When Kate Kelso scheduled a routine pedicure at a nearby nail salon, she expected nothing more than a little pampering.
The North Carolina college student visited the salon regularly and had never encountered a problem.
That changed about a week later, when a small red bump appeared on her left calf. At first, it did not seem serious.
Kate, now 41, initially assumed it was a spider bite. ‘At first, I just put a bit of concealer on it to disguise it before leaving the house,’ she recalled.
When the swelling grew and the pain intensified, however, she sought medical attention.
Over the next year, doctors performed at least 10 biopsies while trying to determine the cause of what they believed was an infection.
Several rounds of antibiotics had no effect. Eventually, the skin surrounding the area turned black, indicating that the tissue was dying—a condition known as necrosis.
As the condition continued to deteriorate, doctors concluded that surgery was necessary.
Kate Kelso, pictured above, told Our News Outlet that she contracted MRSA from a local nail salon while she was in college
‘The last thing I remember is the doctor saying I’d be left with just a two-inch scar and would recover quickly,’ Kate said.
Instead, the procedure was much more extensive than expected, leaving a 14-inch scar along her calf.
Doctors eventually diagnosed methicillin-resistant Staphylococcus aureus, or MRSA, a potentially serious bacterial infection. Kate believes she picked it up from a footbath at the salon.
In her view, the bacteria may have been living in the bath’s filtration system, allowing it to survive routine cleaning.
‘It took a year of my life, and I still have the scar to prove it,’ she said.
‘Sometimes, when people ask what the scar is from, I tell them it was a shark bite or a knife fight. It’s ridiculous that I got it simply by trying to make my toenails look cute.’
Millions of Americans visit nail salons each year, supporting an industry that generated more than $13 billion in revenue in 2024 alone.
Most manicures and pedicures are completed without complications, but dermatologists caution that inadequate hygiene can expose customers to serious infections.
There is no dependable national tally of infections associated with manicures and pedicures, although outbreaks have sometimes involved large numbers of clients.
Earlier this year, a Portland woman sued PDX Nails and Lashes, alleging that she developed herpes after receiving acrylic nails and a hand massage. She claimed the technician was not wearing gloves.
According to the woman’s claim, a burning and stinging feeling developed along her right pinky finger the day after the appointment, followed by a painful, itchy blister.
The allegations were not established in court. A different client made a similar claim against the same salon in 2023; that case was later settled for an undisclosed sum, with no reported finding of liability.
Herpes transmission during a manicure is extremely uncommon, although the virus can infect the fingers as well as the genitals.
In one serious California outbreak, 110 customers developed persistent skin infections after visiting the same salon. Investigators later found potentially harmful bacteria in each of its 10 whirlpool footbaths.
A separate review of 18 California nail salons detected similar bacteria in 29 of the 30 footbaths examined.
Even so, finding bacteria does not automatically mean that every customer will become infected.
The risk increases when bacteria or other microorganisms enter through tiny cuts or abrasions. These breaks in the skin may result from cuticle trimming, aggressive filing or shaving the legs shortly before a pedicure.
Kate, pictured here, now paints her own nails in an effort to reduce the risk of another infection
‘Cuticle cutting is one practice I advise against,’ said Dr Shamsa Kanwal, a consultant dermatologist at My Psoriasis Team.
‘The cuticle forms a protective seal between the nail and nearby skin. Removing it creates an entry point for bacteria.’
Pedicure baths—often small whirlpool-style spas used to soak and soften the feet—are a particular concern. Bacteria can collect in their jets, filters and pipes, where it may be difficult to eliminate without thorough cleaning and disinfection.
Nontuberculous mycobacteria are among the organisms associated with outbreaks. These bacteria are commonly found in water and soil and can cause persistent skin infections that sometimes require months of treatment.
