, and lungs.3
Methacrylic acid
Artificial nailsF,G
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, burning of eyes
and skin, shortness of breath, labored breathing, and cough.2
4-methoxyphenol**
Artificial nailsA
Overexposure may cause irritation to eyes and skin, burning of eyes and skin, and central
nervous system depression.1,2
Methyl ethyl ketone
Nail polish,D,E nail
polish remover,C
artificial nail remover
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, cough, headache,
dizziness, drowsiness, vomiting, and skin rash.1,2
Methyl methacrylate
(typically not used illegal in many states.
Artificial nailsA
Overexposure may cause irritation to eyes, skin, nose, mouth, and throat, sore throat,
cough, shortness of breath, and skin rash.1,2
Poly (ethyl/methyl
Methacrylate)
Powder for artificial
nailsE,F,H
Overexposure may cause irritation to the eyes, skin, and throat (by inhalation).6
Titanium dioxide**
Nail polish, powder for
artificial nailsA
Overexposure may cause lung fibrosis and may be an occupational carcinogen.1
Toluene
Nail polish,A fingernail
glue
Overexposure may cause irritation to eyes and nose, weakness, exhaustion, confusion,
inappropriate feelings of happiness, dizziness, headache, dilated pupils, runny eyes,
anxiety, muscle fatigue, inability to sleep, feeling of numbness/tingling, skin rash, and in
more serious cases of overexposure or intentional abuse, liver and kidney damage.1,2,‡
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Tosylamide
Formaldehyde Resin
(TFR Resin)
Nail hardener,A nail
polishI
Overexposure may cause irritation to skin and skin rash4
Professional nail care products are typically formulated to minimize
exposure and the potential for adverse health effects. Also, nail salon
products are typically used in small amounts, which can further lower
the risk of overexposure. Yet, if proper care is not taken, overexposure
may occur and could result in adverse health effects, such as skin
irritation, allergic reaction, or serious eye injury. By following
recommended sanitation practices, nail salon workers and owners can
minimize exposures and prevent overexposure.
Footnotes to table
* Potential health effects depend on conditions of exposure, which
may be minimized by working safely (e.g., ventilation and use of
masks and gloves).
** Quantities in nail care products are small and application
techniques are designed to minimize the potential for exposure.
† The term formalin describes aqueous solutions, particularly those
containing 37 to 50 percent formaldehyde and 6 to 15 percent alcohol
stabilizer.5.
^ A study has shown that formaldehyde concentrations in nail salons
were comparable to those found in office buildings and did not
increase when nail products were in use and ventilation systems were
operating properly.7
‡ A study has shown that toluene concentrations in nail salons were
below the OSHA safe limit.7
Usage Column References:
A. OPI Products Inc. product MSDS or correspondence with Paul
Bryson, O.P.I.
B. Correspondence from General Dental Products
C. Backscratchers product MSDS (available at: <www.
backscratchers.com>)
D. European Nail Factory product MSDS (available at: <www.
european-nailfactory.com>)
E. Kupa Incorporated product MSDS (contact: 800-994-5872)
F. Nail Systems International product MSDS (available at<www.
nsinails.co.uk/content/msds>)
G. Originails, E.O.H Industries, Inc. product MSDS (available at:
<www.originails.com/msds/index.htm>)
H. Star Nail International product MSDS (available at: <www.
starnail.com/msds.htm>)
I. Sally Hansen product MSDS (available at the National Institute of
Health, Household Product Database: <http://hpd.nlm.nih.gov>)
Symptoms of overexposure column references:
1. National Institute for Occupational Safety and Health (NIOSH);
Pocket Guide to Chemical Hazards; available at <www.cdc.gov/
niosh/npg/npg.html>
2. National Institute for Occupational Safety and Health (NIOSH);
International Chemical Safety Cards; available at <www.cdc.gov/
niosh/ipcs/nicstart.html>
3. Hazardous Substance Data Bank; profiles available at <http://
toxnet.nlm.nih.gov>
4. National Library of Medicine; Haz-Map: Occupational Exposure to
Hazardous Agents; profiles available at <http://hazmap.nlm.nih.gov>
5. Occupational Safety and Health Administration (OSHA); Fact
Sheet on Formaldehyde <www.osha.gov/OshDoc/data_General_
Facts/formaldehyde-factsheet.pdf>
6. ESSCHEM Inc, Linwood, PA. Material Safety Data Sheets
7. Industrial Hygiene Assessment of Toluene and Formaldehyde
Concentrations in California Nail and Full Service Salons,
Clayton Project, project no. 800-97276.00, Clayton Environmental
Consultants, Santa Ana, CA, March 16, 1999
References
1.
2.
3.
1Sutherly, B., and DeVito, M. (2015, May 12). Ohio inspectors, owners are mindful of dangers
of nail salons. The Columbus Dispatch. Retrieved from http://www.dispatch.com/content/stories/
local/2015/05/11/nail-salon-crackdown.html
Maslin, S. (May 11, 2015). Behind perfect nails, ailing salon workers. The New York Times,
retrieved August 31, 2015 from http://www.nytimes.com/2015/05/11/nyregion/nail-salon-workersin-nyc-face-hazardous-chemicals.html?_r=0
Environmental Protection Agency. (2007). Protecting the health of nail salon workers. EPA 744-F07-001. Retrieved from EPA website, http://www2.epa.gov/saferchoice
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Page 7
PEDICURES YESTERDAY AND TODAY-BENEFITS OF NEW SALON SERVICES Final exam
Choose the best answer for the following questions and take your test online at EliteCME.com.
1. It seems that no matter what geographic region or culture, long ago
nail polish was strictly reserved for _______.
a. Men.
b. Women.
c. Royalty.
d. General population.
2. Finding enough cosmetologists to meet the demand for these new
services (artificial nails) became a problem, especially because few
of them fully specialized in the service. The industry’s answer was
to develop what?
a. Schools.
b. More locations.
c. National organization.
d. Manicurist license.
3. Paraffin treatments have a long history of use in the medical
industry for reducing pain from _____.
a. Tuberculosis.
b. Rheumatism.
c. Depression.
d. Pulled muscles.
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4. Essential oils, the active ingredient in aromatherapy treatments,
have been used since antiquity in the art and science of healing and
to _______________.
a. Foretell the future.
b. Cure diabetes.
c. Improve the heart.
d. soothe the body, mind and spirit.
5. The below-market salons attract clients who focus on ___ and _____.
a. Ethnicity and language.
b. Price and speed.
c. Pampering and customer service.
d. Nails and feet only.
6. Every salon shall display all licenses and most recent _________
report in a publicly visible place.
a. Quarterly.
b. Inspection.
c. Appraisal.
d. License.
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Chapter 2:
PROTECTION FROM INFECTIONS IN THE NAIL
INDUSTRY
2 CE Hours
By: JoAnn Stills
Learning objectives
After the participant completes this lesson, they will be able to:
ŠŠ Explain how poor infection control has led to client illnesses and
deaths in the past.
ŠŠ Describe three (3) specific infections, which can be acquired in a
nail salon, due to poor infection control protocols.
Introduction
Scientific studies have documented that nail salon products may
contain many potentially harmful chemicals that can be a major cause
of occupational asthma as well as other health and environmental
concerns (EPA, 2015). Many of the products have ingredients that
should be used with care to minimize the exposure rate to workers.
These ingredients are necessary to provide high quality services all
consumers expect; therefore it is critical that all workers in the nail
salon are aware of the “best infection control practices” to protect
themselves and their clients.
As of 2012, approximately 155,000 people work in the United States
as manicurists and pedicurists (US Bureau of Labor Statistics, 2012)
so it is important that these professionals know how to mix and use
chemicals properly, as well as how to reduce the spread of infection
by assessing their client’s health, implementing protocols to prevent
the spread of bacteria, and how to clean implements properly to avoid
infecting clients in some manner.
ŠŠ Describe proper infection control procedures for cleaning
implements, pedicure equipment, and surfaces.
ŠŠ Explain the importance of the client health questionnaire and how
it helps identify client illnesses and risk factors.
ŠŠ Discuss “best practices” used in providing services to clients with
certain health conditions.
This following section reviews the problems that occur in the nail
industry with regard to infection control. There are a number of
publicized events that occurred where clients or nail technicians
became ill with some type of infection due only, to poor infection
control procedures.
Following the first section, is a brief description of the specific
infections to be aware of, how to identify possible infected areas
and the type of service that is effective in treating those clients
with health conditions. The third part of the lesson describes the
elements involved in using an effective infection control program.
The importance of client health questionnaires is discussed along with
identifying the risk factors involved in the transmission of bacteria and
viruses. Many clients may have health conditions that may prevent
them in receiving certain types of services and some alterations may be
needed. Without infection control in the salon, without a commitment
from the salon professionals, infection control problems will remain in
the nail industry and could potentially harm to profession.
Problems in the nail industry
Poor infection control
As the nail industry grew, so did the problem it ignored: infection
control. Poor infection control has always been a problem in the
nail industry. In the 1970s, infection control was mentioned in
the cosmetology texts, but it was not a focus in the schools. Basic
bacteriology was taught, but many technicians did not commit to strict
daily disinfectant change and correct mix of disinfection solutions; the
textbooks did not emphasize perfect preparation of implements prior to
disinfection, and many nail technicians took it lightly.
In the 1980s, during the explosion of artificial fingernails, it was still
not emphasized, so “greenies” were the constant scourge of artificial
nail wearers. Nail technicians re-used files constantly, pulling them out
of a dirty drawer with the prior clients’ filings on them. In the 1990s, it
is said that as few as 10 percent of nail technicians performed perfect
implement infection control, and fewer than that insisted on the clients
washing their hands prior to nail service.
In 1994, a successful salon owner was featured in an article titled,
“Choosing a Safe Nail Salon” in the Cleveland Plain Dealer Fashion
section. The salon owner listed the basics for consumers in choosing
a safe nail salon. Pre-service hand washing, disinfected implements
and fresh files were three situations they were to evaluate, among
others. Interestingly, three calls came in to the owner from other salon
owners, telling her that she was “ruining” their business, two of them
stating that in colorful language. Her reply? “If you cannot meet state
minimums, get out of the business.”
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Times have not changed. It is estimated that even now, fewer than 30
percent of nail salons meet state minimums for infection control, even
with the continual media attention.
Deaths and the downturn
Every year, stories are aired on local and national TV news magazine
programs about undercover visits to nail salons with videos of poor
sanitation. The shows feature disgusting stories about salons that do
not conduct infection control at all, and worse, stories of persons who
have been hurt, and even died because of poor infection control in
these neglectful salons.
The most publicized incidents
In 1999 and 2000, an outbreak of mycobacterium fortuitum infections
from pedicures in a salon in Watsonville, Calif., caused ugly, slow-healing
lesions and permanent scars on more than 120 women. The outbreak
was caused by the failure to clean the pedicure equipment properly, and
brought intense attention to the lack of infection control in the industry.
In November 2004, another outbreak of mycobacterium fortuitum
lesions occurred in San Jose, Calif. The assessment is that 27 salons
were involved, with more than 120 people infected. No one knows
why it occurred in so many separate salons, but the cause was the lack
of cleaning the screens of the baths.
Then a client died. Kimberly Kay Jackson of Fort Worth, Texas, was
a paraplegic and could not feel the massages and bubbling water on
her feet, but loved pedicures and the resulting, pretty toes. But, after
her heel was cut with a pumice stone during a July 2005 pedicure,
Page 9
she developed an oozing wound that wouldn’t heal, despite repeated
rounds of antibiotics. The 46-year-old died in February 2006 of a heart
attack triggered by a staph infection.
was growing prior to these incidents. Potential clients who decide
against having pedicures are verbal about their fear, and those who
stop having pedicures are even more so.
Then another client died. Jessica Mears, of Sunnyvale, Calif., died
in late June 2006 at age 43 after developing a bacterial infection
from an injury in a pedicure. She had lupus, a chronic disease that
compromises the immune system, and the lesion never completely
healed. She died from complications.
Times have changed ... for the worse
Sanitation and disinfection are extremely important, and the key to
preventing the transmission of infection, their perfect execution, is
even more important. Illnesses are being transmitted much faster
and with more consequences than they were even 15 years ago. We
must do more to protect ourselves and our clients from the transfer
of infection now. Here are just a few examples of infections, now
rampant in our society, from which clients (and nail professionals)
must be protected. If an infection control program protects clients and
professionals from these three illnesses that follow, the salon is safe.
