The Arguments Against Medical Nail Technicians

There are people out there who claim that “medical nail technicians” do not or should not exist. Although I am a certified MNT and CPMA (certified podiatric medical assistant), I do find myself agreeing with some of their arguments. I’ll list the reasons why people refute the existence of (or simply disapprove of the concept of) the MNT and explain why I agree/disagree.

1.) Those who claim MNTs do not exist refute their existence on the basis that none of the services any nail technician performs can be considered “medical.”

I agree and disagree with this. I work in a podiatry practice, but nothing that I do in my office is meant to diagnose or treat any medical disorder. If anything, my work is “preventative maintenance” or “pain management” (where foot/hand massage for arthritis or plantar fasciitis is concerned).

During appointments in my treatment room, I accomplish the same things the podiatrist does during a routine foot care exam and then some. I evaluate the feet and nails for anything abnormal and cut the nails down just like the podiatrist does, but I merge the routine foot care with a soothing pedicure in a relaxing environment.

Because my services are preferable to generic physician appointments (and the cost is equal to or cheaper than most insurance copays), many of our patients that normally only come in for preventative routine foot care exams once or twice a year now come in once or twice a month. This is great for the patients and for the doctor. I can take the routine/preventative patients off his hands so he has more time to address patients that require surgery or medical debridement. If I notice that a patient has an issue developing, I immediately refer them to him for a more thorough examination.

I’m not doing surgery. I’m not cutting the skin. I’m not treating or diagnosing any of our patients with anything. So technically, nothing I do is “medical,” in that sense.

However, the clients I service do require special care due to their existing medical conditions. Unfortunately, my standards of care and my education are not universal, so there exists a need for a term to set me apart from other nail technicians who focus solely on beautifying. The term “medical nail technician” communicates to clients that I am not a traditional nail technician and that the services I perform have different objectives. I have extensive training in nail technology as it applies to a podiatry practice. I’m not “better” than a nail technician, I just operate very differently because the environment I work in and the clientele I perform services on require me to.

in addition to my additional training, what makes me a “medical” nail technician is the fact that I combine spa relaxation with medical values on health and safety.

The majority of my clients are sick. They don’t appear sick and they don’t act sick, but they are very ill. I have clients with HIV, AIDS, hepatitis, diabetes, brain tumors, epilepsy, and various other immune compromising conditions. Chances are, a lot of traditional nail technicians do as well–they just don’t know it.

What sets me apart from these nail technicians is that I’ve been trained to treat these clients, and that training goes beyond “universal precautions.” I know all of my client’s allergies, every medication they’re taking, every medical condition they suffer from, every surgery they’ve had, and how all of those things fit in with the services I perform (or whether they contraindicate portions of it entirely). I work aseptically and all implements are surgically sterilized. I don’t cut the skin…ever. I also know a good deal about foot biomechanics and every type of procedure our office performs, so I’m able to explain to them what a particular foot/ankle surgery entails and what orthotic options are available to them. I can take x-rays, perform strapping, cast molds, and analyze gait. (I rarely have to do any of these things thanks to our medical assistants, but if necessary I’m able to.)

A lot of clients come to me specifically because of this additional training. Some come to me because I have worked in emergency medicine. For example, three of my clients suffer from frequent seizures. They feel more comfortable coming to my office for services because they know that I was a medic and won’t have a heart attack if they slip into one of their seizures under my supervision. The majority of my clients come to me because their immune system isn’t capable of fighting off an infection or their ability to heal from even minor wounds is extremely limited.

So my focus and my ability to care for an ill client is extremely different than that of a traditional nail technician. I’m more concerned about wellness and health, whereas salon techs are solely focused on beautifying. This isn’t to say that technicians aren’t concerned at all about wellness, it’s just not generally their primary objective.

