When Kate Kelso arranged a routine pedicure at a nearby nail salon, she expected nothing more than a little self-care.
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, she barely gave it a second thought.
Assuming it was a spider bite, Kate, now 41, says she simply covered it with concealer before heading out.
But the swelling grew, the pain intensified and the mark failed to disappear, prompting her to seek medical advice.
During the next year, doctors performed at least ten biopsies as they tried to determine the cause of what they initially described as “an infection.”
Several rounds of antibiotics brought no improvement. Eventually, the skin surrounding the wound turned black, indicating that the tissue was dying—a condition known as necrosis.
With her condition continuing 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 when she was in college
“The last thing I remember is the doctor telling me I would have a two-inch scar and recover quickly,” Kate recalls.
Instead, the procedure was much more extensive, leaving her with a scar measuring 14 inches along her calf.
Doctors ultimately diagnosed methicillin-resistant Staphylococcus aureus, or MRSA, a potentially serious bacterial infection. Kate believes she picked it up from the foot bath at the salon.
She suspects the bacteria had survived inside the bath’s filtration system, despite the salon’s routine cleaning.
“It took a year of my life, and I still have the scar to prove it,” she said.
“When people ask what happened, I sometimes tell them it was a shark bite or a knife fight. It feels absurd that I got it simply from wanting cute toenails.”
Millions of Americans visit nail salons each year, helping drive an industry that generated more than $13 billion in revenue in 2024.
Most manicures and pedicures are completed without complications. However, dermatologists caution that inadequate hygiene can expose customers to serious infections.
There are no dependable nationwide statistics tracking infections associated with nail treatments, but documented outbreaks have sometimes involved numerous customers.
Earlier this year, a Portland woman sued PDX Nails and Lashes, alleging that she contracted herpes after receiving acrylic nails and a hand massage. She claimed the technician was not wearing gloves.
According to the woman, a burning and stinging feeling developed along her right pinky the day after the appointment, followed by a painful, itchy blister.
Her allegations have not been proven in court. Another client brought a similar claim against the 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 affect the fingers as well as the genital area.
In a more severe outbreak at a California salon, 110 customers developed long-lasting skin infections after visiting the business. Investigators later found potentially dangerous bacteria in each of its ten whirlpool footbaths.
In a separate review of 18 California nail salons, similar bacteria were found in 29 of the 30 footbaths examined.
Still, finding bacteria in a footbath does not automatically mean every customer will become ill.
The risk increases when bacteria or other microorganisms enter the body through tiny cuts and abrasions. These breaks can result from cuticle trimming, aggressive nail filing or shaving the legs shortly before a pedicure.
Kate, pictured here, told Our News Outlet she now paints her own nails to lower her risks of another infection
“Cuticle cutting is one practice I recommend avoiding,” says Dr Shamsa Kanwal, consultant dermatologist at My Psoriasis Team.
“The cuticle forms a protective barrier between the nail and the surrounding skin. Removing it creates a potential entry point for bacteria.”
Pedicure baths—often small whirlpool spas used to soak and soften the feet—are a particular concern. Bacteria can collect in their jets, filters and internal pipes, which may be difficult to clean and disinfect thoroughly.
Some outbreaks have involved nontuberculous mycobacteria, bacteria commonly found in soil and water that can cause persistent skin infections and may require months of treatment.
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Footbaths are not the only potential source of harmful microorganisms in a nail salon.
Reusable equipment, including nail clippers and cuticle cutters, can pass bacteria, fungi and viruses from one customer to another if it is not properly cleaned and disinfected.
Dr Kanwal also warns that shared nail-polish brushes could potentially spread infection if they touch contaminated nails.
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 before an appointment because shaving can create tiny breaks in the skin.
“Do not have a pedicure if you have cuts or bites on your lower legs,” Dr Debra Jaliman, a dermatologist and assistant clinical professor at Icahn School of Medicine at Mount Sinai in New York City, told Our News Outlet.
Redness, swelling, warmth, worsening pain and pus around the affected area can all signal an infection.
Infections linked to contaminated footbaths may initially look like insect bites before turning into painful sores that gradually enlarge.
Gel nail polish can contain chemicals linked to serious health issues, especially for workers breathing them in all day
People with weakened immune systems face a higher risk of serious complications, although healthy people can also develop infections.
Nail salons present another possible health concern: the chemicals used in polish, gel products, acrylic nails and removers.
Some of these products give off fumes that may irritate the eyes, skin and respiratory system.
The greatest concern is often for nail technicians, who can spend hours each day breathing chemical vapors and fine filing dust.
A recent study in the journal Risk Analysis tested the air in five New York City nail salons and detected benzene, a cancer-causing chemical linked to leukemia.
However, detecting a carcinogen does not by itself show that exposure is high enough to create a substantial cancer risk, especially for customers who visit only occasionally.
“My main concern is nail technicians, who may 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. That exposure should not be compared directly with an occasional manicure.”
UV lamps used to cure gel polish are another subject of concern.
The lamps emit ultraviolet A radiation, the same form of UV light associated with tanning beds, which can penetrate the skin and damage DNA.
In a 2023 study published in Nature Communications, researchers reported DNA damage and mutations in human and mouse cells exposed to UV nail dryers in laboratory conditions.
The research does not establish that using these lamps causes skin cancer in people, and experts say the risk from occasional exposure is probably low.
Even so, dermatologists suggest applying a broad-spectrum sunscreen with an SPF of at least 30 to the hands before a gel treatment or wearing fingerless UV-protective gloves.
Dermatologists say these risks do not mean people must abandon manicures and pedicures. A few practical precautions can help make salon visits safer.
“Choose a salon with good ventilation and clear evidence that its tools are disinfected properly,” Dr Kanwal said.
“Request disposable files and buffers, and ensure that reusable metal instruments have been properly sterilized.”
Experts told Our News Outlet that nail salon goers should consider bringing their own tools and rescheduling their appointment if they just shaved
Dr Jaliman recommends taking personal nail tools to the appointment and asking the technician to leave the cuticles intact.
Customers should also confirm that pedicure baths are cleaned and disinfected between appointments, paying particular attention to the jets and filters where bacteria may collect.
If you have cuts, broken skin or signs of infection on your hands, feet or lower legs, it is safest to wait until the area has healed before returning to the salon.
“Avoid foot soaks if you have open wounds or have shaved your legs shortly before the appointment, since both situations can increase the risk of infection,” Dr Kyle Hoedebecke, clinical advisor at Care Point Boston, told Our News Outlet.
Experts also advise contacting a medical professional if unusual swelling, painful lumps or sores develop after a salon visit—especially if the symptoms worsen or fail to heal.
Serious infections remain uncommon, but identifying the warning signs quickly can help prevent permanent damage.
