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

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

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

Surface should be Smooth Unspotted Without pits No splits

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Treatment: polish Prognosis: grows out

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Onychosis Any deformity or disease of the natural nail

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

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

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

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

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

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

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

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

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

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

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

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

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:

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

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:

Treatment : none Prognosis: refer to physician