The High Price of Pretty Feet:  Addressing the Plight of Nail Salon Workers

Nail salons are often hailed by labor economists as an immigrant success story. Well over half of the 200,000 salons nationwide – up from just 50,000 in 2010 — are owned and operated by Vietnamese women. But there’s a huge downside: the industry is rife with health and safety violations.  Not only are American consumers – mostly women, eager for low-cost manicures and pedicures – increasingly at risk for bacterial and fungal infections, but the salon workers themselves – many of them undocumented, and over 80% women – face workplace exploitation in addition to threats of toxic contamination.  The industry is in desperate need of regulatory reform, union organizing and stronger labor enforcement.  Will it ever get it?

Threats to Consumers

Like so much of the undocumented service industry, abuses largely occur under the radar, until a horrific tale of abuse surfaces.  Back in 2016, a report about an Arkansas woman who contracted a nasty foot infection after visiting a nail salon went viral. Following her visit, the woman’s ankle became swollen and turned red. Soon it spread to her knee and she was barely able to stand. She also developed a high fever.

When the woman went to the hospital, doctors told her she had cellulitis, a bacterial infection that’s most common on the lower legs. She was bedridden for four days and unable to work. She planned to sue the salon for damages.

Stacy Wilson’s case may seem extreme, but incidents like these are becoming more frequent, and thanks to social media, more widely reported. The range of infections varies, from the mild to the severe. Some, left untreated, result in HPV related diseases, lost toe nails and toes, but in some extreme cases, feet and legs may require partial amputation.

In 2017, several nail salons in Indiana were fined and placed on probation after a man’s toe was amputated following a pedicure. The man became infected after a salon cut him while shaving hard skin off of the bottom of his feet.

Florida is another state where the nail salon industry has become notorious for consumer abuse. Back in 2004-2005, an undercover investigation in South Florida found rampant health and safety violations. In fact, the state issued more than 250 citations to a wide range of salons, from small storefront shops to big name operations.

“What’s happening in Florida is the tip of the iceberg,” Nancy King, editor of Nail Pro magazine, told the Orlando Sun-Sentinel. “[Salon workers] are not tested on how to disinfect their tools. And many…..are not even aware of health problems such as not treating someone who is diabetic because they have a high risk of infection and their cuts won’t heal.”

Industry supporters admit that there’s a need for better regulation and enforcement of health and safety laws, and more training for salon technicians.  But industry watchers say conditions have not improved all that much in recent years because salons are growing like topsy and states have only limited resources to monitor them, let alone cite and meaningfully fine offenders.

In fact, some risks to the public’s health are not regulated at all. Chemicals like acetone and toluene, found in nail polish remover and artificial nails, are the biggest culprits. Some of these chemicals will simply make those exposed dizzy and nauseous. However, long-term exposure to toluene, for example, can damage the liver and kidneys and expose unborn children to harm during pregnancy.

Worker Health and Safety

Of course, it’s not just salon customers who are at risk.  The health and safety threat to workers – trapped all day in cramped and dingy rooms with poor ventilation – is far greater. Nail salon workers are known to work long hours for low pay and fail to take their own basic safety precautions, in part because their employers fail to insist on them.

Health studies have shown that salon workers are subject to toxic poisoning but are often completely unaware of the health risks of their profession.  And those that are may be too desperate for the work to inquire, let alone complain.  Some of the most recent health studies have suggested an elevated risk for ovarian cancer and birth defects among pregnant manicurists and other salon workers.

Another problem is cultural and linguistic barriers.  More than 50% of nail salon workers have limited or no English literacy.  Even state-mandated handbills and signage relating to health risks are unlikely to affect their awareness of them – or their ability to protect themselves.

There are growing signs of pushback. In 2016 hundreds of nail salon workers in New York wonalmost $2 million in backpay and damages in a class action lawsuit after a New York Times investigation exposed abusive and unsafe working conditions in the industry.

The state did pass a package of reforms including new licensing rules and beefed-up requirements for personal protective gear and safety training to deal with toxic chemical exposures on the job.  All good measures – but without constant monitoring, not necessarily enforceable in a meaningful ongoing way.

Other states, including California, home to America’s largest Vietnamese immigrant community,  are facing similar regulatory pressures, but progress, if it comes at all, will take time, given the many obstacles to raising awareness and compelling enforcement.

Some of the best studies of abuses in the nail salon industry are being conducted by the UCLA Labor Center, sometime in collaboration with the Healthy Nail Salon Collaborative.  The group’s seminal 2018 study established a compelling demographic profile of the industry in New York and its 2023 study has done much the same for California.

In some ways labor advocates have a unique advantage in pressing the case for reform of the nail salon industry because workers and consumers alike face much the same health risks.

