A client’s fingernail starts oozing a strange substance and you aren’t sure if the disorder, whatever it is, is contagious or dangerous.

A new client arrives for her first appointment and exhibits dark colored, flaky nails. “Don’t worry,” she tells you, “they always look like this. Just cover them with a set of sculptured nails.” You don’t want to lose a new client, but your instinct tells you something is wrong.

In both of these cases, your first response should be to refer the clients to a local dermatologist or podiatrist.

Recent media attention to the health issues of nail care has resulted in both nail technicians and their clients taking nail disorders and abnormalities more seriously. As a result of this, most nail technicians realize the importance of having someone in the medical community to consult with, someone who can evaluate the seriousness of various nail disorders, and treat them if necessary.

While nail technicians may have endured a lack of respect or a condescending attitude from physicians in the past, that is not true today.

“Nail technicians are experts on nail care and decoration,” says Dr. Edward Young, a dermatologist in Sherman Oaks, California. “They’re like the front-line soldiers in the war against nail disease. They see what’s out there and are instrumental in bringing problems to our attention. Problems only occur when they try to diagnose their clients’ nails.”

Because of the wide array of nail disorders and diseases that can occur on and around the nails, it’s unwise for a technician to try to treat a problem. Allergies, mold, bacteria, fungus, and viral infections are just some of the problems clients encounter. To add to the confusion, many different nail conditions—of varying degrees of severity—resemble one another and are difficult to diagnose correctly without medical tests.

“Clients abuse their nails and use them as screwdrivers and toothpicks,” says Joyce Meysami-Johnson, who has been a nail technician for nine years. “Nails are used for scrubbing pots and pans and digging in the garden, all of which make them targets for infection.”

Meysami-Johnson, who has taught classes on nail disorders and infections throughout the country, says technicians can learn a lot by working with dermatologists.

“When I first started doing nails, one of my clients was a nurse for a local dermatologist who specialized in nail disorders and diseases,” she says. “I called the dermatologist, introduced myself, and told him I was new to the business and wanted to learn about different nail disorders so I could be more professional in handling my clients’ problems. He was very open with me, and I’ve been referring clients to him ever since.”

Dr. Marc Blatstein, a podiatrist in Holmes, Pennsylvania, says he welcomes the technician-doctor relationship.

“One of the largest referral sources for a podiatrist is nail technicians,” he says. “They send clients to me, and I refer clients to them for pedicures. It’s a relationship that benefits us both, financially and medically.”

Because forming a liaison with the medical community can be difficult and time-consuming, Young suggests that technicians try out different doctors by first referring one client with a business card and perhaps a short note asking the doctor to notify the technician about the client’s condition, to let her know if and when the client can receive nail services.

“A good dermatologist will respond to this,” Young says. “They know that nail technicians are professionals in their field, and they want to develop a mutually beneficial relationship with them.”

Blatstein also encourages nail technicians to refer clients to him. “It may take time to find a physician you’re comfortable with,” he says, “but once that relationship is developed, it can only benefit both of you.

“When I first started my practice, I had to go out in the community and network to find client resources,” he continues. “The same applies to beginning nail technicians.”

Another way to meet local doctors is by letting your clients know you’re looking for someone to work with. This networking almost always pays off with a few names and phone numbers. Still another way is to network with members of your church or other community organizations for referrals.

If one physician doesn’t work out, try another. Don’t get discouraged by a doctor who doesn’t understand what you’re trying to do or doesn’t take you seriously.

Once you’ve made a contact, don’t be afraid to send clients with even mild symptoms. “Too many technicians don’t refer patients to us until something bad happens,” says Blatstein. “Anyone practicing out of their scope of expertise, even doctors, is bound to get into trouble. It’s the law of common sense.”

Having access to a professional opinion can mean a lot if complications arise or if you find yourself embroiled in a lawsuit. In today’s litigious climate, why take a chance?

Many dermatologists and podiatrists are even willing to act as consultants. If you’re unsure of a new product, for example you can send the doctor a copy of the Manufacturer’s Safety Data Sheet (MSDS), which lists the product’s ingredients, and ask the doctor’s opinion. Some MSDSs clearly state that certain products can cause rashes or allergic reactions. Make your doctor aware of this in case problems arise.

Conversely, doctors may seek your help in treating a client. If you keep detailed records, for example, they may be valuable to the doctor in diagnosing a client’s condition.

“I keep a complete file and history on each of my customers,” says Meysami-Johnson. “I even keep records of clients I no longer see in a dead file, so if they return several years later, which has happened, I can get the card out and know everything about the client.”

Another important way technicians and doctors can work together is by servicing clients who have chronic medical problems, or those who may be sensitive to certain products. Michelle O’Connor, owner of Michelle’s Nails in Lake Elsinore, California, says she always asks new clients if they have any medical problems. If they do, she records the information in the client’s file.

“You may even want to contact a physician before you work on a client with a medical problem,” she suggests. “For instance, you may get a client who is a diabetic. This type of client is very sensitive, and you have to be extremely careful because they’re prone to infection. If you cut them, they can end up with a serious problem.”

O’Connor advises always contacting a physician if in doubt about a client. “I’ve found there are doctors who gladly welcome a liaison with nail technicians, and they respect you for it,” she says.

The majority of the clients you see probably won’t have any problems with their nails. Still, it’s essential to be prepared for those who do. Attempting to treat anything yourself can only lead to trouble. “When you sit down at the manicuring table, you’re supposed to be a professional—someone who is well-educated and knows what she’s doing,” says Meysami-Johnson. “Your clients trust you.”

Don’t abuse that trust. Form liaisons with the medical community and add professionalism and confidence to your abilities as a technician. Your thoroughness will win you respect from the medical community as well as help you increase your knowledge of nail physiology and nail diseases and disorders.