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Welcome To My Slide Show
Nail Myths
Nails don't breathe, they don't sweat, they don't eat, and they don't need a regular rest from artificial extensions.
Nails are a layer of dead keratin, and they don't breathe, eat, or drink.
First and foremost, nails provide a rigid backing to protect the delicate fingertip, which we use to grasp items and distinguish textures. The nails themselves allow us to pick up small items and scratch itchy skin.
FROM THE MATRIX UP
Nail growth begins in the matrix, which is the nail "heart." The matrix is a bed where special skin cells form the nail plate. Damage to the matrix can cause permanent deformity, and can even cause the nail to stop growing completely.
Nails are firmly implanted beneath the skin by the nail root. The root is implanted in a groove under the proximal nail fold just above the matrix.
The nail root and matrix are protected by the proximal nail fold, which is the fold of skin at the base of the nail. Above the proximal nail fold, the white half moon at the base of the nail is the lunula, which is an extension of the matrix. Because the nail plate is still hardening as it grows over the lunula, it is soft and easily damaged.
The nail plate itself is composed of dead keratin. In the nail matrix, keratinocites (a type of skin cell) are compacted and flattened as they push forward toward the nail plate. These flat, compacted cells form the hard nail plate.
The nail bed is the pink bed of skin that extends past the lunula. The nail bed is richly supplied with blood capillaries that oxygenate the nail bed and give it it's healthy pink tone. Physicians can quickly check the hands' circulation by squeezing your nail bed.
The cuticle adheres the proximal nail fold to the nail plate at the base of the nail (called the eponychium) and the nail plate to the nail bed at the nail's free edge (called the hyponychium). The cuticle seals the nail bed and matrix from air and water.
HOW FAST DO NAILS GROW?
Nails grow 1/8 to 1/4 inch per month, depending on a persons age and health, and it takes three to six months for a nail to completely grow out from the matrix to the free edge. Nails grow faster during youth, in warm weather, during pregnancy, and when they are recovering from an injury. Additionally, nails on the right hand (or left, if you are left-handed) grow faster. Nails on the middle finger grow the fastest.
NAILS DON'T BREATHE
The nail plate is made of dead keratin, and contrary to popular opinion, does not require oxygen. The nail bed, cuticle, and matrix do, however, require oxygen because they are composed of live skin cells, but they are supplied by the numerous capillaries that feed the fingertip and nail bed with oxygen-rich blood.
Nails dont sweat. Sweating is the body air conditioning system, cooling the body from the inside out. The nail bed, however, does not have sweat glands, so it can perspire. While the nails do contain a lot of moisture, about 18%, the moisture does not build up under artificial nails. The moisture that causes problems under artificial nails occurs when product lifts and moisture gets underneath; most commonly a result of waiting too long between artificial maintenance.
Nails don't eat, and they don't need vitamins or minerals. Because nails are made from dead protein, they cannot be strengthened by vitamin or mineral supplements. While severe vitamin and mineral deficiencies can affect the nails, Americans are rarely affected by genuine vitamin deficiency. On the other hand, a protein deficiency will affect nail health, but most Americans consume three times more protein than the body needs.
Nails don't need a rest from artificial extensions. The top layers of the nail are thinned by application of artificial product, but this does not affect new growth. However, as the nails continue to be covered they will become thinner and weaker. The condition is NOT permanent, and nails will grow back as healthy as they were before
A nail's strength and thickness is determined, in part, by the nail bed's response to its environment. When the nails are covered by artificial product, the natural nail is not exposed to sensations of water, air, or temperature. In response, the nail becomes thinner and weaker. When artificial product is removed, the nail bed can once again monitor the environment and the nail will grow in thicker and stronger to protect the nail bed and fingertip. It will take three to six months for a stronger and thicker nail to completely grow out.
By understanding what nails are made of, how they grow, and how they adapt to artificial extensions, you can be much more enthusiastic about artificial nails.
You will also be able to recognize and dispel some of the common nail myths that are talked about now that you are educated.
