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Heidi Tarman

on 26 January 2015

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Why study nail disorders and diseases

Nail disorders

Nail diseaes
List and describe the various disorders and irregularities of nails.

Recognize diseases of the nails that should
be treated in the salon.
Since you now understand the growth and structure of the nails,now you must learn about the disorders of nails,so that you will know when it is safe to work on a client.
You must be able to identify any conditions on a client's nails that should NOT be treated in the salon and which may be treated in the salon.
You must be able to identify infectious conditions that may be present so that you can take the appropriate steps to protect yourself and your clients from the spread of disease.
You may be in a position to recognize conditions that may signal mild to serious health problems that warrant the attention of a doctor.
As you now know,
a normal, healthy nail is firm but flexible
The surface is shiny, smooth and unspotted with no wavy ridges, pits or splits
nail disorder

is a condition caused by injury or disease of the nail unit
. A cosmetologist should recognize normal and abnormal nail conditions, understand what to do, and be able to help a client with a nail disorder in one of two ways:
You can tell clientst hat they may have a disorder and refer them to a physician, if required.
You can cosmetically improve certain nail plate conditions if the problem is cosmetic and not a medical condition or disorder.
A client whose nail or skin is infected inflamed, broken or swollen should not receive services.
They should be referred to a physician to determine the type of treatment that is required
Clients cannot sign a waiver or verbally give a cosmetologist permission to disobey state or federal rules and regulations.
There are 13 disorders that we see in the salon that you should have some knowledge of :
Bruised nails

are a condition in which a blood clot forms under the nail plate, causing a dark purplish spot
These discolorations are usually due to small injuries to the nail bed
.They will grow out and can be camouflaged with nail polish or an opaque nail enhancement. Treat nail gently and advise clients that their nails are like jewels not tools!
Eggshell nails
are noticeably thin, white nail plates that are more flexible than normal
. Causes are improper diet, hereditary factors, internal disease or medication. The are very fragile and break easily. Usually best not to file and protective overlays can be helpful as long as you do not extend nails beyond the free edge.
Beau's lines

are visible depressions running across the width of the natural nail plate
. Usually result from major illness or injury that has traumatized the body, such as pneumonia, adverse drug reaction, surgery, heart failure, massive injury or a long-lasting high fever. This happens because the matrix slows down in producing nail cells for the time of the illness and usually will return to normal after the illness or condition is resolved.
, also known as
, is a condition in which the living skin (eponychium) around the nail plate splits and tears
. Hangnails can be carefully trimmed as long as the living skin is not cut or torn in the process. If not properly cared for a hangnail may be come infected. Clients with symptoms of infections in their fingers should be referred to a physician.
Signs of infection are redness, pain, swelling or pus.
Leukonychia spots
, also known as
white spots
,are whitish discolorations of the nails, usually caused by minor injury to the nail matrix
They are not caused from a deficiency of vitamins or minerals, that is a myth
. They will disappear as the nail grows out.
is darkening of the fingernails or toenails. It may be seen as a black band within the nail plate, extending from the base to the free edge.
A localized area of increased
pigment cells (melanocytes)
, usually within the matrix, is responsible for this condition. This is a fairly common occurrence and considered normal in people of color, but could be indicative of a disease condition in caucasians.
Discolored nails
are nails that turn a variety of colors, which may indicate surface staining, a systemic disorder or poor blood circulation.
A discolored nail may be caused by several factors, such as; surface stains from nail polish, foods, dyes or smoking
. Also may be caused by an internal discoloration of the nail plate due to biological, medical or even pharmaceutical reasons.
, also known as
bitten nails
, is the result of a habit of chewing the nail or the hardened, damaged skin surrounding the nail plate. No services can be provided if the skin is broken or infected.
refers to split or brittle nails that have a series of lengthwise ridges giving a rough appearance to the surface of the nail plate. This condition is usually caused by injury to the matrix, excessive use of cuticle removers, harsh cleaning agents, aggressive filing techniques or hereditary.
Nail services can be provided as long as the nail is not split, exposing the nail bed. This condition may be corrected by softening the nails with a conditioning treatment and discontinuing the use of harsh detergents, cleaners or improper filing. Often lacking sufficient moisture, you can treat twice-daily with a high quality, penetrating nail oil. Avoid nail hardeners as these products will increase brittleness.
Plicatured nail
, also known as
folded nail, is a type of highly curved nail plate usually caused by injury to the matrix, but it may be inherited
. This condition often leads to ingrown nails.
Nail pterygium
is an abnormal condition that occurs when the skin is stretched by the nail. Usually caused by serious injury, such as burns, or adverse skin reaction to chemical nail enhancement products. The term cuticle and pterygium do not designate the same thing. Nail pterygium is abnormal and is caused by damage to the eponychium or hyponychium. Do not treat and never push then extension of skin back with an instrument, as this can cause more injury to the tissues and will make the condition worse. Gentle massage of conditioning oils or creams may be beneficial to the affected area. If signs show irritation, pain or infection recommend client to a physician.
are vertical lines running down the length of the natural nail plate that are caused by uneven growth of the nails, usually the result of normal aging.

