Better Safe Than Sorry: Hidden Dangers of the Spa

While I love the thought of community and even communal living, I want my spa/beauty treatments to be contained. The thought of dipping into a communal wax pot, sharing makeup brushes with the last ten people who got makeovers, or having my cuticles cut and pushed with improperly disinfected tools, is not what I see as a relaxing spa day. Other than the occasional horror story about unsanitary manicure and pedicure implements, potential health hazards in the beauty world are seldom discussed. But it’s crucial to be informed and aware, so that pampering and relaxing can be just that.

Looking and feeling good is important, but if you’re not careful, the procedures you undergo can make you sick. While they’re trained, manicurists, stylists, makeup artists, facialists and other beauty professionals are not medical professionals. That said, they engage in practices that have the potential to spread disease. The difference? Salon employees often aren’t trained in safety precautions like those in the medical field. Carried out improperly, beauty services can spread sickness and diseases, like hepatitis C, fungal infections, and pink eye.


  • An easy initial action to take to protect yourself, is to simply ask your makeup artist or esthetician how they keep their implements clean between clients. They should be expecting such questions.
  • Take note of the overall cleanliness of the spa or salon.
  • Keep an eye out for employee hand-washing practices/frequency.
  • Ask to see their system for properly cleaning implements and make sure they have correct disposal procedures. Think sanitize, disinfect, sterilize, from weakest to strongest. Sanitization isn’t enough if there’s blood contact. Disinfection is done with “quats,” the blue liquid you see tools soaking in. Sterilization is done on high heat for an extended period of time with an autoclave.
  • Your risks are greater if you have a compromised immune system and/or open wounds/irritations, like eczema. Lesions are an easy entry point for pathogens, so be sure to point them out or, depending on the severity, avoid treatment altogether.
  • Fill out your intake form thoroughly and make sure to go over all the medications you take, including topical applications. Be sure to bring up any health issues. This will protect both you and your therapist.

Procedure-specific risks and tips


The most common risk in waxing is double-dipping. This means after applying wax on your client, dipping the same stick back in the wax pot, as opposed to discarding it. I’m astonished by the lack of oversight surrounding hygienic practices in waxing.

When hiring facialists, I ask about their double-dipping policy. Their answers often shock me. One explained that in the last spa she worked at they counted her sticks at the end of the day and if they’d used too many, they’d get fired. I want to save on supplies as much as anyone, but this isn’t the healthy practice!

It’s not uncommon to bleed when getting waxed. The more bulbous the hair follicle, the more likely it is. And certain areas also bleed more them others. If this happens, the esthetician must carry out the proper procedures. Most beauty schools teach very little about this. This is particularly crucial with the rising popularity of Brazilian waxes since there is potential exposure to other bodily fluids. The esthetician should be wearing a glove and only touching you with that gloved hand. Anything they touch needs to be covered in disposable plastic or properly disinfected.

Waxing can also cause rashes and burns. Rashes are hard to predict, as everyone’s skin reacts differently. Burns, on the other hand, are preventable.

What you can do
Take a peek at where you’re getting your waxing done beforehand. Notice the level of cleanliness. Ask about gloves, double-dipping, and what precautions they take.

  • During the treatment, be aware if there’s any double-dipping and if the esthetician is touching surfaces with their gloved hand. Ask to see any implements being use come out of the “quats.”
  • You must let your waxing professional know if you’re using any anti-aging or acne creams that may contain a retinoid (vitamin A derivatives retinol, retinyl palmitate, tretinoin, adapalene, tazarotene) as it can cause skin to pull off and other issues when waxing.

Manicures & Pedicures

The metal tools used in manis and pedis can cause bleeding. Therefore, they need to be properly disinfected between uses.

The water basins used to soak hands and feet during nail treatments can also be culprits if not adequately cleaned between services. Many nail salons fail to meet disinfection protocol.

What you can do
Bring your own equipment (that you also disinfect) or give yourself a pedicure at home.

  • If you have an infection or wound, such as a cut or blister on your foot, avoid getting a pedicure.
  • Find a salon that uses plastic disposable liners for soaking feet. I realize it’s wasteful, but it’s the only way you can be 100% sure that you’re protected.
  • You can bring a small bowl from home for soaking your hands.


Open sores, both on your body and your massage therapist’s put you both at risk. From seemingly benign bug bits or cuts to scabies, lice, or fungus.

What you can do
Let your massage therapist know if you have any open sores, so that they can wear gloves. And don’t get a massage if you have any rashes, fungus, or other critters.

  • Make sure sheets/robes are washed and put in hot dryer after every use. Ask. Some spas use chemical sprays to disinfect in an effort to reduce costs and time.


The “quats” disinfecting solution must be mixed properly and changed whenever contaminated to disinfect scissors and razors, and other tools that are potentially exposed to blood. Shaving and haircuts can spread disease if the tools used aren’t clean. Anything that nicks or breaks the skin can put you at risk.

What you can do
Verify that the materials are being properly cleaned or shave/shear at home. You should never share a razor.

  • Make sure the implements and the plastic drape are properly cleaned and disinfected.
  • Don’t go to a salon/barber if you’re dealing with any lice or fungus.


Makeup brushes that aren’t adequately cleaned between clients can cause breakouts and fungal infections. Reused mascara brushes can lead to pink eye and lipstick can transmit herpes. “Conjunctivitis, staph, strep and E. coli are just a few examples of bacteria that can thrive in makeup,” Joel Schlessinger, M.D., board certified dermatologist and RealSelf advisor says “Additionally, sharing lipstick, lip gloss or lip balm can lead to a cold sore.”

What you can do
If you’re getting your makeup done, make sure the brushes have been washed and properly disinfected. The makeup artist should clean the top of the makeup lids and the makeup itself using a cotton round with rubbing alcohol to remove the top layer. Using a brush will simply wipe the potential contaminants back and forth. The top layer of lipstick should be scraped off. Eyeliners need to be re-sharpened with a clean sharpener before use. Mascara should be applied using single-use, disposable wands.

  • You can also choose to bring our own makeup and brushes from home.
  • Be careful at home, too, getting ready with friends. We recommend sharing makeup and makeup tools as little as possible—especially anything used around the nose or eye areas. “We all carry bacteria on the surface of our skin, but inside our nostrils we carry a ton of bacteria. Anything you use around the nose—clippers, tweezers—I’d say probably don’t share that at all,” advises Bethanee Schlosser, M.D., director of the Women’s Skin Health Program at Northwestern Memorial Hospital.


It’s possible for a facialist to draw blood while performing extractions, especially if using metal implements. Hot towels and steam can burn you, which is painful and dangerous. We recommend avoiding lancing altogether. If do decide to, be mindful, as it can also draw blood.

What you can do
Opt out of extractions altogether.

  • Make sure your facialist is wearing gloves and they they get disposed of properly.
  • Metal implements aren’t necessary for extractions. You can request that they not be used. If you choose to use them, verify that they have been disinfected.
  • Ask the facialist to check the temperature of the steam and/or hot towels on a small patch of skin before use.


Or you can pamper yourself! Learn everything you need to know about creating wholesome products for at-home spa treatments in my book, Natural Beauty Skin Care: 110 Organic Formulas for a Radiant You!

The moral here? Better safe than sorry. These treatments are meant to make you look and feel your best. Being cognizant of the risks involved and taking the appropriate precautions takes extra effort on your part. But it’s well worth it to ensure your health, safety, and enjoyment.

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