Splinter Haemorrhages

Blood clots under the nail that tend to run vertically.

Leukonychia

Discoloured, white spots on nails.

APPEARANCE

Milky white spots on the nails.

CAUSES

In most cases, leukonychia is not harmful and is usually caused by a small injury to the base of the nail (nail matrix) during nail development. 

However, leukonychia can also occur as a side effect from some medical conditions, medications and chemotherapy.

DOES IT AFFECT THE PROCEDURE?

Aside from discolouration, leukonychia does not affect nail structure and manicure procedures can be undertaken as normal.

POSSIBLE TREAMENTS/ALTERNATIVE OPTIONS
Reducing the occurrence of minor injuries to the nail will reduce future incidents of leukonychia.
However, as some forms of leukonychia may derive from serious illnesses, it is advised to seek medical attention from a doctor if there is an underlying cause.

BIBLIOGRAPHY
5http://doctorv.ca/wp-content/uploads/2013/01/leukonychia-e1365272360959.jpg
6http://diseasespictures.com/wp-content/uploads/2013/02/Leukonychia-7.jpg

Blue Nails

Blue colouring in the nails present due to poor blood circulation.

APPEARANCE

CAUSES

Blueness in the nail indicates a low presence of oxygen in the blood distributed to the fingers.

When exposed to oxygen, blood takes on a bright red colour. In low amounts of oxygen, blood is blue or purple in colour, leading to blue colouring in the skin.

The following medical conditions are possible causes of blue nails:

Agyria 

Mepacrine 

⦁ Lack of oxygen 

Wilson's disease 

Silver poisoning 

Methemoglobinemia 

⦁ Chronic lung disease (e.g. asthma) 

⦁ Insufficient oxygen 

Subungual hematoma 

Trauma 

Fracture 

See causes of cyanosis 

DOES IT AFFECT THE PROCEDURE?

Not really. However, with lack of blood supply, a massage could be applied, but with extra caution.

POSSIBLE TREATMENTS/OPTIONS

It is advised you should see your doctor to determine the cause. 

Bibliography

3http://gulfnews.com/polopoly_fs/1.1466204!image/640450334.jpg_gen/derivatives/landscape_422/640450334.jpg

4http://www.newhealthguide.org/images/10442685/image001.jpg

Eggshell Nails

So called for their white colour and brittleness, eggshell nails are thin, fragile and curve over the edge of the finger.

APPEARANCE

Extremely thin and curved at the free edge. Nail detached from nail bed. 

Causes

Experts believe nail health is dependent on vitamin and nutrient intake. A deficiency in vitamins and nutrients are linked to nail weakness where eggshell nails may appear. 

Some of the causes include:

⦁ Improper diet

⦁ Medication

⦁ Nervous disorder

⦁ Internal disease

⦁ Stress

DOES IT AFFECT THE PROCEDURE?

Eggshell nails are very fragile and may break if excessive force is applied during manicure. 

POSSIBLE TREATMENTS/ALTERNATIVE OPTIONS

Trimming nails. Change and maintain a healthy diet that fulfils your vitamin and nutrient. Stop medications that may be leading to eggshell nails.

BIBLIOGRAPHY

1http://www.members.shaw.ca/nailsnirvana/disorders/Eggshell.jpg

2http://studydroid.com/imageCards/0v/8m/card-32791478-front.jpg

Onychogryphosis

Also known as 'Ram's Nails', these are nails that grow abnormally, often into long, hardened and yellow calluses. This can be discomforting and particularly painful when wearing closed-in shoes.

APPEARANCE
Yellow, hardened and mouldy. The toes grow abnormally often curling inwards or bending to the left/right, as particularly shown with the toe at the lower picture,  hence the name 'Ram's Nails'.

CAUSES
One quick reasoning is irregular trimming of the nails. However, wearing tight shoes and physical injury can also affect the toenails. Other diseases can be diabetes, decreased blood circulation, vascular disease, or fungal infection.

WILL THIS AFFECT THE PROCEDURE?
With long nails, it could possibly. During a pedicure, the therapist will need to work carefully, in case of any injury inflicted on both the client and themselves. In this case, buffing could be the best way to treat these nails. This will shorten the nail, and also provides healthier growth in the future.

TREATMENTS/POSSIBLE ALTERNATIVES
The only best, complete method is to surgically remove the toenail/toenails, as it will be difficult and long to reduce it back to normal. But if the client chooses not to have surgery, then buffing it regularly is the best option. But as mentioned before, progression will be much slower.

BIBLIOGRAPHY

http://www.remedyland.com/2013/11/onychogryphosis-rams-horn-nails-treatment.html

http://www.epainassist.com/joint-pain/foot-pain/onychogryphosis-or-rams-horn-nails

http://www.footvitals.com/toenails/onychogryphosis.html

Koilonychia (Spoon Nails)

Nicknamed as Spoon Nails, it is when the nails become small and concave, meaning there's more of skin than the actual nail. It gives an illusion of a 'spoon-like' appearance.

