1. Nail Diseases & Disorders Module 24 – 08’ Module 10 – 12’

2. Introduction
Nails are small mirrors of the general health of the entire body
You must be able to recognize conditions you may encounter while servicing clients
Infectious conditions should not be treated by salon professionals

3. Normal healthy nail Firm Flexible Shiny slightly pink in color
Some races have more yellow tones

4. Surface should be
Smooth
Unspotted
Without pits
No splits

5. The Nail Onyx – composed of (protein) Keratin
Nail Bed – portion of the skin on which the nail plate rests
Nail root – Matrix – where the nail is formed
Lunula – half moon – light color is caused by the reflection of light where the matrix and connective tissue of the nail bed join
Nail Body – Plate – rests on and is attached to the nail bed

6. Nail Malformation
Matrix – if disease, injury or infection occurs, the shape or thickness of the nail plate could change
A nail can be replaced as long as the nail matrix is in good condition
Nail replacement - 4 – 6 months

7. Nail Disorders
A condition caused by injury to the nail or some disease or imbalance in the body
May have to refer client to a physician
Cosmetically improve certain nail plate conditions if the problem/disorder is cosmetic and not a medical disorder

8. Refer to physician
It is your professional responsibility and a requirement of your license to know which option to chose
Infected
Inflamed
Broken
Swollen
Did you know? PP 207

9. Bruised Nails
Blood clot formed under the nail plate (body) forming a dark purplish spot
Cause: injury to nail bed
Treatment: gently and avoid pressure
Prognosis: grow out

10. Blue Nails Discolored nails Cause:
poor blood circulation
Heart disorder
Oral medications
Treatment: regular manicures with polish, tips or wraps
Prognosis: until cause is corrected

11. Ridges Running vertically down length of natural nail plate Caused:
uneven growth of nails
Usually result of age

12. Treatment: carefully buff nail plate to minimize appearance of ridges
Ridge filler is less damaging - used with colored polish
Prognosis: regular manicures to keep ridges to a minimum

13. Corrugations (Seleronychia)
Wavy ridges
Cause: uneven growth usually from injury or illness
Treatment: Carefully buff
Prognosis: until it grows out and illness or injury is healed with no damage to the matrix

14. Eggshell Nail Noticeably thin, white nail plate (body)
More flexible than normal
Normally weaker & curve over free edge
Nail plate (body) separates from the nail bed and curves at the free edge
Cause: improper diet
Hereditary factors
Internal disease
Medication
Nervous disorder

15. Treatment: use fine side of file do not use pressure
Fragile and can break easily
Do not use heavy pressure pusher at the base of the nail plate
Nail is thinnest here and most likely to be punctured
Prognosis: grow out after cause has been corrected

16. Furrows (Depressions)
Lengthwise or across the nail
Cause: injury near or at the nail matrix
pregnancy
Stress
Lengthwise
psoriasis
Poor circulation
frostbite

17. Treatment: Avoid use of metal implements
Prognosis: grow out if cause can be removed

18. Beau’s Lines
Visible depressions running across the width of the natural nail plate
Cause:
Major illness or injury that has traumatized the body
Pneumonia
Adverse drug reaction
Surgery

19. Treatment: Heart failure Massive injury High fever
Matrix slows down producing nail cells for an extended period of time (week –month)
Treatment:
Avoid use of metal implements
Carefully buff

20. Prognosis: nail plate thickness usually returns to normal after the illness or condition is resolved

22. Hangnail (Agnail)
Cuticle split around nail – leaves a piece (fringe) of skin
Cause: dryness
cutting too much cuticle
Carelessly removing cuticle tissue

23. Treatment: hot oil manicures
NEVER cut the living skin around the natural nail plate
IT IS AGAINST STATE REGULATORY AGENCY REGULATIONS
Can lead to serious infections for which you and the salon may be legally liable

24. Prognosis: heals when treated (if not infection may set it)
Symptoms of infection
Redness
Pain
Swelling
Pus
Refer to a physician

26. Leukonychia White spots Cause: injury to base of nail Myths:
Minor damage to Matrix
Myths:
Vitamin or mineral deficiency
Calcium or zinc deficiency
Treatment: polish
Prognosis: disappear as nail grows out