Credit for this information is taken from Nailpro Magazine.
Nails are a layer of dead keratin, and they don't breathe, eat, or drink.
First and foremost, nails provide a rigid backing to protect the delicate fingertip, which we use to grasp items and distinguish textures. The nails themselves allow us to pick up small items and scratch itchy skin.
FROM THE MATRIX UP
Nail growth begins in the matrix, which is the nail "heart." The matrix is a bed where special skin cells form the nail plate. Damage to the matrix can cause permanent deformity, and can even cause the nail to stop growing completely.
Nails are firmly implanted beneath the skin by the nail root. The root is implanted in a groove under the proximal nail fold just above the matrix.
The nail root and matrix are protected by the proximal nail fold, which is the fold of skin at the base of the nail. Above the proximal nail fold, the white half moon at the base of the nail is the lunula, which is an extension of the matrix. Because the nail plate is still hardening as it grows over the lunula, it is soft and easily damaged.
The nail plate itself is composed of dead keratin. In the nail matrix, keratinocites (a type of skin cell) are compacted and flattened as they push forward toward the nail plate. These flat, compacted cells form the hard nail plate.
The nail bed is the pink bed of skin that extends past the lunula. The nail bed is richly supplied with blood capillaries that oxygenate the nail bed and give it it's healthy pink tone. Physicians can quickly check the hands' circulation by squeezing your nail bed.
The cuticle adheres the proximal nail fold to the nail plate at the base of the nail (called the eponychium) and the nail plate to the nail bed at the nail's free edge (called the hyponychium). The cuticle seals the nail bed and matrix from air and water.
HOW FAST DO NAILS GROW?
Nails grow 1/8 to 1/4 inch per month, depending on a persons age and health, and it takes three to six months for a nail to completely grow out from the matrix to the free edge. Nails grow faster during youth, in warm weather, during pregnancy, and when they are recovering from an injury. Additionally, nails on the right hand (or left, if you are left-handed) grow faster. Nails on the middle finger grow the fastest.
NAILS DON'T BREATHE
The nail plate is made of dead keratin, and contrary to popular opinion, does not require oxygen. The nail bed, cuticle, and matrix do, however, require oxygen because they are composed of live skin cells, but they are supplied by the numerous capillaries that feed the fingertip and nail bed with oxygen-rich blood.
Nails dont sweat. Sweating is the body air conditioning system, cooling the body from the inside out. The nail bed, however, does not have sweat glands, so it can perspire. While the nails do contain a lot of moisture, about 18%, the moisture does not build up under artificial nails. The moisture that causes problems under artificial nails occurs when product lifts and moisture gets underneath; most commonly a result of waiting too long between artificial maintenance.
Nails don't eat, and they don't need vitamins or minerals. Because nails are made from dead protein, they cannot be strengthened by vitamin or mineral supplements. While severe vitamin and mineral deficiencies can affect the nails, Americans are rarely affected by genuine vitamin deficiency. On the other hand, a protein deficiency will affect nail health, but most Americans consume three times more protein than the body needs.
Nails don't need a rest from artificial extensions. The top layers of the nail are thinned by application of artificial product, but this does not affect new growth. However, as the nails continue to be covered they will become thinner and weaker. The condition is NOT permanent, and nails will grow back as healthy as they were before
A nail's strength and thickness is determined, in part, by the nail bed's response to its environment. When the nails are covered by artificial product, the natural nail is not exposed to sensations of water, air, or temperature. In response, the nail becomes thinner and weaker. When artificial product is removed, the nail bed can once again monitor the environment and the nail will grow in thicker and stronger to protect the nail bed and fingertip. It will take three to six months for a stronger and thicker nail to completely grow out.
By understanding what nails are made of, how they grow, and how they adapt to artificial extensions, you can be much more enthusiastic about artificial nails.
You will also be able to recognize and dispel some of the common nail myths that are talked about now that you are educated.
Credit for this information is taken from Nailpro Magazine.