The results of these tragic stories and the national attention they got is
that the industry lost potential and current clients as soon as the stories
aired. Many times, the publicity about these kinds of problems paint
the entire industry as a dangerous and potentially, deadly one.
Though the number of missed or lost clients cannot be quantified, it is
probably higher than we can imagine, considering the rate the industry
Three primary infections applicable to the salon industry
Methicillin-resistant staphylococcus aureus (MRSA) – This
infection is from the bacteria Staphylococcus aureus (staph), a microbe
that is routine in the flora on our body commonly found on the skin
and in the nose of about 30% of individuals. Most of the time, staph
does not cause any harm. These infections can look like pimples, boils,
or other skin conditions and most are able to be treated.
When it becomes “out of balance” - past a healthy tolerance, or when
a cut on the skin occurs, it can become pathological (capable of
causing illness). People with immune system disorders are particularly
vulnerable. When the microbe is pathological and resistant, meaning
it no longer responds to a certain antibiotic, the person can develop an
even more dangerous illness that can quickly become deadly.
Hospitals in the U.S. have been fighting the presence of staph infection
for decades because it became more and more resistant to first-line
antibiotics. Then, in 1990, the first methicillin-resistant staph was
found “outside the hospital,” and it was no longer contained.
Now, MRSA in hospitals is called hospital-associated methicillinresistant staphylococcus aureus (HA-MRSA); in the greater
population, the incidence of the infection is called communityassociated methicillin-resistant staphylococcus aureus (CA-MRSA).
Whatever its origin, MRSA MRSA bacteria kills nearly 19,000
Americans every year which is more than the annual number of AIDS
deaths in the US, (NPR, 2007).
MRSA is very contagious, and is spread just by touching, between
people (direct transfer) and touching between people and surfaces
(indirect transfer), such as towels, clothing and table tops, just about
everything. The problem is MRSA is resistant to antibiotics.
Nail technicians are especially susceptible to CA-MRSA because they
touch, and hold the hands and feet of their clients, who may be ill or
“colonized,” meaning they carry the MRSA infection, but it is not
pathogenic to them. Studies show that 30 percent of the U.S. population
is colonized, so it is probable that some persons in each nail clientele are
colonized with the easily transmittable staph microbe and don’t know it.
Symptoms of CA-MRSA infection proceed through stages, with
each worse than the last. Too quickly, if not treated, it can carry the
infection into the inner body and to a person’s organs. At this point,
it is difficult to treat, and it can kill the sufferer. Even the first stage is
treated with very heavy antibiotics, because MRSA proceeds through
the stages quickly and must be stopped as early as possible.
Many nail technicians have reported being infected and not knowing
what the lesion was. They usually realize what it is when a client or
their co-workers – who may be exposed – become alarmed and send
the person to the doctor immediately. Professionals in personal care
industries usually will be ordered to stay home for a time until the
infection is controlled to prevent passing it on to others.
Since MRSA infections can be so serious and are sometimes deadly, it
is important to learn to recognize the symptoms of an MRSA infection
so that early treatment can be initiated.
MRSA symptoms
The first symptom is a little red bump or
bumps on the skin that appear like spider
or other bug bites. (For a very short
time, it isn’t even surrounded by
redness.) But it doesn’t stop there. The
area quickly becomes inflamed and
painful, then develops a boil that is
draining or is full of pus. Within 3-4
days, it becomes a deep, damaging
abscess that penetrates the skin. By then,
the person likely will have sought help from a physician or emergency
room and been prescribed heavy antibiotics even before lab tests
confirm the probable diagnosis.
At the same time, the person will feel fatigued,
much like the day before flu emerges, and will
become irritable. If the lesion does not get better
immediately, even stronger antibiotics will be
prescribed. If it still does not begin to get better,
other symptoms, such as fever, difficulty
breathing, chills or chest pain, would typically
be signs of a more serious MRSA infection that
has spread beyond the skin to the blood, lungs or other part of the
body. These symptoms require intense and extensive medical attention
and potentially hospitalization in an infectious ward of the hospital. It
is not unusual for this person to be off work for months and be
permanently incapable of working or no longer allowed to work in a
personal care or food industry.
MRSA bacteria are continually mutating and developing resistance
to medications, making it an even more serious concern in the United
States. Perfect and committed infection control is the only means
to prevent the transfer of this disease in a salon, whether from the
professional to a client or vice versa. This illness is a legitimate
concern to nail technicians and becoming more so every day.
Upper respiratory infections (URI) – Infections of the respiratory
tract cause the highest number of days lost in the U.S. workforce.
They are highly contagious, meaning the URI’s are spread easily from
person to person, and infectious, meaning transmitted by a pathogenic
microorganism; there are more than 200 viruses that can cause URI.
They require a high level of infection control in personal services
such as in the nail industry. Nail technicians and pedicurists are
especially susceptible to respiratory infections because they 1) sit
directly in front of and close to their clients, and 2) hold the client’s
hands or feet in their hands.
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URI Symptoms are fever, sore throat and cough, and examples are
influenza, common cold, tonsillitis, rhinovirus, strep, sinus infections,
laryngitis, measles and many more.
Influenza (flu) – is an acute infectious viral infection involving
inflammation of the respiratory tract and fever, chills, cough, sore
throat, runny or stuffy nose, muscular pain and fatigue. Some
people might also have vomiting and diarrhea. It can cause mild to
severe illness, and can lead to death. Its occurrence is somewhat
unpredictable, but is predictable enough seasonally, to make it
important that everyone over 6 months old should get the flu shot.
available in the fall of each year. The CDC recommends the vaccine be
taken in October and November for best immunization.
Some people, such as older people, young children and people
with certain health conditions, are especially at risk for serious flu
complications. Nail technicians are very susceptible to influenza, both
minor and major, and new and usual forms, so they should always seek
out administration of the yearly vaccination, as soon as it is available.
These viruses can be transmitted from their clients to them 24 hours before
symptoms develop – on that achy, just-don’t-feel-right day the client tells
the nail technician about – and a week after illness begins. Children and
people with compromised immune systems are contagious even longer.
The importance of the influenza vaccine
The administration of the flu vaccine was only by injection until
recently. In 2009, the FluMist was released, a nasal spray made with
live, weakened viruses that do not cause the illness. It is approved
for use in healthy, non-pregnant people ages 2-49. Another new way
to administer the vaccine, which is being tested, is a Velcro-like tape
placed on the skin. The tiny “needles” will disseminate the vaccine
into the skin, and the skin will transmit it into the body.
The predominant influenza virus during the 2013-14 season was the 2009
H1N1 virus. The period of influenza vaccine contained a virus similar to
the 2009 H1N1 influenza virus. The 2013-14 season was the first season
since 2009-2010 during which the 2009 H1N1 virus (which caused the
2009 influenza pandemic) was the predominantly circulating influenza
virus. Results indicated that in 2013-14 vaccination provided moderate
protection against influenza-associated medical visits caused by influenza.
It is estimated that in the United States, each year on average 5% to
20% of the population gets the flu and more than 200,000 people are
hospitalized from seasonal flu-related complications. Flu seasons are
unpredictable and can be severe. Over a period of 30 years, between 1976
and 2006, estimates of flu-associated deaths in the United States range
from a low of about 3,000 to a high of about 49,000 people per year.
During the 2009 flu pandemic, CDC provided estimates of the numbers
of 2009 H1N1 cases, hospitalizations and deaths on seven different
occasions. Final estimates were published in 2011. These final estimates
were from April 12, 2009 to April 10, 2010 approximately:
●● 60.8 million cases (range: 43.3-89.3 million), occurred in the
United States due to pH1N1.
●● 274,304 hospitalizations (range: 195,086-402,719), occurred in the
United States due to pH1N1.
●● 12,469 deaths (Range: 8,868-18,306) occurred in the United States
due to pH1N1.
People with at-risk conditions, such as congestive heart disease,
asthma and diabetes, were among those significantly affected. It also
cost high dollars in the U.S. for health care and in lost production.
H1N1’s track of infection was abnormal in that it caused illness at
times of the year when flu did not normally appear; the first case was
diagnosed on March 28, 2009, a time when the flu is usually greatly
on the decline. The nation was not prepared for its high impact and the
high number of flu deaths when it first became a reality.
The significance of all these statistics and facts about flu for nail
technicians is that they must not consider protection from the flu shot
a choice. Although only 10-20 percent of people in the U.S. willingly
take the shots, nail technicians should not be in that number. For their
protection, and for protection of their clients and their family, they
should be the first take the shot upon its availability in the fall.
Believe it …
The transfer of infection is becoming more and more likely in these
times because the size of our world is shrinking. This is one of the
main reasons infections are more and more dangerous. With airplane
travel, an infection can jump from one side of the world into a country
on the opposite side in days, with infections happening quickly
between exposure-incubation of a microbe to illness.
One of the major problems with persuading nail technicians that they
need infection prevention is they are not convinced, that what they do,
will transfer disease. Many also are not convinced because they cannot
see the culprits. Hopefully, education will change these attitudes as
times become more and more dangerous, microbes become more and
more resistant, and the world becomes smaller and smaller.
Comprehensive prevention in the nail salon
Prevention of the transfer of infection must come from a
comprehensive work philosophy in a salon or spa and requires
knowledge and commitment. Every activity in the salon must be
considered important to, and a part of, this philosophy, from client care
to facility surface cleansing and maintenance.
The Ohio State Board of Cosmetology explains Ohio’s salon sanitary
standards in a document posted on their website. You may access this
document at http://www.cos.ohio.gov/laws-rules.
These
standards are of the upmost importance as they can protect both you and
your clients from illness and perhaps, even death. They are based upon
Ohio’s Administrative Code (OAC) which regulates the profession.
A good example of these regulations deals with workers washing their
hands along with personal hygiene standards.
Personal Hygiene OAC 4713-15-12
Licensees shall wash their hands or use hand sanitizer before serving each
patron. Licensees shall wear a clean, washable outer garment and shall not
carry or store implements in pockets, belts, a leather case or apron.
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One of the most important standards across the board for infection
control is hand washing. Hand washing is a requirement in every
state’s regulations for pre-service infection control in beauty and
personal care services. But, handwashing is also one of the most
neglected practices in the performance of nail services. The hands
must be washed, and some state regulations require the nails to be
cleaned with a nail brush, as well.
This activity is designed to remove dirt, debris and pathogenic
microorganisms from a worker’s hands before working with the
next client. It can also prevent the transfer of infection, from the last
client or from surfaces and other exposures, since the last client. Ohio
mentions this in their personal hygiene regulation.
Following are the techniques for hand washing and nail hygiene,
recommended by the CDC:
You may find this information on CDC’s website at http://www.cdc.
gov/handwashing/
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OSHA requires wearing these, and salon and spa owners are required
to provide them and to enforce their use. If they do not, and an
employee becomes infected, the salon or spa is responsible for the
person’s illness. If they require their use and an employee becomes ill,
it is the employee’s responsibility. It’s as simple as that. More research
will be done but for now OSHA requires wearing PPE.
Steps to proper hand washing: http://www.cdc.gov/features/
handwashing/
1. Wet your hands with clean, running water (warm or cold), turn off
the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Be sure
to lather the backs of your hands, between your fingers, and under
your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the
“Happy Birthday” song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them.
Washing hands with soap and water is the best way to reduce the
number of microbes on them in most situations. If soap and water are
not available, use an alcohol-based hand sanitizer that contains at least
60% alcohol.
The CDC also has a recommendation on how to use hand sanitizers:
1. Apply the product to the palm of one hand (read the label to learn
the correct amount).
2. Rub your hands together.
3. Rub the product over all surfaces of your hands and fingers until
your hands are dry.
Environmental surfaces such as tables and counters may contribute
to the transfer of infection from hand contact, or contact with other
contaminated surfaces. Every surface potentially exposed to human
contact should be cleaned daily with a surface disinfectant. Every
surface area used, during services, must be disinfected after every
client. Effective sprays are available that take minimal time and effort.
According to Ohio’s environmental sanitation regulations, Exhaust
Fumes, OAC 4713-11-09, states that all licensed salons shall have
properly maintained exhaust fans or air filtration equipment that meets
local and state building code.
PPEs (personal protection equipment) are used when providing
services to protect the employee from contamination. Professionals
in the nail industry have always been confused about whether to wear
them, saying, “Our state board does not require us to wear them,” and
that may be true. However, the Occupational Safety and Health Act
(OSHA) in its Universal Precautions Standard states:
“The blood-borne pathogens standard applies to all employees
with occupational exposure to blood or other potentially infectious
materials, even if no actual exposure incidents have occurred.”
