Contraindications of the Hand, Feet and Nails


What is a contra-indication?

It is something that prevents or restricts the way in which the treatment is carried out. It is important that you can recognise a contra-indication so to prevent any further harm to the client or yourself, and to prevent cross-infection and secondary infection.

ABSOLUTE- means the treatment cannot be carried out.

RESTRICTIVE- the treatment can be adapted to suit each client.

Contra-indications that prevent.

  • Fungal infections i.e. ringworm of the nails or athletes foot.
  • Bacterial infections i.e. impetigo.
  • Viral infections i.e. verruca.
  • Parasitic infestations i.e. scabies.
  • Severe nail separation.
  • Severe eczema and psoriasis.
  • Severe bruising.

Athletes foot-

Cause- fungal infection of the skin.

Appearance- the skin in-between the toes appears, sodden, white and itchy- it may be red underneath.

Ringworm of the nail-

Cause- vegetable fungus. Usually the result of nail injury and then infection occurs.

Appearance- 3 forms: a) white patches that can be scraped off the nail surface. B) long yellowish streaks within the nail. C) disease spreads from the free edge to the matrix. You will notice the nail plate starts to lift and thicken.


Bacterial infection (paronychia)

Cause- picking the skin at the side of the toenails, or a break in the skin becoming infected. It can often accompanies ingrowing toenails.

Appearance- inflammation, redness and pus occurs in the tissue.


Cause- bacterial infection or unsanitary habits.

Appearance- small red blemishes form which start to weep and spread. Honey coloured crusts then form.


Cause- Viral infection

Appearance- small circular core that is flat and will often have black dots in its centre, it can sometimes be white around the edges. It indents into the sole of the foot. 


Parasitic Infestations- Scabies

Cause- infestation of an itch mite that burrows under the skin.

Appearance- small red papules occur and they then fill with dirt and give a greyish zig-zag appearance.


Severe Nail Separation (onycholysis)

Cause- Bacterial/fungal infections, trauma or illness.

Appearance- this may be infectious and the nail will be visibly separate from the nail bed, looking white in colour where it has lifted. It may affect part of the nail, or the whole nail. Some discoloration or streaks may be present in the nail, and the nail surface may be irregular.

Severe Eczema

Cause- Internal or external irritant, may be genetic.

Appearance- reddening of the skin, with swelling, cracks and possibly blisters. These blisters leak fluid that form scabs. Quite often present in the joint areas.


Severe Psoriasis

Cause- no real cause is known. It is thought to be hereditary or stress related.

Appearance- red patches of skin appear with scale like waxy cells covering the area. Bleeding will occur if the area is scratched, removing the scales, and secondary infection may then occur.

Psoriasis of the nail

Cause- no real cause is known. It is thought to be hereditary or stress related.

Appearance- Psoriasis of the nail will appear as pitting or thickening of the nail plate, beau lines- horizontal ridges in the nail plate and possible lifting of the nail plate.

Severe Dermatitis.

Cause- skin reacts to a particular substance, this can either be a irritant (a substance that directly damages the outer layer of skin) or an allergen (a substance that causes your immune system to respond in a way that affects the skin).

Appearance- skin to become inflamed (irritant), blistered, dry, thickened and cracked.

Severe Bruising

Cause- trauma to the skin tissues, usually resulting from banging. The blood vessels under the skin burst which allows the blood to seep under the skin surface.

Appearance- may appear blue or black and then fade to a yellowy green.


Contra-indications that restrict.

  • Minor nail separation.
  • Minor eczema and psoriasis (not active).
  • Damaged nails.
  • Broken bones.

Minor nail separation.

Cause- Usually damage to the nail, however could be related to illness.

Appearance- Nail will lift slightly from the nail bed and will appear a creamy, yellow colour where it has lifted.

Damaged nails.

Cause- could be a variety of causes such as: injury to the nail, or trauma i.e. running or playing lots of sport causes the trainers to rub against toenails.

Appearance- spilt or broken nails.

Broken bones.

Cause- injury

Appearance-  client would normally be wearing  plaster cast.


Cause- tight fitting shoes or genetic. Bunions develop as a result of pressure on the side of the big toe.

Appearance- as a result the toe is pushes out of line towards the other toes. The joint is more prominent it can become sore and red. Quit often a hammer toe can accompany this condition.

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