SCRATCHCOLUMNIST

FOOT notes

Pedicure considerations for diabetic clients

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

ABOUT DENISE SPRAGG

Denise set up a tai chi and yoga retreats company with her husband in 2005, which sparked an interest in holistic and beauty treatments. She has practiced manicure and pedicure services since 2011, is trained in advanced pedicure techniques and is an accredited Footlogix practitioner.

Alongside her husband, Denise runs health and wellbeing centre, The Sangha House, in Taunton, Somerset. She offers lacquer and gel pedicure treatments, as well as footcare services for clients with diabetes. In 2023, Denise won the SOS Beauty Award for Footcare Practitioner of the Year, and she is the founder of the Elevate Pedicures website.

www.elevatepedicures.com /denisespragg1971

D iabetes is a growing health concern worldwide, with 4.7 million people affected in the UK alone. The number is rising, with Diabetes UK statistics revealing that cases rose by 155,803 from 2023-24 to 2024-25. For nail technicians, this may mean an increasing number of clients presenting with the condition, and while pedicures are a fantastic way to promote foot health and wellbeing, they carry specific risks for diabetic clients. This article aims to highlight the points nail technicians should consider when working with this client group, in order to provide safe, sensitive and effective care.

Understanding diabetes & foot health

Diabetes affects the body’s ability to regulate blood sugar, which can lead to a range of complications – particularly with circulation and nerve sensitivity in the feet. Peripheral neuropathy, a common diabetes complication, causes reduced sensation, meaning diabetic clients may not notice pain, cuts or infections. Poor circulation further hinders wound healing and increases the risk of ulcers or infections.

Due to these factors, what might seem like a simple pedicure can become a serious health risk for someone with diabetes. It is essential to approach diabetic pedicures with caution and knowledge, combining gentle techniques with strict hygiene to avoid harm.

Pre-appointment consultation & assessment

Before starting any treatment, a thorough consultation and assessment are crucial. Ask open, non-invasive questions about the client’s diabetes management, foot history and any current issues such as numbness, ulcers or infections. If a client mentions foot ulcers, active infections or severe peripheral neuropathy, refer them to a medical professional and do not proceed with a pedicure.

Visual inspection is equally important. Look for:

• Dry, cracked skin.

• Calluses or corns.

• Signs of infection or inflammation, such as redness or swelling.

• Changes in nail shape or colour.

• Cuts, blisters or ulcers. If any suspicious or severe symptoms are observed, it’s safest to decline treatment and recommend the client seeks podiatric advice.

‘‘ A diabetic pedicure is not just about aesthetics; it is an important aspect of foot health maintenance that can contribute to a client’s overall wellbeing.‘‘

‘‘ It is essential to approach diabetic pedicures with caution and knowledge, combining gentle techniques with strict hygiene to avoid harm. ‘‘

Hygiene & tool preparation

Good hygiene practices are essential in order to prevent infection. Use sterilised tools or single-use disposable instruments. Clean your hands thoroughly before and after each treatment and encourage clients to wash their feet before their appointments.

Avoid soaking diabetic feet in water for prolonged periods, as it can soften skin excessively, increasing the risk of damage. Instead, use a warm, damp towel or a foot bath with a controlled temperature that the client finds comfortable.

Treatment techniques: gentle, minimal & risk-aware

Diabetic pedicures require a gentler approach compared to standard pedicures.

• Nail cutting: Do not cut too close to the skin or into the corners, as this increases the risk of ingrown nails.

• Cuticle care: Avoid aggressive cuticle work. Use gentle pushing techniques and only remove loose skin – never healthy tissue.

• Callus and corn removal: If calluses or corns are present, do not aggressively file or shave them. Instead, recommend that clients see a podiatrist for treatment. Light buffing with caution is acceptable if you are appropriately trained.

• Soaking: Limit soaking diabetic feet to no more than five minutes and ensure the water is warm – not hot. Prolonged soaking or hot water can soften the skin too much, making it more vulnerable to tears, cuts and infection. Additionally, diabetic clients often have reduced sensation, so water that feels fine to you may be too hot for them, risking burns.

• Moisturising: Use diabetic-friendly moisturisers to maintain skin hydration. Avoid applying moisturiser between the toes, to reduce moisture build-up that could encourage fungal infections.

Communication & sensitivity

Clients with diabetes may be anxious about foot treatments due to their increased risk of complications. It’s important to communicate clearly and empathetically. Explain every step of the process and encourage clients to speak up if they feel discomfort or pain. If the client has reduced sensation, pay close attention to their body language and check for any signs of distress or discomfort.

Post-treatment advice & follow-up

After a pedicure, advise diabetic clients on daily footcare, including:

• Keeping feet clean and dry.

• Inspecting feet daily for cuts or sores.

• Wearing comfortable, well-fitting shoes.

• Avoiding walking barefoot. Recommend that clients seek regular podiatry check-ups to manage their foot health proactively.

Additionally, advise clients to contact their healthcare provider immediately if they notice any signs of infection, persistent pain or changes in foot appearance.

When to refer to a podiatrist or doctor

Recognising your limits as a nail technician is vital in protecting diabetic clients. If you observe any of the following, stop the treatment and refer the client to a podiatrist or doctor:

• Open wounds, ulcers or infections.

• Severe calluses or corns requiring medical intervention.

• Signs of fungal infections.

• Persistent redness, swelling or pain.

• Numbness or loss of sensation beyond what the client reports.

Conclusion: prioritising safety & care

Performing pedicures on diabetic clients requires skill, awareness and respect for the condition’s challenges. By following these guidelines: conducting thorough consultations, maintaining strict hygiene, employing gentle techniques and encouraging ongoing foot health management, nail technicians can provide a valuable and safe service to this at-risk group.

A diabetic pedicure is not just about aesthetics; it is an important aspect of foot health maintenance that can contribute to a client’s overall wellbeing. Always prioritise safety over style, and remember: when in doubt, seek medical advice.

PRODUCT PICK

Safe for diabetics and ideal for sensitive skin, this hydrating, lightweight, creamy and vegan mousse locks moisture into the skin with each application. Non-greasy and fragrance-free, the anti-microbial properties of the bioactive Spirulina microalgae make this formula ideal for overnight use.

Footlogix DD Cream Mousse Formula £14.45 + VAT www.sweetsquared.com