NEWCOLUMNIST

FOOT notes

Who does what? Understanding footcare roles & how to make the right referrals

Award-winning pedicurist & advanced footcare practitioner, DENISE SPRAGG, shares insights to elevate your treatments

Welcome to the first column in my series for Scratch . I’m delighted to share notes from my work as a pedicurist, to help elevate and empower your services. In this edition, I explore the different types of footcare providers in the UK, because scopes of practice, training pathways and regulatory requirements vary significantly. Understanding these differences will help you feel confident in recognising when you can treat a nail client, and when you need to make a referral.

ABOUT DENISE SPRAGG

Denise spent 26 years practicing criminal and family law before setting up a tai chi and yoga retreats company with her husband in 2005. This sparked her interest in holistic and beauty treatments, and she has practiced manicure and pedicure services since 2011.

During lockdown, Denise trained in advanced pedicure techniques with American practitioner, Lori Halloway, which led to an increase of 17 clients in one week. Denise was the legal and financial director of the Federation of Nail Professionals, and is an accredited Footlogix practitioner. She and her husband have been running health and wellbeing centre, The Sangha House, in Taunton, Somerset, since 2016. Denise offers lacquer and gel pedicure treatments, as well as complex diabetic treatments, and she has a diverse clientele.

In 2023, Denise won the SOS Beauty Award for Footcare Practitioner of the Year and has most recently founded footcare website, Elevate Pedicures.

www.elevatepedicures.com/denisespragg1971

Pedicurist: cosmetic care for healthy feet

Pedicurists provide cosmetic treatments for feet. Their training typically falls within the realm of beauty therapy and focuses on aesthetic improvements, rather than medical care. Services may include nail trimming and shaping, exfoliation, moisturising, massage and the application of colour.

While many pedicurists are highly skilled in delivering relaxing and visually appealing treatments, they must not treat any foot conditions involving broken skin, infection, pain or complex medical history – unless they are medically qualified.

Pedicurists should refer clients to a medically trained footcare professional if they observe:

• Thickened, fungal or discoloured toenails.

• Corns or verrucae.

• Ingrown toenails.

• Any signs of infection or compromised skin integrity.

• Diabetic foot concerns.

Foot note regarding diabetes: Diabetes is not an automatic contraindication to pedicure treatments, but it is a significant cautionary factor. You can work with diabetic clients by modifying your service, but only if their diabetes is well-managed, they are low-risk (no neuropathy, ulcers, broken skin, infections or poor circulation), they are under regular care from a healthcare provider or podiatrist, and you follow strict protocols for safety and hygiene.

Modifications you must make for clients with diabetes:

• Avoid sharp tools (no blades or aggressive cuticle trimming).

• Use only gentle exfoliation (no foot rasps or strong scrubs).

• File nails gently. Do not cut or dig at them.

• Use single-use or sterilised tools to reduce infection risk.

• Use diabetes-safe products.

• Check for redness, swelling or breaks in the skin.

• Keep detailed records and have a clear referral protocol in place if you spot anything concerning.

You should not carry out a pedicure if a diabetic client has:

• Loss of sensation (neuropathy).

• Poor circulation or discolouration.

• Ulcers, cracks or infections.

• Previous history of foot complications or amputations.

• Swelling, pain or signs of skin breakdown. Clients presenting these symptoms must be under the care of a podiatrist, and should not be treated cosmetically.

If you’re in doubt, always refer – ideally to a podiatrist or foot health practitioner – for a risk assessment. In some cases, clients can be cleared for safe cosmetic care, making you part of a supportive care team. Consider completing a course on diabetic footcare, as it builds confidence and shows your commitment to safe, informed practice.

Foot health practitioner (FHP): bridging beauty & clinical care

Foot health practitioners (FHPs) are trained via diploma-level courses, usually run by private institutions, and focus on routine maintenance of healthy or mildly problematic feet. FHPs are not degree-qualified, and the title is not legally protected, however many choose to register with voluntary professional bodies, such as the Register for Foot Health Practitioners (RFHP).

FHPs can provide:

• Nail trimming and thinning.

• Reduction of corns and calluses.

• Basic fungal nail and verruca management.

• Monitoring of low-risk diabetic feet.

• General advice on foot hygiene and care.

FHPs do not have the authority to diagnose, prescribe or treat high-risk conditions. They must refer clients to a podiatrist when there is:

• Evidence of infection or ulceration.

• Severe ingrown toenails requiring surgery.

• Complex diabetic foot concerns (e.g. neuropathy, ischaemia).

• Musculoskeletal issues, pain or gait abnormalities.

‘‘Consider completing a course on diabetic footcare, as it builds confidence and shows your commitment to safe, informed practice.‘‘

Podiatrist: The medical foot specialist

Podiatrists (formerly known as chiropodists) are the most highly qualified footcare professionals in the UK. They must complete an Honours degree in Podiatry and be registered with the Health and Care Professions Council (HCPC). This is a protected title, and podiatrists are legally regulated healthcare professionals.

Their scope of practice is broad and includes:

• Diagnosis and treatment of all foot and ankle conditions.

• Nail and skin pathologies (e.g. fungal infections, verrucae, psoriasis).

• Nail surgery for ingrown toenails.

• Management of diabetic and vascular foot complications.

• Prescription of certain medications (if suitably trained).

• Biomechanical assessments and provision of orthotics.

• Treatment of sports injuries and arthritis-related foot pain.

Podiatrists are the appropriate referral for any complex or high-risk case, especially where a condition may worsen without medical intervention.

Footlogix Product Knowledge Training

Education and product provider, Sweet Squared, offers product knowledge training for the Footlogix Pediceuticals® brand, detailing how to elevate the standard pedicure to a transformational experience, while being gentle enough for even the most sensitive client. Footlogix Pediceuticals® are specifically formulated to be safe for people of all ages, and particularly those with diabetes.

The training combines two hours of online learning with two hours of practical work, including how to perform a comprehensive 10-step Footlogix Pedicure to rejuvenate, repair and moisturise the skin of the feet. For more information, visit www.sweetsquared.com

Diabetic Foot Awareness Workshop

Education provider, DUET Diabetes, offers a Diabetic Foot Awareness Workshop for beauty and wellness therapists. It empowers professionals to recognise the signs of diabetic foot complications, in order to support clients in seeking timely care. The four-hour training session can be undertaken online or face-to-face, and is in collaboration with the Holistic, Beauty & Nail Training Group. For more information, visit www.duetdiabetes.co.uk