Dr Richard Nail Doctor Richard K Scher, M.D.
Nail Doctor Richard K Scher, M.D., Answers Nail Related Questions
Nail Doctor Richard K Scher, M.D., better know in the nail industry as The Nail Doctor, is a dermatologist specializing in nails. He is a Professor of Dermatology and head of the Section for Diagnosis and Treatment of Nail Disorders at Columbia University-Presbyterian Medical Center. He was recently elected president of the American Academy of Dermatology. Dr. Scher is an internationally known expert and pioneer in nail disease treatment and surgery. And in his spare time he writes a bimonthly column for NAILS Magazine.
QUESTION: Does gelatin strengthen weak nails?
ANSWER: Over the decades, people have always looked for an easy way to strengthen the natural nail plate. Nails are made of protein called keratin, and a deficiency of protein can show up as soft, fragile, or brittle nails. Since gelatin is a form of protein, the logic is that the protein would help strengthen nails. It has never been proven in a controlled and scientific fashion that gelatin does anything to strengthen nails. Nails also contain no calcium so there is no rationale for taking calcium to strengthen nails. Several studies have been done with the vitamin biotin that showed some usefulness in making nails stronger.
back to top
QUESTION: I have a client who recently began having an allergic reaction after her salon visits. What could be causing this?
ANSWER: Allergic reactions are caused by prolonged and repeated contact to a specific ingredient in a product. Once a person becomes allergic to something, the allergy can last for life. That is why it is so important to avoid skin contact with all monomers, gels, and resins. Any of these can cause skin reactions if used incorrectly or if they come in repeated and prolonged contact with the skin. A good dermatologist can help identify the ingredient(s) that are causing the allergies by patch testing. Once you know the actual cause of the allergy, you can find products that do not contain that ingredient. Remember, all adverse skin reactions are not completely avoidable, but skin contact must be avoided and products must be used correctly.
back to top
QUESTION: I have a client with brittle nails. What causes this and what should I do about it?
ANSWER: When the nail plate becomes dehydrated, the results can be peeling and splitting nails, which fray at the edges. As a consequence, the nails may break and become more fragile, and can easily catch on clothing. It may also be harder for clients with brittle nails to pick up small objects or button a shirt. This condition also causes polish to chip and peel, although it is still a good idea for the client to wear polish to help protect the nail plate from further dehydration. Use and suggest a non-acetone polish remover, which is also less drying. Treatments with formaldehyde can be drying when used regularly. Treating brittle nails is relatively simple. First, remind the client to wear gloves when using cleaning agents and detergents. Have her avoid trauma to the nail, and not use her nails as tools. Also, recommend clients use a hand moisturizer daily, which will also help moisturize nails. When working on clients with this condition you should avoid excessive mechanical manipulation in the cuticle area. Vigorously pushing back the cuticles with a metal implement, or cutting them, injures the nail matrix (the nail growth center) and causes the nail to weaken.
back to top
QUESTION: Is wearing artificial nails safe?
ANSWER: In and of themselves and when applied properly, acrylic nails are safe. What contributes to the "danger" to clients is repeated exposure to the chemicals on the skin. Most of the chemicals used to create artificial nails are acrylic-based. Certainly they would be dangerous if ingested, but it is not likely that any significant amount of the products can go through the nails into the bloodstream. The danger is when products are applied improperly. Extension products that do not fully cure or harden, whether acrylics or gels, can cause an allergic reaction. Another concern is when the products come in repeated contact with the skin. It is important, as a nail technician, to prevent products from touching client's skin. Do not be overly alarmed, though, if some product touches the skin; it is only through repeated exposure that the harm is done. And while there are no components in the products used to create artificial nails that cause bacterial and fungal infections of the nails, you must make sure that your clients care for their nails so they do not develop these types of problems.
back to top
QUESTION: My client often has white spots on her nails. What causes this?
