The headline from an article in The New York Times (10/17/06) reads: “Medi Pedi Sanitary, But Pricey, Alternative to Regular Pedicure.” The article focuses on TriBeCa MedSpa in New York City, which is overseen by Dr. Joseph Fox, the podiatry director. The article briefly explains the specific products and sanitation practices used for medical pedicures, as well as the types of clients who benefit the most from them. But according to the salon and spa professionals we spoke with, the terms “medical pedicure” and the increasingly popular “medi pedi” are not interchangeable.
Says Katharin von Gavel, the founder of the Toronto-based North American School of Pedicuring (NASP), “If the service is referred to as a medical pedicure, there must be a doctor on staff and on the premises. This person is usually a podiatrist or a dermatologist. A doctor can diagnose a condition and prescribe treatment. On the other hand, the person performing a medi pedi service can only recognize a condition and recommend treatment.”
An actual medical spa facility is where medical pedicures are done, says von Gavel, whereas medi pedis can be done in any salon or spa.
The Medi Pedi Technique
So if a medi pedi can be performed in any salon, what distinguishes it from a traditional high-quality pedicure? Alexis Ufland, owner of Lexi Design Spa Consulting and Sparty, a spa-party company, defines the medi pedi as an enhanced pedicure that can be performed two ways. “One procedure is really about addressing callus care and using a glycolic peel and microdermabrasion on the feet. Another procedure is the detox pedicure, which is more about massage, healing, and relaxation.”
The biggest difference between a traditional pedicure and a medi pedi is the latter is more of a wellness pedicure rather than a slough and buff, says von Gavel. For starters, she terms the products she uses for the service “pediceuticals,” meaning they are specifically made for feet and the treatment of foot conditions.
Says Donald Green, a certified master pedicurist who works at Thrillz Salon and Z Spa in Rochester, N.Y., “Pedicure-specific products are great for medi pedi clients because they are oil-free and allow the skin to breathe,” he says.
“An aggressive skin or nail product, such as one with a high-percent of salicylic acid, can be harmful on typical medi pedi clients, who tend to be older people with compromised immune systems, and those with diabetes,” says von Gavel.
Rhadena Farley, a nail technician at Bella Rinova in Houston, Texas, also warns against using a scrub on medi pedi clients with circulatory problems or diabetes. “It can potentially dehydrate the skin and worsen the problem,” she says.
Adds von Gavel, “For some medi pedi clients, soaking their feet is not always recommended as it can further dehydrate their skin, which can possibly lead to infection. For example, in diabetic clients, who already have thin, fragile, dehydrated skin because of poor circulation, water will often soften their skin too much, which can lead to complications.”
Depending on the client, Rachelle Berman, owner of Z Spa/Salon in Boise, Idaho, uses peels and higher-strength exfoliators to help eliminate excessive callus build-up. “Many of our clients have a greater need for extra foot care because of thick calluses, and thick, dry, cracked skin on their heels,” says Berman. “A standard pedicure will not soften, smooth, and exfoliate clients’ feet as much.”
Just as essential as using proper products for the medi pedi service are following strict sterilization and sanitation practices. With medi pedis, there is a presumption that the most stringent sanitation and disinfection standards are being observed. “The medi pedi has a completely different infection control process than a standard pedicure,” says von Gavel. For example, a standard pedicure requires a low-level disinfectant to clean out the foot tubs while a medi pedi should incorporate a high-level disinfectant. The attention to sterilization also extends to the proper tools one should use on medi pedi clients. Green only uses autoclave-sterilized implements.
Just like any type of nail care service, educating medi pedi clients on proper home-care maintenance is vital to keep their feet as healthy as possible. Berman recommends her medi pedi clients use lotions with AHAs, and for those clients who can use an exfoliant on their feet, she suggests they prepare her granulated foot scrub recipe, which consists of olive oil and sugar.
Explains Berman: “First, they soak their feet in Epsom salt and then gently scrub their feet with the mixture. Next, they wrap their feet with a warm cloth and then towel dry before applying lotion. This gives clients a little TLC between appointments.”
