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
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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
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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