Last reviewed by Faculty of Harvard Medical School on January 14, 2013
Our mothers lived in a time when many women felt that it was better to look good than to feel good. These days, we can have both. Beauty salons and day spas not only offer hair, makeup and nail treatments, but also address the well-being of the inner you through aromatherapy and massage. Since more of us are taking advantage of this pampering, it's important to address health and safety concerns at the beauty salon. During the last few years, I have collected some interesting health questions about day-spa services from my hairdresser, patients and fellow female physicians.
Should we worry about infections during a manicure or pedicure?
Since a manicure or pedicure involves close skin contact and tools that can break the skin or cause bleeding, infection must be a concern. In particular, HIV and hepatitis B and C are among the more serious infections that can be transmitted. Fortunately, there have been no substantiated reports of these infections contracted through nail salons. However, bacterial infections have been contracted from pedicure baths. For example, leg-boil skin infections can occur from pedicure whirlpool baths, although this is quite rare.
There are no studies proving that warts or nail fungus are transmitted through manicures or pedicures, but it is possible. While fungal infections of the nails are generally harmless (unless you have diabetes), this difficult-to-treat infection discolors and thickens nails. Contaminated pedicure instruments potentially could increase the risk of infection. So the safest approach is to wear your own flip-flops or throw-away slippers in the gym or spa, and make sure the nail technician observes the following guidelines:
- All instruments should be cleaned with soap and water and then disinfected. They should be soaked in a federally sanctioned disinfectant that kills bacteria, viruses and fungi. Barbicide is a commonly used agent. Actually seeing the tools soak in Barbicide before use on your nails is reassuring.
- Whirlpool footbaths should be regularly cleaned. The inlet screens should be cleaned regularly as well as the baths themselves. At regular intervals, the baths should be cleaned with bleach.
- The nail cuticle should not be cut. Your cuticle should only be pushed back gently. The cuticle protects you from infection, and any breaks in the skin here promote infection and bleeding.
- Razors should not be used on calluses. In fact, razors should not be used at all.
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Can hair dyes increase my risk of cancer?
This question came from a statement my mother made, as if it were a well-accepted fact. She said, "Well, it's good you don't have to dye your hair now — that way you'll lower your cancer risk because you'll be older when you start."
Since I didn't recall that particular lecture in medical school, I gave my mother the benefit of the doubt and searched the medical literature for references to hair dye and cancer. There have been several studies that looked at the association between hair dye and blood cancers, as well as breast cancer. None have confirmed an association. Of course, as I have found with most other things, I was unable to convince Mom that medical science actually found something to be safer than she thought. Nonetheless, she still dyes her hair.
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Why is my hair falling out?
My hair stylist asked me to type out an answer to this question that he could give to clients, because it is the most frequently asked question he receives. Specifically, he has found this a frequently noted symptom among women about two to six months after delivering a baby. He has tried to explain to them that it was due to the stress of pregnancy and delivery, but he was unable to explain why the hair loss took place so long after the delivery.
The condition he is describing is called telogen effluvium. Your normal hair cycle allows for growth, then a resting phase (telogen) before a new hair grows and pushes the resting hair out. Usually, only a few hairs are in the resting phase at a given time. The shock of severe illness, extreme weight loss, or the hormonal changes of pregnancy or menopause or thyroid disease, stuns many hairs into the resting phase.
When growth resumes two to four months later the new hairs push out the resting hair. Since so many hairs are in the resting phase, the result is more obvious loss of hair. This type of hair loss is not patchy or similar to male-pattern baldness. Women might notice more hair clogging the tub or shower drain or in the hairbrush, but will not experience bald patches or a receding hairline.
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Are there any services that should be avoided during pregnancy?
When I recently indulged in an aromatherapy massage, the therapist asked me, "Before I begin, I need to know if you might be pregnant." I was amused by this question, hoping it didn't refer to my post-holiday weight gain. Then I had a flashback to an alternative-medicine seminar I attended, in which an aromatherapist pointed out, with a dramatic pause and an arch of her eyebrow, "These therapies must be used with caution. Eucalyptus can kill a child," and possibly be dangerous, I supposed, to a fetus.
I began to wonder how safe alternative therapies are for pregnant women. In the case of massage, lying on one's back in the second or third trimester can reduce blood flow to the uterus. Your massage therapist may suggest different positions during that time. In the case of marketed prenatal massage and yoga, in addition to targeting key areas of the body strained by pregnancy, different positions should be used to avoid lowering blood flow to the uterus. Make sure you ask before you book the appointment.
Herbal therapies, whether supplements or skin treatments, can have toxic effects. Although many health claims are made for them, they are not as well studied or heavily regulated as prescription drugs are, so it is best to avoid them during pregnancy.
After a colleague asked me about hair dye and pregnancy, I quizzed my trusted hair stylist of 10 years. After I squelched his excitement that I might be pregnant, he turned on his official voice, saying that while "they" don't know for sure, "they" don't recommend dyeing hair during the first trimester, the fetus' key organ-forming period.
As it turns out, this is what most medical professionals will advise as well. Studies looking at populations of women and their children have not linked birth defects to hair dye, permanent waves or relaxation treatments. But since we cannot directly experiment with pregnant women to test this observation, you also can make the argument that the safest approach is to avoid these treatments in the first three months of pregnancy. But you should feel reassured that if you had any of these treatments before you found out you were pregnant, or if you want to continue them during your pregnancy that there is no information that these treatments pose a danger.
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First, consider the salon that you use. Make sure it displays a certificate from the local Board of Cosmetology and that the place looks clean. Consider splurging for your health's sake at a reputable establishment rather than getting discounted services somewhere smaller.
If you are pregnant or trying to become pregnant, you need to evaluate anything that you do that involves chemical or even herbal or "natural" products. You can also start investigating at home, on the Internet. The National Institutes of Health-sponsored MedlinePlus (www.nlm.nih.gov/medlineplus) is a valuable consumer resource.
Finally, don't forget to consider your health care professional as a resource.
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Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.