ANSWER: White spots on the nail is perhaps the most common nail disorder and are called leukonychia, which literally means "whiteness of the nails." There are many types of nail whiteness, some of which indicate serious illness; fortunately, by far the most common cause of white spots on the nail is minor injury to the nail matrix. Caused by trauma or minor injury to the nail matrix, these spots will grow out from the matrix with the nail plate and eventually disappear. Nail technicians should be aware that this type of leukonychia could be caused by over-vigorous pushing back of the cuticles with a metal or wooden instrument. Always soften the cuticles first with a lotion or warm water before pushing them back, and never use anything but gentle pressure. However, should the condition persist or its cause be inexplicable, recommend that the client have the disorder evaluated by a dermatologist.
back to top
QUESTION: My client's nails are constantly lifting away from the nail bed. What causes this? How can it be treated?
ANSWER: Onycholysis (separation of the nail plate from the nail bed) is a condition with many different causes. The more common causes include fungal infection (particularly the yeast fungus candida), psoriasis, trauma, or perhaps sensitivity to certain nail products. Usually, nails will not reattach on their own unless the causative factor is eliminated. Sometimes cutting back the nails and removing the lifted portion and then treating the nail bed or skin underneath can be helpful, but it is difficult to know which treatment is correct unless the patient is evaluated medically (by a dermatologist) with proper tests that point to a specific diagnosis. Once the diagnosis is made and the client is treated for the disorder, it usually takes anywhere between 3-6 months for the nails to reattach, depending upon the extent of the lifting. Sometimes the nails never reattach. If the cause of the lifting is allowed to continue affecting the nail, it can eventually create a scar in the nail bed and the nails won't be able to reattach. Scar tissue typically accumulates over a very long period of time.
back to top
QUESTION: What are green nails and how do I treat them?
ANSWER: The most common bacterial infection of the nails is due to pseudomonas, and is sometimes referred to as "green nails" because of the greenish-colored nail plate. Pseudomonas is generally caused from air pockets under the nail plate that allow mositure to get in and the green pigment-producing organism thrives in the moist environment. This is usually accompanied by onycholysis (lifting nail), so a dermatologist should intervene. You can advise the client to soak her nail in vinegar or a 5 percent household bleach solution several times a day for about four days. It will usually take several months for the green stain to grow out.
back to top
QUESTION: What causes fungal infections and how should I treat them?
ANSWER: Nail technicians can't actually treat fungal infection, but they should be able to recognize some of the signs of this problem. The green spots frequently seen on clients with extensions are more often pseudomonas and frequently are confused for fungus. (See the next question.) Fungus organisms love to infest wide, open spaces. Keeping nails trimmed short will help prevent this, thus reducing trauma and creating less area for the fungus to invade. Keep in mind that fungal infections occur more often in toenails than in fingernails due to the moist environment in shoes. There are topical and oral medications available for treating nail fungus, which should be discussed with a dermatologist. The yeast fungus, candida, thrives in open spaces beneath the nail plate and is often the culprit in this situation. If the infection persists, antifungal therapy should be administered by a dermatologist.
back to top
QUESTION: What causes grooved nails and how can I treat them?
ANSWER: Nails may be grooved in two directions: from side to side or from the cuticle outward. (Do not confuse these with normal ridges that often appear in older clients.) When the grooves are from the cuticle outward, they are called longitudinal grooves of the nail, and these are most commonly caused by a cyst, or a little growth in the skin next to the proximal nail fold. To treat this type of cyst, called a myxoma, a doctor typically performs some form of surgery. When the grooves are from side to side, which is by far much more common, they are referred to as Beau's lines. The most common cause of this disorder is a yeast infection of the skin around the cuticle. This infection injures the nail matrix and because of this type of injury, the matrix cannot produce a smooth nail but instead produces a grooved one. An infected cuticle is referred to as chronic paronychia, and is most commonly caused by the yeast fungus candida. If your client is in good health and not on any medications, a doctor must first provide a diagnosis and treatment. If it is a common yeast infection, then it can be treated with antifungal creams or pills.
back to top
QUESTION: What effect does cold weather have on the nails?
