Recently on social media we asked NAILPRO readers, “What are the most common health-related nail issues you see in the salon?” and there was no shortage of feedback. However, after diligently tallying up your responses, it became clear which three conditions are presenting again and again. So, this month, we look at the causes, symptoms and best practices related to nail fungus, damaged nail plates and thick nails.
If you’ve ever had a fungal infection, you know that when this unsightly and uncomfortable condition strikes, it’s not to be ignored—and it strikes often, especially around the nails, says Dana Stern, M.D., board-certified dermatologist and founder of the first dermatologist-developed nailcare line, Dr. Dana (drdanabeauty.com). “Onychomycosis [the clinical term for fungal infection of the nail] affects 12 percent to 14 percent of our population,” she says. “In fact, it accounts for about one-half of all nail disorders.”
More common in toenails than fingernails, onychomycosis presents itself in different ways: Red and inflamed skin, flaking, scaling, and intense itching and burning sensations are typical, but extreme roughness and dryness around the nail might be the only signs. Often the nail itself is flaking and it might be thick and/or yellowing.
The condition is common because it’s so easy to catch. “Onychomycosis can be caused by direct exposure to dermatophytes (fungus), yeast or non-dermatophyte molds,” says Stern. Often it’s triggered by environmental exposure compounded with excessive sweating, infected footwear, trauma to the area and poor hygiene. Communal areas such as gyms, public pools and spas are notorious for spreading fungal infections.
Interestingly, not everyone is equally susceptible. “There’s a genetic predisposition to the problem,” Stern says. “Also, we see it more in men and in people with comorbid conditions, such as diabetes, psoriasis and those who are immuno-compromised.”
Now for the million-dollar question: When—if ever—should a nail tech provide services to a client with nail fungus? Janet McCormick, M.S., educator, author and co-owner of Nailcare Academy (nailcare-academy.com), an online education site that offers programs for advanced and medical-level nail care, is clear on the answer. “A tech should never work on a client with diagnosed or obvious fungus,” McCormick says. And if you realize during a service that the client does, in fact, have a fungal infection, you must stop working immediately. McCormick adds that if a tech merely suspects her client has the condition, she should point out the potential problem and advise that client to see a doctor before receiving further nail services. Finally, she stresses that nail techs should always wear gloves for protection against possible infection.
Stern reminds us that nail fungus isn’t just a cosmetic problem; it can lead to more serious infections and even permanent damage that could affect quality of life. Always urge clients with known fungal infections to seek medical help.
2. Damaged Nails
A truly beautiful set of nails is more than just the polish and art on top; the integrity of the natural nail underneath must also be maintained. Unfortunately, nail damage can present itself at your nail table, despite your best efforts. “The two most common ways in which nails become damaged are clients biting or ripping off their nail enhancements and technicians’ misuse of abrasives, either with an electric file or a too-rough plain file,” says Elaine Watson, founder and CEO of Nailebrity. The telltale signs of improper care? “Thinner areas of the nails where damage has occurred will be a darker pink,” she explains. “The deeper the damage, the darker the shade, from pink to red.”
Before working on a client with obviously damaged nails, try to find out the cause. “This can be difficult because clients don’t like to admit that they’re the cause of the problem,” Watson says. If the damage was done by a nail tech, Watson believes that the improper nail care should be reported to the Board of Cosmetology, as this client is likely not the only one who was mistreated.
Meanwhile, educate clients so they can avoid mistreatment at the nail table. “Tell them that techs should not excessively file the nail plate prior to product application. In fact, they shouldn’t be filing the nail plate at all,” says Watson. “Today’s product formulations provide a better bond than they used to, so no etching of the plate should be necessary—and if it is, that’s a sign that it may be time to update your brand!”
Finally, know when the damage is too severe for any service to take place. Watson warns that a broken nail plate with bleeding or oozing is a red flag, as are severely thinned out nails that are no longer protecting the nail bed. She adds, “Serious pain or infection is an indication that a doctor should be involved.”
3. Thick Nails
Although there are no available statistics on the frequency of thick nails, anecdotally, it’s very common, as they occur as a result of our lifestyles as well as natural changes over time. “Our feet are influenced by shoe styles, friction-causing activities, such as running and tennis, genetics and aging,” says Stern. Additionally, a genetic predisposition to bunions and hammertoes increases the likelihood of nail thickening. “Our nails change along with our feet. So, a large majority of thickened nails are secondary to foot biomechanics.”
But are thick nails really a problem, aside from the extra effort it takes to cut them? Potentially, yes, says Stern, if the thickness results in a barrier compromise. “A thickened nail might hit the inside of a shoe, causing it to separate from the nail bed, or the problem nail can lead to a barrier compromise at the cuticle,” warns Stern. “These events can predispose the person to infection.”
If you come across thick nails at the salon, it must first be determined whether the condition is related to a fungus. Once a client is confirmed fungus-free, it’s safe to perform a pedicure, says Stern. What’s more, McCormick recommends taking the thickened nail down in increments, using an e-file and bit “with a rounded end to prevent invading the side walls. Reducing a thick nail is like reducing an overbuilt acrylic or gel nail,” she says. But use caution; heat is transferred more directly and quickly to the nail bed, which can cause pain, while over-filing can cause damage to the nail.
-Linda Kossoff is a freelance health and beauty writer based in Los Angeles.
[Image: Courtesy of Getty Images]