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Originally published Thursday, August 2, 2012 at 6:00 AM

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Manicures and other beauty rituals may come with health risks

Skin Deep: Don't let a spray tan, waxing, extensions or a pedicure leave you with a visit to the hospital.

The New York Times

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When Byl Thompson ran into a nail salon in Manhattan a couple summers ago for a quick manicure, he got more than just a simple buff and file.

Twenty-four hours later, he was in Mount Sinai Hospital with two intravenous drips in his arm, recovering from a staph infection he contracted though a nick from cuticle clippers during the service.

"Little did I know that it was something that would compromise my life," said Thompson, 46, a fashion and entertainment marketing executive who lives in Harlem.

It's far from glamorous, but many salon beautifiers — particularly the ones that are most popular this time of year, like nail treatments, waxing and eyelash and hair extensions — carry real health risks.

"With a lot of these, it's rare for it to happen, but when it does, you really need to be aware of what to look for and be prepared," said Dr. Joshua Zeichner, director of cosmetic and clinical research in the dermatology department at Mount Sinai, who did not treat Thompson.

New York State's nail salon regulations require the disposal of most items used to stop the flow of blood (although not liquid bandage, which Thompson said the salon used on him). The rules are also clear about using hospital-grade disinfectants on tools, and sterilizing them for at least 10 minutes. But with high turnover and (frequently) very low prices, it's easy to understand how some salons let their standards of cleanliness slip.

Clients also often inadvertently put themselves at more risk. Having a pedicure with the cracked heels that are so common during flip-flop season, for example, leaves feet open to infections lurking in whirlpools and on files that haven't been sufficiently cleaned. And even if you bring your own spotless tools, cuticle cutting is not recommended.

"Cuticles serve a function," Zeichner said. "They protect the base of the nail from infections getting in there. I tell people just to have them pushed back."

Soak-off gel polishes like Gelish and CND Shellac are removed with acetone, which can be extremely drying and can cause nails to become brittle or to crack. To remove Gelish, a file is first used to break the topcoat's seal. With all soak-off gels, overzealous aestheticians — or consumers trying to get off stubborn color at home — often end up removing layers of nail, too. Earlier this year, CND began certifying nail salons that perform its Shellac procedures correctly; in New York City, that's just over half of the 95 facilities that offer the service.

Most gel manicures also use ultraviolet lamps to affix each layer of the product. Even though hands aren't under the lamp for that long (six minutes total with Shellac), there is a link between UV exposure and the development of skin cancer, which is why some people also avoid the UV drying lamps used after even regular manicures.

Avoiding UV exposure is a key reason that spray tans have become so popular, but those aren't necessarily safe, either. The active colorant in self-tanners, DHA, was approved by the Food and Drug Administration for external use, meaning that it's potentially harmful if it gets in your eyes, is ingested, or is inhaled through your mouth and nose, something that is nearly impossible to avoid during spray tanning. Some dermatologists, like Zeichner, tell patients to wear masks during the treatment.

Waxing, another bikini season staple, also presents potential health hazards. So-called double dipping — redunking a wax applicator into hot wax after it's been used on a client's skin — can spread bacteria into the pot. If you have a cut in the area that needs waxing, it might be worth rescheduling an appointment.

"Once your skin is not intact, it is more susceptible to infection," said Dr. Doris Day, a clinical assistant professor of dermatology at NYU Langone Medical Center.

That's not all.

"You can get a thermal burn if the wax is too hot," Zeichner said. "You can traumatize the skin if the wax exfoliates too much. You could be taking off more than just hair. You could be taking off the top layer of skin, which can leave you raw and irritated."

At Spa Merge in Manhattan, the wax temperature is lowered several degrees in the summer to account for clients' raised body heat. The spa also advises customers to stay out of the sun for 24 hours post-treatment, since freshly waxed skin is more susceptible to sunburn.

Waxing can also lead to ingrown hairs, which can become infected. There is less of a risk of ingrown hairs with shaving, but tiny razor nicks near the ankle can leave the skin vulnerable. Sharing razors, and the germs they can spread if skin is broken, should be avoided.

Salon eyelash extensions, which last up to six weeks, are also especially popular now, in the season of weddings and vacations. JJ Eyelashes is seeing 80 clients on an average day at its two Manhattan locations. But many clients find it hard not to rub or tug at the extensions.

"If you damage the follicle, you can permanently lose your lashes," Day said.

And the glue used can irritate the eyes. For patients who want thicker eyelashes, she and Zeichner recommend Latisse, a prescription product to stimulate eyelash growth, although it can sometimes darken the color of the eye or eyelid.

And what of your Kim Kardashian look-alike locks?

"Hair extensions can apply pressure, so in addition to permanent alopecia, or hair loss, you can certainly have hair breakage," Zeichner said.

At the Oscar Blandi Salon on Madison Avenue, where extensions can run up to $5,000 for the most dramatic treatment, clients are often advised to take time off between adding and removing extensions or opt for clip-on versions, which are less taxing on the scalp. They are also less taxing on the wallet.

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