ANSWER: Cold weather can wreak havoc on your client's hands and nails. Special care must be taken during the winter months to combat the nail-related problems associated with this time of year. Some of the nail conditions you are likely to see include brittle nail syndrome, bacterial infections, and Raynaud's Phenomenon. (For information on brittle nail syndrome, fungal infections, and bacterial infections, please see the individual questions.) One consequence of cold weather is decreased circulation to the fingers and toes, which can result in Raynaud's Phenomenon. It may cause fingers to become discolored, alternating from red to white to blue and is often painful. Wearing gloves is recommended for people who have this condition because gloves keep the fingers warmer, thus improving blood flow to the nail area. If the symptoms become severe, do not improve, or continue to get worse, then your client should see a dermatologist.
back to top
QUESTION: What is psoriasis?
ANSWER: Psoriasis is a condition that most frequently manifests itself on the skin. When the nails are involved, the function of the nail unit becomes impaired. The psoriatic nail may not be able to protect the finger or toe, perceive fine touch or sensation, pick up small objects or scratch. The most common misdiagnosis of psoriasis of the nail is fungal infection. In fact, the signs and symptoms of nail psoriasis and onchomycosis (nail fungus) can be indistinguishable. It is absolutely essential that your client's doctor perform the necessary tests in order to arrive at a correct diagnosis. (It is not a nail technician's responsibility to "diagnose" any nail condition.) The changes in the nail that occur when psoriasis is present include onycholysis (separation of the nail from the nail bed) and subungual hyperkeratosis (thickening of the nail bed). Other signs of psoriasis include splinter hemorrhages, reddish-brown discoloration of the nail bed, and white spots on the nail plate. It should be made clear that psoriasis of the nail is a serious and often disabling condition. It should be accurately diagnosed by a physician who will perform the necessary tests (including a KOH wet mount, culture, and possibly a nail biopsy) before starting treatment. After confirming that nail psoriasis is present, an appropriate and safe routine should be established, tailored to the type and severity of the disorder. Clients with nail psoriasis should not wear acrylics because the acrylic can sometimes aggravate the condition.
back to top
QUESTION: What is the best way to treat a client with scarring of the proximal nail fold region?
ANSWER: Scarring of the proximal nail fold region involving the matrix (nail growth center) is referred to as pterygium (not to be confused with the common cuticle overgrowth that is often incorrectly referred to as pterygium). This disorder is actually an overgrowth of the proximal nail fold onto the nail bed. By definition, pterygium forms if there is scar tissue in the nail matrix. Since the nail matrix at that particular site cannot manufacture nail plate, the proximal nail fold skin grows out with the skin of the nail bed, giving rise to the triangular formation known as pterygium. A number of skin and nail disorders may cause pterygium to form. There are two approaches to treat pterygium. The first is used if the pterygium is permanent due to scarring, but the primary disease is now inactive. Under some circumstances, these clients may be helped by surgical reconstruction with the removal of the pterygium and the scar tissue in the matrix, which results in a nail more cosmetically acceptable than it was before. In patients whose pterygium formation is still in an active stage, then the treatment would be directed at the primary disorder. Once the disorder is brought under control, further scarring will not occur and pterygium can be reduced or even prevented.
back to top
QUESTION: When can I work on bruised nails?
ANSWER: When a nail is injured, it can assume a number of different appearances. The most common, of course, would be a discoloration of the nail plate due to bleeding under or around the nail. This condition is referred to as a subungual hematoma, or hemorrhage in the nail plate (similar to a bruise on the skin). When this occurs, the blood accumulates under the nail and it usually causes the nail plate to separate from the nail bed. In addition, the accumulation of blood underneath the nail plate can create pressure and pain. To relieve the pressure, a doctor will cut back the nail plate with a nail nipper to release the accumulated blood. This now leaves the nail bed exposed, and the client will have to wear a bandage for a few days. The new nail will grow rapidly when the separated nail plate is cut away. Once the discolored, bruised, or infected nail has been properly diagnosed by a doctor and treated, it is then safe to work on that client, provided there is no sign of infection, bleeding, pain, or allergy to acrylic. A tip may be applied to the remaining nail plate if the client has no sensitivities to the products (not recommended for clients with chronic lifting). There is no harm in applying nail polish. Clients may actually appreciate the camouflage.
