Nail Care and Skin Care Services
Nail anatomy and disorders
This domain tests nail and skin structure, disorders, and safe service practice. The nail plate is the hard keratin surface; the nail bed lies beneath it; the matrix produces the plate; the lunula is the visible portion of the matrix; the cuticle is dead tissue on the plate; the eponychium is the living fold at the base; the hyponychium is the seal under the free edge. Disorders include onychomycosis (fungal, contagious-refer), paronychia (bacterial inflammation-refer), onycholysis (separation), onychorrhexis (ridging), leukonychia (white spots), koilonychia (spoon nails), and pterygium. Do not diagnose or treat disease; refer.
Skin care
Skin has three main layers: epidermis (including the stratum corneum), dermis, and subcutaneous tissue. Skin types are normal, dry, oily, combination, and sensitive. Facial services include cleansing, exfoliation, massage, masks, and moisturizing. Massage manipulations include effleurage, petrissage, tapotement, and friction. Contraindications include open lesions, inflammation, recent surgery, and contagious conditions. Waxing requires a patch test, direction of hair growth, and caution with isotretinoin, diabetes, and varicose veins.
Sanitation in nail and skin services
Clean implements with soap and water, then disinfect with an EPA-registered hospital-grade disinfectant using the label contact time. Porous items-files, buffers, wooden sticks-are single-use. Foot spas require cleaning and disinfection between clients. Wash hands before and after service and wear gloves when blood or body fluids may be present.
Worked example. A pedicure client has a thick, yellow-brown nail with debris under the free edge. Reasoning: the appearance suggests a fungal infection. The nail technician must not apply polish or attempt treatment; refer the client to a physician, do not service that nail, and disinfect all implements and the foot spa.
Traps that cost marks. Cuticle and eponychium are not the same; cutting living tissue can cause infection. Do not disguise a disorder with polish. Fungal infections are contagious-refer. A diabetic client needs extra caution because of circulation and sensation loss. Massage is contraindicated over inflamed or swollen areas.