When manicuring a client with this condition, carefully buff the nail plate to minimize the appearance of these ridges
Take care not to overly thin the nail plate, which could lead to nail plate weakness and additional damage. Ridge filler is less damaging to the natural nail plate and can be used with colored polish to give a smooth appearance while keeping the nail plate strong and healthy.
Splinter hemorrhages

are caused by physical trauma or injury to the nail bed that damages the capillaries and allows small amounts of blood flow.
The blood
then stains the bed epithelium tissue.
This blood oxidizes and turns brown or
black, giving the appearance of
a small splinter under the nail plate.
They will always be positioned lengthwise in the direction of growth.
They are normal and
usually associated
with some type of hard impact or other physical trauma to the
Nail plates with a deep or sharp curvature at the free edge have this shape because of the matrix; the greater the curvature of the matrix, the greater the curvature of the free edge. This curvature can range from mild to severe pinching of the soft tissue at the free edge.
In some cases, the free edge pinches the sidewalls into a deep curve. This is known as
pincer nail
also known as

trumpet nail.
The natural nail plate should be carefully trimmed and filed. Extreme or unusual cases should be referred to a qualified medical doctor.
Fungi are parasites that may cause infections of the feet and hands. Nail fungi are of concern to the salon because they are contagious and can be transmitted through contaminated implements.
Fungi can also spread from nail to nail on the client's feet, but it is less likely that these pathogen will cause fingernail infections. They prefer to grow in conditions where the skin is warm, moist and dark, like in shoes.
It is extremely unlikely that a cosmetologist could become infected from a client, but it is possible to transmit fungal infections from one client's foot or toe to another client
. They can be easily avoided by proper cleaning and disinfecting. Clients with suspected nail fungal infection bust be referred to a physician.
In the past, discoloration of the nail plate (especially those between the plate and nail enhancements) were incorrectly referred to as molds
This term should not be used when referring to infections of the nails
The discoloration is usually a bacterial infection such as
Pseudomonas aeruginosa
, one of several common bacteria that can cause a nail infection, or Staphylococcus aureus
. Infection can be caused by the use of implements that are contaminated with large numbers of these bacteria. Water does not cause infections. Infections are caused by large numbers of bacteria or fungal organisms on a surface.
A typical bacterial infection on the nail plate can be identified in the early stages as a yellow-green spot that becomes darker in its advanced stages
. The color usually changes from yellow to green to brown to black. Clients with these symptoms should be immediately referred to a physician for treatment. It is illegal for a cosmetologist to diagnose or treat a nail infection. You should never provide any type of nail services to clients with a nail bacteria or fungal infection..
There are several nail diseases that you may come across. Any nail disease that shows
signs of infection or inflammation (redness, pain, swelling or pus
) should not be diagnosed or treated in the salon.
A person's occupation can cause a variety of nail infections. For instance, infections develop more readily in people who regularly place their hands in harsh cleaning solutions. A cosmetologist's hands are exposed daily to professional products. Use them according to the manufacturer's instructions to ensure that they are being used correctly and safely.
In this chapter we will cover 8 different diseases of the nails.
is any deformity or disease of the natural nail.

