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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 – 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 – 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  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  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  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  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 – 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  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 – 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  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