Every nail technician can say he or she has never drawn blood, but
they have. And it does not have to be a large amount. For that reason,
the answer is: Nail technicians must wear PPE, which includes gloves,
masks and eye protection designed to protect nail technicians from
disease-producing microbes that may be in their work environment.
Gloves protect their hands from contamination from clients and surfaces.
Masks protect their respiratory system from airborne infection, and eye
protection protects their valuable eyes from flying debris and microbes.
In May of 2015, the New York Times published an article entitled,
Perfect Nails, Poisoned Workers by Sarah Maslin Nir. In this article,
Dr. Charles Hwu stated that he noticed a particular set of symptoms
among the nail salon workers he treats. “They usually come in with
breathing problems, some symptoms similar to an allergy, and also
asthma symptoms.” Skin disorders were mentioned as another
problem for nail salon workers. Many of the chemicals in the salon
products are classified by government agencies as skin sensitizers,
capable of provoking painful reactions.
In the same article, in mentions a 2006 study
published in the Journal of Occupational and
Environmental Medicine that included more
than 500 Colorado manicurists. They found
about 20 percent of them had a cough most
days and nights. The same examination
showed those who worked with artificial nails
were about three times as likely to get asthma
on the job as someone not in the industry.
Pedicure equipment disinfection has become
a major issue in the nail industry. Poor
disinfection of pedicure chairs is said to
be the cause of several of the most serious
injuries and deaths. Since those occurrences, most state boards have
incorporated rules for cleaning and disinfection of these chairs.
In 2014, the United States Environmental Protection Agency (EPA) along
with the CDC provided guidance to salon owners, operators, and workers
on preventing pedicure foot spa infections. This pamphlet is available on
CDC’s website, http://www.epa.gov/pesticides/factsheets/pedicure.htm
Outbreaks of skin infections on the legs and feet of patrons following
spa pedicures have caused concern about spa safety. If this
information is used, it will greatly reduce the potential for infections.
It is important to note that the infections and deaths described earlier
may not have occurred if disinfection had been properly performed on
implements and pedicure stations. Ohio, again has laid out equipment
sanitation in their regulations that describe when each piece of
equipment should be cleaned and sanitized.
Equipment Sanitation OAC 4713-15-15
A. Salons shall maintain a copy of the manufacturer’s/owner’s
manual for all equipment in service and shall follow the
manufacturer’s suggestions for cleaning.
B. Electrical equipment that provides circulating, whirlpool or
vacuum effects shall be cleaned and disinfected after each use and
shall be maintained as recommended by the manufacturer.
C. Electrically heated equipment shall first be cleaned to remove any
hair or debris. After cleaning, use the heat source of the equipment
to disinfect as suggested by the manufacturer or use the procedure
for disinfecting equipment described in paragraph(D) of this rule.
D. Any other electrical equipment, including trimmers, clippers and
attachments shall be cleaned and disinfected after each use. Such
equipment shall be disinfected using the following method:
1. Before beginning the disinfection process, remove hair and/
or all foreign matter by using an implement or other tool,
and the implement or tool shall be cleaned and disinfected by
immersion after each use as described in rule 4713-15-03 of
the Administrative Code.
2. After removing all foreign matter, saturate the equipment
with an appropriate disinfectant solution, spray, or foam used
according to the manufacturer’s instructions.
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Infection control for the implements used in the profession is necessary
to protect the worker and the client from the transfer of pathological
microorganisms. For an implement to be appropriately disinfected or
autoclaved, the surface must first be cleansed with a brush, soap and
water, then rinsed and patted dry. Neither disinfection nor sterilization
can be performed properly on dirty implements.
Even a tiny injury, with an implement that is not disinfected, can
become infected. If the client is immuno-suppressed, poor healing
will follow, and the damage goes from there. A tiny injury has
the potential to cause amputation or death. Following is Ohio’s
regulation on disinfection.
Disinfection of implements and spills; blood and body fluids
OAC 4713-15-03
Disinfectants are not active and not effective when the implement to be
disinfected is visibly contaminated with debris, hair, dirt, particulates
and/or when heavily soiled.
Non-porous implements and all salon surfaces shall be thoroughly
cleaned (sanitized) prior to disinfection. Porous implements shall be
discarded after each use and shall not be disinfected for reuse.
1. All used non-porous implements shall first be cleaned with warm
soapy/ detergent water to remove visible dirt, debris and/or
bodily fluids and then disinfected by completely immersing in an
“appropriate disinfectant.” A covered container of adequate size
shall be used for the wet disinfectant.
a. All non-porous implements, which come in contact with intact
skin, shall be thoroughly cleaned before immersion in an
appropriate disinfectant.
b. All non-porous implements, which have come in contact
with blood or body fluids, shall be thoroughly cleaned before
immersion in an “appropriate disinfectant.”
An appropriate disinfectant includes an EPA disinfectant registered as
effective against “HIV/HBV.” For personal protection against bloodborne pathogens, cleanup should always be done wearing non-porous
disposable intact gloves and gowns and eye protection for large spills.
2. Disinfectants shall be prepared fresh at least daily when the salon
opens for business. Disinfectants shall be prepared more than
once a day if the solution becomes diluted or soiled. An individual
disinfecting surfaces shall follow the contact time suggested as
appropriate by the manufacturer. Bleach is an effective disinfectant
for all purposes in a salon. Bleach solutions shall be mixed daily
and used in a nine to one solution (nine parts tap water and one
part bleach). Always clean up blood and bodily fluid spills with the
appropriate disinfectants as soon as possible.
Perfect implement infection control can be performed only with an
autoclave, a “steam-under-pressure” machine that kills everything on
whatever is put through the process of sterilization within its chamber.
Chemical disinfectants also called disinfection (intermediate-level),
can kill bacteria, but do not destroy the spores. The process called
“sterilization” destroys spores and bacteria. It is done at high
temperatures and under high pressures, such as in an autoclave.
Disinfectants are appropriate for use in salons and spas if the product
is virucidal, bactericidal and fungicidal and is used according to the
instructions on the label; it is changed in the time dictated by the
instructions; mixed exactly as directed on the label; the implements
are cleansed with warm water, brushed with soap; the implements
are dried prior to insertion into the product so the solution will not
become diluted over time; and the implements maintain their state of
disinfection during storage.
Safe services and best practices
To protect the client and perform safe services always demands
maintaining certain safe practices or best practices in regards to infection
control. Some of these practices are obvious standards but at times, we
all must be reminded. The payoff is additional client referrals due to the
standards that are continuously upheld in the salon, such as:
●● Obvious cleanliness and infection control for implements, equipment
and surfaces will tell clients the story, and they will tell their friends.
●● A thorough foot exam will provide the information for qualifying
whether the client can have a pedicure.
●● Knowledge that supports the recognition of “out-of-normal” will
allow the technician to inform the client that he or she needs to go
to a podiatrist, or that the feet are healthy.
●● No pain should interfere with the enjoyment of a pedicure. If a
client has memories of pain, the quality of the pedicure is reduced
in his or her mind, and the possibility of an injury is there.
●● A relationship with a physician or podiatrist, or several, enables
cross referrals.
Please circle any medical problems you have or have had
Blood pressure (high or low)
Tuberculosis
Arthritis, tendinitis, bursitis
Diabetes (I or II)
Heart problems
Thyroidism (hyper or hypo)
Nail or foot fungus
Lymphedema
Open lesions of any kind
Kidney problems
Varicose veins
Hepatitis A, B or C
Circulatory problems
Stroke
HIV-AIDS
Sunburn
Cold hands and feet
Anemia
Cancer
Fibromyalgia
Stress-related illness
Scoliosis
Any skin disease
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●● A caring attitude will ensure all the above and will bring clients
back to the salon.
Health questionnaire
Many salons bypass the use of a new client sheet which includes the
important health questionnaire. They feel it takes up service time.
Others, who do have them filled out, do not use them.
This is proving to be a dangerous mistake, even more so in recent
times. Clients with certain health conditions require special care, and
the most important thing a caring nail technician can do is know the
client’s condition, if one exists, then learn how to perform the service
with the special care required.
Health questionnaires provide the information on why to especially
protect certain clients – though all should be protected – and how the
nail technician can protect him- or herself from the transfer of infection.
What follows is a typical all-services health questionnaire list:
Are you using or taking
Antibiotics
Accutane®
Rapid exfoliants
Glycolic, acne products
Chemotherapy
Tanning bed
Hormone replacement
Medications causing skin light sensitivity
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This questionnaire is extremely important as it contains client
precautions to take in providing services. High blood pressure,
diabetes, circulatory problems, sunburn on the legs/feet, skin disease
of any kind, and foot fungus are conditions that prevent soaking in a
whirlpool. A soakless pedicure is an option.
Arthritis of the feet/toes, fibromyalgia, varicose veins, and lower leg/
ankle swelling (lymphedema) should indicate a gentle or no massage of
the legs. Have clients with these conditions check with their physician.
In most states, it is against the law to perform services on anyone with
an active foot fungus or other conditions. Check with your state on this
policy. It may instruct you to use universal precautions and proceed.
It is also important to nail technicians to check medications and usage
of products and services. Many of the listed medicines will increase
the response of the skin to treatments. For example, the skin of clients
taking antibiotics, Accutane™ and using rapid exfoliants such as
Retin A or similar products will turn red and even become inflamed or
blister after treatments; it can happen also after glycolic treatments for
calluses, after waxing the toes or legs, even after using scrubs.
Use of a tanning bed can cause skin irritation that is not evident, if it
was just before the treatment. The result may be a burn-like response
that can be blisters, or the outer layer of the epidermis peeling, leaving
a lesion. The skin of a client taking hormone replacements or certain
birth control medications can be very sensitive and respond with
irritation and inflammation; clients on chemotherapy require gentle
and non-irritating products because there is no way to know how their
skin will respond.
The bottom line of all this is that you must know your clients’ health
conditions and medications and the relevance to the service.
Pedicure explosion of 1990’s
The number of these special care clients coming into nail salons
for pedicures exploded in the mid-’90s because of a decision in
Washington, D.C. Medicare stopped paying for routine foot care
for patients, except under certain narrow parameters, and insurance
companies followed soon with the same restrictions.
Routine foot care is the trimming and shaping of nails, debridement
(reduction of a thickened toenail with an electric file) and curettage,
which are usually legal for nail technicians to perform on a healthy
client. (Check your state regulations.)
Suddenly, an entire group of people were without their paid, routine
foot care, even though a high percentage of these people could not trim
their own toenails because 1) many could not see their toes, 2) many
could not reach their toes, and 3) many could not hold or squeeze the
nail clippers. Many were elderly, healthy for their age, but just could
not take care of their feet. All required good infection control practices
and injury prevention during their care because of chronic conditions.
Who would perform their routine foot care? Many thought because they
now had to pay for their foot care, why not go where they can relax and
leave with pretty nails, instead of paying for clipped off nails with lousy
shaping, no filing, and of course no pretty polish in the podiatry offices?
This was an entirely new group coming into nail salons, clients who
have changed the nail industry significantly, in both good and bad ways.
Many of these clients were at-risk people who are healthy, meaning
they had no obvious disease or condition, but were always at risk
for infection, and when infection did occur, they healed slowly,
improperly, or never healed at all. These special-care clients require
foot-care persons who are trained in providing gentle, safe services for
them or who care enough to refer them to pedicurists, who are trained
to perform those services.
Who are at-risk clients?
Most times, a nail tech cannot see a client is at-risk for infections,
so professionals must have a health questionnaire and have a
working knowledge of what the problems there may be for clients
with certain, chronic health conditions. The following is a partial
list of these conditions:
●● Circulatory conditions of the legs, such as lymphedema, varicose
veins and many others.
●● Diabetes, which adversely affects the feet; this client needs very
special care.
●● Immuno-suppression and compromised immune systems, seen in
persons who suffer from HIV/AIDS, transplant patients, those in
chemotherapy or who recently experienced it, the elderly, those
who suffer from lymphoma, and those using certain medications
that reduce the immune system.
●● Recent illnesses such as influenza, endocarditis, staph and strep
infections, pneumonia, food poisoning, shingles, septicemia,
candidacies.
Even with questionnaires, a technician should keep up with what has
happened to a client since their last appointment. Questions to ask
include “Has anything changed with your health since you were last
in?” and “Are you on any new medications?” Clients’ consults regarding
their health questionnaires should be discussed at every appointment.
Pedicures require more expertise in qualifying clients and in
performing services than any other beauty treatment, and nail
technicians must perform pedicures that will not cause injuries,
scarring, death and amputations.
