A North Carolina woman claiming to have been hospitalized for a disease that occurred during a routine pedicure is a case of multiple questions the safety when making nails raises.

Last year, several nail salons in Indiana were fined and put on probation after a man was amputated after a pedicure. The instrument in question was a callus cutter, a razor that scraped off hard skin from the soles of the feet. The devices, which are not approved for salon use in some states (including Indiana and North Carolina), are just one of many ways people can get an infection in a nail salon.

And it's not always obvious how bacteria and fungi can wreak havoc. Rachel Miest, assistant professor of dermatology at Mayo Clinic, said even shaved legs or cut cuticles could seriously increase the risk of infection. Note: Serious infections with nail salon services are rare, she said.

The following should be known to you before you receive a manicure or pedicure:

Come hairy

OK, you do not have to walk with furry legs into the salon, but avoid shaving them right before a pedicure. Shaving causes micro-cracks in the skin that increase your chance of infection, Miest said.

New Files and Buffers Only

All salon tools should be new or sanitized before touching your hands or feet. This means that technicians should open a package or draw tools from a sanitizing solution (usually a blue liquid). New nail files and buffers should be used for each client as there is no way to clean them up completely. According to the North Carolina Board of Cosmetic Art Examiners, only non-porous tools can be properly disinfected. States are responsible for enforcing sanitation guidelines in nail salons, but that does not necessarily mean that inspectors often turn up. A CBS subsidiary in Atlanta pointed out last year that only 12 inspectors are responsible for overseeing each nail salon in the state of Georgia.

About these Pedicure Basins

Watch out for the Pedicure Spa Basin before putting your feet into it. Salons should disinfect them after each use. The EPA recommends that a hospital disinfectant should sit in the basin for approximately 10 minutes to kill bacteria; and if it is a hot tub, the cleaner should circulate throughout the unit. After disinfection, the basin should be drained and rinsed with clean water. Some government regulations require salons to flush whirlpools with bleach every week and hold the bleach for more than eight hours, EPA notes. If you are not clear about the cleaning practices of a salon, it does not hurt to ask.

Save the Cuticle

Cutting the cuticles is routine in most manicures and pedicures. The practice has no use apart from cosmetic (if cut, a thin cuticle is on the back of the nail bed and there is more nail to polish). The cuticle itself protects the nail and skin around the nail from infection, said Miest. Cutting the cuticle welcomes the infection. She recommends that technicians push back cuticles, but do not cut them.

paper cut? Cancel your appointment

Do not go to a nail salon if you have cuts, scratches or open wounds. Also keep your athlete's foot (yes, it is contagious) mushroom away from these pedicure shells. Salon workers should also inspect customers' feet and legs before services, the EPA notes. Feet and legs are at a higher risk of developing an infection, Miest said.

You may have an infection if …

Your skin is red or sensitive. A fever may also be a sign that you have taken something other than a hot pink tone, and you may want to call your family doctor, Miest said.

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