One of the many benefits of being a nail tech is that we get to see a lot of interesting skin conditions. After years of experience, it can be tempting to share what we suspect, or “know,” about diseases and disorders of the skin and nails. Unfortunately, the resulting education can easily cross the line into what the state defines as a professional assessment — something illegal for nail techs since we are not licensed or trained to provide a diagnosis. Ultimately, it serves clients best to send them to a doctor, both for peace of mind and for a prescription if necessary. Many conditions look similar and nail techs risk delaying effective treatment when we offer well-meaning opinions.
Take ringworm as an example. This fungus can appear on the skin, scalp, and nails. The earliest stages may be mistaken for dry skin or psoriasis, while advanced ringworm can be itchy, painful, and unsightly. When you recognize a problem, gently explain the benefits of consulting a doctor. That conversation could go something like this:
You: Hmm. There seems to be something wrong with this nail. It looks as though it’s flaking and discolored, and the edge doesn’t feel that firm. Have you noticed this on any of your other nails?
Client: No, only on that one. I’ve actually had a few skin problems lately. Not to be gross, but I had a few rashes and itchy spots. I just assumed it was from that.
You: This looks like more than dry skin. See how it’s a little bit thicker than the other nails and slightly discolored? It also looks as though it’s beginning to pull away from the nail bed. I think you should have a doctor look at this before we put any product over it. It might be nothing, but it could be something that will worsen, such as ringworm or another fungus. If so, you’ll want to get it treated immediately so it clears up without causing a lot of damage to your skin and nails.
Client: Ringworm?! Isn’t that a worm under the skin? Isn’t that something we treat on dogs?
You: No. Ringworm is a fungus that appears on the skin in the shape of a ring. That’s why it’s called ringworm — not because it’s an actual worm. It’s similar to the fungus that causes athlete’s foot. It can appear on the skin, or on the scalp, or even under the nails. It’s actually common, and it’s extraordinarily contagious, so that’s another reason to get it checked early. We don’t want to spread it to anyone — including my other clients.
Client: You know what? Now that you’re saying this, you’re making me realize the patches of dry skin I mentioned are round and ring-shaped. I’ve been putting cream on them thinking they would go away.
You: If it’s ringworm, it won’t just go away; it’ll spread. And don’t feel embarrassed; it’s so contagious, you could have picked it up from anywhere: a floor, a pet, even someone’s clothing. It’s a fungus, so it’s likely to keep spreading. Hopefully, a doctor can diagnose it simply by looking at your symptoms. Treatment is often just a prescription for a topical antifungal cream. Antifungal creams are available over the counter, of course, but you’ll get a stronger one with a prescription. Let me know as soon as you’ve seen a doctor. Hopefully, she’ll alleviate our concern about your nail, so we can apply the enhancement at your next appointment.
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