It’s a simple act of bliss: sinking into a fat massage chair and surrendering to an adept technician who rubs away tension, kneading lotion into thirsty skin. In fact, the process of getting a pedicure often has less to do with perfectly polished nails and more to do with taking time out of your day to relax (preferably in the company of a tasty gossip magazine). If you have diabetes, the need to pamper yourself—and forget for a few moments about the hard work of managing your condition—is all the more crucial.

But before you kick off your shoes, consider the potential downsides of pedicures. “People with diabetes are at risk for a number of complications. Foot infections are common. If they develop a break in the skin, it can be a life-threatening complication,” says Lee J. Sanders, DPM, chief of podiatry service at VA Medical Center in Lebanon, Pa. “I would caution individuals with diabetes not to receive a pedicure because of the sanitary conditions of the salon, the skills of the individual performing the pedicure, and the cleanliness of the instruments used.”

Still, women (and, yes, even men) with diabetes are heading to salons and spas. The reason? Aside from being an indulgent way to spend an afternoon, pedicures can ensure that feet are clean and hydrated, which is important when you are managing diabetes. That’s why doctors, such as Jodi S. Politz, DPM, a podiatrist with her own practice in Las Vegas, say pedicures are possible—if you’re picky about your salon. “[Anyone with diabetes] can get a pedicure anywhere,” she says, “as long as the nail technician is using very clean instruments and they know what they’re doing.” At her own practice, Politz has created a spa that provides sanitary, medically supervised pedicures. “Women are going to get [pedicures] whether they’re diabetic or not,” she points out, adding that people with diabetes do “have to be more conscious about it.”

So read on to learn how experts advise you can keep your feet safe.

Know When to Skip It

If you are healthy and complication-free, getting a pedicure doesn’t pose a threat the way it does for people with the foot complications of diabetes. But if you have an infection, ulcer, cut, or neuropathy, don’t book an appointment. An open wound is an open door for any bacteria that may be in the foot basin’s water, and nerve damage will make it hard for you to tell if you’ve been cut or if the bath’s water is too hot.

Stake Out the Salon

Scheduling a pedicure at just any old nail salon is a bad idea. “The most important thing is that wherever people go, they need to make sure they’re using clean practices,” says Donna Perillo, owner of Sweet Lily Spa in New York City. As podiatrist Sanders puts it: “We don’t know how clean the basin is. We don’t know how clean the water is.” He urges women to look into the place’s sanitation practices, the technician’s training—make sure she’s licensed—and how the tools are cleaned. “If a woman is going to seek out this service, it is important [she] address these issues,” he says.

If the salon looks clean but you’re still unsure about the sanitization process, don’t be afraid to ask. “Ask them how they clean their things,” says Perillo. “We get asked all the time, and I’m happy to answer.” According to Lisa Tep, owner of Sesen Spa in Vienna, Va., after each service, foot baths should be cleaned with a hospital-grade, EPA-registered disinfectant made specifically for pedicure chairs. If a spa doesn’t clean as often or with the proper chemicals, walk away. “I wouldn’t take a chance,” says Perillo. “There are so many things you can catch. Fungus is the number one thing you see.”

Carroll Klingbile of Damascus, Ore., who was diagnosed with type 2 diabetes three years ago, inspects new nail places by getting a manicure first before leaping into the pedicure chair. “I’ve walked in and sat around and waited” in order to check a salon out, she says. “There are a couple places I’ve walked out of.”

Examine the Foot Bath

Sure, sinking your feet into a pool of warm, bubbly water is relaxing. But did you know that bacteria may be introduced into your bath thanks to the pipes that carry the water? Avoid soaking in someone else’s bacteria by being picky about your foot bath. Some spas, such as Sesen, use “pipeless” pedicure chairs, which reduce the area in which bacteria can hide. Others, like Sweet Lily, opt for easy-to-clean individual buckets or bowls. Before you book your service, ask the spa which type of basin it uses. And remember, regardless of basin type, the technicians should still clean between each client.

Inspect the Tools

Before you let a pedicurist touch your feet, find out how her tools are sanitized. Like foot baths, imple­ments should be cleaned between each use. But, be warned: Just because tools were pulled from a sterilization pouch or drawn from a jar of blue liquid doesn’t mean they’re safe, says Tep. Dirty instruments used on past customers may soak in unchanged fluid or open containers. Ask if the salon operates an autoclave (a hot, pressurized chamber used to sterilize medical instruments), and make sure packages of uncontaminated tools aren’t opened until the minute you sit down—otherwise they may be compromised, she says.

Another tip: Pick a salon that uses stainless steel instruments, which are easier to clean than porous nail files and those wooden sticks used to push back cuticles. If emery boards and nail buffers are used, they should be thrown out after each client to prevent the spread of bacteria.

Some people even tote their own tools as an extra precaution. But then cleanliness becomes your responsibility: “You have to, as an individual, make sure you wash your tools,” says Perillo. “You can infect yourself. As long as you go home and wash them really good … that’s a great solution.”

Give Instructions

“I always tell people: If they have diabetes they should let us know,” says Perillo. “The massage should be gentler.” Though you may feel nervous saying something, nail technicians actually want you to speak up. “I tell my pedicurist, ‘You know, I can’t have [the water] too hot,’” says Klingbile. “I have never found anyone to be nonresponsive to that. They’ve always been very, very nice.”

Request that the technician not clip your cuticles or file your heels or calluses. Make sure the basin’s water is warm, not hot, and that your toenails are cut straight across. Ensure that moisturizing lotions are thoroughly massaged into your feet to prevent excess lotion collecting between the toes. And insist that the pedicurist avoid a credo blade—that’s the one that looks like a razor—on your feet. The tool is illegal in many states.

Plan Ahead

As lovely as freshly shaven legs are, in this case they can do more harm than good. Stop shaving your legs two days before your scheduled pedicure to prevent skin from getting irritated or bacteria from entering any tiny nicks or cuts.

Use Your Judgment

These measures may seem extreme, but consider the alternative: Unsterilized instruments can pass bacteria and infections between clients. So, what do you do if you suspect a salon isn’t practicing safe sanitization? “I would say get up and leave,” says Tep. “You’re risking a lot for a pedicure. If you’re not sure, and you’re not comfortable, it’s better to be safe than sorry.”