1. Nail Diseases & Disorders
Cosmetology:
Nail Diseases & Disorders
Milady’s Standard Cosmetology

2. “Decide what you want, decide what you are willing to exchange for it
“Decide what you want, decide what you are willing to exchange for it. Establish your priorities and go to work”
H. L. Hunt

3. Objectives
List and describe the various disorders and irregularities of nails
Recognize diseases of the nails that should not be treated in the salon
LEARNING MOTIVATION (WHY?)
Nail disorders and diseases are certainly not the most glamorous portion of your training in cosmetology, but they could be one of the most critical. More infections are spread through the nails and hands than any other area of the body. You actually have a greater chance of contracting a nail disease from a client than the ever dreadful head lice or even a skin disease.
Therefore, careful analysis of the client’s hands and nails is crucial to your safety and that of your other clients. You must understand that contracting such an infection will prevent you from working for an extended period of time and that will cost you money.
A normal, healthy nail is firm and flexible and should be shiny and slightly pink in color, with more yellow tones in some races. Its surface should be smooth and unspotted, without any pits or splits. Certain health problems in the body can show up in the nails as visible disorders or poor nail growth.
So our lesson today is very relevant to your future success and well-being.

4. Nail Disorders Nail malformation Disease, injury, infection
Healthy matrix, nail replacement
Fingernail replacement 4-6 months
NAIL DISORDERS
NAIL MALFORMATION: Disease, injury, or infection can affect the formation of the nails. If matrix remains in good condition, a normal nail will be replaced. Replacement normally takes 4 to 6 months.

5. Nail Disorders Condition caused by injury, disease, or body imbalance
Bruised nails
Ridges
Eggshell nails
Beaus lines
NAIL DISORDERS: A condition caused by injury to the nail or disease or imbalance in the body. As a professional, you must recognize those conditions you can treat and those that must be referred to a physician.
HINT: If the area to be worked on is inflamed, infected, broken, or swollen, it should be referred to a physician.
Bruised nails. Caused by a blood clot forming under the nail plate resulting in a dark purplish spot, usually due to injury. Treat gently; avoid pressure.
Ridges. Ridges run vertically down the length of the natural nail plate; caused by uneven growth of nails, usually a result of age. Carefully buff the nails; use ridge filler with colored polish to give smooth look.
Eggshell nails. Have a noticeably thin, white nail plate and are more flexible than normal. Nail separates from nail bed and curves at free edge. Caused by improper diet, internal disease, medication, or nervous disorders. Be very careful and gentle as these nails are fragile and can break easily. Use the fine side of an emery board to file; do not use a metal pusher.
Beaus lines. Also known as furrows or depressions. Can run either lengthwise or across the nail. Result from illness or injury to the nail cells in or near the matrix; can be caused by pregnancy or stress. Lengthwise ridges can be caused by psoriasis, poor circulation, and frostbite. Use great care when manicuring; avoid using a metal pusher; use plastic pusher or cotton-tipped orangewood stick. An infected finger is indicated by redness, pain, swelling, or pus. Refer to a physician.

6. Nail Disorders Hangnail or agnail Leukonychia
Hangnail or agnail. A condition in which the living skin splits around the nail. Skin dryness or cutting the living tissue can result in hangnails. Hot oil manicures will help. Never cut living tissue. Hangnails can become infected. If redness, pain, swelling, or pus is present, refer to a physician.
Leukonychia (white spots). Whitish discoloration of nails, usually caused by injury to base of nail or nail matrix; eventually grows off.

7. Nail Disorders Melanonychia Onychophagy Onychorrhexis
Melanonychia. Indicated by darkening of nails; may be seen as a black band under or within the nail plate, extending from base to free edge. Caused by a localized area of increased pigment cells (melanocytes) within the matrix bed.
Onychophagy (bitten nails). Caused by an acquired nervous habit. Frequent manicures and care of the hardened cuticle help overcome this habit.
Onychorrhexis. Split or brittle nails with lengthwise ridges. Caused by injury to matrix; excessive use of cuticle solvents, harsh cleaning agents, polish removers, aggressive filing, or hereditary causes. Nail services can be performed only if nail is not split and exposing nail bed. Correct with conditioning treatments such as hot oil manicures and eliminating cause.

