A contra-indication is a factor which will prevent you from carrying out your treatment, whilst contra-actions are things which may occur as a result of the treatment, either during or after it.

The following disorders and diseases do not prevent treatment, but your treatment may have to be adapted to suit the condition. In extreme cases or if you are uncertain, you should refer your client to their GP before treatment.

Ingrowing Toenails

This occurs when the nail penetrates the nail wall, and is usually caused by ill-fitting shoes or the nail being cut down the sides instead of straight across. The problem can cause redness, inflammation and in severe cases the formation of pus in the area. It is most commonly seen on the big toe. If there is no sign of infection the area can be avoided so not to cause discomfort to the client. The client will need to be advised that you are not qualified to offer corrective treatment for ingrowing toe nails and that they should visit a qualified chiropodist. If there is any sign of infection the client should be referred to a doctor and treatment must not go ahead until any infection has cleared up.

Corns

These are often caused by tight shoes and consist of a central core which is surrounded by thick layers of skin. They often appear over the joints, are white in appearance and can sometimes be painful.

The client should be referred to a chiropodist for treatment. It may be possible to work around the area to avoid causing the client discomfort.

Calluses

These are thick, hardened patches of skin usually around the heel or the ball of the toe. They can be gently removed using a rasp or pumice, and need regular maintenance. If the calluses are painful, the client should be referred to a chiropodist for specialist treatment.

Thickening Nails

Toe nails can sometimes become thick and discoloured. This is often brought about by the constant irritation of ill-fitting shoes. If the toe nails are too thick to be cut during the pedicure treatment, the client should be referred to a chiropodist.

Bruised Nail

This is normally identified by a blue-black mark on the nail bed which has been caused by injury. The bruise will change colour and disappear as the injury heals, but should be excluded from treatment if it is painful.

Hangnail

Hangnail is identified by the cracking of the epidermis around the nail plate, usually caused by biting. A small piece of skin protrudes between the nail plate and wall, sometimes with swelling. A warm oil treatment will soften the skin so that the protrusion can be removed with cuticle nippers.

Leuconychia

Noticeable by white spots or marks on the nail plate, leauconychia is caused by a trauma to the nail plate. This will grow out with the nail, and can be covered with nail varnish.

Pterygium

Neglected nails can suffer from overgrown, thickened cuticles which can lead to a splitting of the cuticle and possible infection. Regular pedicure services including extra treatments such as hot oils or paraffin wax will help to soften the cuticle, which can then be removed. In extreme cases, the client should be referred to their GP. If there is any sign of infection the client should be referred to a doctor and treatment must not go ahead until any infection has cleared up.

Onychorrhexis (Brittle nails)

Onychorrhexis is the splitting and flaking of the nail plate. One of the main causes of this condition is extreme dryness of the nail. As people age, their nails become drier and more brittle, long, hot baths and showers can also make nails dry. This condition can be helped with regular pedicures and paraffin wax treatments.

Bunion

Bunions are most common in middle-aged women and are caused by the prolonged wear of badly fitting shoes. A bunion is recognisable as the large joint at the base of where the big toe protrudes. This forces the big toe towards the other toes. The client should be referred to a doctor or chiropodist if the bunion is painful. It may be possible to work around the area to avoid causing the client discomfort.

Psoriasis

Psoriasis appears as scaly patches of red or silvery skin which can break open and become sore. A direct cause for this is not known, but it is thought to be linked to the nervous system and is a recurring condition. This means that whilst soothing or relaxing treatments do not treat the problem itself, they can often help the initial cause. Psoriasis can appear anywhere on the body, but is most frequently found on the limbs around the knee and elbow areas.

All psoriasis conditions of the skin or nails will require medical attention, however, some clients will only suffer from very small patches triggered by stress which can be worked around. Open or bleeding patches are contra-indicated.

Eczema

Eczema is a non-infective inflammatory disorder of the skin, with a variety of possible causes, both internal and external. It is usually identified by patches of very dry skin which is often scaly and flaky. It can be red in appearance and is often itchy. Eczema can appear anywhere on the body, and once a medical diagnosis has been made, it is discretionary whether you should treat the client. If the eczema covers a large area and is infected or inflamed with broken skin then it should be left alone. If the eczema is just a small patch then the area can be excluded and the rest of the treatment continued as normal. The use of hypo-allergenic products is recommended, and a patch test should be carried out if the client is very sensitive.