APPEARANCE

Visually 'like a spoon'. The nail is bent inwards, to resemble an 'in arch' appearance. Often the nail is shrunk and the fingers are fleshy. One example to determine Koilonychia is the 'water drop test'- by putting a drop of water onto the nail, if it fits into the 'arch'. 

CAUSES

With Koilonychia,  it's a 'deterioration of the internal tissue'. One of the most common factors is anemia and/or iron deficiency. Other factors could be Nail Patella Syndrome, Renal Disease, Thyroid dysfunction. Chemotherapy, Malnutrition, Metabolism Problems have also been known to cause it.

WILL THIS AFFECT THE PROCEDURE?

Mainly not. 

TREATMENTS/POSSIBLE ALTERNATIVES

- Limiting on oils/moisturisers

- Iron intake

- Vitamin intake

- (With Toes) Wear more open or looser shoewear.

BIBLIOGRAPHY

http://www.medicinenet.com/koilonychia/symptoms.htm

http://byebyedoctor.com/koilonychia/

Onychophagy

Literally 'Nail Biting Disease', Onychophagy occurs purely by 'nail biting'. As with Onychauxis, Onychatrophia and Onchorrexis, the word part 'Onych' refers to 'deterioration of nail'. So nail biting dissolves the structure of the nail, literally deteriorating it.

APPEARANCE

Hence the name 'Bitten Nails', the nails literally are chewed away and there usually isn't much of the free edge remaining. Sometimes bacteria could even form, as some nails can have tinges of yellow. Skin can also be affected too, and signs can include dried skin and wounds.

CAUSES

As Onychophagy stands for, the habit of nail biting.

WILL THIS AFFECT THE PROCEDURE?

Nail work, aside from buffing, could still be able to be treated. 

TREATMENTS/POSSIBLE ALTERNATIVES

The only way to stop Onychophagy is to stop the habit of nail biting. This habit is related to psychological health, so there needs to be reminders set for the client to not bite. While manicurists may not have the exact knowledge as psychologists do, general reminders that could be set up is to apply special clear nail polish- one that is safe and non-toxic. This is bitter and can discourage the person from biting any further.

BIBLIOGRAPHY

https://nailsbiters.wordpress.com/onycophagy/what-is-onychophagie-in-english/
http://www.skinnail.com/eng/skin-nail-onychophagy
https://www.psychologytoday.com/blog/intense-emotions-and-strong-feelings/201205/reforming-the-nail-biter
http://www.bbc.com/future/story/20140710-why-do-we-bite-our-nails

Onychophagia

Onchorrexhis

Also known as Brittle Nail Syndrome,  Onychorrhexis dehydrates the moisture of the nail, making it more prone to breakage, including chipping, splitting, and partial breakage.

APPEARANCE

Brittle, hence the name 'Brittle Nails Syndrome'. It is hard and dry, and depending on the severity, either the nail can be partially chipped with one layer, or almost the entire layer of nail.

CAUSES

As Onchorrexhis is 'dehydration of the nail', products such as nail polish removers and soap can be a factor.  Iron deficiency is critical for Onchorrexhis, as nails need iron to retain its structure.

But there are also other health factors including the following:

- Bullimia

- Anorexia

- Malnutrition

- Psoriasis

- Physical Injury/Trauma

One environmental factor can be cold exposure.

WILL IT AFFECT THE PROCEDURE?

With nails, the manicurist/pedicurist needs to have extra caution when treating them. Not only do nail polish removers dehydrate the plate, buffing could also damage them. However cuticle cream and oil can benefit with treating nails, as they moisturise the nail plate, although cuticle removal would have to be done with extra caution.

TREATMENTS/POSSIBLE ALTERNATIVES

Soaps should be avoided or limited for people with brittle nails. Moisturisers or nail oils are essential in restoring and hardening the nail plate. Vitamin intake is also essential, especially for malnutrition and Iron deficiency. Zinc and Vitamin B-12 are also essential for nail strengthening. In general, regular water intake also improves nail moisture as well.

BIBLIOGRAPHY

http://www.medicineonline.com/articles/o/2/Onychorrhexis/Brittle-Nails.html

http://healthool.com/onychorrhexis/

http://www.nailsmag.com/encyclopedia/64079/onychorrhexis

http://www.primehealthchannel.com/onychorrhexis-pictures-causes-symptoms-and-treatment.html

https://www.google.com.au/search?q=nail+oil&oq=nail+oil&aqs=chrome..69i57j69i60j69i65l2j69i60l2.1492j0j7&sourceid=chrome&ie=UTF-8

http://www.totalbeauty.com/content/article/best-vitamins-for-nails

Pterygium

A condition that affects the nails, it is a type of fungus that eats away at the edges, often leaving a 'winged' like shape, hence the name 'pterygium'. As a result, skin forms over the missing edges, consuming the nail plate.