QUESTION: Does gelatin strengthen weak nails?
ANSWER: Over the decades, people have always looked for an easy way to strengthen the natural nail plate. Nails are made of protein called keratin, and a deficiency of protein can show up as soft, fragile, or brittle nails. Since gelatin is a form of protein, the logic is that the protein would help strengthen nails. It has never been proven in a controlled and scientific fashion that gelatin does anything to strengthen nails. Nails also contain no calcium so there is no rationale for taking calcium to strengthen nails. Several studies have been done with the vitamin biotin that showed some usefulness in making nails stronger.
back to top
QUESTION: I have a client who recently began having an allergic reaction after her salon visits. What could be causing this?
ANSWER: Allergic reactions are caused by prolonged and repeated contact to a specific ingredient in a product. Once a person becomes allergic to something, the allergy can last for life. That is why it is so important to avoid skin contact with all monomers, gels, and resins. Any of these can cause skin reactions if used incorrectly or if they come in repeated and prolonged contact with the skin. A good dermatologist can help identify the ingredient(s) that are causing the allergies by patch testing. Once you know the actual cause of the allergy, you can find products that do not contain that ingredient. Remember, all adverse skin reactions are not completely avoidable, but skin contact must be avoided and products must be used correctly.
back to top
QUESTION: I have a client with brittle nails. What causes this and what should I do about it?
ANSWER: When the nail plate becomes dehydrated, the results can be peeling and splitting nails, which fray at the edges. As a consequence, the nails may break and become more fragile, and can easily catch on clothing. It may also be harder for clients with brittle nails to pick up small objects or button a shirt. This condition also causes polish to chip and peel, although it is still a good idea for the client to wear polish to help protect the nail plate from further dehydration. Use and suggest a non-acetone polish remover, which is also less drying. Treatments with formaldehyde can be drying when used regularly. Treating brittle nails is relatively simple. First, remind the client to wear gloves when using cleaning agents and detergents. Have her avoid trauma to the nail, and not use her nails as tools. Also, recommend clients use a hand moisturizer daily, which will also help moisturize nails. When working on clients with this condition you should avoid excessive mechanical manipulation in the cuticle area. Vigorously pushing back the cuticles with a metal implement, or cutting them, injures the nail matrix (the nail growth center) and causes the nail to weaken.
back to top
QUESTION: Is wearing artificial nails safe?
ANSWER: In and of themselves and when applied properly, acrylic nails are safe. What contributes to the "danger" to clients is repeated exposure to the chemicals on the skin. Most of the chemicals used to create artificial nails are acrylic-based. Certainly they would be dangerous if ingested, but it is not likely that any significant amount of the products can go through the nails into the bloodstream. The danger is when products are applied improperly. Extension products that do not fully cure or harden, whether acrylics or gels, can cause an allergic reaction. Another concern is when the products come in repeated contact with the skin. It is important, as a nail technician, to prevent products from touching client's skin. Do not be overly alarmed, though, if some product touches the skin; it is only through repeated exposure that the harm is done. And while there are no components in the products used to create artificial nails that cause bacterial and fungal infections of the nails, you must make sure that your clients care for their nails so they do not develop these types of problems.
back to top
QUESTION: My client often has white spots on her nails. What causes this?
ANSWER: White spots on the nail is perhaps the most common nail disorder and are called leukonychia, which literally means "whiteness of the nails." There are many types of nail whiteness, some of which indicate serious illness; fortunately, by far the most common cause of white spots on the nail is minor injury to the nail matrix. Caused by trauma or minor injury to the nail matrix, these spots will grow out from the matrix with the nail plate and eventually disappear. Nail technicians should be aware that this type of leukonychia could be caused by over-vigorous pushing back of the cuticles with a metal or wooden instrument. Always soften the cuticles first with a lotion or warm water before pushing them back, and never use anything but gentle pressure. However, should the condition persist or its cause be inexplicable, recommend that the client have the disorder evaluated by a dermatologist.
back to top
QUESTION: My client's nails are constantly lifting away from the nail bed. What causes this? How can it be treated?
