Lab Reports

i have a new client who is a diabetic. Is it safe to do a paraffin dip on her?

 

Dr.Mix: Before you can determine if a paraffin dip is safe, you need to get a detailed medical history from your client. How old is she? How good is the circulation in her hands and feet? How long she has been a diabetic? Is she a Type I insulin controlled diabetic or a Type II non-insulin controlled diabetic? Is the diabetes under good control with the blood sugars averaging less than 200? Has she lost the feeling in her hands or feet?

 

The age of the client will give you some idea about the overall well-being of that client. If she is elderly, her circulation is more apt to be impaired than in the younger diabetic client. You can check the circulation by feeling for the pulse in the wrist and on the feet. Capillary fill time – the time it takes for the skin to turn pink again after compression has squeezed the blood from an area in the finger or toe – should be less than 10–15 seconds. This is a rough test to determine how good the blood supply is to the skin and its underlying tissues. If the capillary filling time is slow or if you can fell no pulses, then the client should not have a paraffin service.

 

The length of time one has been diabetic is a rough indicator of how much damage this disease has caused to the client. The longer a person is a diabetic, the more changes are seen in the blood vessels and nerves. The Type I diabetic generally has more severe problems that does the Type II diabetic. The loss of feeling in the hands and feet (diabetic neuropathy) is seen in both types of diabetics, and as a rule the longer a person is diabetic the greater the loss of sensation can be. This is particularly true if the blood sugars have not been well controlled throughout the course of the disease. I find that diabetics who follow their doctor’s orders will generally be able to keep their blood sugar below 200. Because of this, the detrimental changes caused by their disease are usually not as severe. For these reasons one needs to be more careful about giving paraffin services to clients who have had diabetes for a long while or who can not keep their blood sugar under good control.

 

Do not give a paraffin service to the diabetic who has lost sensation in her hands or feet. The average temperature of the paraffin bath is 121°. This temperature can cause burns to those clients with impaired circulation or the loss of sensation.

 

If you have any questions about giving the service, do not do it until you have checked with the client’s physician or podiatrist. For more information, see my article “A Pedicurist’s Education in Diabetes,” in NAILS’ March 1996 issue.

 

I have a natural nail client with a seriously damaged thumbnail. She has lost the lunula from what I believe is the result of nervously picking and digging at the cuticle. I think she has damaged the matrix area and created the deformed nail. The new growth has come in with ridges and it looks like there’s a bruise beneath the nail. Her doctor told her it was dirt (from gardening) on the surface of the nail embedded within the ridges. The dark area is becoming sensitive to the touch. What do you think is going on?

 

Dr. MacDougall: Ridging of nails, called onychomadesis, can certainly be triggered by neurotic picking and digging at cuticles and can be a difficult habit to break. However, the observation of “discoloration” under the nail may actually signal the formation of a bone, spur, cyst, or even benign tumors such as glomus tumors, or malignancies such as a malignant melanoma. Any of these growths or tumors can also affect nail growth by how they push on and deform the nail. Your client should be examined by her physician. He may, depending on findings, want to X-ray the finger or biopsy the spot.

 

My coworker’s client has skin peeling on her fingertips. Is she allergic or is the technician using too much primer?

 

Doug Schoon: Without knowing more, it is difficult to answer your question. However, with a little information, you can solve this puzzle yourself. Skin contact with primer causes an immediate and painful burning sensation. Clients won’t allow primer exposure to happen very often before they complain or find a new technician who isn’t so sloppy with the product. If primer gets on the fingertips, it may cause skin to peel, but the person would know immediately that she had been overexposed.

 

On average, allergies to UV gels, acrylics, wraps, and adhesives require four to six months of prolonged or repeated skin exposure before they develop. Any product in these categories can cause allergies, regardless of its composition. Since true allergies usually require many months to develop, clients and nail technicians often don’t relate the problem to skin exposure with nail enhancement products.

 

Product allergies usually start as itching, reddened skin. Tenderness, peeling, swelling, water blisters, warmth, and throbbing sensations often appear if skin exposure continues. Of course, primer can cause the symptoms you described, but they would happen immediately and with a lot of pain. If these symptoms occurred gradually over time and continue to worsen, it is probably from skin exposure to the enhancement product. I would recommend that your coworker “clean up” her act and avoid all skin contact, especially where the skin is already damaged. If this is an allergy and she continues to overexpose the client, matters will only get worse.

 

Is it OK to use products like Lysol and supermarket antibacterial sprays in the salon? Theses products are much cheaper that salon disinfectants and the packaging says “Kills 99.9% of germs.”

 

Schoon: Retail disinfectants are designed for home use and do not meet the requirements of the professional salon. Most experts recommend that salons use EPA-registered, hospital-level disinfectants that are viricidal, bactericidal, and fungicidal. Any disinfectant that can meet these strict standards will undoubtedly exceed all salon requirements.

 

Also, implements should be washed and then fully immersed in disinfectant for 10 minutes to achieve complete disinfection. Spraying implements with household level disinfectants may save some money, but this technique is not effective for true client safety. Proper disinfection is not an area where you should skimp.

Over the last few months, we had numerous clients coming into the salon for fills with terrible, brittle, lifting product. Through a process of elimination, we found that the majority of them were using a particular brand of lotion that contains mineral oil as the first ingredient after water. We had our clients stop using this product for a two-week period. Upon their return we found no lifting and the product was no longer brittle. How is it that mineral oil that breaks down acrylic product?

 

Schoon: It is a common myth that mineral oil will break down artificial nails. There is no truth to this rumor and you can prove it yourself.  Glue a tip to a stick and use your favorite product to make an enhancement overlay. Then soak the entire tip overnight in pure mineral oil (which can be purchased at most pharmacies). The next day, you will see for yourself that mineral oil does not harm the enhancement.

 

Nail technicians are quick to blame mineral oil for many problems, but I have extensively researched this claim and found no evidence that any commonly used cosmetic oil, including mineral oil, will damage the acrylic or cause lifting when the nail plate is properly prepared and the product is properly applied.