8. Nail Disorders Plicatured (folded) nail Pterygium
Plicatured (folded) nail. Highly curved nail plate often caused by injury to the matrix, but may be inherited. Often leads to ingrown nails.
Pterygium. Abnormal condition that occurs when skin is stretched by the nail plate. Caused by serious injury (burns) or an adverse nail reaction. Cuticle and pterygium are not interchangeable terms. Nail pterygium is abnormal damage to the eponychium or hyponichium. Do NOT push extension of skin back with an instrument as it may cause injury and worsen the condition. Gently massage cuticle creams and conditioners into affected area. Oil manicures may be helpful.

9. Nail Disorders Increased curvature nails Plicatured nails Pincer nails
Trumpet nails
Increased curvature nails. Nail plates with a deep or sharp curvature at the free edge. This is due to greater curvature of the matrix.
Plicatured nail. The free edge pinches the sidewalls into a deep curve.
Pincer nails. A form of dramatically increased nail curvature.
Trumpet nails. Another form of dramatically increased curvature nail.
ACTIVITY: Conduct a term pronunciation activity. Ask students to properly pronounce one term. Be prepared to work with them on correct pronunciation. After you have confirmed the proper pronunciation, have the entire class pronounce each term.

10. Nail Fungus Fungi: vegetable parasites Mold or not mold
Highly contagious
Grow where skin is warm, dark, moist
Mold or not mold
Actually a bacterial infection caused by
Pseudomonas aeruginosa
NAIL FUNGUS
FUNGI: Vegetable parasites which may cause infections on the hands and feet.
Highly contagious. Transmitted through unsanitary implements and work conditions. They are spread from nail to nail or from one client to another.
Grow where skin is warm, dark, and moist.
MOLD OR NOT MOLD: In the past, discolorations (especially those between nail plate and artificial enhancements) were incorrectly referred to as molds. However, it is actually a bacterial infection caused by Pseudomonas aeruginosa. These bacteria can grow out of control and cause infection under certain conditions.

11. Nail Diseases
Infection: indicated by redness, swelling, pus, inflammation
Causes of Infection
Contaminated implements
NAIL DISEASES
INFECTION: Indicated by redness, pain, swelling, pus, inflammation. Should not be treated in the salon, but referred to a physician.
Causes of infection. Contaminated implements. It is NOT caused by moisture trapped between an unsanitized natural nail and artificial enhancements. That is a myth. Moisture produces the anaerobic (no oxygen) condition sought by Pseudomonas aeruginosa.

12. Nail Diseases Indications of infection Avoiding infection
Yellow-green spot
Avoiding infection
No shortcuts; check for infections; disinfect all materials
Indications of infection. A yellow-green spot. Spot becomes darker in advanced stages. The color usually changes from yellow to green to brown to black.
Avoiding infection. Don’t take shortcuts or omit sanitation and disinfection procedures. Don’t perform services if client is suspected of having an infection. Completely disinfect all metal and reusable implements, wash linens or replace with disposable towels; thoroughly clean table surface before and after procedures.

13. Causes of Occupational Infections
Harsh cleaning solutions
Not wearing gloves as directed
OCCUPATIONAL INFECTIONS
Harsh cleaning solutions. Frequent use of harsh cleaning solutions or highly alkaline products can cause infections. Natural oils are removed from the skin by frequent exposure to soaps, solvents, and other substances.
Not wearing gloves as directed.

14. Nail Diseases Onychosis Onychia DISEASES OF THE NAIL
Onychosis. Any deformity or disease of the nails.
Onychia. An inflammation of the nail matrix with formation of pus and shedding of the nail. Can be caused by a skin opening that allows entry of bacteria, fungi, or foreign materials. Can also be caused by improperly disinfected nail implements and bacterial infection.

15. Nail Diseases Onychocryptosis (ingrown nails)
Onychocryptosis (ingrown nails). Affects fingers and toes. Nail grows into the sides of the tissue around the nail. If area is infected, it must be referred to a physician. Poorly fitted shoes or walking can press the soft tissues up against the toenail margin and contribute to the ingrown nail condition.

16. Nail Diseases Onycholysis
Onycholysis. The lifting of the nail plate from the bed without shedding, usually beginning at the free edge and continuing toward the lunula. It is usually the result of physical injury, trauma, or allergic reaction of nail bed. Less often, it is related to a health disorder. Often occurs when natural nail is filed too aggressively or artificial nails are applied improperly.

