Contra-indications are referred to as the situations when a treatment can’t be carried out on a client or it restricts/changes how some parts of the treatment is carried out so that the treatment doesn’t cause any harm to the client or to the therapist themselves. Contra-indications also reduce the risk of cross-infections and secondary infections.
After examining a client before starting the treatment, if you get an indication of a contra-indication, you need to tactfully deal with the client and ask them to refer to a general physician before getting the treatment done. Never mention to the client what contra-indication they might have as it may upset them, instead refer them to seek medical advice before getting the manicure or pedicure done.
As a manicurist you must be able to identify disorders of the skin which prevent giving a manicure or which require special care. Contra-indications can be categorised into contagious or non-contagious disorders. The disorders of the skin or nails that are not infectious may not contraindicate a manicure/pedicure treatment. However, if there are blisters or the skin is weeping, the therapist must not proceed with the treatment.
Clients must be advised to seek medical attention so that their condition doesn’t worsen and the treatment doesn’t amplify their suspected contra-indication. Also mention to the client to bring a doctor’s note and prescription for carrying out the treatment the next time they visit you and try to keep the record of your client to avoid any complications in the future. This would not only protect the client and the therapist but would also minimise the chance of cross-infections, maintain the cleanliness of your place of work and assure the safety of your other regular clients. Some possible contagious and non-contagious contra-indications are listed below:
List of Contra-indications that may occur more generally:
| Contra-indication | Description | Treatment Execution |
Dermatitis | Dermatitis is an inflammatory skin disorder. The skin appears red and becomes swollen with possible appearance of blisters. | Non-contagious so manicure treatment can be conducted. |
Eczema | Eczema is also caused by the skin’s reaction to an irritant. Skin appears reddened and swollen with blisters in severe cases. Manicure could be given if there are no blisters. | Non-contagious so manicure treatment can be conducted. |
Psoriasis | Psoriasis appears as red dull papules, and develops into red plaques with white silvery scales. The nail appears pitted. The nail fold is affected with a build up of cells under the free edge. | Non-contagious so manicure treatment can be conducted. |
White spots | A common nail irregularity. As the nail continues to grow they will disappear. | The therapist could do treatment as it is a non-contagious. |
Corrugations | Wavy ridges caused by uneven growth of nails. These are usually a sign of illness or injury. Carefully buff nails with pumice powder. | The therapist could do treatment as it is a non-contagious. |
Bitten nails | This may be caused by a nervous habit. Regular oil manicures will soften cuticles and assist in breaking the habit. | The therapist could do treatment as it is a non-contagious condition. |
Ringworm | It is a fungal infection that affects the nails, feet and hands. Ringworm is highly contagious. For that reason manicurists must refer a client showing symptoms of ringworm to the doctor. | It is a contagious disorder and treatment must not be conducted. Client to be referred to the doctor immediately. |
Athlete’s foot | This is a condition that affects the feet, particularly between the toes. | It is a contagious disorder and pedicure treatment must not be conducted. Client to be referred to the doctor immediately. |
Bacterial Infection | Infectious and inflammatory condition of the tissues surrounding the nails. This can occur when the nail is exposed for long periods to alkaline products such as soap. | It is a contagious disorder and treatment must not be conducted. Client to be referred to the doctor immediately. |
Viral Infection | Infectious condition of hands and feet that includes:Plantar Warts grow on the feet. They are contagious and usually gotten from walking barefooted in changing rooms.Hand warts are contracted from contact with persons, for example shaking hands. Warts are also contracted from infected towels and surfaces. | It is a contagious disorder and treatment must not be conducted. Client to be referred to the doctor immediately. |
The term contra-actions is the reactions that a client may face after a particular treatment e.g. manicure/pedicure. Before the therapist begins with a treatment, it is beneficial to explain to the client what would be the expected reactions on the skin (if/any) after or during the process of the treatment. In case the client doesn’t overcome the reactions that occurred within a 24 hour time period, he/she must be referred to a general physician. The most general contra-actions which clients may experience are:
- Discolouration of the nail plate that is caused by not using a base coat
- Split or torn cuticle that is caused by the improper use of cuticle nippers
- Split nail caused by improper filing techniques
- Thinning of nail plate due to buffing
There are some extreme contra-actions that are very rare among the clients but need to be discussed prior to the treatment. Allergic reactions to nail cosmetics around the fingers usually appear as redness and swelling of the fingertips. Other affected areas show a typical allergic contact dermatitis reaction. There may be intense swelling and redness of the area within a few hours or a rash may appear after a day or two after contact. The affected skin may be red, swollen and blistered or dry and bumpy. Nail plate discolouration occurs with long-term use of coloured nail enamels, particularly if deep red nail polishes that contain D&C Reds No. 6, 7, and 34 are used. The nail plate is stained yellow after 7 days of continuous wear. In addition to causing allergic and irritant contact dermatitis reactions, some ingredients of nail cosmetics may also cause secondary nail infections such as onycholysis, paronychia, hand dermatitis and pro-longed paraesthesia. These contra-actions can be extremely painful, long-lasting and debilitating.
