1. Nail Disorders & diseases
Chapter 10
Courtney Shrock, Andrea Goings, Jessica Bartrom

2. Pinpointing common and uncommon nail disorders
A healthy nail is firm but flexible, shiny, smooth, and has no wavy ridges, splits, or pits.
A nail disorder is caused by injury, hereditary, or previous disease.
If the condition is abnormal, refer the client to the physician if needed
You can cosmetically improve certain nail plates if the issue is cosmetic and not medical

3. Common disorders

4. Beau's Lines Sometimes called furrows or corrugations
Visible depressions running across the width of the natural nail plate
Result of major injury or illness that has traumatized the body (pneumonia, surgery, heart failure, etc.)
They occur because the matrix slows down in producing nail cells for several weeks or a month, so the nail plate grows thinner, then returns to normal after the injury is resolved

5. Blue Fingernails Lack of circulating oxygen in red blood cells
May also represent a high level of an abnormal form of hemoglobin in the circulation
If a massage returns the fingernail to its normal color, it is due to them not getting enough blood supply. If the fingernails remain blue, it may be an underlying disease or structural abnormality

6. Bruised nail beds
Blood clots form under the nail plate, causing a dark purplish spot
Due to small injuries of the nail bed
Can be covered with polish or camouflaged with opaque nail enhancements

7. Discolored nails
Indicate surface staining, a systemic disorder, or poor blood circulation
May be caused from nail polish, foods, dyes, or smoking

8. Eggshell Nails
Noticeably thin, white nail plates that are more flexible than normal
Usually caused by improper diet, hereditary factors, internal disease, or medication
Be gentle if needing to file these nails!

9. Hangnail The living skin around the nail plate splits and tears
Dry skin or small cuts can result in hangnails
Advise the client that hot oil manicures would aid in correcting this condition
NEVER cut the living skin around the nail plate
If not properly cared for, hangnails can become infected

10. Koilonychia
Soft spoon nails with a concave shape that appear to be scooped out
The depressions are usually large enough to hold a drop of liquid
They are a sign of iron deficiency, anemia, or a liver condition in which your body absorbs too much iron from the food you eat
They may also be associated with heart disease and hypothyroidism or other long-term illness

11. Leukonychia spots
Known as white spots, they are whitish discolorations of the nails, usually caused by minor injury to the nail matrix
It is a myth that these are caused by a vitamin mineral deficiency
Eventually as the nail grows the white discoloration will disappear

12. Melanonychia The darkening of the fingernails or toenails
May be seen as a black band within the nail plate extending from the base to the free edge
In some cases it may affect the entire nail plate

13. Onychophagy Known as bitten nails
The result of a habit of chewing the nail or the hardened, damaged skin surrounding the nail plate
If the skin is broken or infected, no services can be provided until the area is healed

14. Onychorrhexis
Refers to split or brittle nails that have a series of lengthwise ridges that give give the nail plate a rough appearance
Usually caused by injury to the matrix, excessive use of cuticle removers, harsh cleaning agents, aggressive filing techniques, or hereditary
Avoid nail hardeners on split nails

15. Plicatured nails
Also known as folded nails, a highly curved nail plate caused by injury to the matrix, but it may be inherited.
It often leads to ingrown nails

16. Ridges
Vertical lines running down the length of the natural nail plate that are caused by uneven growth of the nails, usually the result of normal aging
Carefully buff the nail plate to minimize the appearance of these ridges

17. Splinter hemorrhage Caused by physical injury
Damages the capillaries; allows small amounts of blood to flow
The blood stains the epithelium
Considered normal

18. Uncommon or abnormal disorders
These disorders must not be treated in any way unless they are cosmetic

19. Onychauxis Refers to the thickening of the nails
Treatment is to trim or bring the nails down to size

20. Onychogryposis
Also known as ram's horn or claw nails, it's an enlargement of the fingernails or toenails with an increased thickening and curvature

21. Nail Pterygium The skin is stretched by the nail plate
Usually caused by serious injury such as burns, or an adverse reaction to chemical nail enhancement products
Do not treat this condition

22. Pincer nail A deep or sharp curvature at the free edge
The free edge pinches the soft tissue at the free edge
Also known as trumpet nail

23. Onychia An inflammation of the matrix
Followed by shedding of the natural nail plate
Be careful to avoid injuring the sensitive tissue

24. Onychomycosis A fungal infection of the nail plate
Begin with a small separation between the end of the nail plate and the nail bed
Soft yellow material gradually builds up in the separation and the nail will thicken and yellow
Untreated, this disease may cause a partially destroyed nail

25. Paronychia
A bacterial inflammation of the tissues surrounding the nail
May be caused by overexposure to water which leads to dry or chapped skin
Toenails are also more susceptible because they spend a lot of time in a moist, warm environment

26. Pyogenic granuloma
A severe inflammation of the nail in which a lump of red tissue grows up from the nail bed to the nail plate

27. Tinea pedis A.K.A. Athlete's foot
Advise clients with this to wash and dry their feet completely every day; to wear cotton socks, and to change them at least twice a day; to avoid wearing the same pair of shoes each day

28. Nail psoriasis
Tiny pits or severe roughness on the surface of the nail plate
Can occur randomly and sometimes appear in evenly spaced rows
Is not infectious

29. Onychocryptosis Ingrown nails
The nail grows into the sides of the living tissue around the nail
If the tissue surrounding it is not infected, and if the nail is not imbedded in the flesh, you can carefully trim the corner of the nail into a curved shape to relieve pressure
If there is any redness, swelling, pain, or irritation, you may not provide any services

30. Onycholysis
The lifting of the nail plate from the bed without shedding
Happens often on natural nails when filed too aggressively, and nail enhancements when they are improperly removed
If there is no sign of infection or open sores, a basic manicure and a basic pedicure may be given

31. Onychomadesis
The separation and falling off of a nail plate from the nail bed
Can be traced to a localized infection, injuries to the matrix, or a severe systemic illness
If it is present, do not apply nail enhancements

32. Tips to helping recognize these disorders and diseases
Observe the following:
Moisture level- should be soft and supple, with no signs of dehydration or flaking skin
Temperature of skin- cold skin may be bad circulation, warm skin may signal infection
Condition of skin- redness may indicate inflammation or infection
Tenderness to the touch- if the client has pain when you touch their hands, it may require caution or special techniques during massage
Examine the nails- length, shape of free edge, cuticle, and thickness of nail plate