ANSWER: Onycholysis (separation of the nail plate from the nail bed) is a condition with many different causes. The more common causes include fungal infection (particularly the yeast fungus candida), psoriasis, trauma, or perhaps sensitivity to certain nail products. Usually, nails will not reattach on their own unless the causative factor is eliminated. Sometimes cutting back the nails and removing the lifted portion and then treating the nail bed or skin underneath can be helpful, but it is difficult to know which treatment is correct unless the patient is evaluated medically (by a dermatologist) with proper tests that point to a specific diagnosis. Once the diagnosis is made and the client is treated for the disorder, it usually takes anywhere between 3-6 months for the nails to reattach, depending upon the extent of the lifting. Sometimes the nails never reattach. If the cause of the lifting is allowed to continue affecting the nail, it can eventually create a scar in the nail bed and the nails won't be able to reattach. Scar tissue typically accumulates over a very long period of time.
back to top
QUESTION: What are green nails and how do I treat them?
ANSWER: The most common bacterial infection of the nails is due to pseudomonas, and is sometimes referred to as "green nails" because of the greenish-colored nail plate. Pseudomonas is generally caused from air pockets under the nail plate that allow mositure to get in and the green pigment-producing organism thrives in the moist environment. This is usually accompanied by onycholysis (lifting nail), so a dermatologist should intervene. You can advise the client to soak her nail in vinegar or a 5 percent household bleach solution several times a day for about four days. It will usually take several months for the green stain to grow out.
back to top
QUESTION: What causes fungal infections and how should I treat them?
ANSWER: Nail technicians can't actually treat fungal infection, but they should be able to recognize some of the signs of this problem. The green spots frequently seen on clients with extensions are more often pseudomonas and frequently are confused for fungus. (See the next question.) Fungus organisms love to infest wide, open spaces. Keeping nails trimmed short will help prevent this, thus reducing trauma and creating less area for the fungus to invade. Keep in mind that fungal infections occur more often in toenails than in fingernails due to the moist environment in shoes. There are topical and oral medications available for treating nail fungus, which should be discussed with a dermatologist. The yeast fungus, candida, thrives in open spaces beneath the nail plate and is often the culprit in this situation. If the infection persists, antifungal therapy should be administered by a dermatologist.
back to top
QUESTION: What causes grooved nails and how can I treat them?
ANSWER: Nails may be grooved in two directions: from side to side or from the cuticle outward. (Do not confuse these with normal ridges that often appear in older clients.) When the grooves are from the cuticle outward, they are called longitudinal grooves of the nail, and these are most commonly caused by a cyst, or a little growth in the skin next to the proximal nail fold. To treat this type of cyst, called a myxoma, a doctor typically performs some form of surgery. When the grooves are from side to side, which is by far much more common, they are referred to as Beau's lines. The most common cause of this disorder is a yeast infection of the skin around the cuticle. This infection injures the nail matrix and because of this type of injury, the matrix cannot produce a smooth nail but instead produces a grooved one. An infected cuticle is referred to as chronic paronychia, and is most commonly caused by the yeast fungus candida. If your client is in good health and not on any medications, a doctor must first provide a diagnosis and treatment. If it is a common yeast infection, then it can be treated with antifungal creams or pills.
back to top
QUESTION: What effect does cold weather have on the nails?
