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The Therapeutic Medi-Pedi Treatment

Contact Author Denise Dubois July 2012 issue of Skin Inc. magazine

Thank you for your inquiry. Please note that the author cannot provide individual medical advice. Also, if you have a customer service question, email customer service at

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Editor’s note: As always, Skin Inc. magazine recommends that skin care professionals obtain the proper training before offering any new treatments in their skin care facility. Also, to learn more about health-challenged skin, be on the lookout for Morag Currin’s book, Health-challenged Skin: The Esthetician’s Desk Reference, available from August 2012.

How many steps per day does the average American take? A study conducted by pedometer researcher Catrine Tudor-Locke, PhD, and published in Medicine and Science in Sports and Exercise in 2004, showed a wide variation in the 200 women and men who participated. The men in the survey took an average of 7,192 steps per day and the women in the survey took an average of 5,210 steps per day.

The average person endures several hundred pounds of pressure on the feet on a daily basis, and walks four times the circumference of the Earth in a lifetime. Your feet get you up in the morning and out the door for your busy days, and yet, they tend to be one of the most neglected parts of the body. Approximately 85% of the population have foot or foot-related problems. It is imperative that the skin, the largest organ on the body, remains healthy in order to perform its main function, which is to protect against injury, infection and the entry of bacteria. This holds particularly true with regard to the feet.

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A therapeutic pedicure focuses on addressing the health of the feet and conditions ranging from simple dryness to more severe conditions, such as those resulting from diabetes and fungus. (See Therapeutic Medi-Pedi Treatment.) In the case of diabetics, even ordinary problems can get worse and lead to serious complications. Foot problems most often happen when there is nerve damage, also known as neuropathy, resulting in the loss of feeling in the feet. Nerve damage can also lead to changes in the shape of the feet and toes. Poor blood flow or circulation can make feet feel cold and be less able to fight infection. In severe cases, it can lead to foot ulcers, and even amputation.

It is not mandatory for a client to see a physician before having a therapeutic pedicure. A trained and licensed skin care and nail professional should not work on individuals who have open wounds or sores on their toes or feet, or a visible infection due to ingrown toenails. If any of these conditions are present, refer the client to a physician for appropriate care.

A therapeutic treatment focuses on the greater need for extra foot care rather than just a feel-good experience. Clients are looking for solutions with results. To properly perform this procedure, it is highly recommended that a licensed nail technician obtain advanced training in podology beyond their basic education. Conditions that a therapeutic pedicure should be able to address include persistent dryness due to poor circulation, callousness from weight and improper gait, fissures from excessive dryness, fungus of the nail and skin, cold feet and excessive perspiration that can also lead to foot odor.

Marketing and retail

The Therapeutic Medi-Pedi Treatment can be introduced by hosting an educational healthy feet spa party. Consider inviting a local podiatrist to the event to give an informative presentation about various foot conditions. Following the presentation, clients should be offered a complimentary foot evaluation and a 20% discount if they book an appointment that evening for the treatment. Clients are looking for solutions to their foot challenges, and this treatment gives them the results they need. It is imperative to recommend a supportive foot treatment line for at-home maintenance and optimal long-term results.

A supportive foot treatment line is more than a feel-good, fragrant cosmetic skin care line. The line used should be specifically developed to address a variety of skin and nail conditions with proven results that are backed by science. It should address the health of the feet and issues from simple dryness to more severe conditions, such as those resulting from diabetes and fungus. The products should be simple and easy-to-use for clients, as well as skin care and nail professionals.

To maintain and enhance the results from the service, recommend follow-up home care. Use a recommendation pad and write out exactly what the client should use and how it should be applied at home. Bring the products to the pedicure chair and put them in the client’s hand as you are explaining their benefits.

It is also crucial for receptionists and booking attendants to ask the appropriate questions when answering the phone to identify if a client would benefit from a therapeutic pedicure versus a traditional spa pedicure. These questions include the following.

  • Do you have a particular concern with your feet?
  • What are your goals with this appointment?
  • Are you looking for a traditional spa pedicure or more of a treatment to address a particular concern with your feet or nails?