The reason pedicures need expertise? The feet heal slower than any
other part of the body because feet have less-than-optimal circulation,
even in healthy people, and most at-risk clients, especially have poor
circulation in their lower legs, ankles and feet, causing poor healing
and making them susceptible to slow or non-healing infections.
Injuries, even amputations, can and have happened because routine
foot care is no longer paid for by Medicare, and these clients are now
coming into salons and spas to nail technicians who are not trained to
perform foot care appropriately on them.
As of 2014, Medicare does not cover routine foot care, such as
trimming nails or removing calluses. However, Medicare may cover
routine foot care when:
1. The services would be unsafe if someone other than a doctor
performs them because the client had a serious medication
condition affecting their whole body (such as diabetes).
2. There are signs of fungus in the nails, and the client has pain,
infection, or problems walking.
Services considered routine foot care include:
●● The cutting or removal of corns or calluses.
●● The trimming, cutting, or clipping of nails.
●● The debridement of nails.
●● Cleaning and soaking the feet.
●● The use of creams to maintain skin tone.
●● Any service performed when there is not an illness, injury, or
symptom involving the feet.
Training nail technicians how to perform services for “at-risk” clients
The industry has suffered a hit on its reputation because pedicures
have been performed on clients who are at-risk by nail tech
professionals who:
1. Did not know what at-risk meant (see above).
2. Were not trained to determine which clients were at-risk.
3. How to perform services on them.
4. Were not performing adequate infection control (or none at all).
The result has been enumerable injuries to clients and many lawsuits,
known and unknown.
Some schools are now incorporating this topic into their curriculum. As
educators and researchers continue advocating for more infection control
protocols, the nail tech professionals should be practicing these standards
every day. There is training on infection control and quite a bit of it!
Page 14EliteCME.com
The CDC has a great site on infection control in varying environments.
Training is also available through continuing education online courses.
Qualifying a client for a pedicure
Many nail technicians do not understand that qualifying a client and skin
assessment is the most important portion of a pedicure service. They
may never perform one, and many times do not even look at the bottom
the client’s feet. This is dangerous, for both the client and the pedicurist.
This is the protocol for a client assessment:
1. Check the client health sheet and ask questions concerning the
answers and the conditions that were circled. Also, ask whether the
client has shaved her legs in the last 24 hours; if so, the pedicure
must be delayed.
2. Move the foot around and touch it to search for lesions and any
out-of-normal areas. An “out-of-normal area” can be redness,
a blister, a shiny area on the skin, a scrap, anything that is not
normal. It is important that if the skin is broken in any way, the
client be disqualified for a pedicure.
3. Refer the client to a podiatrist, if necessary. Is this going to happen
often? Probably not if you have a diverse clientele, meaning they
are not all elderly.
4. Perform the appropriate pedicure with the client’s needs in mind
and with comprehensive infection control.
Developing a relationship with a podiatrist is not easy because they
have seen so many fungal infections on clients who have had pedicures
in nail salons. There are podiatrists out there, however, who are willing
to refer clients to a nail technician who performs comprehensive
infection control that includes the use of an autoclave on implements.
They know their patients love pedicures, so some do want to have a
nail technician they can recommend to their patients for safe pedicures.
Pedicures for diabetics
Diabetics represent the benchmark condition for requirements
for protecting all clients from injury, illness and more serious
consequences of unsafe pedicures. Forty percent of diabetics will have
minor to serious neuropathy on their feet and possibly on their legs.
Nerve damage on their feet causes the lack of sensation; many cannot
feel pain, a signal of injury on their foot or legs. Early symptoms may
include tingling, numbness, burning (especially in the evening) and
pain. The condition proceeds to numbness.
A nail technician can be a diabetic’s first line of defense against
severe consequences of this condition, or can be the cause of serious
consequences. One who is caring and trained to perform pedicures
on diabetics may see conditions and injuries, during the pre-pedicure
evaluation, which the client does not see or even feel because of
neuropathy. The nail technician can draw attention to the existence of
the out-of-normal condition to the sufferer and suggest a visit to his
or her podiatrist or physician. A client might not get treatment much
earlier than he or she would have, if the nail technician had not called
attention to the problem.
Injury is significant for these patients, because neuropathy increases the
possibility that foot injuries will go unnoticed and develop into ulcers
or lesions. Even severely dry skin of the feet (xerosis) can be serious
because the cracks and openings in the skin can become infected.
Ultimately, these infections, if diagnosed late, can lead to amputation
because of the poor healing capabilities of people with diabetes.
Safe services for diabetics and all at-risk clients require:
●● Perfect infection prevention on equipment, implements, and in
the environment.
●● Especially gentle care, to prevent obvious and microscopic injury.
●● Use of universal precautions and personal protective equipment.
●● The safe use of implements.
●● The ban of unsafe implements, such as blades and rough, porous
pumice stones.
●● Knowledge of which clients must be considered at-risk.
●● Knowledge of foot assessment for qualifying clients for pedicures.
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●● Exceptional knowledge of foot diseases and disorders.
●● Knowledge of the relationship between pedicures and chronic
illnesses.
●● Knowledge of a referral system, when needed.
●● A solid and trusting relationship with a podiatrist to whom a nail
technician can refer clients to for care.
●● Relational expertise in working with these clients.
It is the nail technician’s responsibility to perform services that are safe
and effective and to inquire about the client’s health history in order
to follow infection control protocol. Do not perform a pedicure on a
person with a foot condition or injury.
Causes of injury during pedicures
Damage performing pedicures happens often, especially during 1) nail
trimming, 2) shaping, 3) callus care, 4) nail debridement, 5) cuticle care
and 6) removal of nail debris (curettage). If nail technicians are honest
with themselves, they will acknowledge having caused past injuries in
the performance of these segments of nail care. The number of these
possibilities, alone suggests the need for training in working with at-risk
clients. The only deterrents against injuries are training, concentration
during foot care performance, and sincerely caring for these clients.
Poor technique in nail trimming often causes injury to the skin
surrounding the toenail through misuse of the pedicure nail trimmer
(nail clipper).
Shaping can also cause damage, especially with a poorly prepped
file, or even with concentration on achieving a result and not on the
surrounding skin. Innumerable cuts have occurred from files that have
not been prepared for use during services, meaning the removal of the
sharp edges surrounding the file. These sharp edges are removed easily
by rubbing the edges of a file over the edge of the file to be used. It is
important to use a new or disinfected file to prep the new file.
Callus care can be especially damaging if the nail technician cuts
or abrades the skin, allowing a portal of entry for microbes. Nail
technicians should never fully remove calluses, and a healthy amount
needs to remain for protection of the area. Always leave at least oneeighth inch to one-fourth inch of callus to perform this protection.
That means many times all a nail technician can do is smooth the
callus. Nail technicians also need to understand that blades are a
surgical instrument, one that is not legal for a nail technician to use,
regardless of whether it is prohibited in state board regulations. For
that reason, a damaged client will win a lawsuit for damages with this
instrument every time. Further, if nail technicians work outside the
scope of practice for nail technicians in their state, some insurance
policies are not obliged to pay damages.
Nail debridement is the smoothing or reduction of a hypertrophic
(thick) nail, usually a great toe, with a manual or e-file. This usually
is a legal service that nail technicians can perform – check your state
regulations for confirmation. However, a poorly trained nail technician
can cause an ulcer to develop beneath a toenail, just by moving too fast
on the nail, causing unnecessarily intense heat. The damaged nail bed
develops an ulcer beneath the nail of at-risk patients, who heals slowly.
If it cannot be seen by the nail technician or client, it can progress to
serious damage before being treated. It is a dangerous occurrence with
an at-risk client, and can cause serious injury and even loss of the toe.
Cuticle care and removal of debris with implements can cause
injuries to clients that may be dangerous even if they are not obvious
to the client or technician. A microscopic injury with the implement
may not bleed but does allow a portal of entrance for microbes.
Examples would be rough use of a nail pusher and cutting cuticles.
Cuticle trimming or cutting on at-risk clients should never be done.
Careless cleaning out under a nail can also break the seal of the
hyponychium, allowing entrance for pathogenic microbes. These
injuries are extremely dangerous.
Page 15
Marketing safe pedicures
Salons that practice perfect infection control
and market themselves as a “safe salon” will
attract new clients and bring those who are
afraid of having pedicures, back in, to enjoy
the service again. Those salons that can prove
they perform perfect implement, and pedicure
chair infection control will always enjoy the
best reputation for providing safe services and
again, attract more clients. The only way to
prove performance of implement infection
control is through the use of an autoclave for implements and an
autoclave pouch system. The best scenario is for the autoclave to be
visible to the clients, though many salons cannot do that. The
verification for those that cannot have their autoclave in the workroom
will be through the use of sterilization pouches.
Methods to verify to clients infection control is followed
Sterilization pouches hold the cleansed implements, while they are in
the autoclave. The implements are cleansed and placed in the pouch,
which is sealed and then placed in the autoclave. After the sterilization
cycle, the pouches are removed and placed in a clean storage area
for later use. Usually, the pouches hold a set of implements, all those
that are used in one service. While the client is at the chair, the nail
technician should retrieve and open the pouch in the view of the
client. Tearing open the pouch in front of the client is great proof that
sterilized implements are used. The mottled appearance of the pouch
verifies the sterilization and provides obvious proof that the pouch has
only been used and sealed once.
Verification of disinfection of the pedicure chair can be performed
while the client is in the chair. The client enjoys her pedicure, and
then during the set time for the mask or paraffin (after the whirlpool is
needed), the nail technician should clean the tub and set it to soak with
disinfectant. Then the tech will complete the pedicure. This client can
be confident that the disinfection step is always performed on the tubs
because she saw it happening.
You can place a well-designed sign on every chair, after the final step
of disinfection, after the client leaves that says “Cleaned, disinfected
and ready for you,” or something similar; remove it as the client
climbs into the chair.
Teaching clients
Educate your clients about the correct way a sterilization pouch will
appear after the cycle, and tell them “if you see a pouch that has been
resealed, the implements have not been sterilized.” These pouches
wrinkle from being steamed in the autoclave, and the pouches only
close correctly, once. Make sure clients know this. If they go to
another salon that is placing implements in pouches for show, for
example, they will know it. Clients also should be shown that the color
code on the pouches changes color, from a lighter tone to a darker tone
when sterilization temperature has been reached. That cannot be faked.
Benefits to good infection control
The benefits of using an autoclave far outweigh the negatives. The
negatives are the cost of the unit, which can run $800 and up, and a
longer time to complete a cycle, than with liquid solution disinfection.
Liquid immersion disinfection is usually about 10 minutes, while an
autoclave will take 20-25 minutes. But with autoclaves:
●● Clients know their implements are clean and safe. The number of
clients who will appreciate knowing their implements are safe is huge.
●● Marketing as a “safe salon” can bring fearful clients and those who
have been told by their physician to avoid nail salons because of
supposed, poor infection control.
●● Salons who have committed to this program are enjoying growth
with new clients who will bring in others. The autoclave is paid for
in a very short time – some in less than a month, or 16 to 20 clients
for a small unit.
●● These clients are very loyal; they feel there is nowhere to go
except to this safe salon.
●● Podiatrists may develop a referral relationship with the salon for
sending their patients. Some salons are enjoying referrals from
multiple podiatrists and physicians.
Autoclaves can be a marketing advantage for a salon or spa that
commits to its use. However, if a client, who has come to the salon or
spa because of its use, sees other poor infection control activities, he
or she will not be back. Comprehensive infection control is the answer.
Commit to it, or don’t bother to purchase an autoclave.
Pedicures are stress-relieving treatments that provide relaxation,
produce softer skin and leave the client feeling revitalized. They have
a higher rate of retention in salons and spas than any other service
offered. They also have the highest lawsuit rate and a reputation that
must be overcome. Setting up and performing safe services, letting
people and physicians know the salon is committed to that philosophy,
can greatly enhance the salon’s growth rate. This concept not only
protects clients, it sets a salon or spa apart from others and supports
growth that will surpass any former rate.
References
1.
2.
3.
4.
Environmental Protection Agency. (2015). Guide to protecting health of nail salon workers.
Retrieved from website http://www.epa.gov/oppt/salon/
National Public Radio (October 18, 2007) Staph killing more Americans than AIDS. Retrieved
from website: http://www.npr.org/templates/story/story.php?storyId=15391478
U.S. Bureau of Labor Statistics. (2012) Occupational outlook handbook. Rerieved from website
http://www.bls.gov/ooh/personal-care-and-service/manicurists-and-pedicurists.htm
Maslin Nir, Sarah. (May 11, 2015). Perfect nails, poisoned workers. N.Y. Times Newspaper.
