Nail Disorders, Diseases, and Contraindications
Domain 3 separates cosmetic nail disorders from contagious or systemic disease and identifies when a service is contraindicated.
Core rules
- Disorder: abnormality in appearance or growth without infection (ridges, spots, Beau's lines, onycholysis). Disease: bacterial, fungal, viral, or systemic condition.
- Contagious conditions include onychomycosis, Pseudomonas, warts, herpes, and impetigo. Refer.
- Contraindications: open lesions, active infection, unexplained swelling, red streaks, fever, severe pain, uncontrolled diabetes with circulatory problems, and allergies to product.
- Do not diagnose or treat. You may describe what you see and refer.
- A doctor's release may be required by state rule before service over a treated condition.
Worked example
A client with acrylics has green-black discoloration and a lifted edge. That suggests a Pseudomonas infection under the enhancement, not a stain. Do not file, fill, or apply product over it. Remove the enhancement gently, clean and disinfect tools, advise the client to see a physician, and document the referral. Re-service only after resolution and approval.
Traps
Calling every discoloration “fungus”; treating with tea tree oil or bleach; working over paronychia; using a doctor's note as blanket permission; and failing to disinfect after a suspected infection.