Summertime is pedicure time, and you should be promoting pedicures as the healthy thing that a client can do for her feet.
This article will help you keep your clients’ toenails comfortable by showing you how to properly trim them. But first let me dispel some of the myths that exist about toenails.
Myth: Trimming toenails straight across prevents ingrown toenails.
Fact: The only structure of the nail unit that produces nail plate is the matrix bed. Therefore a malformation of the matrix is the usual cause of a nail deformity that leads to an ingrown nail.
Myth: Cutting a “V” at the free edge of a toenail helps to prevent an ingrown nail.
Fact: Because the shape of the nail plate is determined by the shape of the matrix bed, a “V” cut in the nail at the free edge does nothing to change the nail shape.
Myth: Packing cotton under the edge of the toenail helps to prevent ingrown toenails.
Fact: The cotton may help prevent the nail from penetrating the skin for a little while. However, as the nail continues to grow, sooner or later if the nail is not trimmed properly, an ingrown nail will occur.
Proper trimming is the best way to prevent ingrown nails. Some ingrown nails cannot be prevented by trimming alone and the nail margin must be surgically removed (see “A Doctor’s Notes on Ingrown Toenail Surgery,” NAILS, October 1996). This, however, is very rare. For the most part, proper trimming with the proper instruments is all it takes to keep toenails healthy. The purchase of quality stainless steel instruments is cost effective because good quality stainless steel instruments will last for many years. Stainless steel instruments may be easily disinfected, making them safe for multiple client use. The instruments I recommend for trimming the toenails are a toenail clipper, a curette, a small nail rasp, a nail file, and tissue nippers.
Do not purchase the cheap toenail clippers that are really only a large version of the fingernail clipper. Also do not purchase the large so-called “podiatry toenail clipper.” If you look at the jaws of these instruments you will notice a direct similarity to the toenail clippers, only these are a much larger version with handles. I have never seen a podiatrist use these clippers to trim toenails. Instead, invest in a good toenail nipper rather than the concave jaw models. With the straight jaws, one knows exactly where the point of the nipper is when the nail plate is being trimmed. With the curved or concave jaws, one must accommodate for the curve of the jaw when clipping off the corner of the nail.
Yes, I said to slip off the corner in a manner which gently rounds it, the sharp corner of the nail will not penetrate the skin. One can get into trouble when cutting the corner if you cut back too far and leave a “hook,” which remains attached to the nail margin deep in the nail groove. The hook is created by not having the tip of the nail nipper extend slightly beyond the nail margin when the nail is cut. The plate will break at a 90° angle to the tip of the nipper. This leaves a sharp hook of nail attached to the nail margin.
The toenail nipper should be used like a pair of scissors. The nail should be cut in a number of small cuts rather than a single cut. This is because toenails are oval shaped and a single cut will tend to flatten out the oval. This is painful to the client and can tear the nail plate away from the hyponychium, allowing the entrance of bacteria and fungi under the nail plate. The free edge of the nail plate should be even with or just behind the tip of the toe.
The curette is a small, cup-shaped instrument used as an extension of the fingers. It can be used as a probe to gently feel for the shape of the nail along the nail margin before trimming. It is also used to carefully remove the debris and dead skin that builds up on the nail margin and to remove dead cuticle form the top of the nail plate. When working in the nail groove, keep the cup edge against the nail margin and draw the curette gently from the bottom of the groove up toward the free edge of the nail. Do not use the curette to dig out the debris. You will be surprised how much will come out of the groove by carefully using it in the manner I have described.
To remove the dead cuticle attached to the surface of the nail plate, work from the nail grooves toward the center of the nail plate. Do not work from the center of the plate toward the groove as it is easy to slip and cause injury to the eponychium or the skin along the groove. Do not push or nip the cuticle of the toenails. Many infections are caused by pedicurists who do this, and their very unhappy clients end up in the podiatrist’s office because of it.
The nail rasp is a narrow file used to smooth the edges of the nail along the nail groove. It smoothes away any sharp edge as well as removes any small “hooks” that may have inadvertently been caused during the trimming process.
A diamond-impregnated metal file is an excellent nail file to use for pedicures. It is easily disinfected so that it may be safely used over and over on many different clients. It is used to give the final shape to the nail and, because it is so coarse, it can even be used to thin abnormally thick nails. Use it like you would use any of your nail files.
Tissue nippers or acrylic nippers are sometimes used to trim the corners of the smaller toenails or even to trim these toenails. Do not use them to cut cuticles (for reasons which I have already explained).
Remember, practice makes perfect. Correct toenail trimming makes for comfortable, satisfied clients who will return time after time for your services.