Retrieved from website http://www.nytimes.com/2015/05/11/nyregion/nail-salon-workers-in-nycface-hazardous-chemicals.html?action=click&contentCollection=Opinion&module=MostEmailed&
version=Full&region=Marginalia&src=me&pgtype=article&_r=0
Page 16EliteCME.com
PROTECTION FROM INFECTIONS IN THE NAIL INDUSTRY Final Exam
Choose the best answer for the following questions and take your test online at EliteCME.com.
7. What is the first symptom of a MRSA infection?
a. Little red bumps on the skin appearing like spider or bug bites.
b. Coughing.
c. Skin rash that is yellow in color.
d. Boil.
8. MRSA bacteria are continually mutating and developing
______________ to medications, making it an even more serious
concern in the United States.
a. Complications.
b. Resistance.
c. New genetics.
d. Persistence.
9. One of the most neglected practices in the performance of nail
services is what?
a. Wiping down surfaces.
b. Cleaning implements.
c. Hand washing.
d. Sanitization.
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10. Nail technicians must wear PPE, which includes gloves, masks and
______ protection designed to protect nail technicians from diseaseproducing microbes that may be in their work environment.
a. Eye.
b. Ear.
c. Skin.
d. Hair.
11. The bottom line of a health questionnaire is that you must know
your clients’ health conditions and ______________ and the
relevance to the service.
a. Status.
b. Family.
c. Natural hair color.
d. Medications.
12. Early symptoms of diabetes may include tingling, numbness,
burning and pain - the condition proceeds to _____________.
a. Bleeding.
b. Sharp pains.
c. Dry skin.
d. Numbness.
Page 17
Chapter 3:
SKIN CARE ESSENTIALS AND THE
NEW MANICURE/PEDICURE
1 CE Hour
By: JoAnn Stills
Learning objectives
After the participant completes the lesson, they will be able to:
ŠŠ Explain the treatment philosophy of the new skin-based manicures/
pedicures.
ŠŠ Differentiate between a traditional manicure/pedicure and a skin
care based manicure/pedicure.
ŠŠ Describe the routine steps to abide by when providing a client
analysis and consultation.
ŠŠ Describe the three (3) layers of the skin and the purpose of each.
ŠŠ Identify the best skin care treatments to recommend for common
types of skin.
ŠŠ Explain the various skin-care nail services that can be applied for
various types of conditions including “at risk” client conditions.
ŠŠ Memorize what the important ingredients are in skin care products
for the purpose of treatment and in home care recommendations.
Introduction
A new world for manicurists
The most significant change in manicure and pedicure services came
when a few manicurists added a second license to their skills, esthetics.
These manicurists developed an entirely new and different view of their
hand and foot services. Information in the course showed them the
obvious synergy of the two specialties, and they began merging their
new knowledge of skin care into their hand and foot care services.
They changed their products to more skin care-oriented products, and
the service protocols, even the basic, to be similar to the facials they
were trained to perform in their esthetic training. The manicures and
pedicures became more treatment-oriented for these professionals,
including the skin of the hands, arms, feet and legs in the treatments,
rather than focusing on just the nails and a comforting mask.
These new skin care-based manicures and pedicures require a trained
manicurist who can recommend services that are appropriate for
individual clients’ hands, arms, or feet and legs. This approach is
much like that of a skin care department where estheticians analyze
the skin before choosing the facial treatment. With this new treatment
philosophy, clients and their needs are the focus, not the services, and
it is central to the success of the service, not the resulting beautification
– although that is also the result of this focus.
Manicurists may think, “There is nothing new we can do in
manicures and pedicures,” but the new choices that are oriented to
skin care for manicures and pedicures prove this untrue. Even the
new protocol for them changes the outcome of the services. The new
protocols warm the skin, and this opens the pores, which allows a
deeper penetration of the product ingredients and an immediate and
noticeable improvement in clients’ skin.
The following chart compares the traditional protocol with the new
skin care-oriented protocol:
Traditional manicure and
pedicure
Skin care-based manicure
and pedicure
Shorten shape, remove polish
Shorten shape, remove polish
Soak
Analysis and recommendations
Cuticle treatment
Skin prep and massage
Mask
Treatment product
Massage
Cuticle work
Polish prep and polish
Polish prep and polish
Home care, reappointment
and release
Home care, reappointment and
release
The differences between the traditional and skin care-based manicure
and pedicure services are:
1. Skin care-based manicures and pedicures contain an analysis of the
skin and nails, on the hands and feet.
2. The hands and arms, feet and legs are included in the treatment.
For example, the scrub pedicure is the answer to scaly winter legs.
3. The skin is prepared for the products through a scrub exfoliation to
facilitate penetration of ingredients.
4. The massage is earlier in the treatment, warming the skin, opening the
pores and allowing more penetration of ingredients. Clients also relax
earlier in the treatment, resulting in a more pleasant experience.
5. Treatment products in a skin care-based manicure or pedicure
are chosen to meet the needs of clients’ skin. All skin care-based
services have a treatment of some kind.
Water – or not
Manicurists have always soaked their clients’ nails in water. It has
always been thought to be important, and the best option, to soften the
skin and thus, allow the best treatment. Few manicures were willingly
performed without the soak.
Now, this practice is being questioned for several reasons. First, a
fingernail is constructed horizontally in layers that appear similar to
fiberboard. They are held together by intercellular adhesive materials
that stiffen and shape the nails – the healthier the intercellular
adhesive, the healthier the nail. However, when in water often,
these oils and natural adhesives may be softened or damaged, often
causing a condition referred to as layering or peeling. This condition
is aggravating, and most times prevents much length past the
hyponychium because of tearing of the nail’s free edge. Manicurists
are often asked to solve this problem for clients.
The natural adhesives holding the nails together on the free edge
are the root of the problem. Water is a universal solvent, meaning it
will dissolve something when many other solvents will not. But, this
will not usually happen with the natural adhesives in the nail plates,
without the help of an additional solvent – and manicurists provide
it. When soaking the fingertips, manicurists usually add something to
the water to increase and speed its ability to soften the nail plate and
cuticles (eponychium). Many times, detergent is added because it is
effective in dissolving oils. (Other soak products are similar.) Nail
plates and the skin around them become weakened by these solvents,
and that can result in layering.
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Another reason many manicurists are opting for the soakless protocol
for manicures is the effect on the retention of polish when nails are
soaked. With soaking, water is absorbed into the nail plate, and it
changes its shape, usually to less of a horizontal curve. The nail
maintains this soaked shape for the manicure and while the polish is
applied and dries. During drying, the acrylic in the polish hardens into
the shape of the nail place – a flatter shape than the nail is naturally.
Later, after the nail plate dries to its usual shape, a deeper curve from
side to side, the polish is stressed into the new shape and weakened,
often damaging the retention of the polish. The polish will try to
return to the shape the nail was when it dried, the flatter shape. The
result is that the polish is more susceptible to chipping and peeling.
For this reason, many believe the soakless manicure method allows an
improvement in polish retention.
The soakless manicure is best for several nail types: the eggshell, the
lacy and the post-acrylic, but many manicurists are changing to it
completely just for the retention of polish.
However, pedicures are another issue. Most clients will prefer the
whirlpool soak because of the bubbling of the water, and pedicures,
generally, have no problems with polish coming off. (Actually, polish
will stay on so long, it may grow off because the feet are not working
tools.) But there are some clients who should not have soak pedicures,
the at-risk clients who heal slowly. You must ask these clients to check
with their doctor to see whether they can have a whirlpool pedicure.
Podiatrist generally will say, “Please perform the soakless” service, if
they know it exists, because of their fear of infection for their clients.
Many pedicurists working in podiatry offices perform only soakless
services. And, all podiatrists will say there should be no soaking on
clients who have any type of lymphedema, swelling of the legs. Some
will also say that diabetics should not be soaked, nor should patients
with immune-suppression illnesses.
The final word on it is this: Always ask a client to check with his/her
doctor or podiatrist if the person has a chronic disease. It is the safe thing
to do, and a responsible manicurist will insist on it. If a client has not
consulted a doctor, you may help the person place a call to the doctor, but
understand that physicians may be unwilling to discuss the question with
you because of privacy concerns. And finally, know that many clients will
prefer the soakless method to the whirlpool protocol after trying it.
The differences
Soakless services are not difficult. The only difference between
soakless and the whirlpool pedicures is in the whirlpool protocol in
which clients usually soak their feet at the start of the service. With
the soakless protocol, the manicurist applies a good lotion and cuticle
softener, then puts the client’s feet in a thin plastic bag. The feet are
then placed in heat mitts for the same amount of time, as they would
soak. In addition, while some pedicurists replace the feet in the soak
to keep them warm, in the soakless protocol, the foot is wrapped in
warmed towels. The process is the same for manicures: Where the
fingers would soak, lotion is applied, and then their hands are placed in
a plastic bag and put inside mitts.
How to treat - and keep - a client
First greeting
Skin care-based manicures and pedicures are upgrades to the usual
services, are customized, and require trust in the manicurist, by the
client. This trust begins with the professionals’ activities, when the
client comes through the door and it continues throughout the service,
into the following appointments. Clients must feel the nail professional
sincerely cares about the condition of their hands and feet. If they are
to purchase, they must not feel the manicurist is just pushing products.
The initiation of trust must be established upon first meeting the client
and then carried throughout the first service, into the next, and the next
appointment. Usually, when a new client is in a waiting room filling
out a new client sheet, initial trust can be established immediately,
even before the person is seated at the table or in the pedicure chair. It
is initiated by asking questions (qualifying a client) and establishing a
conversation with them. Each manicurist will have their own unique
style when working with clients, and building relationships with them.
As many of you already understand, asking questions helps to identify
what the client likes and wants. Client’s medical concerns and any skin
issues they may have, can also be noted.
At the table
The routine performed upon seating clients at the nail table or in the
pedicure chair is important and includes steps manicurists are not
usually trained to perform, an analysis and consultation. These are
performed at every appointment, though familiarity may lessen the
length, and a discussion of the treatment may be brief. Clients will
come to expect it, and other salons and spas will be measured by this
activity. Still, this step is unfamiliar to many manicurists. Performing
this step will set the service apart from the salon down the street.
For example, a manicurist should check the condition of clients’ hands
and feet to decide which service to recommend. This is how it is
done: After a client washes his or her hands and is seated, the seated
manicurist should reach forward with both hands, palms up, and take
each of the person’s hands in one of hers and then survey them. If it is a
pedicure, the manicurist should reach forward and place each foot on the
footrest in an individual movement, putting one hand on top at the ankle
and the other underneath, and then pulling each one forward. After these
moves, the analysis begins, ending in recommendations for a service.
During the analysis and throughout the appointment, the professional
should educate clients on how to extend the beautification and nurture
the improvements achieved by the service through home care products
and future professional nail care. The manicurist should describe
the ultimate results of a treatment plan, recommend future care, and
instruct clients on the use and importance of home care.
An analysis/consultation should follow this routine:
●● Determine the skin type and condition of the hands.
●● Establish the probable causes for any conditions or problems.
●● Suggest the appropriate service.
●● Prescribe home care products and their use.
●● Define and recommend possible changes in client activities.
●● Outline a specific program for improving the look and condition of
the hands and legs.
●● Determine the condition of the nails.
●● Recommend treatments for the nails.
A routine, always-performed part of a service is one that trains clients
to always look for it in every manicure and pedicure service, anywhere
they are done. It is designed to set a standard and, small as it may seem,
it does. Clients soon believe the ritual is essential to good service.
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Page 19
present in the epidermis and connect to the subcutaneous layer below.
It consists of two layers: the papillary and reticular. The papillary layer
is named from the papillae arranged in curved, almost parallel ridges
on its surface. Since the epidermis conforms to these ridges, the
papillae are also reflected in the contour of the epidermis, especially on
the tips of the fingers and toes and are the basis of fingerprints and toe
prints. No two human beings have identical finger and toe prints with
the exception of identical twins. The reticular layer consists mostly of
collagen, protein fibers that provide the tone and suppleness of the
skin, and elastin, which provides the flexibility of the skin. These
fibers provide structural support for the cells and blood vessels. They
also aid in the healing of wounds.