In my opinion, there shouldn’t be a need for a designation to set apart “medical” nail technicians. This training and standard of care should be universal for everyone that works in the beauty industry. Every nail technician should be able to easily identify nail disorders and have a network of physicians to refer to. Every nail technician should be working aseptically. Every nail technician should have an autoclave and know how to use it properly. (Don’t argue with me on this–autoclaving is foolproof and cheaper than immersion disinfection. Sure, immersion is suitable for salon environments, but why introduce any margin of error if there’s an alternative that doesn’t? That’s another post for another day.) Every nail technician should be aware of any contraindicating conditions and how to adjust their service protocols for their clients accordingly, but our schools don’t really train us for that.

For now, the separate designation is necessary. For as long as nail technicians out there continue to use “disinfectable” nail files and improperly clean their piped pedicure tubs, I have to set myself apart. Until the states start requiring beauty schools to step up their training and for salons to ramp up their infection control standards, I have to belong to another category of professional.

2.) Nail technicians abuse the “medical nail technician” title and use it to falsely advertise themselves, their services, and their ability to care for the clients they’re attracting.

The main issue many people have with the “medical nail technician” designation is that technicians may abuse it. I agree with this as well because I’ve seen it. Fortunately, the people abusing the title aren’t the ones that are actually certified in medical nail technology, so it doesn’t bother me.

Call yourself what you want, if you don’t have the credentials or training to back up your boast, you can’t be taken seriously by anyone…least of all me.

Legitimately certified MNT’s are not permitted to advertise themselves as such (or display their certificate) in a salon, therefore, anyone advertising themselves as a “medical nail technician” at a salon is most certainly NOT one. Certified MNTs can ONLY operate as such in a podiatry practice.

At any point in time during an appointment, I can call a board certified podiatrist into my office. If you can’t do the same, do yourself a favor and drop the “medical” from your title.

If you are working in a salon without a physician on staff, you are not a “medical” anything. Quit calling yourself that. You’re inviting a lawsuit.

Unfortunately, the MNT title periodically attracts clients who I legally and ethically can not service. Specifically, I’m talking about clients with extremely contagious skin and nail disorders. I also get a lot of clients who think they’re saving money by coming to me for a consultation instead of the doctor. (Clear, specific advertising deflects most of that, though.)

In a salon environment, these clients are far outside a nail technician’s scope of practice. By taking on those clients, nail technicians are putting their other clients at risk. If you’re servicing contagious clients and clients with compromised immune systems in a salon, you’re a fool. Plain and simple. A certified MNT will never take those clients. If a “medical” nail technician is advertising that they can treat athlete’s foot or nail fungus, they’re a fraud.

Legitimate medical nail technicians are acutely aware of their capabilities and advertise themselves appropriately. Most medical nail technicians don’t typically offer more “advanced” services, we are simply better educated about how to provide safe services to clients with advanced medical disorders. Many of us are also cross-trained to act as podiatric medical assistants as well and incorporate some of those “lighter” skills into our spa services (for example, I offer a plantar fasciitis ice massage with strapping).

3.) The term “medical nail technician” gives nail technicians the false belief that they’re capable of working outside their scope of practice.

This I do not agree with, simply because I believe that most nail technicians don’t need a special designation to give them a false belief in their abilities.

I’ve seen the handiwork of a number of salon techs who thought they were qualified and legally permitted to cut out ingrowns, shave corns off, or slice off calluses with a blade.

These techs didn’t need a special title to delude themselves into believing they were capable of butchering their clients.

Genuine medical nail technicians are actually far more conservative in their treatment of their clients because they’re more conscientious about how their treatment affects those clients. We know the consequences of even the most minor microtrauma injuries, so we’re far more careful with our implements. Because of these factors, we’re more likely to refer to a physician instead of taking matters into our own hands.

4.) The “MNT” isn’t recognized by any state or national regulatory board, therefore it isn’t a legitimate title.

