Updated

As summer starts, strappy sandals and teeny-weeny bikinis come out of the closet, inciting a rush to salons for nail care and waxing appointments.

But the dirty secrets lurking in some salons can brew infections that make people with otherwise polished bods want to cover up.

The health risks associated with the beauty industry, according to the American Academy of Dermatology, include viral infections such as HIV, hepatitis B and C, and warts, as well as bacterial and fungal infections.

Beauty editor Didi Gluck went for a standard manicure, but awoke in the middle of the night to find one of her hands with freshly painted nails, throbbing, swollen and so painful she raced to the ER.

"I went to a reputable salon for a manicure," said Gluck, of Marie Claire magazine. "The manicurists just ever so slightly nicked me, but I don’t think the utensil was as clean as it could have been." At the emergency room later that night Gluck’s infected finger was injected with Novocain, lanced and drained.

Infected pedicure footbaths, manicure tools and shared waxing applicators are the perpetrators that cause most infections.

In an extreme case, more than 100 women who went to the same salon in Watsonville, Calif., for pedicures were horrified when bumps formed on their legs and feet. The bumps turned into purple pus-filled boils that erupted discharge, seemed to heal, and then formed again and spread to other areas.

This outbreak of Mycobacterium fortuitum infections in September 2000 was recently examined in The New England Journal of Medicine, which reported that all patients had had whirlpool footbaths and 70 percent had shaved their legs before the pedicure, which raises the risk of infection.

Although they went to the salon (which was later closed by the health department) to improve their looks, some patrons were left with "disfiguring scarring on their legs," said Betsy McCarty, chief of public health for the Santa Cruz County Health Department.

And the strong antibiotics, taken for six months by the infected women were "no picnic," McCarty said, with side effects including yeast infections, diarrhea and nausea.

Footbaths with whirlpool jets may seem more luxurious, but they can harbor the most bacteria. Nail clippings, skin and hair are just some things that linger in the jets and behind the drainage screens of these baths.

"Most people wouldn't say 'take that screen out and let me see what's behind it,'" McCarty said. "A bacterial soup was back there behind the screens … There was enough hair to make a toupee."

To minimize the risk of infection Gluck recommends looking for a prominently displayed operator's license, bringing your own nail implements and getting a pedicure in salons that bathe your feet in a basin that can be dumped out after each use.

But there are other ways to catch a contagious disease.

Jeanine Camerlengo of Staten Island, N.Y., went to her local salon for an eyebrow waxing, and, according to her lawyer Bruce Egert, the attendant applied the wax with "a terribly infected stick," that had been "used on somebody else in a rather delicate part of her body," he told the New York Post.

Some of the wax dripped onto the corners of her eyes. Five days later an ophthalmologist found she was "suffering from herpetic keratoconjunctivitis in her eyes," the Post reported.

Contracting herpes from a wax is unlikely, said Dr. Lynn McKinley-Grant, a dermatologist in Chevy Chase, Md., but it is possible.

However, for those who bear the pain of a bikini wax, other complications are more common.

McKinley-Grant said she often sees patients with burns resulting from wax heated too hot, and the bacterial infection Folliculitis, which "looks like little yellow pus bumps around the hair follicles and can be treated with antibiotics," she explained.

To help avoid these mishaps, use common sense when selecting a salon, McKinley-Grant advised.

"Make sure the waxing room is clean, that the technician has washed [her] hands or is wearing gloves, that the paper on the exam table has been changed, and that a new applicator stick is used for each person," she said.

McCarty said women should be aware that the organism that caused suffering for so many in Watsonville could lurk in footbaths anywhere.

"Unless people are conscientious about cleaning those tubs in a very thorough way, this could very easily happen again," she warned.