Showing posts with label Nail Disorders. Show all posts
Showing posts with label Nail Disorders. Show all posts

Friday, October 2, 2015

Common Nail Disorders: Chloronychia aka "Greenies" (Pseudomonas Aeruginosa)

Your favorite clients walks into the salon. You are chatting while you remove her nail polish and she is telling you how she was gardening all weekend and now has a bunch of zucchini and she asks if you would like her to bring you some. You say "That would be great!" and look down at her nails......one of which is as green as the zucchini she was talking about! What in the world happened and how do you fix it?


What are "Greenies"?
Pseudomonas aeruginosa is a common bacteria that can cause disease in plants and animals, including humans. It is found in soil, water, plant, pets, skin flora, and most man-made environments throughout the world. When it grows, it's waste produces pigments that impart the green color of chloronychia (the technical term for green nails caused by p. aeruginosa bacterium).
Normally, nail plate and nail bed are not hospitable places for the bacteria, but if they have become compromised in some way, then the pseudomonas can find a home. It feeds off the dead tissue in the plate of the nail and this is what causes the separation of the nail and nail bed. Chloronychia can occur between the natural nail plate and the nail bed or between an artificial nail coating and the natural nail plate. Some people mistakenly categorize chloronychia as a mold, but in reality mold is not a human pathogen.

How Do You Get It?
This bacterium flourishes in wet environments, such as Jacuzzis (where it can cause a rash), swimming pools (where it can cause swimmer's ear), contact lens solution, sinks, and bath sponges. Because it thrives on moist surfaces, this bacterium is also found on and in medical equipment, including catheters, causing cross-infections in hospitals and clinics. 

In a salon environment,  the vast majority of infections that occur on nails with no signs of lifting are often caused by the nail tech, according to Doug Schoon. For example, if a client touches her nails to her face and the nail plates aren’t re-cleaned the chances of an infection go up tremendously. That’s why it’s important for both nail techs and clients to wash their hands before every service. Nail techs should also individually clean the nail plates just before applying product. If you get rid of surface moisture and oils (and the bacteria) before product is applied, it will be highly unlikely for your client to get infections. "They're all over us," explains Schoon. "We typically carry hundreds of species of bacteria on our skin at any time, depending on what we're in contact with."  Improper application can lead to lifting, which can allow bacteria to get under the area where the product has separated.

"On rare occasions pseudomonas aeruginosa can cause serious infections, particularly of the eyes, so good sanitation and disinfection practices are important for more than just cosmetic reasons," says Vicki Peters. "An untreated greenie can turn into a black/brown nail and can cause the client permanent [nail] damage."


Treating Chloronychia under the Natural Nail
if the infection is under the natural nail it is usually a secondary infection and the client must be referred to a medical doctor who can treat the bacteria and clean up the nail

Treating Chloronychia under Nail Enhancements
It is best to keep nails short and free from enhancements if a Pseudomonas aeruginosa infection is suspected.  Instruct your clients to come to you if they experience lifting and not to attempt to take care of the problem themselves by gluing down the lifted area which will trap any bacteria present.

It is possible to work on a client with pseudomonas. According to Dr. Phoebe Rich, the infection is not easily transmitted from person to person in a salon. However, as a precaution, once you use a file on an infected nail, don’t use it on another nail. Wrap it in plastic wrap and toss it in the trash.

To help rid the nail plate of the infection, remove the enhancement, lightly buff the stain to open up the nail plate cells, and remove all moisture and some of the surface oils. Instruct the client to keep the plate clean and dry at all times, and wear gloves when having her hands in water or using household cleaning solutions.

"Pseudomonas will often spontaneously disappear when the underlying nail problem is cleared up. There are several home remedies that will treat pseudomonas very effectively. The simplest treatment is to use diluted white vinegar soaks (1 part vinegar to 2-4 parts water) for several weeks. You can store the solution in a dropper bottle and apply one drop under the nail twice a day. To remove the discoloration, the nails can be rinsed in a diluted bleach solution (1 part bleach to 4 parts water) once or twice, but not for prolonged periods. If these simple remedies fail, a doctor can prescribe antibiotics for resistant cases." — Dr. Phoebe Rich

Ultimately, the nail but be cleaned, disinfected, and have any enhancements removed. But remember, you are a nail tech, not a doctor. If it looks like there is an infection present, do not risk trying to rectify the clients' problem. In most cases, it is actually illegal for a tech to work on nails that appear to be infected. Instead, at this point, you must refer your guest to a medical doctor who can treat the bacteria and clean up the nail


What if We just "leave it alone"
All pseudomonas infections can make you very sick if they spread through the bloodstream. A serious infection can cause symptoms of high fever, chills, confusion, and shock. If the infection spreads to critical body organs, such as the lungs, the urinary tract, and kidneys, the results can be fatal. The infections are hard to treat because the bacteria can resist many types of antibiotics




References
https://en.wikipedia.org/wiki/Pseudomonas_aeruginosa
http://www.nailsmag.com/article/40049/pseudomonas
http://www.aocd.org/?page=GreenNailSyndrome
http://www.nailpro.com/germs-keep-out
http://www.beautyweb.com/Ask_the_Experts/Nails/nail_fungus.htm

Tuesday, September 29, 2015

Common Nail Disorders: Nail Fungus


Onychomycosis/tinea unguium or nail fungus could be indicative of other medical problems or it could have caused complications. Fungus can become systemic (spread throughout the body).People with compromised immune systems (Lupus, HIV, etc) with invasive fungal infection have higher risk of complications and death.