I disagree entirely. There are plenty of professions that are based on continuing education or aren’t recognized by any regulatory agency at all. For example, medical estheticians are considered pretty commonplace at this point, but few states ‘officially’ recognize the title since a medical esthetician is simply a licensed esthetician that has taken additional CEUs (or has obtained an additional degree in nursing or medical assisting). “Trichologists” (hair and scalp specialists) do not have their certification recognized by any state, but their training requires a cosmetology license (or a medical license) and an intense certification and internship program.

In my state of Florida, medical assisting is not a licensed or officially recognized profession.

Combining fields to create a hybrid field is a legitimate way to effectively separate yourself from similar professions and clarify that you function in a manner that is similar yet different. Any additional training is a bonus and deserves to be recognized. The MNT curriculum was actually far more intensive than the curriculum found in the beauty academy I attended and the one I taught in. MNTs are also required to complete an internship. This internship requires the completion of a skill log under the physician’s supervision.

A certified MNT can not even be compared to a traditional nail technician.

  • The duties MNTs perform are similar to a salon technician’s, but the MNT’s objective is very different.
  • The majority of the clients MNTs work on have medical disorders that need to be treated with care.
  • The MNT’s sanitation standards are different because the needs of our clients require them to be.
  • The MNT’s education is beyond that of a salon technician.

Prior to pursuing a career in medical nail care, I worked in upscale spas. I didn’t take medical histories. I didn’t perform foot evaluations. My job was to soak, clip, shape, buff, exfoliate, massage, and polish. That’s it.

An MNT’s job includes all of those things, but they also have to check pulse and capillary refill, perform Semmes Weinstein filament tests, evaluate pedal edema, evaluate gait, check footwear for proper support and fit, perform strapping and casting, hypertrophic nail debridement, apply and monitor prosthetic toenails, and about a dozen other duties a traditional nail technician would never be expected to (or capable of) performing.

MNTs do exist. The career is a legitimate one. In every profession idiots will tarnish the name of the profession itself. Technicians as a group have to contend with terrible NSS techs that make us all look bad. For certified MNTs, we have to deal with the pretenders that masquerade as as MNTs.

The whole profession shouldn’t be discriminated against because a few techs abuse a title they likely haven’t earned to begin with.

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Tina Alberino
Tina Alberino
Beauty industry survivalist, salon crisis interventionist, tactical verb-weapon specialist, and the leader of at least a hundred workplace revolutions, Tina Alberino is known as much for her extensive knowledge as for her sarcastic wit and mercilessly straightforward style. She’s the author of The Beauty Industry Survival Guide and Salon Ownership and Management: A Definitive Guide to the Professional Beauty Business. When she’s not writing, educating, or consulting, she can be found overthinking everything, identifying problems people didn’t know existed, and stubbornly working to change the things she cannot accept.

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  1. I am a licensed nail tech in the state of Nebraska. I work in a salon in an assisted living facility . I am very interested in acquiring this certification. I think it would assist me better with dealing with the majority of my clients issues. My Grandfather was Diabetic before he passed and the podiatrist he saw new that I was a licensed nail tech and went over the proper care of my Grandfathers toenails with me . I would just like to be able to provide this to more people that I encounter. I saw an online class to acquire the certification. I just want to make sure I am going in the right direction and not spending money on something that does not exist.
    Please help! My clientele base needs a nail tech that has this certification!!!

    Thanks in advance


    Mickala Stark
    Licensed nail technician
    State of Nebraska LIC#1855

    • For you, I would highly recommend it. You’re exactly the type of professional who could benefit from the education. The program I took was through MediNail Learning Center, back with Dr. Spalding and Janet McCormick were partnered. The ANT and MNT programs were the result of the two of them collaborating on the curriculum. They’ve since separated into two different entities. I’m unfamiliar with how the programs have evolved since then, but I know both of them personally and I can vouch for their passion for the content. I’d recommend contacting both of them for more information on their individual programs before making a decision on which to take.

  2. Hi Tina, thank you for this article.

    I am a retired RN, 60 yrs of age. I am currently working part time as a home health aide. In the past i worked in Canada as a visiting nurse, i took a college course for “foot care” which allowed me to do home pedicures for the agency (Victorian Order of Nurses)

    Here in the US I am unable to even cut toenails! (I got pretty good at it!)

