Green Discolouration Under a Gel Overlay
A 29-year-old client returns for an infill on a gel overlay she has worn for four weeks. On the right index finger, the nail plate shows a 4 mm oval, blue-green stain under the enhancement, with slight lifting at the lateral edge. The surrounding skin is not swollen, hot, or painful, and the client has no fever. She is a nurse and needs short nails for work; she has a holiday in four days and asks you to fill over it and cover it with a darker colour. The salon uses a file-and-fill system and a UV-cured gel. The client's previous technician used a drill and the enhancement is thick. She has no known allergies and does not bite her nails.
1. What is the likely cause and what must you do before applying any new product?
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The blue-green colour under a lifted enhancement is most consistent with Pseudomonas aeruginosa colonisation, often called green nail syndrome. Moisture trapped under the lifting edge creates a warm, wet environment. It is not simply a stain that can be covered. I would remove the enhancement, gently clean the nail plate, and avoid drilling or filing over the discoloured area. I would not apply a new gel overlay, because covering it traps moisture and can worsen the infection. If the area is painful, spreading, or the client is unwell, refer to a GP; if it is localised and improving, advise keeping the nail dry and short and monitoring it. I would use disposable files or thoroughly disinfect reusable tools, clean the work surface, and perform hand hygiene. I would explain that a dark colour would hide the problem, not treat it. The client's occupational needs do not change the infection-control risk.
2. The client insists on coverage because of her holiday. How do you handle this professionally and commercially?
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I would be firm and compassionate: 'I understand the holiday timing, but covering this could make it worse and I would not be insured to do it. I can remove the product safely and give you a plan for the next four days.' I would not fill over it even with a darker colour. I would offer a dry manicure, shaping, cuticle oil and advice to keep the nail dry, plus a rebooking for after the holiday. I might offer a complimentary removal or a small service-recovery gesture, but not a free enhancement that hides the problem. I would avoid sounding punitive. If she chooses to go elsewhere, I would still document the advice. This protects her nail, the salon's insurance and my professional standing.
3. What decontamination and documentation steps follow?
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Use single-use files and disposable barriers where possible; if a reusable tool touched the nail, clean it and then disinfect it with a product effective against Pseudomonas at the stated contact time; heat-sterilise heat-tolerant metal bits if the salon has an autoclave. Discard buffing blocks and any porous items. Clean the drill handpiece according to the manufacturer, and avoid using it on the affected nail. Clean the table, lamp and chair. Record the date, nail, appearance, lifting, action taken, product removed, advice given, refusal of coverage and referral advice. Take a photo only with explicit consent. Complete an incident or adverse-event log and review the client's aftercare advice, because lifting after four weeks suggests the original application or home care needs attention.