TUCSON — The summer rite of a pedicure has its risks: Unsanitary practices can lead to infections.

While some are merely unpleasant, others are dangerous. One young woman may have contracted flesh-eating bacteria while having her feet cleaned and toes painted at a Tucson salon.

Over the past 14 months, state records show that one-third of the 181 Tucson-area salons licensed only to do nails — and also, in some cases, skin care — agreed to pay fines for a variety of state violations, including not sterilizing instruments after each use and performing services without a proper license.

State officials stress — and records show — that the vast majority of the state's salons have excellent safety standards and pass their inspections. But violations do occur, most of them concerning pedicures. Specifically, many nail salons are not properly cleaning whirlpool foot baths, which can cause skin, clipped nails, grease and debris from other clients to collect behind suction screens and contaminate what appears to be a fresh tub of water. It's a scenario ripe for spreading infection-causing bacteria.

State regulations require pedicure spas to be drained, cleaned and disinfected in between each client. And at the end of each day, the salon must disinfect them again, after detaching all filters, screens, drains and other removable parts.

In January 2008, an inspector reported pulling the handles off a foot bath at the far East Side Nail Star and smelling a sewer odor. The salon's owner says she has since passed a state inspection and now knows how to properly clean the baths.

In another case, a salon was fined after a woman complained that callus removal in April 2008 left her feet bloodied and painful. Susie Watson, a mother of three, said L'Amour Nails used a "razor" type of instrument, which the salon has denied. Nail salons aren't supposed to do anything invasive, including taking out ingrown toenails or scraping off anything other than dead skin.

"It's a little disappointing because having a pedicure is a nice way to do something relaxing that doesn't cost a fortune," said Watson, who is in her 40s. "But I won't ever go for a pedicure again."

Sixteen local nail salons paid fines in the past year after inspectors said they were improperly cleaning pedicure foot baths.

Contaminated water contains the risk of exposure to several types of fungi and mycobacteria from contaminated water, said infectious disease expert Dr. Sean P. Elliott, medical director of infection prevention at University Medical Center. Even a small nick in the skin would be enough to cause ulcers and abscesses on the skin, he said. It's also possible to contract athlete's foot from pedicure baths, he said.

Instruments used to work on cuticles and calluses could also transmit infectious disease if they have not been properly cleaned. To prevent such problems, officials with the Arizona State Board of Cosmetology try to make an unannounced visit to each of the approximately 1,100 cosmetology, aesthetic and nail salons in the Tucson area once per year. But with just one inspector assigned to southern Arizona, that doesn't always happen.

Just four board employees —three full-time inspector-investigators and one full-time inspector — monitor all of Arizona's 9,000 hair, nail and aesthetic salons and the 108,000 licensees who work in them. That's the same number of inspectors it had five years ago, when there were at least 1,500 fewer salons in the state.

There were 2,165 complaints filed with the board statewide in 2008 for a variety of problems, most of them involving injuries, infections and unlicensed workers, said board Deputy Director Donna Aune. Officials typically respond to complaints within a week, she said, and cases take an average of 150 days to resolve because they often require multiple visits and interviews.

Awareness of the risks of pedicures heightened in 2000, when contaminated whirlpool foot baths were blamed for infecting at least 110 customers at a salon in Watsonville, Calif., with M. fortuitum, a mycobacterium that caused pimply, pus-filled sores and boils on customers' legs. The salon, the manufacturer and the supplier of the pedicure baths settled a lawsuit with 74 of the clients for $2.9 million.

Their sores ranged in size from pennies to silver dollars and varied in severity — one woman had more than two dozen, said Dr. Kevin L. Winthrop, an infectious-disease epidemiologist at Oregon Health and Science University who led the investigation as an employee of the federal Centers for Disease Control and Prevention.

When he went to the salon and removed a screen at the back of one of the footbaths, he found enough hair to make a toupee.

"I was surprised to see so much debris," said Winthrop, who found the same mycobacterium in pedicure baths at several other California salons.

His investigation caused several states, including California and Arizona, to adopt regulations about cleaning salon foot baths.

After the pedicure that left her feet bloodied, Susie Watson complained to the Arizona State Board of Cosmetology. The salon was fined $250 and reimbursed the $30 cost of Watson's pedicure. L'Amour Nails manager Tram Phan wrote an apology to the state board, saying his employees don't speak English well, which may have caused communication problems with Watson.

Other local salons were fined for having unlicensed workers, and workers who didn't wash their hands in between clients. At some salons, workers ran out the back door when the inspector arrived.

The typical fine for a salon with no prior problems is $250, though Aune said the amounts are under review. The fine for an unlicensed worker was recently raised to $500 per person. The maximum fine, set by state statute, is $2,000. Salons that dispute the fines or don't pay them have a hearing before the state board, which has shut salons down for non-compliance.

The state requires that nail technicians have a license, which guarantees they've been trained in infection control.

Information from: Arizona Daily Star, http://www.azstarnet.com