Spa Safety for People With Diabetes

How to avoid nicks and cuts that can cause infections.

Medically Reviewed by Michael Dansinger, MD on December 27, 2014
From the WebMD Archives

What’s more relaxing than soaking your feet and getting a pedicure? If you have diabetes, you'll have more peace of mind if you take precautions to avoid nicks or cuts on your skin at the spa or salon. You'll also lower your odds of getting an infection.

“Your blood flow is reduced, and even a small cuticle cut can get infected,” says Chuck Collins, 66, of Atlanta. Collins has type 2 diabetes, but he doesn't let that stop him from visiting a nail salon every 2 weeks for a pedicure.

To stay safe, Collins bought a set of his own nail-care tools, such as files and cuticle sticks, for his specific use at the salon.

“They do not use my tools on anyone’s hands or feet. And when I come in, I insist that they sterilize the bowl before I put my feet in,” he says, adding that they know he has diabetes.

Look for Cleanliness at Salons and Speak Up

In general, it’s safe to get manicures or pedicures at a spa or nail salon if you have diabetes that's well-controlled, says Fred Williams, MD. He's a clinical endocrinologist in Louisville, KY. But choose carefully before you get services somewhere.

“The general rule of thumb is that there are really good places to get a pedicure and there are bad places,” Williams says. “Talk to someone you know who has been to that particular spa. Make sure they practice good hygiene, that their soaking solutions are changed frequently, and their instruments sterilized before each use. If the salon doesn’t seem quite right or doesn’t look clean, don’t go back.”

Always tell your nail technician or any spa-service provider that you have diabetes. This lets them know to use extra care while pampering you, even if you don’t feel anything is wrong, says Brent Bauer, MD. He is the medical director of the International Spa Association.

“Patients with diabetes often have special health challenges in addition to diabetes, such as heart disease, poor circulation, or nerve damage. So patients with diabetes who have nerve damage in their feet might not be able to feel pain during a pedicure. So they may be less able to give feedback to the technician,” Bauer says.

Risky Nicks and Cuts

Because diabetes can cause poor blood flow to your limbs, it’s harder for white blood cells to reach small wounds so they can heal properly. If your nail technician nips your cuticle or rubs too roughly on your heel to remove dead skin, you can get a small wound that turns into a serious infection, Williams says.

Ingrown toenails may also lead to foot infections, so it’s important to keep your nails trimmed and filed. If your blood sugar isn't well-controlled, or if you have damage to your nerves (diabetic neuropathy), be careful when trimming your nails. Also tell your technician to be cautious before they give you manicures or pedicures at a salon.

“You can cut your nails way too short, and can cut the soft tissue around your nails,” Williams says. “For someone with diabetes with complications like neuropathy, this can open the door to infection. Use caution with scissors or clippers, or using anything that can cut or lacerate your skin.”

If you don’t feel comfortable trimming your own nails or going to a salon or spa, ask a podiatrist to do it instead, Williams says. Podiatrists are doctors who specialize in foot care and treating foot diseases. A nurse practitioner or physician assistant at a podiatry clinic might also safely trim your nails, he adds.

Collins skips his salon pedicures if he sees any sign of a cut, scrape, or wound on his feet, he says. He works at a retail furniture and design store, “so I am on my feet all day. My doctor told me that I don’t want to bruise or cut my feet, so I should be careful,” he says. “I go to my podiatrist to get my nails trimmed if anything doesn’t look right.”

Tips for Safe Spa Visits

Ronnie Oller, 67, has type 1 diabetes and severe damage to her nerves. The Florida resident does visit a local nail salon for manicures and pedicures on occasion, but like Collins, she takes her own tools with her to avoid contact with other patrons’ fungus or tissue. She has lost fingernails and toenails after skin infections, she says.

“In the past, I wouldn’t go for a pedicure, because I thought, ‘I don’t need the trouble of getting an infection.’ Then I started going once a month for my feet and twice a month for my fingernails. I’m not afraid to speak up and tell them I have diabetes.”

Here are some safety tips for your next salon or spa visit:

  • Tell the spa or salon owner, or your aesthetician, that you have diabetes before you begin any service. Talk to the staff about any concerns you have or precautions you need to take.
  • It’s safe to use tools like a pumice stone or sanding surface to remove dead skin from your heels. Be gentle, though. Avoid using metal scrapers to remove skin.
  • If you have corns or calluses on your feet, tell your technician to gently rub or smooth them rather than cutting them or using any liquid callus remover.
  • Make sure soaking water is not too hot to avoid burns you might not be able to feel. The water should be between 90-95 F. Ask the technician to test it before you put your feet in.
  • Tell your nail technician to trim your nails with a clipper and then file them smooth with an emery board.
  • Ask if soaking tubs and tools are washed and sterilized after each person’s use. If a salon or spa doesn't seem clean, don’t go there.
  • Tell your nail technician to never cut into the corners of your toenails. This might cause an ingrown toenail and an infection.

Show Sources


Fred Williams, MD, Endocrine and Diabetes Associates, Louisville, KY.

Brent Bauer, MD, medical director, Rejuvenate Healthy Living Program, Mayo Clinic, Rochester, MN; medical director, International Spa Association.

Chuck Collins, Atlanta.

Ronnie Oller, Ft. Lauderdale, FL.

American Diabetes Association: “Foot Care.”

Diabetes UK: “Myths About Diabetes.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Prevent diabetes problems: Keep your feet healthy.”

Houston Methodist Multidisciplinary Limb Center: “Conditions and Treatments: Diabetic Foot Wounds.”

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