Skin structure review:
To perform an accurate analysis, the manicurists must first know the
overall skin structure. The skin is a thin, flat organ that encases a human’s
organs, bone structure, blood vessels, nerves and so on to protect them
and perform other duties, while defining people, as who they are, in
appearance. Its structure is in layers: the top layer is the epidermis, the
second layer is the dermis, and below that is the support structure, the
subcutaneous. The epidermis is composed five layers that work together in
an ongoing cycle of cells that constantly reproduce, push outward and die
during the trip to reach the outer layer, the stratum corneum. There they
become flat and scaly and are released from the surface. The process of the
release of dead epidermal cells is called desquamation.
The dermis is
dense, fibrous
connective
tissue
containing an
abundance of
circulatory
vessels (blood
and lymphatic
vessels) and
nerve endings
that are not
The subcutaneous (or hypodermis) is not part of the skin, but
connects the dermis with the muscle tissue below. Fat cells are in
the subcutaneous to act as a cushion between the muscles and skin
and to provide energy to the body functions. The thickness varies
with age, sex, the overall health and weight of the person. One of
its many functions also is to maintain skin smoothness, one of its
most important functions in beautification of the skin. It provides
the contour to the skin, also, defining individual appearance. It
also provides energy (from fat), nourishment (from the blood) and
metabolic support (for functioning of the body).
The manicurist, who has
expanded manicures and
pedicures to include the skin
care, will be working with
the epidermis, the layer of
the skin that maintains
softness and elasticity when
healthy, and reflects damage,
when not healthy. To
improve the skin, this
manicurist must define the
needs of the skin through analysis, then make appropriate service
recommendations to clients, that will bring the skin back to a healthy
appearance, despite damage to its layers. A more comprehensive
description of the skin relevant to skin care-based manicures and
pedicures can be found in “Spa Manicuring for Salons and Spas,” by
Janet McCormick, Milady Publishing.
Analysis of the skin
The first thing performed in defining skin and nail care treatments is to
determine the skin type and condition of the hands and feet. Skin types
for the face are categorized as normal, dry, oily, combination, acneic,
sensitive, mature and dehydrated. The types for the hands and feet are
basically the same, though no oily or acneic skin will be seen. Following
are a list of the usual skin types, as they are seen on the hands and feet
●● Normal skin– Normal skin is smooth, soft and moist and springs
back when a pinch of skin is pulled away from the hand.
○○ Treatment: This skin should be treated preventively
to maintain the texture and hydration of this skin. The
professional treatment is the hydrating manicure or pedicure.
○○ Home care: Hydrating lotion and SPF.
●● Dry skin – Dry skin will be resistant to movement across its
surface, feel coarse and tight, and appear dull in color. Wrinkles
will be obvious, not just creping (tiny, crevice-like).
○○ Treatment: A scrub is included in the service to loosen the
dead cells off the skin surface and to encourage penetration
of the hydration ingredients in the mask. A hydrating mask
is the base treatment, but the addition of a paraffin treatment
enhances penetration of the ingredients.
○○ Home care: A hydrating lotion and a biweekly exfoliation lotion.
●● Dehydrated skin – This skin will have fine lines and wrinkles and
will appear thin and stressed.
○○ Treatment: The first week, perform a scrub manicure with a
mask and paraffin. The second week, perform an Alpha hydroxy
acid (AHA) treatment, followed by a mask and paraffin. A series
might be required. This skin should not be soaked.
○○ Treatment: Hydration through the hydrating manicure is
important to these hands. The clients should also be trained
to protect the hands from the loss of moisture from the
hands through water exposure, such as during dishwashing.
Encourage the client to use of gloves during these activities.
●● Sensitive skin – This is mainly on the hands, not the feet.
Sensitive skin will react to many products, may appear irritated
and will probably have a dry, possibly even rough surface. This
client will need weekly manicures, working up to a hydrating mask
during the second or third treatment.
○○ Treatment: The first treatment is a gentle introduction of the
hands to the products. Perform a light scrub, very light, and
use a hydrating lotion under paraffin, for only 2-3 minutes.
During the same treatment, put a dot of the hydrating mask
on the inside of her wrist. If there is no response during the
treatment, move up to the gentle scrub and a mask in the next
treatment. By the third treatment, the client should be ready
for a normal treatment. This skin should not be soaked, and
hydration is extremely important to this skin.
Page 20EliteCME.com
○○ Home care: If the skin responds positively – fingers or feet – to
the lotion, send it home with the client. This client must use
the products every night at home.
●● Mature skin – These hands will be crêpe in appearance (usually
dehydrated), with wrinkles. Hyperpigmentation may occur in varying
degrees, according to the amount of exposure to sun over the years.
The clients should be educated on the cause of age spots (sun damage)
and that prevention of further hyperpigmentation is important now;
recommend an SPF product and train the client on how to use it.
○○ Treatment: These hands will need an AHA series. Hydration is
important in both professional treatments and home care.
○○ Home care: This client must use a lotion with an AHA
ingredient at night and regular lotion in the morning and
during the day. SPF is especially important. Use of lighteners
on the top of the hand.
●● Environmentally exposed skin – These hands may be one or
more of the above, due to overexposure to chemicals, water/
solvents, the sun, the wind or weather, and possibly abrasion.
Callusing is often present on these hands, and always on feet
that have been excessively barefoot. Hyperpigmentation usually
appears around age 40 on these hands and feet.
○○ Treatment: The treatment will be the anti-aging program
with AHA.
○○ Home care: AHA and good hydration home care.
●● Callused skin – Calluses on the feet are not unusual, and are from
small to huge. Clients hate them and ask manicurists to remove
them. To do so, the manicurist will use a callus softening lotion
that will make it easier to reduce them.
○○ Treatment: Some clients are recommended a callus control
series, a series of 6-8 weekly or biweekly visits for AHA
treatments that will reduce the calluses slowly, so it will be less
likely they will return. If they aren’t softened and then reduced
slowly, they will quickly return. The treatment can be a brushon or a 15 percent lotion that is massaged for five minutes. A
hydrating treatment follows.
○○ Home care: An AHA lotion for application every night is
important, plus the use of a pedi-paddle after showers. A
hydrating lotion for AM is also important.
Nail structure: A brief review
It is likely that “nail structure” was part of your pre-licensing training.
Here is a short review: The hard surface of the nail has three parts: the
root, or base of the nail; the body or nail plate, the hard exposed surface
of the nail; and the free edge, the exposed tip of the nail. The lunula is
the white half-moon shape that lies at the base of the nail. The nail fold
overlaps the base, and the eponychium (or cuticle, as some call it) is at
the peak of the nail fold. The perionychium or the nail wall is the skin
overlapping the sides of the nail. The hyponychium is the attachment to
the nail under the free edge. For more information, read “Nail Structure
and Product Chemistry.” Second Edition, by Doug Schoon,
Nail plate analysis and treatment
After skin condition is addressed, the analysis continues with a
thorough look at clients’ nail plates and your recommendations for
their care and improvement. An analytical look at the nail plate
should not be seen as an afterthought or separate procedure. It should
be seamless with the analysis of the skin and nail plates; both are
important to the recommendation of treatment for a client.
Here are seven common nail conditions that manicurists see:
1. Normal nails – These nails get a maintenance procedure. They are
strong but flexible with a shaped free edge of whitened opacity.
They resist breakage through their flexibility and have a uniform
and healthy coloring in the nail bed.
○○ Treatment: The client must use oil on the nail plates and the
surrounding skin to maintain their flexibility and strength.
○○ Home care: Application of a good oil will maintain their
flexibility and strength.
2. Peeling/layering nails – This problem will send a client to a
manicurist faster than any other. The nails lose the natural adhesive
that bonds the layers of the nail plate at the free edge, and then
peel apart, layer by layer, until they are thin and weak. They tear
easily until there is no free edge.
○○ Treatment: It is believed that layering is caused by having
the nails in water too often, especially with the presence of
detergent that removes the oils. This person must have waterless
manicures. These nails will need nail treatments to strengthen
them. Many manicurists brush a thin layer of glue horizontally
across the free edge. The theory is that if you can keep them
together until the layering area has grown out and is filed off, the
nails will not layer. Others believe a tip wrap is the only answer.
○○ Home care: These nails need a nail strengthener and oil
massage treatments every night. Maintenance of flexibility of
the nail plates is very important.
3. Brittle nails – This free edge breaks with very little pressure.
There is no crack in the nail; it just comes off in a chunk. Clients
usually say the break makes a snapping sound.
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4.
5.
6.
7.
○○ Treatment: Manicures for the skin conditions are good
treatments, but home care is most important.
○○ Home care: This nail is between being hard and dry. Oil
massage is imperative, and should be performed often.
Eggshell nails – These nails are thin and weak and peel off with
very little pressure. They bend and straighten with little effort.
Many times they appear to grow over the end of the finger,
adhering tightly to the skin and having no arch of their own,
appearing flat from the side. These type nails are more often on
people who have flat (instead of arched) nail beds when looking
from the side of the finger.
○○ Treatment: The treatment will be according to the skin.
○○ Home care: The nails should have nail strengtheners and
nightly oil massage.
Lacy nails – These nails also are weak and tear easily, but the
free edge seems thinner than even eggshell nails. Some areas of
the free edge will appear translucent, while others will be opaque.
This causes a lace-like appearance. They snag and tear clothing
and hosiery, so these clients seldom can grow free edge to any
significant length.
○○ Treatment: The manicures and pedicures for the skin conditions
are good treatments, but home care is most important.
○○ Home care: These nails should have nail strengtheners.
Stress breaks – These nails give the impression of being too
strong. They appear thick and healthy, then suddenly there is a
break on the side at the stress area. These nails may have had
long-term overexposure to high percentage formaldehyde in nail
hardener, or it may be a hereditary trait to have hard nails.
○○ Treatment: Will respond to the skin care treatment.
○○ Home care: These nails need oil applied every night.
After-enhancement nails: These nails will vary in health
according to 1) the skill and care of the application technician, 2)
the health of the client’s nails, 3) the general health of the client,
and 4) the technique of the removal.
○○ Over-prepping and etching will cause thin or post-acrylic nails
to have curved markings in the nail as it grows out. Incorrect
use of a nail e-file during finish of acrylic enhancements
will also cause severe trauma and markings in the nail plate,
“rings of fire,” curved burns by the e-file into the nails, as the
artificial nails are finished. Correct application of products
and finish will not produce an unhealthy nail, though it
may be more flexible for a short time after removal of the
enhancement product.
Page 21
Skin care nail services
Basic manicure and pedicure
The difference between what used to be considered basic manicures
and pedicures and skin care-based basic manicures and pedicures, is the
protocol. The basic skin-care version is designed to produce more vibrant,
glowing, relaxed skin, even though the service is considered basic.
Scrub manicure and pedicure
This is the basic manicure plus a scrub step before the massage. A
scrub product is placed on the hand or foot, and then manipulated
around the surface. A good product will remove the right amount of
dead cells in one minute of even pressure over the hand or foot. The
product must be removed well before the next step, the massage.
In this manicure, an especially hydrating lotion should be used for
massage because the scrub has removed the oils – it will require
reapplication of product during the movements.
massaged with the usual massage product. The product must be
removed afterwards with a wet towel, and then a hydration lotion
applied. Paraffin is not used in this treatment.
●● Home care: Lotions and treatment products are important in
this program. A chemical exfoliating lotion with AHAs will be
important, as is a moisturizing lotion with SPF. Lightening home
care is also very important.
Hydrating manicure and pedicure
These manicures and pedicures are the most performed in salons and
spas. It is the spa manicure with good, hydrating products, a mask and
a paraffin product over the mask. Apply a hydrating lotion, the mask,
and then the paraffin.
Callus control manicure and pedicure
The function of this treatment is to remove calluses and to slow or
prevent their return.
●● Treatment: This manicure and pedicure contains the application of
callus softeners and the use of a pedi-paddle to address calluses.
A good softener is required. Some manicurists perform an AHA
treatment on the calluses to soften them more, and then use the
pedi-paddle. For heavy calluses, a series will reduce the calluses
slowly, preventing their return, which happens when they are
removed quickly, as they are with illegal blades.
●● Home care: The clients must use an AHA lotion nightly and a pedipaddle after each shower to slowly reduce the calluses.
Anti-aging manicure and pedicure
Anti-aging manicures require good treatment planning that usually
includes a series of services. Clients must commit to weekly manicures
and/or treatments (a program) with their eye on the future result. This
treatment can be for wrinkles, dehydration, and hyperpigmentation. Hands
will look younger, take on a more even and youthful glow, and appear
more toned for those who commit to this service. They love the results.