This allows the appropriate treatment to be recommended. A therapeutic pedicure is not a fluff-and-buff type of treatment; it is more clinical and does not include the use of scrubs, masks or paraffin.

Benefits for better health

Providing a therapeutic pedicure allows the skin care and nail professional the opportunity to aid in the client’s pursuit of health and wellness. A classic spa pedicure addresses appearance and feels great; however, a therapeutic pedicure’s emphasis is on correcting specific conditions with benefits that can translate into better health.

Denise Dubois graduated from the Catherine E. Hinds Institute of Esthetics in 1984, and is currently the president and owner of Complexions Spa for Beauty & Wellness in Albany, New York. One very important component of Complexions is the medical spa, which Dubois implemented after building a solid bond with dermatologists and plastic surgeons. She has also developed a program for Age Management Skin Care. In the spring of 2009, Complexions became the first spa in the country to receive Gold LEED certification for new construction, one of the highest honors granted by the U.S. Green Business Council.

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Transverse Arch

How-to: Therapeutic Medi-Pedi Treatment

Cost: $77

Duration: 60 minutes

Contraindications: The presence of open wounds, sores on the toes or feet, or a visible infection due to ingrown toenails.

Equipment and supplies needed:
Pedicure throne or sanitized stainless steel foot basin or foot bowl
1 large bath towel
2 hand towels
1 foot nail file
1 callus remover paddle
Pedicure double spoon
Small flat-edge nipper
Medium flat-edge nipper

Products needed:
Polish remover
Antibacterial foot soak
Urea-based callus softener
Urea-based foot massage cream
Very dry foot foam
Hydrating skin cream
Nail polish

Step 1: Ask the client to fill out a foot and health intake form.

Step 2: Perform a thorough consultation, as well as a foot and skin analysis. This helps to identify medical conditions affecting the client’s feet and assist with understanding her specific foot care needs. 

Step 3: Ask the client to remove her shoes and socks, and to stand on floor in order for you to evaluate the position of her arches. The purpose of this is to identify if the transverse or longitudinal arch have dropped. If this has happened, it can lead to foot discomfort or pain. In this case, the nail technician will refer the client to a podiatrist or certified pedorthist for possible orthotics.

Step 4: Fill tub with warm water and one capful of pH-balanced antibacterial foot soak. Insert both feet and allow them to soak for 5–7 minutes (less than 5 minutes if client is diabetic). This hydrates the skin and softens calluses, allowing for easier removal.

Step 5: Remove both feet from the foot bath and dry them completely.

Step 6: Apply callus softener to the dry skin around the nail bed and onto calluses. Let it absorb for two minutes. The callus softener’s active ingredient should be urea, which breaks down the callus walls and softens the skin of the cuticles for easier removal.

Step 7: Using the medium flat-edge nipper, gently trim toenails and shape with a file. Avoid going beyond the hypernicium, because this will cause discomfort.

Step 8: Use the small spoon to clean around the cuticle area, removing any excess eponychium, or cuticle.

Step 9: Using the callus remover paddle, debride calluses on the toes, the balls of the feet and the heels. The callus remover works best if it is left on the foot. Do not re-soak or rinse off as it continues to benefit the skin. Repeat Steps 6–9 on other foot.

Step 10: Use two or three pumps of foot massage cream to massage feet and legs for 5–7 minutes. This relaxing foot and leg massage should contain urea, leaving the skin feeling silky soft.

Step 11: Wrap feet with warm towels and let the client relax for a few minutes. The heat from the towels helps aid the penetration of the cream and is very comforting.

Step 12: Apply very dry foot foam to both feet, which instantly restores the proper balance of hydration to the skin of the feet.

Step 13: Clean nails to remove all traces of oil in preparation of the nail enamel application.

Step 14: Apply polish of the client’s choice to toenails and allow it to dry.

Step 15: Recommend at-home foot care for prolonged benefits and continued results.

Step 16: Reschedule client for maintenance in four weeks.

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