APPEARANCE

Chewed out, most of the nail plate are gone. The appearance can be barely noticeable. As the nails have mostly deteriorated, it leaves lots of flesh and sometimes even mould.

CAUSES
Nail biting can contribute to pterygium, as the tissue and nail structure weakens and dissolves over time. However, physical nail injuries are another factor. Other health problems that contribute to this are Rheumatic Diseases, and lichen planus. Other times malnutrition, chemotherapy and iron deficiency can contribute as well.

WILL THIS AFFECT THE PROCEDURE?
It will affect the nails, but not the rest of  the manicure/pedicure.

TREATMENTS/POSSIBLE ALTERNATIVES
Like Onychatrophia, Pterygium is permanent and there can't be any natural replacements for the nail. However early signs can be detected during a manicure/pedicure, which is essential. However, the scar tissue overgrowth can be reduced with surgery or cortisone injections.

BIBLIOGRAPHY

http://www.nailsmag.com/encyclopedia/64119/pterygium

http://www.drraoof.com/hair-nail-disease-treatment

http://www.hooked-on-nails.com/naildisorders.html

http://www.ehow.com/about_5644679_pterygium-nail-disorders.html

Onychatrophia

These nails have deteriorated in structure and in the layers, leaving a chewed-out, deteriorated appearance.

APPEARANCE

Chewed-out, rotting and deteriorated. Sometimes the entire nail plate is gone, which leaves only remnants of the nail bed.

CAUSES

While one factor can be biting nails consistently, other health problems can also contribute to this, such as burns, nail injury, skin diseases, or fungal infection. Other times it can happen as a result of Thyroid diseases, Lyell's Syndromes or vascular problems.

WILL IT AFFECT THE TREATMENT?

Apart from not being able to perform nail services on them, the rest of the manicure/pedicure procedure could still go as usual.

TREATMENTS/POSSIBLE ALTERNATIVES

Unfortunately, nails that are severely damaged by Onychatropia can go beyond any repair or preventions: so early detection is essential. To make up with the rest of this, a visit to the doctor or seeking further medical treatment can help treat the condition that caused it.

BIBLIOGRAPHY

http://www.nailsmag.com/article/97480/onychatrophia

http://www.sterishoe.com/foot-care-blog/toenail-fungus/onychatrophia-toenail-fungus/

Onychauxis (Hypertrophy Of The Nail)

An enlargement of the nail structure, the toenail affected grows unnaturally, thickening into a callus.

APPEARANCE

It can affect either the entire toe or in several or even a singular nail. As a result, it becomes a callus, meaning it is greatly thickened and hardened. The nails can grow unnatural and bent, and it can also appear mouldy.

CAUSES
As Onychauxis is an internal nail condition, it is caused by bacteria entering the nail. Bacteria can form under the nail if it's exposed to humid conditions. The most common reason for this is wearing closed in shoes and socks. Other factors can be psoriasis.

WILL THIS AFFECT THE TREATMENT?
Other than requiring to see a doctor for further examination, the nails should be safe to buff and clean depending on the severity of  the disorder.

TREATMENTS/POSSIBLE ALTERNATIVES
One way is to try and even out the nail layer, at least shaping it to reduce the thickness and mould. This can improve the condition and shape of the nail and prevent it from worsening.

https://www.google.com.au/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=hypertrophy+meaning
http://www.nailsmag.com/article/82023/what-is-onychauxis
http://www.nuricare.com/en/services/details/22/5/Nail-abnormalities/Onychauxis
https://www.google.com.au/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=onychauxis%20nails

Hammer Toes

A form of foot deformity in which the toe is severely deformed, disproportioned in an unnatural angle. 

APPEARANCE

Severely deformed toe, which can bend to the left. If severe, it would go under the second toe and some others, giving it a 'binded, contorted' appearance.

CAUSES

Hammer Toes can be affected by arthritis, diabetes, a serious toe injury/damage, or prolonged constriction by footwear that isn't appropriate for the foot. Other preceding injury include bunions.

DOES IT AFFECT THE PROCEDURE?

As Hammer Toes are an internal injury, this could severely affect the pedicure procedure, since it causes pain and discomfort for the client affected by this. While massage and foot wash can still be done without any interruptions, the toes should be avoided altogether. 

TREATMENTS/POSSIBLE ALTERNATIVES

Depending on the severity of the injury, if the toe could still be moved, then surgery isn't required. However, it is not recommended to wear foot pads, as this is a drastic move for the disrupted foot. Instead, have a transitional approach, and that involves prevention. Tight shoes should be constricted. 

BIBLIOGRAPHY

http://www.healthline.com/health/hammer-toe

http://www.webmd.boots.com/foot-care/hammer-toes-causes-symptoms-treatment-prevention
https://health.clevelandclinic.org/2015/04/best-ways-you-can-treat-prevent-hammertoe/