SCRATCH COLUMNIST

FOOT notes

Award-winning pedicurist & advanced footcare practitioner, DENISE SPRAGG, shares insights to elevate your treatments

A guide to common toenail and foot conditions

As qualified nail professionals, we are often the first to spot subtle changes in a client’s toenails or foot health – sometimes before they notice themselves. Whether you offer standard pedicures or advanced footcare services, understanding common nail and foot pathologies is essential to the delivery of safe treatments. Recognising when to treat, when to adapt and when to refer is a key part of a nail professional’s responsibility.

ABOUT DENISE SPRAGG

Denise set up a tai chi and yoga retreats company with her husband in 2005, which sparked an interest in holistic and beauty treatments. She has practiced manicure and pedicure services since 2011, is trained in advanced pedicure techniques and is an accredited Footlogix practitioner.

TOENAIL DISORDERS

Toenail health is a reflection of both localised trauma and broader systemic issues. You should be able to identify the following:

Alongside her husband, Denise runs health and wellbeing centre, The Sangha House, in Taunton, Somerset. She offers lacquer and gel pedicure treatments, as well as complex diabetic treatments. In 2023, Denise won the SOS Beauty Award for Footcare Practitioner of the Year, and she has founded footcare website, Elevate Pedicures.

1. Ingrown toenails (onychocryptosis).

Typically caused by poor nail cutting techniques or restrictive shoes, ingrown toenails can be painful and prone to infection. While minor cases may be safely worked around, inflamed or infected nails must be referred to a podiatrist. Always cut toenails straight across and avoid aggressive shaping of the sidewalls. www.elevatepedicures.com /denisespragg1971

2. Fungal nail infections (onychomycosis).

A fungal infection can present as thickened, discoloured, brittle and/or flaky nails. As the condition is contagious, treatment should be refused and the client advised to seek guidance from a health professional. Emphasise the importance of maintaining good hygiene practices with shoes, socks and towels.

‘‘ Toenail health is a reflection of both localised trauma and broader systemic issues. ‘‘

3. Nail trauma & subungual haematomas.

Nails that have been damaged through stubbing, ill-fitting shoes or impact from heavy objects may lift from the nail bed (onycholysis), discolour or become deformed over time. Be cautious when working on traumatised nails, and refer to a specialist if there is persistent discolouration, pain or signs of infection.

4. Nail dystrophy & onycholysis.

Nails that show thickening, pitting, ridging or separation from the nail bed may be displaying signs of underlying issues, such as psoriasis, eczema or thyroid dysfunction. These clients should be referred to their GP for further investigation.

SKIN CONDITIONS OF THE FEET

The skin on the feet is often overlooked, but plays a crucial role in comfort and confidence. You should be comfortable identifying the following:

1. Athlete’s foot (tinea pedis).

This fungal infection commonly presents as peeling, itching and redness – particularly between the toes. It is contagious and often accompanies fungal nail infections. Treatments should be paused until the client seeks medical advice. Educate clients on drying their feet thoroughly, changing their socks daily and not sharing towels.

3. Plantar warts (verrucae).

Caused by the HPV virus, verrucae are often mistaken for corns. Be aware of cauliflower-like skin texture and pinpoint black dots. Verrucae are highly contagious, so avoid treatment and advise affected clients to seek treatment from a pharmacist or podiatrist.

‘‘ Educate clients on drying their feet thoroughly, changing their socks daily and not sharing towels. ‘‘

STRUCTURAL & NERVE-RELATED CONCERNS

While structural foot issues do not fall within a nail pro’s remit, knowing what to look for helps you adapt your services appropriately.

1. Plantar fasciitis.

Clients with plantar fasciitis often experience stabbing heel pain, particularly in the morning. If they are uncomfortable lying back during a pedicure, offer foot support or modify positioning as needed.

3. Morton’s neuroma

Characterised by a burning or tingling sensation between the third and fourth toes, this condition stems from nerve compression. A client experiencing this should be encouraged to consult a medical professional.

2. Blisters, corns & calluses.

Blisters are caused by friction or burns, while calluses and corns are a response to repeated pressure. The latter can be gently reduced through exfoliation and foot filing. However, avoid over-thinning the skin, and remember that the use of open blades, scalpels and razor blades are not within a nail professional’s scope of practice. Never attempt to treat corns manually; refer to a foot health practitioner or podiatrist.

4. Cracked heels (heel fissures).

These result from extreme dryness and pressure, particularly in clients who go barefoot or wear open-backed shoes. While you can offer high-urea content creams as retail products and encourage regular exfoliation, deep or bleeding fissures must be referred to a podiatrist.

2. Bunions (hallux valgus) & hammertoes.

These can change the shape of feet and create pressure points that affect comfort and make certain footwear painful. Keep techniques gentle and non-restrictive, and prioritise the client’s comfort.

BEST PRACTICE POINTERS

Maintaining professional standards in footcare is vital for client trust and industry integrity. Here are some key reminders:

• Adhere to your scope of practice – never diagnose, always refer.

• Use disposable or sterilised tools for every client.

• Clean and dry feet thoroughly before beginning any treatment.

• Wear gloves to maintain good health & safety measures.

• Keep accurate consultation notes and update them regularly.

• Recommend aftercare products such as antifungal sprays and foot creams, and remind clients to wear breathable socks when possible.