17. Nail Diseases Onychomadesis Nail psoriasis Paronychia
Onychomadesis. The separation and falling off of a nail from the nail bed. Occurs on both fingernails and toenails. Can be caused by a localized infection, minor injuries to matrix bed, or severe systemic illness. Can also be caused by chemotherapy or cancer X-ray treatments. Do not apply enhancements if this condition is present. If no infection is present, basic manicure and pedicure services can be provided.
Nail psoriasis. Often causes tiny pits or severe roughness on the surface of the nail plate. They appear both randomly and in evenly spaced rows. Can cause the nail plate to look like it has been filed with coarse abrasive or cause a ragged free edge. Can affect nail bed causing yellowish to reddish spots under nail plate (called salmon patches).
Paronychia. A bacterial inflammation of the tissues surrounding the nail. Pus and swelling are usually present. Individuals who work with their hands in water are more susceptible as hands become dried and chapped. Use moisturizing lotions.

18. Nail Diseases Pyogenic granuloma Tinea pedis Onychomycosis
Pyogenic granuloma. Severe inflammation of the nail in which a lump of red tissue grows up from the nail bed to the nail plate.
Tinea pedis. The medical term for fungal infections of the feet, also known as athlete’s foot. In acute conditions, deep, itchy, colorless vesicles (blisters) appear. They spread over the sole and between the toes, perhaps involving the nail fold and infecting the nail. Can become chronic.
Onychomycosis. A common form is whitish patches that can be scraped off the surface of the nail. Another form is long, yellowish streaks within the nail plate. It invades the free edge and spreads toward the root. A third form causes the free edge to crumble and may even affect the entire plate; can invade free edge and spread toward matrix.
ACTIVITY: Conduct a term pronunciation activity. Ask students to properly pronounce one term. Be prepared to work with them on correct pronunciation. After you have confirmed the proper pronunciation, have the entire class pronounce each term.

19. Summary and Review
What conditions do fungal organisms favor for growth?
Name 2 common causes of onycholysis
SUMMARY AND REVIEW
Well-manicured nails, whether natural or artificially applied, have always been recognized as an indication of good grooming. It’s important to also remember that nails originate in the epidermal layer of the skin and, like hair, their condition is dependent upon the individual’s overall health. Nails contain the chemical substance called keratin, and can be cut without pain. You cannot apply any topical product that will cause nails to grow, but a balanced diet filled with the daily required vitamins and nutrients, will help produce healthy, disorder-free nails. Remember that your creativity in providing quality nail services must be grounded in a thorough knowledge and awareness of the structure and physiology of the nails. Working on unhealthy nails can be dangerous to both you and your clients. Learning to identify those conditions that must be referred to a physician is critical to the safety of both you and your clients.
Let’s review.
What conditions do fungal organisms favor for growth?
ANSWER: Dark, warm, moist environment.
Name two common causes of onycholysis.
ANSWER: Injury or allergic reactions.

20. Summary and Review
In what situation should a nail service not be performed?
What is pseudomonas aeruginosa and why is it important to learn about it?
In what situation should a nail service not be performed?
ANSWER: If the nail or skin to be worked on is infected, inflamed, broken, or swollen, you should not service the client but rather refer the client to a physician.
What is Pseudomonas aeruginosa and why is it important to learn about it?
ANSWER: It is a naturally occurring bacteria on our skin that can grow out of control and cause an infection under certain conditions, especially lack of oxygen. Nail fungi are of concern to the salon because they are contagious and can be transmitted from one client to the other through unsanitary implements and working conditions.

21. Summary and Review
Name at least 8 nail disorders and describe their appearance
What is the most effective way to avoid fungal or bacterial infections among your clients?
Name at least eight nail disorders and describe their appearance.
ANSWER: Bruised nails: dark purplish spots under nail plate. Ridges: vertical ridges down length of nail plate. Eggshell nails: thin, white nail plate that is more flexible than normal. Beaus lines: visible depressions running across width of nail plate. Hangnail: living skin splits around the nail. Leukonychia: white spots on the nail. Melonychia: darkening of fingernails and toenails. Onychophagy: bitten nails. Onychorrhexis: split or brittle nails that have a series of lengthwise ridges.
What is the most effective way to avoid fungal or bacterial infections among your clients?
ANSWER: Practicing strict sanitation and disinfection procedures during every nail service with every client.

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