I have a few clients who sometimes get a deep crack in the middle of the nail plate. Sometimes there is bleeding or the nail is lifting on each side of the crack. What can I do to prevent this problem? How can I explain to these clients that they should not receive any type of service on that nail?

A deep crack in the middle of the nail plate, particularly if associated with bleeding and/or lifting of the nail (called onycholysis), may be a sign of a possible underlying disorder. A fungal infection (onychomycosis), psoriasis, a nail bed infection, and many other conditions can cause this type of nail defect Even a tumor, benign or malignant, is capable of causing a split nail with bleeding. Therefore, I agree with you that no service should be performed on such a nail. I suggest that you advise each of your clients who have this problem to see a dermatologist who can determine the cause of the split. The doctor may perform a series of tests to arrive at a specific diagnosis. These tests may include a potassium hydroxide wet mount and a culture to test for fungus. An X-ray and a nail biopsy may also be done to determine the cause of the problem.