YOU MIGHT ALSO LIKE: Lisa Bessette: Carolyn Bessette’s Sister Makes First Public Appearance in Nearly Three Decades: A Rare Glimpse
Footbaths are not the only salon equipment that can harbor harmful microorganisms.
Reusable tools such as nail clippers and cuticle cutters can spread bacteria, fungi and viruses from one customer to another if they are not cleaned and disinfected correctly.
Dr Kanwal also warns that shared nail-polish brushes could potentially transfer infection if they touch an infected nail.
Experts recommend postponing a pedicure if you have cuts, scratches or insect bites on your feet or lower legs. They also advise against shaving for at least 24 hours beforehand because shaving can create tiny breaks in the skin.
‘Avoid pedicures when there are cuts or bites on the lower legs,’ Dr Debra Jaliman, a dermatologist and assistant clinical professor at the Icahn School of Medicine at Mount Sinai in New York City, told Our News Outlet.
Possible signs of infection include redness, swelling, warmth, worsening pain and pus around the affected area.
An infection linked to a contaminated footbath may initially look like an insect bite before developing into a painful sore that continues to enlarge.
Gel nail products contain chemicals that may pose health concerns, particularly for workers exposed to them throughout the day
People with weakened immune systems face a greater risk of serious complications, although healthy customers can also develop infections.
Nail salons present another potential health issue: the chemicals found in polishes, gels, acrylic products and removers.
Some of these products give off fumes that can irritate the eyes, skin and respiratory system.
The greatest concern is often for nail technicians, who may inhale chemical vapors and fine dust for hours each day.
A recent study in the journal Risk Analysis analyzed air in five New York City nail salons and detected benzene, a cancer-causing chemical associated with diseases including leukemia.
However, detecting a carcinogen does not by itself show that exposure levels are high enough to create a significant cancer risk, especially for customers who visit only occasionally.
‘I’m particularly concerned about nail technicians, who inhale chemical vapors and filing dust throughout their working day,’ Dr Kanwal said.
‘Long-term workplace exposure to certain chemicals raises additional reproductive and cancer-related concerns, although an occasional manicure should not be considered equivalent to chronic occupational exposure.’
Ultraviolet lamps used to cure gel polish are another potential concern.
The lamps emit ultraviolet A radiation, the same type found in tanning beds, which can penetrate the skin and damage DNA.
In a 2023 study published in Nature Communications, researchers found that UV nail dryers caused DNA damage and mutations in human and mouse cells grown in a laboratory.
The results do not prove that using these lamps raises the risk of skin cancer in people, and experts consider the risk from occasional use likely to be low.
Still, dermatologists suggest applying a broad-spectrum sunscreen with an SPF of at least 30 to the hands before treatment, or wearing fingerless gloves designed to protect against ultraviolet radiation.
Despite these potential hazards, dermatologists say people do not need to abandon manicures and pedicures entirely. A few precautions can help reduce the risks.
‘Choose a salon with good ventilation and clear evidence that its tools are disinfected properly,’ Dr Kanwal advised.
‘Ask for disposable files and buffers, and check that reusable metal instruments have been properly sterilized.’
Experts told Our News Outlet that customers may consider bringing their own tools and rescheduling an appointment after shaving
Dr Jaliman also recommends bringing personal nail tools and asking technicians to leave the cuticles intact.
Customers should ensure that pedicure baths are thoroughly cleaned and disinfected between appointments, paying particular attention to the jets and filters where bacteria can collect.
If you have cuts, broken skin or signs of infection on your hands, feet or lower legs, postpone the appointment until the area has healed.
‘Also avoid foot soaks if you have open wounds or shaved your legs immediately before an appointment, since this can increase the risk of infection,’ Dr Kyle Hoedebecke, clinical advisor at Care Point Boston, told Our News Outlet.
Finally, seek medical advice if unusual swelling, painful lumps or sores develop after a salon visit—particularly if they worsen or do not heal.
Serious infections are uncommon, but spotting the warning signs early may help prevent lasting damage.