ANSWER: Cold weather can wreak havoc on your client's hands and nails. Special care must be taken during the winter months to combat the nail-related problems associated with this time of year. Some of the nail conditions you are likely to see include brittle nail syndrome, bacterial infections, and Raynaud's Phenomenon. (For information on brittle nail syndrome, fungal infections, and bacterial infections, please see the individual questions.) One consequence of cold weather is decreased circulation to the fingers and toes, which can result in Raynaud's Phenomenon. It may cause fingers to become discolored, alternating from red to white to blue and is often painful. Wearing gloves is recommended for people who have this condition because gloves keep the fingers warmer, thus improving blood flow to the nail area. If the symptoms become severe, do not improve, or continue to get worse, then your client should see a dermatologist.
back to top
QUESTION: What is psoriasis?
ANSWER: Psoriasis is a condition that most frequently manifests itself on the skin. When the nails are involved, the function of the nail unit becomes impaired. The psoriatic nail may not be able to protect the finger or toe, perceive fine touch or sensation, pick up small objects or scratch. The most common misdiagnosis of psoriasis of the nail is fungal infection. In fact, the signs and symptoms of nail psoriasis and onchomycosis (nail fungus) can be indistinguishable. It is absolutely essential that your client's doctor perform the necessary tests in order to arrive at a correct diagnosis. (It is not a nail technician's responsibility to "diagnose" any nail condition.) The changes in the nail that occur when psoriasis is present include onycholysis (separation of the nail from the nail bed) and subungual hyperkeratosis (thickening of the nail bed). Other signs of psoriasis include splinter hemorrhages, reddish-brown discoloration of the nail bed, and white spots on the nail plate. It should be made clear that psoriasis of the nail is a serious and often disabling condition. It should be accurately diagnosed by a physician who will perform the necessary tests (including a KOH wet mount, culture, and possibly a nail biopsy) before starting treatment. After confirming that nail psoriasis is present, an appropriate and safe routine should be established, tailored to the type and severity of the disorder. Clients with nail psoriasis should not wear acrylics because the acrylic can sometimes aggravate the condition.
back to top
QUESTION: What is the best way to treat a client with scarring of the proximal nail fold region?
ANSWER: Scarring of the proximal nail fold region involving the matrix (nail growth center) is referred to as pterygium (not to be confused with the common cuticle overgrowth that is often incorrectly referred to as pterygium). This disorder is actually an overgrowth of the proximal nail fold onto the nail bed. By definition, pterygium forms if there is scar tissue in the nail matrix. Since the nail matrix at that particular site cannot manufacture nail plate, the proximal nail fold skin grows out with the skin of the nail bed, giving rise to the triangular formation known as pterygium. A number of skin and nail disorders may cause pterygium to form. There are two approaches to treat pterygium. The first is used if the pterygium is permanent due to scarring, but the primary disease is now inactive. Under some circumstances, these clients may be helped by surgical reconstruction with the removal of the pterygium and the scar tissue in the matrix, which results in a nail more cosmetically acceptable than it was before. In patients whose pterygium formation is still in an active stage, then the treatment would be directed at the primary disorder. Once the disorder is brought under control, further scarring will not occur and pterygium can be reduced or even prevented.
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QUESTION: When can I work on bruised nails?
ANSWER: When a nail is injured, it can assume a number of different appearances. The most common, of course, would be a discoloration of the nail plate due to bleeding under or around the nail. This condition is referred to as a subungual hematoma, or hemorrhage in the nail plate (similar to a bruise on the skin). When this occurs, the blood accumulates under the nail and it usually causes the nail plate to separate from the nail bed. In addition, the accumulation of blood underneath the nail plate can create pressure and pain. To relieve the pressure, a doctor will cut back the nail plate with a nail nipper to release the accumulated blood. This now leaves the nail bed exposed, and the client will have to wear a bandage for a few days. The new nail will grow rapidly when the separated nail plate is cut away. Once the discolored, bruised, or infected nail has been properly diagnosed by a doctor and treated, it is then safe to work on that client, provided there is no sign of infection, bleeding, pain, or allergy to acrylic. A tip may be applied to the remaining nail plate if the client has no sensitivities to the products (not recommended for clients with chronic lifting). There is no harm in applying nail polish. Clients may actually appreciate the camouflage.
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