But public attention tends to focus almost exclusively on threats to consumers, who tend to be middle class and above, and have the social leverage to be more vocal about threats to their well-being.  Union organizing might help, but the workers, given their irregular status, and language and cultural status, are difficult to approach.  Many just prefer to stay quiet.

Looking Ahead:  The Expanding DIY market

The last five years have witnessed a significant shift in the nail salon industry, analysts say.  The COVID-19 pandemic led to a growing number of niche companies (as well as big names like Marie Claire) expanding into both the mobile salon and the DIY market.

With the pandemic shut down orders, many salons were forced to close. Others began reopening with masking and the installation of plexiglass barriers, but some regular clients have been afraid to return because of the close intimate contact with salon workers required.

In the coming years, expect the nail salon trend – including new “mobile” salons that bring the service to women at their place of work or nearby — to grow.

But experts say there is also the potential for a glut in the market that will narrow the profit margins that salons already facing stiff competition can earn.

That’s a recipe for smaller salons especially cutting corners on cost and safety. One industry analyst estimates that presently at least 75% of all US nail salons are guilty of at least one health and safety violation.

The Bureau of Labor Statistics projects employment in the nail salon industry to grow “much faster than the average for all occupations” in the next decade—by 22 percent. That should make health and safety in the industry a top priority.  But regulations and enforcement resources continue to vary sharply by state, and the undocumented nature of the workplace leaves workers extremely vulnerable to abuse.

In some ways, demand from consumers is also driving the problem. New beauty trends and products with unknown chemical compositions are emerging on a daily basis.  And the growth of the DIY market is only narrowing the already tight profit-margins in the industry.

That’s a recipe for smaller salons, especially, cutting corners on cost and safety. One industry analyst estimates that presently at least 75% of all US nail salons are guilty of at least one major health and safety violation.

Organizing for Labor Rights

In the short term, salon workers will continue to face enormous challenges. Labor unions haven’t yet cracked the industry and OSHA, the federal workplace health and safety agency, is still poorly funded and hamstrung by employer-friendly regulations.

Moreover, fierce market pressures are pushing the industry to expand under intense competitive pressures.  Not only employers but even sympathetic local regulators and politicians, anxious to spur small business development, especially among minorities, seem reluctant to crack down on time-worn industry practices.

In the short term, the most optimistic scenario is for nail salon workers to begin speaking out and organizing on their own – and then demanding reform and supportive legislation – from local and state governments.

That effort is already underway.  Earlier this year in New York, home to the highest concentration of nail salons in the nation (more than 4,100 statewide), salon workers began promoting a bill, the “Nail Salon Minimum Standards Council Act” and are now working to secure passage by the state assembly.  The bill calls for the creation of a semi-permanent sectoral council comprising salon workers, business owners and government representatives to jointly recommend reform. Instead of a conventional union, the board would support and promote sector-wide changes, better protecting salon workers but also streamlining business licensure requirements. Businesses deemed in compliance might also receive special tax incentives and loan subsidies.

It’s not a novel solution. Across the country, other vulnerable groups facing barriers to union organizing are following suit. So far, these efforts include nursing home employees in Minnesota, fast food workers in California and rideshare drivers in Massachusetts. In each case, workers are mobilizing to develop their own version of a permanent tripartite council that includes business and government representatives coming together to establish industry-wide standards. But the salon worker effort may be unique for having such a high percentage of undocumented workers who are women – and Asian women to boot – spearheading their cause.

Another important innovation is the development of salon worker healthcare interventions.  Last year an all-Vietnamese research team led by D.T. Nguyen, founder and CEO of Koan Health, investigated health conditions in nail salons in the greater Philadelphia region. Nguyen’s team interviewed Vietnamese-speaking salon owners, workers, and community-based organizations to design and implement a health promotion plan. The team collected baseline and post-intervention individual data about health symptoms and behaviors, as well as personal chemical exposures.  A local community partner was trained to deliver in-language training with technical assistance from the research team.  A counterpart intervention by Nguyen’s team brought the relevant stakeholders together, including salon owners, to discuss the results, and push for greater workplace cooperation.  The project’s still in its infancy, but it promises to achieve results that could be recognized and validated by local regulators, establishing a de facto enforcement regime.

Ad hoc sectoral councils and successful academic-community partnerships are no substitute for the institutional reforms needed to protect nail salon workers from ongoing occupational abuse. But like similar interventions among Mexican farmworkers facing pesticide poisoning, partnerships of this kind can highlight critical unmet issues, raise public and consumer awareness and spur workplace interventions to ameliorate dangerous conditions. Designed properly they also allow one of the most disadvantaged and super-exploited constituencies – low-income Asian women – to achieve a meaningful social protagonism that can foster greater recognition for their struggle for dignity and human rights at the workplace.

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