[Question #9644] Pedicure/manicure risk

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30 months ago
Hi Dr, 

First of all, thanks for the wonderful service. It really help many ppl like who is going through tremendous stress/anxiety. 

I have always have this irrational fear due to hiv. 
Today I went for a pedicure. It’s a very old shop and the lady is not a professional. While she peeling my nail skin at bottom of big toes, she accidentally poke it. Immediately I start bleeding. I just put a plaster and left the place. Below are my questions : 

1) Now is it a hiv risk? 
2) What if there is hiv positive blood in the cutter/tools she used? 
3) is it consider as deep injury? 
4) anyone tested positive due to incident? 
5) do I need hiv testing?
6) it happens 8 hours ago. Do I need PEP for this? 

Thanks 
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Edward W. Hook M.D.
30 months ago
Welcome to our Forum.  Thanks for your questions.  I'll be glad to comment.  I'm sorry that you were stuck during your pedicure  but am pleased to tell you that it was a no risk procedure with no need for concern ofr for testing.  HIV is more difficult to transmit that people somethings think and is effectively transmitted only through direct sexual contact with an untreated, infected person or injection of infected material  deep into tissue.  Thus, in response to your specifc questions:

1) Now is it a hiv risk? 
This was zero risk

2) What if there is hiv positive blood in the cutter/tools she used? 
HIV becomes non-infectious quickly on contact with the environment and is not transmitted on solid instruments (hollow point needles are different)

3) is it consider as deep injury? 
No

4) anyone tested positive due to incident? 
Never to my knowledge

5) do I need hiv testing?
no

6) it happens 8 hours ago. Do I need PEP for this?
Absolutely not.  While PEP is a personal choice, I would not prescribe PEP for you based on this event

I hope this perspective is helpful. Please don't worry.  EWH
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30 months ago
Hi Dr, 

Thanks a lot for your answer. Truly appreciate. Just for my knowledge:

1) for a successful transmission - how much blood need to present? 1 drop is enough or more blood needed? 

2) what they meant by open wound? Does small injury from scratches/nail clipper/pedicure tools is consider open wound/deep wound? 

Thanks again. 
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Edward W. Hook M.D.
30 months ago
1.  If the person is infected and untreated (most people are not infected, most people who are infected are on treatment), then a single drop of blood. injected DEEP into tissue, will cause infection in some people (remember, even most people who are exposed to a contaminated needle do not get infected)

2.Open would are not meaningful risk factors for infection.  Further the term is imprecise and not much use.

It sounds like you're looking for answers on the internet.  If so, please don't.  Much of what is there is theoretical or, even worse, taken out of context, out of date, or just plain wrong.  EWH
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30 months ago
Hi Dr, 

Sorry to trouble you. Today I went to see a HIV doctor in my country, Malaysia. However, that doctor told me it’s a risk same as needle prick. The transmission rate is 0.3% and advised me to take PEP.  He said eventhough there is no visible blood in that cutter, but virus can stay there and transmission could happen if it’s touch my open wound. Now I’m worried again. 

1) if there is abit blood in that cutter - does it cause transmission? 

2) is my wound is consider deep? I saw blood coming out for 15 seconds. After that it’s stop. 

Sorry in advance for being anxious. 
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Edward W. Hook M.D.
30 months ago
With all due respect, the doctor you spoke to is incorrect.  Needles which transmit HIV are hollow, not solid like the instruments used for manicure and as I mentioned, HIV quickly becomes non-infectious on exposure to the environment.  As I said, PEP is a personal choice although I would not be willing to prescribe it for you under the circumstance you describe.

1) if there is abit blood in that cutter - does it cause transmission? 
See my comment above about the difference between hollow needles and solid instruments of the sort used for manicure.

2) is my wound is consider deep? I saw blood coming out for 15 seconds. After that it’s stop
A puncture of the sort you describe would not introduce blood

My assessment is unchanged.  I have done my best to explain why.  I have never seen nor heard of someone who acquired HIV from a manicure (or from a scrape in a barber shop, something we are rather frequently asked about).  I am confident that you will not be the first.

This completes this thread which will be closed shortly without further responses.  EWH
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