●● Treatment: It usually includes chemical exfoliants, lightening
agents and hydration. A service would be the performed as the
basic spa manicure with anti-aging treatments added, but if the
professional product is a brush-on AHA product, the massage will
not include the area where the AHA will be applied. If the product
is a 15 percent AHA lotion, however, the massage on the hand
will include that product, while the non-treated areas would be the
Nail growth manicure
This is not a specific manicure; it is a massage of the matrix to
stimulate the growth of the nail plate.
●● Treatment: The manicure is performed according to the skin-care
condition, and then the matrix massage is performed before the
massage of each hand and arm. Toenails that grow slowly can also
benefit from a matrix massage, though the result is not as fast.
●● Home care: An oil is applied, and then the clients must massage
the nail from side to side on the matrix. Medium pressure is
applied during the side-to-side movement.
Aromatherapy manicure and pedicure
This is a spa manicure with synergistic products throughout, plus
support items such as drinks, candies, cookies and candles. This highly
pampering and luxurious service is also very moisturizing.
Special manicure/pedicure services
These manicures are usually not listed on menus, but the situations are
important to discuss because of the special people receiving them.
Manicures and pedicures for the elderly
These clients have thin and weak skin on their hands, arms and
elbows, and their blood vessels have weakened walls. Their skin may
easily split with a carelessly firm massage, or a bruise can happen,
showing up immediately even during the massage. Gentleness is the
key. These clients are massaged by the manicurists using the palms
of the hand, gently and carefully in more of a rub with very little
movement of the skin. They love the attention and become loyal
clients, but injury is always possible, so special care must be taken in
the service. The service recommended is usually a hydrating manicure,
but can be done with manicures for other skin conditions.
Arthritic hand and foot care
These clients are special, and their massage must be gentle and
carefully performed. Their hands and joints are stiff and usually
painful and will be even more painful if the manicurist does not take
special care. Do not perform the pull movement on the fingers or toes
because it has been known to pull weakened joints apart, resulting in
excruciating pain. These clients require gentle, slow-moving massages,
with manicurists using only the palms of their hands to exert little
pressure, and no pressure by the fingers. The manicure will usually
include a paraffin treatment that provides soothing relief from pain. It
is welcome relief for this client.
Anti-aging of the hands and feet
Women have accepted skin care to help them look and feel younger,
and it has worked. They want to find that special manicurist who is
willing to learn and perform those special services that will anti-age
their hands, as well. Add comprehensive infection control, and this
manicurist’s books are packed, and she has a waiting list.
Sun spots (age spots), also known as lentigines, are hated by all mature
women. They are harmless, flat, brown discolorations of the skin on
the back of the hands, neck and face of people over 40 years of age.
Manicurists must learn treatments for these spots on the hands. They
are hyperpigmentation caused by darkened, damaged melanocytes in
the base of the layers of the skin that show through to appear as age
spots. They are caused by the skin being exposed to the sun over many
years and are very difficult to fade to nothing.
Client after client will ask a manicurist, “Can you get rid of these?”
The answer is, “Probably not, but we can lighten them and keep
them from getting larger and darker.” Treatments such as exfoliation
treatments with glycolic and/or microdermabrasion, plus red LED light
will lighten age spots, but not totally remove them. Compliance to
home care is very important.
Programs are services
Programs are services recommended to clients to achieve a certain
result, such as anti-aging and maintaining beautiful skin and nails.
There is no specific number of services. They are developed through
analysis and recommendations and are customized to each client, such
as the care for those clients in the skin care department.
Page 22EliteCME.com
The most dramatic results will be in the first appointment, followed by
others that will show progressive results. Many salons and spas include
a picture of the hands or feet, prior to the first treatments, to allow the
client to see the difference in a later appointment. Clients watch the
results and sometimes forget how their skin originally appeared.
A series is a set number of treatments for a condition, sometimes
purchased before the first treatment. Callus control series might be
a series of six or eight, according to the severity, or they may be a
program with no set number.
Choosing skin care products
High quality and appropriate products,
teamed with effective treatment
protocols, can be the very thing that
will have clients wanting to return to
the salon or spa. To choose good
products, manicurists must know what
their ingredients are and each
product’s purpose in the treatment and
in home care. The basic products are:
Scrub – This product has an ingredient that will loosen and even
slide off loosened, rough, dry or dead epithelial cells from the
surface layer (stratum corneum) of the skin in a gentle abrading
massage. It should be in a lotion, and is usually in a water-based
product to allow its smooth movement over the surface. It usually
will not have penetrating ingredients, though the home-care scrub
product will, including antioxidants and hydrators. Instead, it will
have barrier ingredients to seal the surface of the skin while the
abrading ingredients move over the surface.
These ingredients are usually smooth and round jojoba or
polypropylene beads, and they gently, but effectively remove loosened
skin cells when rubbed against the skin. Formulas will vary in 1) the
size of the beads, and 2) the number of beads in a good lotion base.
Scrub products in a professional service are a treatment for dry
and callused hands and feet, and they are used in some anti-aging
treatments. Home care scrubs are used according to the condition of
the hands and the instructions of the manicurist. These products are in
every pedicure to remove dead skin from the feet and to prepare the
calluses for easier reduction.
In choosing a scrub, avoid products with rough granules, such as
ground walnut shells or apricot seeds, because they can scratch the
surface of the skin microscopically and cause irritation. Most natural
abraders that are crushed shells or seeds should not be included in a
scrub, especially in one used on at-risk clients. Some manicurists will
say, “The rougher, the better,” but this is a dangerous mantra when
performing treatments on at-risk clients. These clients have skin that
can easily become infected, even with a microscopic injury, plus they
heal poorly. Jojoba and polypropylene beads work well and do not
damage the skin when used properly.
Moisturizing treatment lotion: Many times, moisturizing products
are formulated in a gel or serum because they are absorbed by the
skin more quickly than lotion and leave no residue. However, when
purchasing a gel or serum, look closely at the list of ingredients
for alcohol – usually it is there somewhere, and can counter the
moisturizing property if it is used, in excess, by the client. A better
moisturizing formula is a light lotion that has a balanced barrier (stays
on the surface to seal in the skin’s own naturally produced moisture);
penetrating hydrators (supports the production of water in the skin);
and moisturizers (supports the production and retention of sebum,
the natural skin moisturizer). Many experts feel the best moisturizing
ingredient is hyaluronic acid, a barrier product that also moisturizes.
It is more expensive than most moisturizing ingredients, however,
so it will only be in higher-cost formulas in amounts that get results.
(Products that list it lower in the ingredient list may or may not get the
benefit of its inclusion – or it can be “label dressing,” an ingredient
that is not in an amount for positive activity in the formula, but is on
the label list anyway.) This ingredient is listed as hyaluronic acid or
as sodium hyaluronate. Hyaluronic acid is seldom seen in inexpensive
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body care products because it is very expensive; sodium hyaluronate
becomes hyalonic acid when on the skin.
There are many good moisturizing ingredients, and manicurists do
not have to learn them all – and if they did, there would still be new
ones coming out all the time. For those reasons, it is best to purchase a
cosmetic ingredient dictionary and carry it you when choosing products.
Moisturizing SPF lotion – The ingredients in these lotions are
moisturizers and protection from the sun. Their job – an important one
– is moisturizing and sun protection.
The saying goes, “Daytime products protect, night-time products
repair.” For that reason, daytime products usually do not include
expensive treatment ingredients, and if they do, they are sometimes
label dressing (low and mostly ineffective, but look good on the label).
Some types of SPF ingredients make the product thicker, so they need
to be put on a half-hour before going out to allow them to “set.” There
are two types of SPF ingredients, physical and chemical.
Physical: Products containing physical SPF ingredients reflect and scatter
the UV rays from the surface of their metallic particles, namely zinc oxide
and titanium dioxide, which are suspended in an emulsion. These products
have been available for years and were called a “sunblock”; we all can
remember lifeguards wearing zinc oxide in a thick, white coating on their
noses to prevent sunburn. Recently, however, the FDA banned that word
from use on SPF product labels because there is no ingredient or product
available that will truly block all UV rays.
Initially, physical SPF ingredients, usually zinc oxide and titanium
dioxide, caused a whitening of the skin because their large, white
particles laid on its surface. Their new micronization formulations (tiny
particles of the ingredient suspended evenly in an emulsion) now allow
uniform dispersion of the ingredients within a short time after their
application while maintaining a high SPF with little or no whitening.
Chemical: These SPF ingredients absorb and transform UV radiation to
harmless heat. The ingredients include chemicals such as benzophenone,
oxybenzone and avobenzone (Parsol, 1789), and others. Chemical SPFs
tend to be more sticky and oily, and have an undesirable aroma, unless
carefully formulated. They also cause more allergic reactions than
physical SPFs, and should not be used close to the eyes.
SPFs are multitasking products. Aside from being cancer preventives,
they are also anti-aging products. The link between UVB and cancer
has long been established, but since the first scientific evidence
documenting the link of UVA to aging of the skin in 1998, the use of
SPFs as anti-aging products has boomed.
It is known now that UVA rays cause 90 percent of the aging of
the skin, and clients who wish to stay younger in appearance must
purchase and use SPF products the protect from both rays. SPF is a
“must sell” for a manicurist to every client. When asked what the most
important beauty product is, beauty professionals should answer with
certainty, “SPF,” and that includes products for the hands.
A recent entry into the SPF range of physical SPF products is mineral
makeup, a makeup formulated from minerals that reflect UV rays.
Mineral makeup is not only a great SPF product for the face of all
clients; it is also especially beneficial as an SPF for hands because of
its ease in reapplication. A quick brushing with minerals and it is done.
Mineral makeup SPF is from 15-22.
Its benefits originate from the zinc oxide and titanium dioxide
ingredients that have great broad-spectrum capabilities. Many clients use
Page 23
a gel or lotion SPF for the first application of the day, but after that, they
use a mineral makeup reapplication on the face and the hands all day.
Clients love the ease in using them, which makes them more compliant
in the use of SPF products: Just brush and go, with sun protection.
Clients should be trained in how to choose the correct SPF. First, the
product should be useable on the specific part of the body they need to
address, or on all parts. However, products for the face and those for
the body are sometimes exclusive in use. This means that many people
use the wrong products on their faces. Generally, SPF products that
state on their label they are formulated for the face can also be used
on the face and body, but they are usually more expensive than those
formulated only for the body. Conversely, those that are formulated for
the body should not be used on the face because they may clog facial
pores. For these reasons, the labels must be read carefully. If a product
is to be used on the body and does not state it can be used on the face,
as in “Face and body SPF lotion,” it should not be used on the face.
All SPF products, whether designed for the face or the body, can be used
on the hands. Every nail department should carry a good moisturizing
SPF lotion to sell to manicure and pedicure clients. All clients, no matter
their ages, should be educated on anti-aging and age spot-prevention
qualities of moisturizing SPF products and be urged to use them
faithfully. If the client is in an anti-aging or age spot treatment regimen
for the hands, sun protection product is standard in their home care sales.
Without use of an SPF product, the treatments are futile.
The SPF industry is relatively new, and there has been much
controversy about it. Initially, SPF products were designed to protect
from exposure to Ultraviolet B rays – those that burn the skin and
are the rays considered the main cause of basal and squamous cell
carcinomas, as well as a significant cause of melanoma. But, the SPF
does not measure protection from ultraviolet radiation A (UVA) rays
that penetrate the skin more deeply, and are believed to be the chief
culprits behind wrinkling, leathering and other aspects of “photo
aging.” The latest studies show that UVA rays not only increase UVB’s
cancer-causing effects, but also are indicated to cause some skin
cancers, including melanomas.
In the US, the FDA finally took steps to help protect consumers from
skin damage caused by excessive sun exposure in 2011. FDA made
changes to how sunscreens are marketed in the United States as part of
the Agency’s ongoing efforts to ensure that sunscreens meet modernday standards for safety and effectiveness and to help consumers have
the information they need so they can choose the right sun protection.
The 2011 final rule established labeling and effectiveness testing
requirements for certain OTC sunscreen products containing specified
active ingredients and marketed without approved applications, to be
codified in the Code of Federal Regulations.
It also amended to classify as new drugs, requiring premarket approval,
sunscreens labeled with certain claims (claims for ‘‘instant protection’’
or protection immediately upon application, or claims for ‘‘all day’’
protection or extended wear claims citing a specific number of hours of
protection that is inconsistent with the directions for application).
