Your Pearls Of Wisdom Please? Onycholysis & Plate Separation?

[Mrs.Clooney]

Hi Geeks, I wonder if you can please look at these pics for me and share your thoughts? I have a lovely client who comes to me regularly for manicures, pedicures and facials.

When I first saw several months ago, her fingernails nails were badly peeling and flaking at the free edge and less so on her toes. I encouraged her to regularly treat her nails with oil and moisturizer between treatments and fairly rapidly the flaking and peeling was less although still present. We have never fully been able to overcome it and it has been a life long problem for her.

She has been wearing the same Calgel (03 Light Pink) on her toes for several weeks now (her choice but not my recommendation) and there are a couple of things I would like some thoughts on please.

This week I removed the toe gel and found greenie with onocholysis on her Rt big toenail and what looks like nail plate separation on her Lt big toenail although it initially looked like it might be fungal until it dried. She has had plate separation happen on her left tonail before (old injury) and I filed it out at the free edge prior to her gel application several weeks ago. This new split is at the spot where the old gel finished iykwim, so I get the impression that the wearing of gel on her toes has helped protect the nail plate actually.

I also think that the greenie Bacterial infection was right through the full thickness of the Rt toenail which has resulted in the onycholysis which goes about half way down her nail bed. I gently cleaned and buffed as best I could without hurting her although it was quite mucky between her nail plate and nail bed and then applied coloured polish.

I was not concerned to do this as I am seeing her tomorrow for a facial and will remove the polish on that toe an check on it.

Apart from further encouraging her to not let her gels go so long between treatments (she is a mature single mother with a full time job) any other suggestions or comments please?

 

[Gigit]

I spy fungus

 

[Mrs.Clooney]

I spy fungus

Where do you spy fungus? Which pics? Please be more specific.

 

[VHunter]

This might help

Please see this article:
http://www.salongeek.com/health-safety-unatural/2641-moldy-oldy-fun-guys.html


Hth's

 

[Envy]

The left toenail with the white area could be one of several things with two of the more likely being a yeast infection or even just trauma.. I would ensure the area is thoroughly sanatised and keep an eye on it, if it gets worse... I would recomend a podiatrist.

Personally I would be more concerned with the right toe - that extent of bacteria under the nail could potentially grow out of control. There is obviously a lot of seperation for bacteria to be that prolific.
the only safe option I can recommend is to supply her with some scrub fresh to get under there and help keep the bacteria under control (of course this won't remove the colour)

If either get any worse you should really be referring her to a podiatrist ...

hth's

 

[uniq12u]

My suggestion would be to not even begin to dianose what she has. It isn't within our certification. She should go to a doctor have it diagnosed and treated by someone with a medical background. Even though it is a loss of income, she shouldn't get any nail services until it she is released to do so by a doctor. I might be overly cautious on this issue, but I do whatever I can to ensure my client's health and safety and keep myself from being named in a lawsuit and losing my insurance coverage. JMO!!

 

[geeg]

I doubt that helping the client to do a little treatment at home would result in a lawsuit and trying something like that first with perfectly safe and harmless products is a perfectly good option with, as Allen said, perfectly good advice to go see a derm or podiatrist if there is no improvement.

I'm a professional and give my clients good sound advise all the time for the care of their nails at at home. What's more, none of the products I sell could do the slightest harm to anyone. These toes are suffering from nothing out of the ordinary and would improve immeasurably by being in the open air as much as possible and some home help on the side in the way of tea tree or other medications sold over the counter .. THEN if there is no improvement after a month or 2 she can seek further advice.

Conditions like this are so common that we have all seen them and know about them and the fact that there are dozens of over the counter products for things like this shows that even the ordinary man in the street can diagnose athletes foot and a fungus under the toenail.

 

[uniq12u]

You really should talk to Doug Schoon about this issue Gigi. He has given the same advice on another forum. Said he has testified at trials where the nail tech was sued and lost because of diagnosing and advising treatment. I would just hate to do something that could jeopardize my career and the health and safety of my clients. We are not doctors and don't have enough medical background to be doing so. Again, this is my opinion, but it is based on advice given by Doug, not just something I made up!!

 

[geeg]

You really should talk to Doug Schoon about this issue Gigi. He has given the same advice on another forum. Said he has testified at trials where the nail tech was sued and lost because of diagnosing and advising treatment. I would just hate to do something that could jeopardize my career and the health and safety of my clients. We are not doctors and don't have enough medical background to be doing so. Again, this is my opinion, but it is based on advice given by Doug, not just something I made up!!

I doubt very much that the problem that the nail tech was sued for was a simple green nail.

I would not attempt now nor ever have to diagnose anthing more serious

Attempting to offer help with a natural product and then suggesting to see a derm or podiatrst if the condition does not improve (which is waht I suggested above) is not an offense for which one could sue. Nor is it diagnosing nor naming a condition.

I will continue as I have always done for the past 25 years which has worked out very well but thanks so much for the advise.

 

[Mrs.Clooney]

Thank you all very much for your comments. I am not overly concerned about this, but as I have never really seen a fungal/yeasty pedicure client before, I thought it a good idea to be able to bounce ideas off other therapists on this forum. What the pics in the books show don't always represent the presentation in real life.

The reason I initially considered an infection of sorts in the second two pics was because her toenail was quite moist after soaking in the Calaway solution. Once it was dry, I felt more certain that it was a crack widthwise across her toe with layer separation (damage in the matrix). She has had this problem before after doing a ten mile hike in poorly fitted trainers.

I will most definitely keep an eye on the greenie/onycholysis as well. I honestly don't take the welfare of my clients lightly but do feel it a bit premature to be whisking her off to the doctor just yet. I am allowing common sense to prevail rather than making random diagnosis here.

Thanks all x

 

[Gigit]

In a world like this, often there are people wiling to take small business owners to small claims court, especially where medical issues are involved.

Sorry my response was brief, was in a hurry, things get so nutty around the holidays.

The nails definitely have fungus, that thick white/yellow look where the nails sort of go flakey and waxy and have a bit of an odor beyond ordinary feet. Fungus and yeast problems respond very well to a very inexpensive home remedy - white vinegar soaks or even better apple cider vinegar. Dead sea salt would be good to add in as well to help dry out the excess moisture. I would recommend a good pair of cotton socks, tell your client to avoid nylon socks and to air out the feet at home and continue viengar soaks daily. There are good OOC fungal treatments as well. Add in some tea tree oil and lots of time (these things take time to reverse) and it will go away if the infection is superficial. Once it starts going deep into the nail and skin, RX medications are needed.

I wouldn't put any overlays on as this sort of thing flourishes under enhancements (dark damp no natural light.) Usually this sort of thing starts off as athletes foot and spreads to the nails.

 

[mum]

I think some reading up of the differences between bacterial and fungal infections wouldn't go amiss for those interested in answers within this thread!

Mouldy Ole Fun Guys and Doug Schoon is a very good start

 

[Mrs.Clooney]

May I just add that my clients feet were not stinky or smelly. They never have been. Mucky residue bits only came out from underneath the greenie toe, but no odour.

I have had to reschedule my clients appointment again for early next week to review her big toes. I will let you know my findings.

 

[Mrs.Clooney]

Hi geeks, I was prompted to reply to this thread with an outcome. My appologies for not doing so before.

All well with the clients toe, and after the initial thorough cleansing, sanitizing and buffing, my client's greenie and onycholysis was stopped in its tracks with no further problems.