In about one out of two dozen cases, the fungus migrates to other parts of the body, like the hands, back and legs, said Dr. Boni E. Elewski, a professor of dermatology at the University of Alabama at Birmingham who specializes in nail disorders.  For people who have nerve damage and poor circulation -- someone with diabetic neuropathy, for example -- this can have serious consequences. “Podiatrists frequently cite this as a cause of diabetic amputations,” Dr. Elewski said. “The fungus paves the way for bacteria, and it can definitely be a problem.” 

It’s not at all uncommon for patients with toenail fungus to also succumb to athlete’s foot, jock itch, and ringworm. “If your immune system isn’t functioning at its very strongest, the fungus will work against you to open the body up to other attacks,”  Dr. Nadia Levy explains. "The longer you wait, the harder it is to treat"

Dermatologists estimate these fungal infections account for 50% of all nail disorders they treat. Recent studies suggest that as much as 13% of the U.S. population has a fungal infection of one or more nails. As the fungal infection advances, the separated nail appears yellow and opaque, then appears crumbled and can brown.

Aging is the most common risk factor for onychomycosis due to diminished blood circulation, longer exposure to fungi, and nails which grow more slowly and thicken, increasing susceptibility to infection. Nail fungus tends to affect men more often than women, and is associated with a family history of this infection.

Onycholysis is NOT Fungus
Onycholysis refers to the detachment of the nail from the nail bed, usually starting at the tip and/or sides and is often caused by an internal disorder, trauma, infection, or certain drug treatments.

If addressed quickly, this common nail disorder poses no danger to clients. In general, clients should clip the affected portion of the nail and keep the nails short, keep the nail bed dry, avoid exposure to contact irritants, and wear gloves for wet work. The portion of nail that has separated will not reattach to the nail bed, so you will have to wait until the nail is fully regrown for the condition to be completely gone.  It is not recommended that the client have enhancements put on the nail until the onycholysis is gone.

Because the nail is lifted off the nail bed, creating a nice warm "pocket", onycholysis can allow fungus to more easily take root on a nail so it is important to keep an eye on the nail while the onycholysis is growing out.

As a nail technician, know that if you get a client with a nail fungus you must refer them to a doctor for treatment. Giving advice regarding nail fungus could be considered practicing medicine without a license.



References:
http://www.aafp.org/afp/2001/0215/p663.html
http://well.blogs.nytimes.com/2013/10/11/ask-well-leaving-nail-fungus-untreated/?_r=0
http://healingfeet.com/toes-2/danger-leaving-toenail-fungus-untreated#sthash.kT74aPa4.dpuf
http://www.nailsmag.com/article/92526/under-the-microscope-onycholysis
https://en.wikipedia.org/wiki/Onychomycosis

Monday, September 7, 2015

Common Nail Disorders: Powdery white spots under polish

Someone asked me a question about white spots on the nail - not your "normal" Leukonychia - but the kind that is under polish and is almost powdery.
Keratin granulations are the result of excessive dehydration of the keratin molecules that have turned into a chalk like substance on your nail surface; they are completely harmless and are easily corrected with a few weeks of moisturizing treatments. This is the most likely reason for the spots, especially if they appear after removing nail polish.
However, as nail techs, we all also need to be aware of white superficial onychomycosis.
This type of infection is the second most common type of infection you can get that commonly affects the toenails and not the fingernails. The main cause of this type of nail fungus infection is the dermatophyte, Trichophyton mentagrophytes.
This fungus has the unique feature to develop on the top layers of the nail, and eventually spreads on the entire nail-plate.
Initially, tiny white patches appear on the surface of the nail-plate. As the fungus spreads, the nails may dry out and the surface of the nails flake and crumble.
The fungus feeds on the nail protein, keratin, to obtain its nutrients, which further weakens the nail-plate, and makes it distorted. White superficial onychomycosis is spread it is spread like any fungus - unsanitary tools and files for one - but also locker rooms and other places people go barefoot . it's interesting to note that not everyone exposed develops it though, it's a very complex thing
Of course, we are not licensed to diagnose things like this so if there is ANY question, your client should be sent to a doctor.

Sunday, September 6, 2015

Cuticle vs Eponychium vs Pterygium

One of the marks of a true professional is using proper terminology. Many nail technicians use these term incorrectly - including some big name companies that I know! A true professional should know what they are dealing with and they should be able to use the correct terms when talking to their clients.
I found this picture online and love how it shows what is the true cuticle vs what is the eponychium. True cuticle is dead tissue and there is absolutely no reason you cannot remove it - and if you are applying enhancements you MUST remove it or the nail will lift! The eponychium on the other hand is living tissue and should not be removed - it is sealing your matrix from infection.

Now, by definition, pterygium forms if there is scar tissue in the nail matrix. this is scar tissue and is NOT removable. I have attached a picture of this disorder. As you can see, you will not be able to remove this scar tissue and should not try. You cannot put an enhancement over pterygium as it is living tissue - the enhancement will not stick and it could lead to an eventual allergic reaction.