It's open-toed shoe season and that can only mean one thing — it's time to give your toes some TLC. Before you book your next nail salon appointment to show off your clean and pretty feet in a pair of sandals or strappy heels, it's essential to follow good pedicure care. In 2012, the nail-care industry saw a record-breaking growth of $7.47 billion in nail services with 32 percent of salons providing a new service, reports the 2012-2013 The Big Book — a compilation of market research conducted by Nails Magazine. While the cost for a standard pedicure can cost anywhere from $20 to $50, the cost of your health is priceless. The American Academy of Dermatology (AAD) says getting a pedicure can have some health risks such as fungal infections, athlete's foot, nail fungus, bacterial skin infections, and a potentially serious staph infection. Moreover, extra precaution is taken now after an outbreak of mycobacterium fortuitum furunculosis — boils on the feet and legs caused by the mycobacterium often associated with whirlwind footbaths in nail salons in 2000.

In a study conducted in five large counties in California, nail salons across the state were randomly selected to participate in a survey by a team of regional investigators of the California Bureau of Barbering and Cosmetology and a local public health professional. Footspa equipment, cleaning solutions, and cleaning methods and frequency were under review by the state health bureau, in addition to the collection of swab samples. Investigators tested each swab for mycobacteria at the California Microbial Disease Laboratory and found that nontuberulous mycobacteria in 29 footspas, and from 15 footspas, one or more mycobacterium species were isolated or found. The survey found that all pedicure spas had mycobacterium that was isolated except for one footspa that had only been in service for 11 days. Adequate safety measures should be taken by pedicurists to ensure good health in all their customers.

Debra Jaliman, M.D., New York Dermatologist and Assistant Professor of Dermatology at the Mount Sinai School of Medicine told Medical Daily, "I have seen fungal toenail infections, bacterial infections of the nail (paronychia) and even viral infections (herpes simplex)." A common misconception by nail salon customers is that if they pay more for the service, then it must be more hygienic in comparison to less expensive salons. "Just because a salon is expensive doesn't mean it's sterile," said Jaliman. Unsanitary tools and contaminated footbaths are the primary causes of why you can walk out of the salon nail with an infection. To lessen the likelihood of an infection occurrence, here are some pedicure care safety tips to follow before you book your next nail salon appointment.

Pre-Pedicure Safety

Time of Day

When you plan your next pedicure visit, be sure to schedule it during the morning hours. The American Podiatric Medical Association (APMA) reports that pedicure tools and footbaths are the cleanest at the beginning of the day where the volume of clients tends to be relatively low. However, if you are simply not a morning person, be sure to track the gap between appointments. The United States Environmental Protection Agency (EPA) says a foot spa should be disinfected between each customer and at night. A typical disinfectant takes effect 10 minutes after it is applied to the whirlwind foot spa, so be sure your pedicurist disinfects accordingly.

Skip The Leg Shave

While legs are the prime area of exposure at a nail salon, it can be hard to bare your legs with stubble. Skipping a shave 24 hours before your next pedicure can prevent the spread of infection. Shaving can create small, microscopic cuts on your legs that can invite bacteria in the body when you get a pedicure, says the International Pedicure Association (IPA). Skipping the leg shave does not mean to practice poor hygiene on the rest of your body. Barbara Bergin, M.D., Orthopedic Surgeon in Austin, TX said to Medical Daily, "Be sure your skin is clean when you go there. Wipe down your feet with the same gel we use on your hands."

Pedicure Safety At The Salon

Bring Your Own Pedicure Tools

While nail salons are fully equipped with the proper tools to do a pedicure, you can limit the risk of infection by bringing a few tools of your own. Pedicure instruments should be sterilized after every use but the effectiveness of this procedure is limited because these items are not always sterilized correctly. Nail buffers, filers, and pumice stones are items not sterilized and can increase the risk of infection from person to person. These tools are often not discarded after just one use for one customer so it is safe to invest in some for your own use. Bergin suggests customers to bring their own clippers but to be sure to sterilize them with alcohol because even your own skin bacteria can infect your skin.

Say No To Cuticles Cutting And Razors

On your next visit, if your pedicurist asks to cut your cuticles, say no. Cutting your cuticles will only produce thickened cuticles, says the AAD. Instead, ask that your cuticles be pushed back using an orange wood stick cuticle pusher to clean your nails. "Don't allow for aggressive cuticle clipping," said Bergin to Medical Daily. "If you often notice that you have small nicks on your cuticles, find another salon or ask them to cut less of." "We need our cuticles and it's not good to cut them back too far."

Razors should not be utilized to work on calluses. A pumice stone, preferably your own, should be used because the use of a credo blade can cut healthy skin and build up thick layers of skin that can cause further foot damage. The entire callus will be removed if a credo blade is used, says Aesthetics By Rachel. The callus will grow back thicker and thicker every time a callus is removed.

Know Your Disinfectants

On your next pedicure visit, be sure to know which disinfectants are used in the foot spa. The disinfectants should have a label that says they are approved for hospital use and shows that it is EPA-approved. The EPA suggests nail salon clients to not use a foot spa if they have any uncertainty on whether or not it is disinfected and safe to use. If you see poor nail salon practice, it is important to contact your state's cosmological board to report health concerns.

Failure to take pedicure care safety precautions can result in poor health. If you see any redness or warmth around your fingers or toes after getting manicure or pedicure, Bergin suggests to go to the emergency room because these infections can spread quickly, requiring surgery. "When they're caught early they can usually be treated with antibiotics," she said.

Diabetics should always inform nail technicians of their condition so that they can take the proper precautions to ensure a safe and healthy pedicure experience for clean and pretty feet.