27. Melanonychia Darkening of nail plate (body)
Black band under or within nail plate –extending from the base to the free edge
Cause: localized area of increased pigment cells
Fairly common occurrence
Considered normal in African Americans
Could be indicative of a disease or condition in Caucasians

28. Treatment: polish
Prognosis: grows out

30. Onychatrophia Atrophy or wasting away of the nail
Cause: injury or disease
Treatment:
file smooth with fine file
DO NOT USE METAL PUSHER!
Prognosis: depends on how badly injured or if disease is curable

31. Onychauxis Hypertophy – overgrowth of the nail in thickness Cause:
local infection
Internal imbalance
hereditary
Treatment:
if infected - DO NOT TREAT!
If no infection - file smooth and buff
Prognosis: depends on cause, and how long it has been left untreated

32. Discolored Nails Nails that turn a variety of colors Surface staining
Systemic disorder
Poor blood circulation

33. Cause: Surface stains from nail polish Foods Dyes smoking
Internal discoloration due to
Biological
Medical
pharmaceuticals

34. Prognosis: depends on cause
Treatment:
Colored polish
Prognosis: depends on cause

35. Onychophagy Bitten nails Cause:
Chew the nail or hardened damaged skin surrounding the nail plate
habit
stress
nervous

36. Prognosis: good if habit stops
Treatment:
Enhancements
Frequent manicures
Care of hardened eponychium
Improving health and appearance of hands
Prognosis: good if habit stops

38. Onychorrhexis
Abnormal brittleness or splits with striation (lengthwise lines) of the nail plate – appearing rough
Cause:
Injury to Matrix
excessive use of cuticle solvents/polish removers
Aggressive/careless filing
vitamin deficiencies
illness
frequent exposure to strong soaps, harsh cleaners
Hereditary causes

39. Prognosis: good over time with treatment
Can only be treated if nail is not split and exposing the nail bed
oil manicures
Prognosis: good over time with treatment

41. Plicatured Nail Folded nail – 90 degrees or more down into tissue
Highly curved nail plate
Cause:
Injury that deforms the matrix
May be inherited
Leads to ingrown nails

42. Treatment: careful filing or physician
Prognosis: possibly need to see a Podiatrist

44. Nail Pterygium
Abnormal condition that occurs when skin is stretched by the nail plate
Forward growth of the Eponychium
Cause:
Improper cuticle care
Serious injury – burns
Adverse skin reaction to chemical products

45. Prognosis: usually not reversible
Treatment:
DO NOT USE METAL IMPLEMENTS!
Gentle massage of cuticle creams/oils
Hot oil manicures may be helpful
Prognosis: usually not reversible

46. ** If irritated, painful or shows signs of infection – refer to a physician
Note: - Pterygium is not normal – denotes damage to the eponychium or hyponychium

48. Splinter Hemorrhages
Appearance of a small splinter under the nail plate
Positioned lengthwise in the direction of growth
Cause: physical trauma or injury to the nail bed that damages capillaries and allows blood flow
Treatment: colored polish
Prognosis: grows out as nail grows

49. Increased Curvature Nails
The greater the curvature of the Matrix – the greater the curvature of the free edge
Range
Mild
Severe pinching of the soft tissue at the free edge

50. Tile – Shaped Nails
Increased crosswise curvature throughout the nail plate
Cause: increased curvature of the matrix
Treatment: none
Prognosis: irreversible

51. Trumpet or Pincer Nail
Edges of the nail plate curl around to form the shape of a trumpet or cone at the free edge
Cause: Nail bed becomes constricted and may be painful
Treatment: carefully trim the margins of the nail plate and file
Extreme or unusual cases - refer to physician/podiatrist
Prognosis: none

53. Nevus Black or brown stain Cause: birthmark/heredity
Treatment : polish
Prognosis: none

54. Nail Fungus Fungi – parasites
May cause infections of the feet and hands
Severe case: cheesy, sticky residue progresses to a dry and crusty texture
Contagious
Transmitted:
Unsanitary implements
Work conditions

55. Fungi infections grow:
Skin is warm
Moist
Dark
(feet/shoes)
Possible to transmit fungal infections form one client to another!!!!!!!!!

