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Are there special considerations when cutting elderly clients' toenails?

January 1, 2004

I do a lot of pink-and-white acrylic nails. They sometimes turn yellow after one or two weeks. How do I prevent this?

Christine Turner: There are many reasons for yellowing. First, you need to decipher if the yellowing is topical or within the acrylic itself. If it is topical, it may be your top coat or the acrylic’s top layer itself that is yellowing due to exposure to UV light or chemicals. Ask your clients some questions about their lifestyle to narrow the field. Do they tan in- or outdoors? Do they use a self-tanning lotion or a tan lotion with bronzer in it? Do they wear gloves when they clean? Are there any chemicals they might be inadvertently handling without gloves? Hair color and some hair products can cause yellowing. I had one client with yellowing due to her poor quality top coat and another whose nails turned yellow when she used a nail strengthener designed for natural nails over her acrylic. In these instances, you can try using a UV-protective top coat to keep the color true or you may want to consider using an acrylic with UV-inhibitors or labeled “non-yellowing.”

If the yellowing is not on the surface, then there may be a more extensive underlying problem. If your brush has come in contact with another monomer, plastic, nail filings, or you have touched it with your fingers, it may be contaminated. Even using brush cleaners may not help and may in fact contribute to yellowing so use monomer to clean your brush instead. Storing your brush “tip up” can cause monomer to seep into the ferrule and also cause yellowing. You will know if your brush is contaminated if the lint-free pad that you wipe your brush on during application has traces of yellow on it. If this is the case, you’ll most likely need to replace your brush and discontinue whatever caused the contamination in the first place. Even the residue in a new brush can contaminate your acrylic application, so be sure to prepare it properly and remove all traces of residue before using it the first time. If the yellowing is on a couple of nails and appears to be deep within the acrylic, it may be caused by an air pocket between the acrylic and nail plate. Inaccurate mix ratios, oily or unsanitary nail plates, and bumping the nail can lead to pocket lifting. Over time, moisture and oils from the nail plate will collect under the pocket and start to discolor under the acrylic.

Check with your manufacturer for correct mix ratios to rule this out as a possibility. Be sure that you are starting with a clean, dry nail plate and use an antiseptic or dehydrator to thoroughly clean the nail before every application. Keep in mind that acrylic can also discolor or lose its color over time. It’s a good habit to replace at least some of the acrylic over the entire nail — as opposed to just the new growth and free edge — when doing a backfill. Thin and shape the nail before you apply new product and lightly refine the new application with a fine grit so as to leave the fresh acrylic in place. This will help to keep the color true and prevent the older acrylic, which has grown up from the cuticle to the center or free edge, from becoming as brittle over time.

Are there special considerations when I cut the toenails of elderly clients? When should I refer them to a podiatrist?

Dr. Youner: The quick of the nail grows more closely to the nail tip as we age. Consequently, it becomes easier to nick a client if you cut too closely.

If you notice that the center of the underside of the nail is thickened, take care to avoid cutting into this area, as it will bleed. If the client is a smoker, diabetic, or has poor circulation, her nails will grow more slowly and her skin will be thinner and more fragile. Take care reducing calluses. Gentle rules on this. The feet are also more sensitive. If the nail technician notices any sores, especially on the bottom of the foot where the client can’t see them, or any bleeding, discoloration of nails or toes, foul odor, skin rash, or other abnormality (even an abnormally dark mole on the bottom of the foot), it is best to refer the client to the podiatrist. Any cracking between the toes can initially be treated with simple corn starch, but a fungal infection requires prescription medication.

I had a client with calluses between her toes. She asked me what can be done, but I couldn’t help her. Any suggestions?

Youner: Calluses between the toes are knows as ballerina corns and are very painful. They may be caused by a too-narrow shoe after as little as one day of wear or by toes that have been squashed together in shoes for too many years. After years of pressure, the bones grow and surgery may need to be performed. Trimming the inter-digital corn is helpful, as is the old ballet trick of wrapping the toe with lambs wool, available at most drugstores.

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