    There are MANY elderly people here who just need basic footcare and pedicures, not medical, but they do have medical and age conditions which keep them pretty much homebound. I KNOW I am capable and willing to do this, but of course I am not a “nail tech”.

    I have this idea to become a certified nail tech, but I do not want to do the entire cosmetology course (hair and facials… not for me!)

    So, my question is, is it possible to become a certified nail tech in the state of Florida without all the other?

    My idea is to continue to work for my agency (it is in my estimation a very good one), but to somehow have them enhance services provided to clients with home pedicures (provided by me of course!).

    I don’t know if anyone out there does this, and I have not approached the agency with this idea that is running around my head, and wouldn’t know where to begin.

    This idea keeps coming to me, especially when yesterday, a very elderly lady, wife of my client, barely able to walk with her walker, got in her van and drove to her pedicure appointment… a risky and likely expensive adventure… And I know I could have done it much better and much more comfortably in her own home.

    What do you think about all of this? Is anyone out there doing such? Any advice would be greatly appreciated.

    Thanks again

    • Hi Evelyn! I live in Florida also and, while I could explain how similar my career is and has been to what you’re pursuing, I’ll just leave a link to my salon right here so you can take a look. Basically: there is a HUGE market for medically necessary routine foot care, particularly in towns like Venice where the average resident is 55+. There are a few people out there doing what we do, but not nearly enough to meet the demand. I would consider it entirely worth it to pursue a nail specialist license in the state and start serving those clients, because it really is desperately needed here.

      You can obtain a nail specialist license, but it can be hard to find schools that just offer the nail specialty program. I don’t know what part of the state you’re in, but Sunstate Academy offers the program, as does Fashion Focus in Sarasota.

      In Florida, it is legal to perform services in the homes and facilities of clients who are mobility impaired or homebound by medical necessity, but there’s a protocol to follow outlined by the State Board. (This post can help a little, but the Board’s regulations are linked within it too, so follow those links.)

      If you have any further questions, I’d love to help you in any way I can. You can email me at [email protected]. There’s a good possibility your agency won’t want to deal with including the services, as there are some regulatory hoops to jump through and some liability complications, but if you’re in the Sarasota/Venice area and are really passionate about providing quality foot care to the elderly, we’re hiring and you’re exactly the type of professional we look for.

  3. Thanks, Tina! I am in Citrus County, far away from the hustle and bustle (and hope to stay that way!)

    Thanks for the names of the schools, I will definitely look into that. If anything, once I become a nail tech, I might find myself in a podiatry office (not preferred, but a possibility).

    Who knows, with all these home health agencies popping up, one of them just might want to jump through the regulatory hoops to get a competitive edge.

    I would love to work “unvarnished” ( l love that name) but the boonies are my retirement place.

    Thanks again.

    • One of our salons is in a podiatry practice and I can say it’s the smartest move you (or any other nail technician) could possibly make. It’s a great relationship to have, one that benefits both businesses. Good luck out there! 🙂

  4. Hiii, I absolutely LOVE this article and totally agree with what has been said. Im am a licensed Nail Technician and reside in South Florida and am taking the AMNT&MNT bunde because i want to further my knowledge and my main goal is to provide preventative maintenance and pain management services but to NEVER service out of my scope of practice. I have completed the modules and test but I’m having trouble locating a podiatrist to do the internship do you of any places to complete this or tips to help me find one?

    • I recommend persistently trying to get an audience with any and every podiatrist in your area. I was lucky because I already had access to one, but it can be hard to establish those relationships. Dr. S should be able to help you also. I’d also highlight the fact that you can refer people to their practice exclusively as a benefit.

      • Thank you, I’ll keep trying and if not I’ll show Dr. Spalding my progress and she what he advises. I appreciate your suggestions.


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