Nail Service on a Client with a Green Nail
A client comes for a gel manicure removal and new set. On one nail she has a dark green-black discoloration under the free edge that has been there about two weeks; the nail plate looks slightly lifted at the corner and the surrounding skin is a little puffy but not draining. She says it does not hurt much and asks the tech to 'just cover it with a dark color.' The tech has a fresh set of implements and an autoclave, and the salon uses a hospital-grade disinfectant for implements.
1. Should the tech proceed with the manicure and gel set on this client? Explain the reasoning and the infection-control principles involved.
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No, not over that nail. The green-black discoloration with lifting suggests possible bacterial involvement under the nail plate, often associated with moisture trapped under artificial product. Covering it with opaque gel would trap moisture and organisms and hide a condition that needs evaluation.
Principles:
- Do not diagnose, but do not service over signs of infection or unexplained discoloration.
- Refer to a physician.
- Single-use items that touched the area go in the trash; reusable implements get cleaned and then disinfected per label.
- The tech's hands and the station are cleaned and disinfected before the next client.
Judgment: the client's request to hide it does not override the duty to avoid harm. The tech can decline that nail and offer service on the other nails only if it can be done without cross-contamination and with the client's informed agreement.
2. How should the tech communicate this, and what is the plan for the rest of the appointment?
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Communication: Be calm and non-alarming: 'I can't put product over this nail because it could make it worse and hide something that should be looked at. I'd recommend having a doctor check it.' Avoid naming a condition.
Plan: Remove the existing gel from the affected nail carefully without abrading the lifted area, or leave it and refer. Service the other nails only with clean implements and fresh product, and do not let product or tools contact the affected nail. Do not apply a new set over it. Document the observation, the advice, and the client's choice.
Follow-up: Invite her back once a physician clears it, and review home care to keep the area dry.