Nail and Skin Conditions
As nail professionals, it is important to be able to recognise various nail and skin conditions. There are many common conditions that do not prevent a nail service, others that need special care and, some that prevent any treatment all together.
1. Nail professionals should only ever work on healthy hands, feet and nails.
2. We are not doctors or dermatologists and therefore should not diagnose a medical condition.
3. If there is any doubt about a condition, do not continue, but suggest the client seeks medical advice.
Treatable Nail Conditions
LEUKONYCHIA - There are three types.
1) White spots in the nail plate. Some people are more prone to these than others, and it normally depends on the clients occupation. These are normally caused by minor trauma injuries to the matrix such as knocking.
2) White spots or areas on the surface of the nail plate. This is almost always due to some form of damage to the nail. It could be from over-filing weakening the nail, harsh removal of any nail coating or picking nail coatings.
3) White superficial onychomycosis is more common on toes but can be seen on the fingers. It appears as a powdery looking or fuzzy surface. It is a fungal infection caused by a few different organisms. It is usually superficial and will grow out.
Tiny black streaks under the nail. Usually due to minor trauma and occasionally due to illness. They are splinter-shaped due to the forward growth of the nail plate. The will grow out.
Horizontal ridges across the nail plate. These should not be confused with damage to the nail plate. They will noticeably be on all nails and are caused by internal health issue that continues around a month or more. The matrix will be forced to slow down for a period of time, creating interruption in the nail plate formation. They will return to normal when the client has recovered.
Beaded ridges are longitudinal lines with little bumps are usually associated with circulatory problems. Buffing them will thin the nail plate so should be avoided.
You will also come across age related ridges usually noticed in older clients, again buffing cold thin the nail plate.
ONYCHORRHEXIS ASSOCIATED WITH A FURROW
These are usually prone to splitting down from the free edge. This occurs when the matrix is permanently damaged at some stage. The nail plate grows slightly deformed and thinner in this area. If the damage is recent it may cure itself within a year. If the damaged part of the nail is prone to splitting, extreme care should be taken at the free edge as its very easy for infections to get into the nail bed. The best thing to do is keep this nail short with no free edge or it could be protected from splitting by a thin, light overlay.
This is peeling or flaking of the nail. This is normally caused by lack of moisture in the nail plate, chemical damage or minor trauma to the edge of the nail e.g. typing. It can be overcome by avoiding the above, regular use of cuticle oil, very gentle regular filing until the damaged area has grown out and keeping the edges sealed with a nail polish.
This is nail biting. Frequent nail services can stop this problem, as the cuticle can be treated immediately to improve appearance and condition and that is often enough encouragement to stop the habit.
These are longitudinal lines from matrix to free edge. A single furrow may be congenital or caused by injury to the matrix. Treat with care, as the furrow may be very thin.
Nails with a blueish tinge. Usually due to poor circulation or sometimes illness. The nails are often weak and thin. Hand massage and careful buffing will stimulate the circulation in the area. Artificial nails is not recommended if the nails are very thin as this will cause too much trauma to the nail.
A small tear in the cuticle or a sharp point on the side of the nail., usually due to neglect of cuticles or dryness. They can carefully be removed with a clean pair of nippers. The condition can be prevented by gently lifting the nail fold, when softened, from the nail bed and keeping it moisturised.
Dark spots of blood under the nail plate. Avoid the area if painful, if there is pressure under the nail or the bruise covers more than a quarter of the nail. Otherwise treat gently, the blood will eventually grow out.
Thin, pale and fragile nails, usually curving under. Can be hereditary but can also be indicative of illness or medication. Treat very gently.
A series of horizontal ridges down the centre of the nail. Caused by picking at the nail fold. Usually associated with a very large and exposed lunula. Advise the client of the damage being done, but do not try to buff out.
Flat or spoon-shaped nails, which are thin and soft. Can be caused by an iron deficiency or excessive exposure to oils or soaps. Treat gently.
Small pits over the surface of the nail, usually due to psoriasis or dermatitis. Can also be caused by applying a cortisone cream to another area of the body. Treat gently,
This is an abnormal condition where the skin adheres to the nail plate and is stretched by the nail growth. This usually happens as a result of damage to the area at the base of the nail and can also be seen under the free edge. Gently massaging oil into the area will help but never try to remove it. Avoid using solvent based products.
A mild case of this condition is seen as pitting on the nail. The nail will be delicate and must be treated with care. A more severe condition can result in the destruction of the nail plate and should not be treated.
Common and Avoidable Nail Conditions
1. Bacterial Infection
This is unfortunately a common condition seen during nail services. This is caused by an overlay lifting from the nail plate and bacteria entering. The warm, moist environment provides perfect conditions for the bacteria to grow. It is seen as an area that is discoloured. This starts as a faint yellow colour and can progress, if left untreated, to a very dark green. It will remain as a stain on the nail plate even after the bacteria has gone. If this is treated early it will not cause any long lasting problems. But, if left, it can eventually destroy the nail plate. This is caused by lifting of an overlay. To treat, remove nail products completely from the nail and throw away any buffers and files used. The dehydrate the nail. Now the environment does not support bacterial life. It is safe to reapply the overlay.
2. Onycholysis associated with nail services
Nail plates can be damaged by over-buffing and thinning the nail. They can also be damaged by improper removal of coatings and by the client picking off coatings e.g. gel polish. If the nail plate is thinned, Onycholysis can easily result. This opens up the bed to infection. This is easily avoidable by correct preparation, application and removal as well as good client education.
Skin Conditions where Restricted Services can be Offered
This is an over activity of the sweat glands on the feet. If the condition is severe, then the client should be referred to a GP or chiropodist. The client should keep the feet clean and dry at all times and the use of a fungicidal foot powder may be helpful.
This is a patch of hard skin often found on the side or top of the toes and usually caused by pressure from ill-fitting shoes. The surface of this can be removed during the hard removal stage of a pedicure, but if the corn is big and invading lower levels of the skin, the client should be referred to a chiropodist.
These are similar to a corn, but over a larger area such as the heel or under the foot.
This is a misaligned toe joint. This can be really painful for your client so care must be taken when working in the area.
These are treatments where a therapist should not carry out a treatment. If you are unsure whether you may treat refer your client to their GP for permission.
If there is a noticeable infection or inflammation, treatment should be avoided. Not only is there the possibility of aggravating