56. Proper sanitation and disinfection practices – transmission can be avoided
Clients with suspected fungi infections should be referred to a physician

57. Pseudomonas Aeruginosa
Discolorations between nail plate and artificial enhancements
Naturally occurring skin bacteria can grow out of control & cause an infections if conditions are correct for growth
Cause:
Contaminated implements (with large numbers of bacteria)
Large numbers of bacteria or fungal organisms on a surface

58. Prognosis: nail could fall off
NOT result of moisture trapped between natural nail plate and enhancement
Water does NOT cause
Treatment:
Remove enhancements; physician
Proper cleaning of nail plate
Proper sanitation
Proper disinfection of implements
Refer to a physician
Prognosis: nail could fall off

59. Bacterial infection Early stage: yellow-green spot
Advanced stage: darker to brown/black
Soften and smell bad
Plate becomes sensitive to touch
(goes from yellow – green – brown – black)
Caution box page 649/210
Table 24-1 page 648/Table 10 – page 211

61. Nail Diseases
Person’s occupation can cause a variety of nail infections
Natural oils are removed by frequent exposure to:
Soaps
Solvents
Many other substances

62. Products should always be used according to mfg. directions
If the mfg. recommends to wear gloves – DO SO TO PROTECT YOUR SKIN!!!!!!!

63. Onychosis
Any deformity or disease of the natural nail

64. Onychia
Inflammation of the nail matrix followed by shedding of the nail plate
Cause: improperly cleaned and disinfected implements
Treatment : avoid pressure
Prognosis: grows out as infection is removed

65. Onychocryptosis Ingrown nail Cause: poor fitting shoes
Improper filing/cutting nails

66. Prognosis: grows out when cause is corrected
Treatment :
In no infection present – carefully trim corner of nail in a curved shape to relieve pressure
If infection is present – refer to a physician/podiatrist
Prognosis: grows out when cause is corrected

68. Onycholysis Lifting of the nail plate from the bed without shedding
Cause:
Physical injury
Trauma
Allergic reaction of the nail bed
Health disorder
Aggressive filing – natural nail
Improper removal of enhancements

69. Prognosis: grows out as trauma is removed
Improperly fitted shoes
Treatment :
No infection or open sores – basic manicure or pedicure
Cut free edge short
Infection present – refer to physician/podiatrist
Prognosis: grows out as trauma is removed

71. Onychomadesis Separation and falling off of nail plate Cause:
localized infection
Injuries to matrix
Severe systemic illness

72. Prognosis: once problem is solved – nail grows out
Treatment :
Do not apply nail enhancements
No infection or open sores – basic manicures/pedicures
Prognosis: once problem is solved – nail grows out

74. Nail Psoriasis
Non infectious condition that affects the surface of the nail plate causing tiny pits or severe roughness on the surface
May develop yellowish to reddish spots under nail plate – salmon patches
Cause: birthmark/heredity

75. Treatment : polish if no infection present
Prognosis: refer to a physician

77. Paronychia Bacterial inflammation of the tissues surrounding the nail
Redness, pus, selling around nail plate
Cause:
Hands in water all the time
Dry chapped hands from exposure to water, detergents, harsh soaps
Toenails – warm moist, environments

78. Treatment : refer to physician
client can do at home
moisturizing hand lotions
Keep feet clean and dry
Prognosis:

81. Pyogenic Granuloma
Severe inflammation of the nail with a lump red tissue grows from the nail bed to the nail plate
Cause:
Treatment : refer to physician
Prognosis: none

83. Tinea Pedis
Fungal infection of the feet (athletes feet) – ring worm of the feet
Red itchy rash in spaces between the toes
Small degree of scaling of skin
Cause:

84. Treatment : refer to physician
Client – keep feet dry and clean daily
Wear cotton socks
Change shoes daily
Over-the-counter antifungal powders
Prognosis: grows out when infection is gone

86. Onychomychosis
Fungal infection of the natural nail plate – ringworm of the nails
Whitish patches
Long whitish or pale yellowish streaks within the nail plate
Free edge of the nail to crumble
Cause:

87. Treatment : none
Prognosis: refer to physician