Lichen planus is an inflammatory skin condition that can be itchy, painful and leave permanent scars.
Because lichen planus can be itchy and can cause inflammation, doctors sometimes prescribe steroids or suggest a cortisone shot at the base of the nail.
WHAT’S A TECH TO DO?
If a tech suspects a client has lichen planus, send the client to a doctor. Because lichen planus is so hard to diagnose, educate the client about the condition before her doctor’s visit, and suggest she ask her doctor specifically about the condition. When a tech sees the damage lichen planus can cause to a client’s nails, it’s natural for her to want to make the nails more beautiful by applying an enhancement. Take caution. “There is a risk to using artificial nails on clients with lichen planus,” says Dr. Hitchins. The problem lies in the fact that lichen planus destroys the matrix, which deforms the nail, leaving an uneven nail bed. Because the surface isn’t smooth, it’s possible for pockets of air to get trapped under the enhancement. “Never use a tip,” says Hitchins. A tip can trap air, water, debris, bacteria, and any number of other things, which could eventually promote a fungal infection. “Once fungus has developed on the nail,” says Hitchins, “clients will need to have a prescription for an oral treatment.” Careful application of a gel or acrylic overlay, which will fill in all the unevenness of the nail, could be used as a temporary beautification for a special event, suggests Hitchins, but the product should not remain on the nail for a significant length of time. The safest approach for nail techs to take is to keep the nail natural. Simply shape and buff the nail without adding an enhancement. Even in this, though, techs should use caution. “The damaged nail is sort of like a teepee,” says Hitchins. “The outer nail can be gently buffed to smooth out the ridges, but underneath the damaged nail is soft skin.” Excessive or aggressive filing can break the delicate skin underneath and cause bleeding. Eventually, lichen planus should clear up, but varying damage to the nail bed and nail plate will remain. It is possible, once the condition has cleared, that techs will be able to safely apply and maintain enhancements on a client whose nails are rough and split due to permanent damage of lichen planus. Assess the nails to confirm the natural nail fully covers the nail bed — so product isn’t applied over unprotected skin — and take special care that the product adheres where the nail remains unsmooth to avoid air getting trapped.