Don’t let your salon fall under fire
for spreading MRSA.
by Tracy Morin
No one in the salon industry will likely forget the case of Kimberly Jackson. In 2006, this Fort Worth, Texas-based woman allegedly contracted Methicillin-Resistant Staphylococcus Aureus (MRSA) during a pedicure at a local salon—and later suffered a fatal heart attack due to the disease. Though most nail technicians are careful to properly disinfect their equipment and implements, the media pounced on this tragic exception and quickly sent salon-goers across the country into a state of panic. Nail techs, too, were in shock and had their own questions about how this could happen.
Unfortunately, years later, MRSA continues to be a concern in salons. In November 2009, Fox 10 News on the Gulf Coast reported that a salon client in Alabama was cut with an emery board several times during a routine manicure, leading to severe pain, swelling and redness. A doctor diagnosed her with staph in five of her fingers—luckily, before amputation was necessary. You can’t change the fact that this may happen in a salon, but you can prevent it from happening in yours by understanding what MRSA is and how to prevent it.
MRSA Statistics* |
- Staph is one of the most common causes of skin infections in the United States
- MRSA is carried or “colonized” by about 1% of the population, although most carriers aren’t infected
- 25% to 30% of people have staph bacteria in their noses
- In U.S. hospitals, MRSA causes more than 60% of staph infections
- The Centers for Disease Control reports that in 2007, 14% of people with MRSA infections had Community-Associated MRSA (CA-MRSA)
*Source: WebMD.com
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Understanding MRSA
Many nail techs have wondered what MRSA is and why it has become so newsworthy in the past few years. “MRSA is a common bacterium (staph) that causes skin infections that have become resilient to several antibiotics,” explains Vicki Malo, BScPod, CEDESCO, RMTA, president of the North American School of Podology in Toronto and member of the International Pedicure Association Advisory Board. “At one time, MRSA was found only in healthcare settings, such as hospitals and nursing homes, but now MRSA is being found in gyms, spas, health clubs, schools—anywhere there is direct skin contact.” These more recent infections, which usually
occur in otherwise healthy people, are referred to as community-
associated MRSA, or CA-MRSA.
In the United States in 2008, 18,000 people died from MRSA, says Malo. In other words, you and your clients are justifiably concerned; MRSA is easily spread and more common than ever. “The pathogen is now out in the community,” warns David Calfee, MD, associate professor of medicine, infectious diseases at Mount Sinai Medical Center in New York. “It’s spread through a person who is infected with or carrying the organism; this can mean skin-to-skin contact or indirect contact, such as touching something that has been contaminated.” Calfee recalls that a few years ago outbreaks were common on sports teams due to shared towels and, thanks to all of the communal equipment and surfaces in a salon’s intimate setting, no one was surprised when MRSA made its way to the beauty industry.
Indeed, MRSA exists everywhere in society. “Staph is a ubiquitous organism, one we will never eradicate completely,” says Aaron E. Glatt, MD, FACP, FIDSA, FSHEA, president and chief executive officer of New Island Hospital in Bethpage, New York, and spokesperson for the Infectious Diseases Society of America. “Skin is not sterile, and in the past 10 years, we have seen more frequency in the general population that is colonized with MRSA.” Infection most easily occurs after exposure to MRSA when there is a breach in skin, such as a cut, a nail infection or even a hangnail. But many people can have staph on their skin and not experience a problem; Glatt states that this is because being colonized with staph is different from being infected by it—people who are colonized have no signs or symptoms of infection. 
For those who are infected, the symptoms of MRSA are noticeable, but some clients may ignore them, misjudging them as mere cosmetic issues. “MRSA infections may appear as a reddened, swollen, tender area of skin called cellulitis; there may also be pustules or boils,” relates D’Anne Kleinsmith, MD, dermatologist in private practice in West Bloomfield, Michigan. Some treatments that may be successful, she explains, include doxycycline and tetracycline (antibiotics often used to treat acne), which are typically safe; other strains require stronger antibiotics such as Bactrim. However, she adds, “the fear is that the MRSA strains will become even more resistant to the antibiotics we have, and the infections will become more serious and difficult to treat.” Luckily, over the years of dealing with MRSA, doctors have learned not to treat the problem with traditional antibiotics, which in the past allowed infections to worsen.
“MRSA is not more dangerous [than other forms of staph infections] in and of itself, but it is resistant to commonly used antibiotics, so it is more difficult to treat,” explains Glatt. “MRSA is not untreatable but, if left untreated or if improperly treated, it can progress.” Because MRSA symptoms look the same as those for Methicillin-Susceptible Staphylococcus Aureus (MSSA)—a strain of staph that can be treated with typical antibiotics—a physician must culture the bacteria to determine the strain. Although it is rare for a mild case in a healthy person to result in death, ignoring symptoms can lead to a fatal conclusion. Therefore, if you notice an abscess, a boil or a pus-filled lesion on a client’s skin, do not touch the area and tell her to have it checked out immediately by a physician.
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