“Pterygium of the nail can be described as an adhesion between the skin surrounding the nail (dorsal nail fold) and the area under the nail plate, which eventually leads to partial nail destruction,” says Dr. Andrea Cambio. There are a number of causes of pterygium. One common cause is the skin disease lichen planus, which along with pterygium of the nail, appears as a purplish rash on the skin and possibly even in the mouth. Other causes of pterygium include blunt force trauma or rheumatic disease. There is also a hereditary form of pterygium, says Cambio.
Pterygium can appear on the fingernails or the toenails, and it affects both men and women. Women are more likely to catch the disease in its beginning stages, because they are generally more conscious of their nails and are more likely to get their nails manicured by a professional who would recognize the disease, says Dr. Gregg Severs, an osteopathic physician.
Severs says treatment for pterygium begins with topical steroids in the form of creams and lotions, or anti-inflammatory medications. Tier two of treatment moves into cortisone injections at the matrix of the nail (which is very painful for clients). In advanced cases, treatment requires the nail to be removed through surgery.
Techs can best identify pterygium on a client by studying photos of the disease to get acquainted with the triangular, winged shape of the skin that grows into the nail plate. If a tech suspects a client has pterygium, she should proceed with caution. “Don’t push the cuticle back,” says Dr. Cambio. “This may lead to further scarring, infection, and bleeding.” Polish and acrylic products are considered safe to apply, but are not advised, as the product will be applied directly on the skin. This presents two problems: one, the product will have difficulty adhering to the skin; two, nail product should never be applied to the skin, because it is an allergen and could cause a reaction. Techs should simply manicure the section of the nail plate that has not been compromised with pterygium, but avoid sanding down the nail plate which is already weak. Strongly advise clients to schedule a doctor’s visit.
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