Q&A

A clien'ts nail has not grown for six months and it peels constantly. Should I be working on her?

Q.

Q: My client has ringworm under one of her nails. She went to a dermatologist, but none of the over-the-counter treatments he prescribed are working. Her nail has not grown for six months now, and it peels constantly; it looks deformed. Should I be working on her, and if so, what services can I perform? Can I spread this to other clients? Should she get a second opinion?

A.

Q: My client has ringworm under one of her nails. She went to a dermatologist, but none of the over-the-counter treatments he prescribed are working. Her nail has not grown for six months now, and it peels constantly; it looks deformed. Should I be working on her, and if so, what services can I perform? Can I spread this to other clients? Should she get a second opinion?

A: Ringworm of the nails is a fungal infection of the nails. This form of onychomycosis is known as tineaunguium. I assume that her dermatologist took samples of the nails to prove that the condition is actually a fungal infection, in which case your client has two choices. The first is to use an external medication in the form of a cream, gel, or lotion. Local medications, however, will not always be effective for fungal infections of the nails and internal treatment might be required. Presently, there are three internal medications for fungal infections available by prescription only. Itraconazole (Sporanox), terbinafine (Lamisil), and fluconazole (Diflucan) work well on ringworm of the nail, and should have cleared up the problem by now. She should return to her dermatologist and have her nails re-evaluated or, as you suggest, consider obtaining a second opinion.

While the infection is present, it is not a good idea to be working on her nails. Although disinfected implements should prevent the spread you could inadvertently spread the infection to her other fingers. You can apply nail polish but be sure not to push or trim the cuticles, as you can worsen the infection if you break the skin.

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