The question of managing thick toenails came up several times in our December survey. This is a great question and a very serious topic we all need to talk about. Not only because we see this quite often in our Salons, it is also an area of concern when it comes to working within the limits of our license. In addition, how we manage thick toenails can literally be a matter of life or death.
Let’s first discuss what can actually cause thick toenails;
  • Walking barefoot in public areas
  • Frequent or prolonged exposure to water
  • Shoes which constrict your feet
  • Damage to a toenail
  • Athlete’s foot that spreads to your toenails
  • Medications which suppress your immune system
  • Genetics
      Plus
  • Smoking
  • Aging
Approximately 20% of our adult population has onychomycosis. This is a condition when a fungus or yeast enters your toenail.
The fungus or yeast grows under the nail, where it is moist. The infection will initially be minor, but with time, lack of care and improper pedicuring it may spread and cause your toenail to grow thicker and in many cases cause other symptoms as well.
For many reasons, I love that this question was asked.  Statistics show us the geriatric client, the diabetic client are our greatest source of revenue in the Foot Care venue.  All of the above bullet points, affect a fair amount of these clients.
This brings us to the question….does performing a service on a client with thickened toenails place us out of the limits of our license?   Working on a thickened toenail “does not”.  However, working on a thickened toenail with suspect of fungus “does”.  And, the only way to know for sure is to refer to a Medical Professional.  A Dr. can order a culture which will determine if the thickening is indeed a fungus.
If the client is cleared and you move forward with a Foot Care service, it is imperative to know how to manage this service and how to inform our clients that at home care is mutually important.
Advanced education on this subject is always the best way to go.  I’ve said this before, and I will say it again….”Having a Professional license does not qualify you to care properly for this type of client!”  There are so many concerns in the proper way to manage thickened toenails.  Concerns which, CAN be a matter of life and death.
  • “digging” to aggressively, to deep
  • causing separation from the thickened build up to the skin
  • expecting this issue to clear in just one service
  • causing bleeding
  • causing more damage

IF and only IF it is determined through Dr. referral which verify’s you are not dealing with a fungus…here are some tips and precautionary measures;

  • Never clean under or around the nail when the area is dry
  • Never clip the nail when the nail is dry
  • Soften the nail and surrounding area with a callous softening product while slowly working the accumulation under and around the nail-DO NOT FORCE THE THICKNESS AWAY FROM THE SKIN.  Doing this will cause a separation which can cause portal of entry for bacteria or fungi to enter
  • Trim the toenail in little bites.  Improper trimming can also cause the nail to lift up from the skin
  • Use proper tools when working with these clients.  Stainless steel (100%) is the only proper tool
  • Practice proper disinfection procedures
  • Follow up with a recommendation for at home care is mandatory
  • Schedule subsequent appointments for evaluation and further care if necessary

It is only with proper advanced education which will help you gain the know how AND the confidence to service a client with thickened toenails.  Knowledge will build your confidence and will help you to educate your clients on the importance of Foot Care.