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

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

Common disorders

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

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

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

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

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!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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