When a client comes in with a skin condition, it’s up to the nail tech to determine if the best choice is to proceed or reschedule pending a doctor’s release. If the condition is contagious, you don’t want to put yourself or your other clients at risk. Eczema — an itchy, red rash — isn’t contagious, but products in the salon could cause a client to react or have a flare-up. You may find it’s best to recommend a natural nail manicure rather than enhancements. That conversation could go something like this:

You: Your skin looks a little irritated and dry today. Have you ever talked to a doctor about that area to see if it could be eczema?

Client: Actually, yes. It was so itchy and red I was embarrassed. I had no idea what it was, so I made an appointment with the dermatologist. She said it was eczema.

You: OK, it’s great that we know. I’m going to make a few changes to your treatment today. First, I’m going to wear gloves so nothing on my hands causes a reaction. Plus, I’ll switch to a gentle cleanser without fragrance so it doesn’t irritate your skin. I’ve asked a dermatologist what she recommends I use on clients with eczema. She suggested CeraVe hand cream or Neutrogena Norwegian hand cream. Your doctor may have given you a steroid cream, but this is a safe over-the-counter moisturizer for me to use today.

Client: Do you think the products you use on my nails make it worse?

You: Well, it’s hard to determine what, exactly, could trigger an outbreak, and some of the products we use in the salon do contain allergens, so it’s possible. If the skin is compromised when a client comes in, it will be more sensitive to the products we use, so it’s best to stay away from artificial nails or anything with glue or adhesives.

Client: So, what should I do?

You: Hydrate and cover any affected area of your skin before you come in for an appointment so the dust doesn’t aggravate it when you’re here. I’ll make a note on your file to use products without fragrance. When your skin is healthy, we can apply the enhancements or gel-polish. If you have a flare-up, we can do a natural nail manicure and shine.

Client: Do you think I should just cancel when I have a flare-up?

You: I’d suggest you keep an eye on it and stay in touch with your doctor on the best way to manage it. That could be through medication, diet, reducing stress, discovering an allergy — any number of things. Because your skin looks a little irritated today, let’s do your pedicure as we always do, and then a natural nail manicure using a standard polish. Let me know how your skin responds. We’ll track what nail services you get and if you have any outbreaks, and together we’ll come up with a workable solution.


Get a Diagnosis

Because eczema is a broad term, the untrained eye may mistake conditions such as psoriasis or a fungal infection for eczema. Encourage your client to get a definitive diagnosis from her doctor.

> Psoriasis: a chronic condition causing red and flaky patches of skin. It can affect the hands and nails.

> Eczema: a condition that causes skin to be inflamed and irritated either through skin allergies or sensitivities.


Dr. Michelle Pennie contributed to this story.


For reprint and licensing requests for this article, Click here.