Prior rules on sunscreens dealt almost exclusively with protection against
sunburn, which is primarily caused by ultraviolet B (UVB) radiation
from the sun, and did not address ultraviolet A (UVA) radiation, which
contributes to skin cancer and early skin aging. After reviewing the
latest science, FDA determined that sufficient data are available to
establish a “broad spectrum” test for determining a sunscreen product’s
UVA protection. Passing the broad spectrum test shows that the product
provides UVA protection that is proportional to its UVB protection.
Sunscreen products that pass the broad spectrum test are allowed to
be labeled as “Broad Spectrum.” These “Broad Spectrum” sunscreens
protect against both UVA and UVB rays. Scientific data demonstrated
that products that are “Broad Spectrum SPF 15 [or higher]” have been
shown to reduce the risk of skin cancer and early skin aging, when
used with other sun protection measures, in addition to helping prevent
sunburn. Other sun protection measures include limiting time in the
sun and wearing protective clothing.
Clients should be educated on sun protection products that protect
them, and those who purchase products for salons and spas should also
learn how to choose products that actually work.
Chemical exfoliating lotions: The manicurist must choose two
chemical exfoliating lotions: one for professional use and one for selling
as home care. Chemical exfoliating lotions usually contain glycolic
acid (GA) or lactic acid (LA), the two most used alpha hydroxy acids
(AHAs) in skin care. AHA works by dissolving the outermost layers of
skin therefore encouraging cell turnover and bringing new, healthy cells
to the surface., making the skin look more youthful. They are marketed
as smoothing fine lines and surface wrinkles, improving skin texture,
cleaning pores, and improving skin condition.
Chemical exfoliation can be performed with 30 percent AHA products
or lotions with AHAs in them. The 30 percent AHA products are
usually too potent for the hands as are the 20 percent AHA lotions;
services are usually performed with 15 percent AHA hand lotions in
massage techniques.
●● Treatment: The lotion is rubbed over the skin for 3-5 minutes
then removed with a wet towel. A hydrating mask is applied and
allowed to set, then removed, and an SPF lotion is applied.
●● Home care: An exfoliating lotion, usually a 10 percent AHA lotion,
a moisturizing lotion and an SPF lotion.
These products are important in treatments and home care for dry skin,
callused skin, sun-damaged skin and in anti-aging. More information
is available on FDA’s website at http://www.fda.gov/Cosmetics/
ProductsIngredients/Ingredients/ucm107940.htm
Lightening lotion: The former term for lightening skin was “skin
bleaching,” but that term is no longer appropriate, according to the
FDA, unless there is hydroquinone in the formula of the product.
Hydroquinone is the only FDA-approved ingredient for skin
bleaching in salons and spas, sold in percentages of 2 percent and
below. Only medical offices can sell products with more than 2
percent hydroquinone.
In different concentrations hydroquinone inhibits or prevents skin
from making the enzyme responsible for triggering melanin, the chief
pigment that gives skin its color (Journal of Drugs in Dermatology,
March 2010, p. 215-218). Over-the-counter hydroquinone products
can contain 0.5% to 2% concentrations, with 2% being the most
effective OTC amount.
That ingredient, despite being banned in Europe, Asia, Africa and many
other nations, because of concerns for health issues allegedly caused
by its application, was allowed to be sold in the United States under a
“tentative final monograph” issued by the FDA in 1982. For those who
wish not to use products with hydroquinone, , it is time to look for other
lighteners, many of them proving, in new combinations and formulas, to
be better than hydroquinone, though some take more time.
Following are some ingredients that have proven good lightening
substances. Note that their action usually is centered around suppression
of tyrosinace, an enzyme required to produce melanin the skin.
●● Kojic is derived from koji, a Japanese mushroom. It lightens by
inhibiting the production of tyrosinase.
●● Mulberry is extracted from the roots of the paper mulberry
plant. It takes less mulberry/lower concentrations to lighten than
hydroquinone and kojic acid.
●● Alpha and beta arbutin are derived from the leaves of bearberry,
cranberry and blueberry plants and work like kojic acid, in that
they inhibit the production of tyrosinase. Alpha is stronger than the
beta arbutin, but is more likely to cause irritation.
Page 24EliteCME.com
●● Licorice root also works to inhibit the enzyme tyrosinase to
limit the amount of pigment produced. It has anti-inflammatory
properties, as well as lightening.
reduction of cuticles.) Some products in lower percentages are designed
for home care use to control fast growing cuticles and calluses and are
important home care products for these clients.
Callus remover: Actually softeners, these products make smoothing
and reducing calluses easier. Most of them contain sodium hydroxide, a
good tissue softener ingredient, but the formulation must also contain a
hydrator to counter its drying properties. Callus removers have greatly
improved in recent years, and hopefully will reduce the use of illegal
blades by manicurists during pedicures. It can also be used to soften and
reduce dead, hardened cuticles (eponychium) during services, though
the callus remover companies have not added it to their label directions.
(If so, this indicates they will not legally support its use in that manner
yet. Check the labels and contact the companies before using them in
Successful manicurists have found that they must know their
professional and home care products well; to produce the results that
bring clients back to them. They or the persons in charge of choosing
products must study the product ingredients, mentioning them in the
products and introducing them into their manicure and pedicures
services. New kinds of manicures and pedicures have been introduced
using these products, and properly trained manicurists are excited
about their new capabilities, in both meeting the needs of clients and in
the potential for making money.
Selling in the nail care department
Manicurists have never liked selling, nor have they done much of it.
The median sales percentage for nail salons and nail departments in
salons and spas is a pitiful 7.5 percent. This percent of sales indicates
that clients are forced to ask to purchase an item, and also that products
are not being recommended to them by manicurists. This is not selling.
It also indicates poor training in sales and in how to recommend
products, or that these salons and spas do not have products for them
to sell beyond polish, hand lotion and some fun items.
Manicurists are no different from skin care and hair professionals in
selling, though they usually believe they are, and most owners do also.
Some believe selling is “pushing products,” and when they sell products,
they are stealing from their poor clients who cannot afford them. That
simply is not true. The focus for all beauty professionals, including
manicurists, should be selling to needs, not pushing products. This, of
course, does not prevent bringing in fun products that might interest a
client, but the main focus should be meeting client needs.
To sell these items, the mind-set of most manicurists must be changed.
Sales of these items are not called retail sales; they are called “homecare sales.” Changing this and explaining the difference can raise the
percentage of sales in itself, though training still has to be performed.
The difference is obvious once it is stated: Retail items are those that
are picked up by clients just because they want them, not always
because they need them, such as a line of jewelry or purses in a salon.
Home care products in a salon are those that clients realize they need to
maintain or enhance service results. But the biggest difference between
retail and home care sales in salons is that home care sales come from
recommendations of a professional for a product that meets the needs of
the client in 1) improving or changing the client’s skin or nails as initiated
during the service, or 2) in maintaining or extending the condition of the
skin or nails or the change that has been achieved during the service.
Selling and success
Selling good home care products is a responsibility of manicurists,
and not for just the dollars they bring to the salon or spa. Clients spend
their money on a service they want to last more than 48 hours, and the
only way that is going to happen is if they take home the appropriate
products and instructions on how to use them. Disappointment in the
longevity of the service results, will adversely affect the retention of
a client. The products must be recommended, explained and sold.
One measure of whether a manicurist is meeting this responsibility is
defining the home-care sales percentage against production.
Experts say manicurists working in a salon or spa that markets and
brings in new clients should sell 40 percent of their production in
home care and, if so, their retention is excellent and their clientele
is growing at a good rate. At the same time, the salon or spa grows.
These manicurists will be fully booked in less than a year, possibly
much less.
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This is how that figure is found:
Determine the dollars in sold products, for example, $80
Determine the dollars brought in through services, for example, $200
Now divide the service dollars into the home-care sales dollars =
_________
200/ 80.00= 40 percent
If manicurists in a salon or spa, that markets externally, are selling
less than 30 percent, they are going to be booked, but not fully booked
with requests, as quickly as the one at 40 percent, and the department
will not grow as quickly. If there are not appropriate products on the
shelf to sell, manicurists and owners should define the reason and take
action. These manicurists (and the spa or salon) are not making the
money they should.
Manicurists working in a salon or spa that does not do external
marketing of the services will have fewer new clients, so their home
care sales percentage will be lower than in one where external
marketing is active..
Salon professionals should understand that home-care sales and client
retention are linked, according to the International Spa Association.
Clients who purchase home care products are more likely to return
to the salon or spa, and the more home care they purchase, the even
more likely they are to return and to remain a client. This indicates that
home care sales can initiate loyalty and the return of clients.
Ultimately, responsibility goes back to management. To attain these homecare sales, the manicurists must be 1) expected to sell, 2) trained in selling,
3) trained in the ingredients in their products, and 4) have the products to
recommend and sell on the shelves. If these are not conditions in the spa
or salon department, few, if any manicurists will reach their potential in 1)
home-care sales, 2) client retention, and 3) bringing in the optimal amount
of money for the salon or spa, or for themselves.
Many types of rewards are offered to interest manicurists in selling.
The traditional incentive is 10 percent of gross sales. But there are
others, such as education dollars, which a person can use for training
of their choice on the salon or spa when they have earned enough
points (sold enough dollars).
Another might be a trip of financial bonus when a certain dollar
goal is attained. Some salons use more immediate rewards, such as
gift certificates and other rewards for the highest producer of each
department in a certain timeframe. Rewards programs are limited only
by the imagination of the management of salons and spas.
Some experts in the industry dislike incentives, and believe beauty
professionals should recommend products because it is important to
client care. However, because it is clear that clients who purchase
products are more loyal and come in more often, while many others
believe it is as important to the service, as the protocols.
Page 25
Conclusion
Continuing education, beauty industry books and articles in trade
magazines all can empower the manicurist to learn about innovative,
as well as tried-and-true services, and their appropriate uses. They
also can help the beauty professional to formulate highly effective
treatment plans for their clients.
This knowledge, coupled with consistent analysis procedures, welldesigned protocols and good products for changing the skin will
perpetuate the beautiful results that clients’ desire. When that happens,
the manicurist’s books will be full, clients will be happy, and they and
the salon or spa will make the maximum amount of revenue.
References
1.
2.
3.
4.
5.
6.
Denver Evening Post, Classified Ad, Volume LXXIX, Issue 116, 18 May 1910, Page 1.
http://www.pedicuresandfootcare.com/pedicure-infections.html/
A Vietnamese American Dynasty, Feature Article, Nails Magazine, March, 2006.
http://regalnails.com/home/about_us.html
Mayo Foundation for Medical Education and Research
“The Skin Care Professionals Chemistry Ingredient Handbook,” Laura Root, Esthetic Education
Resource, Mesa, AZ.
7.
8.
9.
“Spa Manicuring for Salons and Spas,” Janet McCormick, Milady Publications.
“Nail Structure and Product Chemistry” Second Edition, Doug Schoon, Milady Publications.
Federal Drug Administration (FDA)(2015). Understanding over-the-counter sunscreen products
marketed in the U.S. Retrieved from website http://www.fda.gov/Drugs/ResourcesForYou/
Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm258468.
htm#Q3_What_does_the_SPF
SKIN CARE ESSENTIALS AND THE NEW MANICURE/PEDICURE final exam
Choose the best answer for the following questions and take your test online at EliteCME.com.
13.With this new treatment philosophy, ______________are the
focus, not the services, and it is central to the success of the
service, not the resulting beautification – although that is also the
result of this focus.
a. Client nails and feet.
b. Clients and their needs.
c. Clients and skin type.
d. Clients and their income.
16.The manicurist, who has expanded manicures and pedicures
to include the skin care, will be working with the _________,
the layer of the skin that maintains softness and elasticity when
healthy, and reflects damage, when not healthy.
a. Epidermis.
b. Subcutaneous.
c. Dermis.
d. Hypodermis.
14. Clients that should not have soak manicures / pedicures are at-risk
clients because they _____ slowly.
a. Heal.
b. Move.
c. Are infected.
d. Sickly.
17. What is the home care treatment for a client with “lacy nails”?
a. Nail strengthener applied.
b. Use oil on surrounding skin.
c. AHA lotion.
d. Hydration.
15. The skins structure is comprised of layers: the top layer is called
the __________.
a. Dermis.
b. Subcutaneous tissue.
c. Arteriole.
d. Epidermis.
18. When purchasing a gel or serum, look closely at the list of ingredients
for ______– usually it is there somewhere, and can counter the
moisturizing property if it is used, in excess, by the client.
a. Salt.
b. Alcohol.
c. Peptides.
d. Hyaluronic acid.
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