First and Foremost
For every new medi pedi client that walks through the door, von Gavel is adamant the person performing the service do a client consultation and complete evaluation before touching the feet to find out about any health problems or concerns the client may have.
Warns von Gavel, “During the evaluation, if you see any part of the foot that is red, swollen, hot, inflamed, or infected, do not touch it and recommend the client sees a podiatrist or dermatologist immediately.”
Green says the person who will be performing the medi pedi service should be able to recognize disorders, recommend products, and refer to other professionals, such as a podiatrist or a dermatologist, if need be. He calls this, “The Three Rs.”
In addition to clients who are elderly, diabetic, or have auto-immune disorders, typical medi pedi clients may suffer from obesity, which can lead to circulatory problems.
But medi pedis aren’t just for clients with medical conditions. Berman finds many of her medi pedi clients are women over the age of 35 who are either runners or go barefoot a lot or who frequently wear sandals or high-heels.
“When going barefoot, for example, the weight of our feet compounds into the heel area, which causes the skin to dry out and split and crack,” says Berman.
Many of Green’s medi pedi clients are baby boomers. “They have a little more disposable income now that the kids are out of the house,” he says. “Now it’s their turn to be taken care of.”
At The PediPros pedicure spa in Overland Park, Kan., owner Teresa Sullivan says physicians and nurses make up about 30% of her medi pedi clients. Sullivan, a member of the International Pedicure Association, attributes this to her high standards in every aspect of her salon’s services. “We have always strived to go above and beyond what’s required and what’s expected of us among our clients,” she says.
The Medi Pedi Professional
When it comes to who should perform the medi pedi service, there are varying schools of thought (see sidebar on pg. 116). Not surprisingly, given her role as an educator, von Gavel says medi pedis should be done only by a person who has advanced training in all aspects of the pedicure service, such as the certified master pedicurist program offered by NASP.
As a graduate of the program, Green says he not only learned the proper protocol for doing the medi pedi service, but his certification has given him confidence in his ability to perform the best and safest service possible for his clients.
Berman says her clients are very appreciative of the medi pedi service. “Many times, during one of our standard pedicure services, we will suggest a medi pedi to the client and explain the benefits of the service without making the client feel embarrassed or self-conscious. When clients find out they have an option, they really appreciate it,” she says.
How often clients receive the medi pedi service depends on the condition of their feet. On average, von Gavel recommends it every four to six weeks. The service usually lasts from 60 to 90 minutes, and the price should be determined by what is needed. The price range for the salon professionals we spoke with ranged from $50 to $100.
Whether medi pedis are a passing trend or are here to stay, educating yourself on the specific needs of the client as well as the safe steps to take while performing the service are critical to ensure a healthy, positive experience for the client.
JoLynn Vensel is a freelance writer based in Redondo Beach, Calif.
What You Can and Can’t Do in the Salon
Not everyone we spoke to was comfortable with medi pedis in the salon environment. Dr. Dennis Arnold, a podiatrist and president of the International Pedicure Association in Ft. Worth, Texas, takes issue with the term itself. “My concern with this terminology is the word medical, which implies you are treating someone for a condition,” he says. “If you’re performing a medi pedi in a salon or spa, you cannot diagnose or treat. You can, however, use electric files, buffers, pumice stones and callus softeners to help remove and smooth calluses.”
As the executive director of the National Coalition of Estheticians, Manufacturers/Distributors & Associations (NCEA), Susanne Warfield is also concerned about technicians over-stepping the bounds of what’s appropriate in a regular salon or spa setting.
Says Warfield, “According to the National Interstate Council of State Boards of Cosmetology (NIC), the individual providing the pedicure service may hold a manicurist, nail technician, or cosmetology license. This person is only allowed to beautify the nails and feet, not treat any disease.
“My concern is technicians who lack the additional training to perform a procedure outside their scope of practice, such as the removal of corns, calluses, and ingrown toenails,” Warfield says. “Licenses are given to protect consumers.”