is an inflammation of the nail matrix followed by shedding of the natural nail plate
. Any break in the skin surrounding the nail plate can allow pathogens to infect the matrix. Be caeful t avoid injuring sensitive tissue, and make sure that all implements are properly cleaned and disinfected.
, also known as
ingrown nails
, can affect either the fingers or toes. In this condition, the nail grows into the sides of the living tissue around the nail. If the tissue around the nail plate is not infected, or if the nail is not imbedded in the flesh, you can carefully trim the corner of the nail in a curved shape to relieve the pressure on the nail groove. If there is any redness, pain, swelling or irritation, you may not provide any services. Cosmetologists are not allowed to service ingrown nails. Refer the client to a physician.

is the lifting of the nail plate from the bed without shedding, usually beginning at the free edge and continuing toward the lunula area.
Usually the result of physical injury, trauma or allergic reaction of the nail bed, and less often related to a health disorder. Often occurs when nails are filed to aggressively, on nail enhancements when they are improperly removed or on toenails when clients wear shoes without sufficient room for the toes. If there is no indication of an infection or open sores, a basic manicure or pedicure may be given. The nail plate should be short to prevent further injury and the area underneath the nail plate should be kept clean and dry. If the trauma causing the onycholysis is removed, the area will begin to slowly heal itself.

is the separation and falling off of a nail plate from the nail bed. It can affect fingernails and toenails
. In most cases
the cause can be traced to a localized infection, injuries to the matrix, or a severe systemic illness.
Chemotherapy may also be the cause. Whatever the case, once the problem is resolved, a new nail plate will eventually grow again. If this condition is present, do not apply enhancements to the nail plate. If there is no indication of an infection or open sores, a basic manicure or pedicure service may be given.
Nail psoriasis
is a noninfectious condition that affects the surface of the nail plate causing tiny pits or severe toughness on the surface of the nail plate.
Sometimes pits occur randomly, and sometimes they appear in evenly spaced rows. It can look like it has been filed with a coarse abrasive, can cause a ragged free edge or can cause both. It is not infectious. It can also affect the nail bed, causing it to develop yellowish to reddish spots underneath the nail plate, called salmon patches. Onycholysis is also much more prevalent in people with nail psoriasis. When all these symptoms are present at the same time, client should be referred to a physician.
is a bacterial inflammation of the tissues surrounding the nail. Redness, pus and swelling are usually seen in the skin fold adjacent to the nail plate. Individuals who work with their hands in water, such as dishwashers and bartenders, or who must wash their hands continually, such as health-care workers and food processors, are more susceptible because their hands are often very dry or chapped from excessive exposure to water, detergents and harsh soaps. Use moisturizing hand lotions to keep skin healthy and keep feet clean and dry.
Pyogenic granuloma

is a severe inflammation of the nail in which a lump of red tissue grows up from the nail bed to the nail plate.
Tinea pedis
, also known as
athlete's foot
, is the medical term for fungal infections of the feet.
These infections can occur on the bottoms of the feet and often appear as a red itchy rash in the spaces between the toes. Clients with this condition should be advised to wash their feet every day and dry them completely. This will make it difficult for the infection to live or grow. Advise client to wear cotton socks and change them at least twice per day. Avoid wearing the same shoes daily, since shoes take up to 24 hours to completely dry. Over the counter anti-fungal powders can help keep feet dry and may help speed healing.

is a fungal infection of the natural nail plate
. A common form is whitish patches that can be scraped off the surface of the nail. Another form of this infection shows long whitish or pale yellowish streaks within the nail plate. A third common form causes the free edge to crumble and may even affect the entire plate. These type of infections often invade the free edge of the nail and spread towards the matrix.
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