If your client has psoriasis, there is a good chance that her nails will be affected along with her skin, so you should be ready to counteract some typical symptoms that occur. "Nail changes occur in up to 50% of people with psoriasis, and at least 80% of those with psoriatic arthritis," says Bosland. Common nail changes in clients with psoriasis include:
Psoriasis is also closely linked to fungal infections. "Some patients have the psoriasis process—scaling and inflammation—occurring at the base of the nail (where the new nail is formed) and nail psoriasis may be present with any type of psoriasis," explains Brodell. "But it’s important to distinguish psoriasis from yeast-induced fungal nails or dermatophyte-induced athlete’s foot."
Bosland explains that because psoriasis of the nails can present with fungal infections, it can be difficult to tell which is which. "About one-third of people who have nail psoriasis also have a fungal infection," she adds. If there are any doubts, a dermatologist can pinpoint the problem through one or more simple tests—and keep in mind that it's not part of a nail technician's job to diagnose medical problems.
To help your clients who suffer from psoriasis, Bosland recommends that nail techs keep nails trimmed as short as possible so as to avoid trauma to the nail, which can worsen or trigger nail psoriasis. Cosmetic repairs can also help offset the nails’ unpleasant appearance. Service options include: filing the nails down to counteract the thickening and using a ridge-filling base coat to help with the pitting. Other options include applying nail polish to mask imperfections or applying short enhancements to reinforce the natural nail.
There is no doubt that psoriasis can take an exacting physical and emotional toll on a client’s well-being and self-esteem, but you can take an active part in helping her through this often sudden and unpredictable disease by making her feel beautiful at a time when she may feel less than her best. Whether your client has a mild or severe problem, listen to her concerns, be sensitive to the changes in her skin and nails, and when in doubt, have her ask her doctor about what nail services are acceptable. Because this disease is different for every person, examine each client on a case-by-case basis. With a little extra attention and customization, you’ll do wonders to improve her entire outlook, both at your salon and in her daily life.
Tracy Morin is a freelance writer and editor based in Oxford, MS.