A Day in the Life of a Podiatrist: Gel Nail Reconstruction

Posted 28/08/2017
A Day in the Life of a Podiatrist: Gel Nail Reconstruction

“But that’s what beauticians do! I didn’t go to university for four years to do beauty therapy!”

This is the view of many podiatrists who feel that gel nail techniques are beneath them; that what we do is so much more advanced and important than making someone’s toe look nice.

We keep the nation mobile. We are at the frontier of research into understanding the lower limb. We are a shining example of evidence-based, peer-reviewed science. Why on earth would we let our professional standards stoop to beauty and aesthetics?

Because it makes a difference.

We have the skills to deal with the underlying issues of why a nail is disfigured in the first place. And we have the knowledge and experience to know how to safely prepare a nail plate to take the best advantage of gel additions. We can give the proper advice on the causes of a nail condition and what can be done in the long term to manage or improve the condition.

Podiatrists have the skill set already in place to provide a gel nail reconstruction in a safe and controlled environment.

Distress, worry, and disgust at that toe.

A new patient came to see me at the clinic recently. She seemed a little nervous but I soon put her at ease and she noticeably relaxed once she was seated comfortably in the patient chair. And when I ask how I can be of help to her she tells me a little about why her “ugly” nail is such an issue. She can’t take her shoes off; she is just so scared that someone will see her “horrible feet”. “Holidays aren’t what they used to be”, she said. They’ll holiday in hot countries but her toes never make an appearance so the sandals stay safely ensconced in the suitcase, never to be worn. She tells me she’s even self-conscious in her own home, with loved ones. It’s genuinely a source of worry for this patient: cold sweats and deep feelings of anxiety created by this nail that hasn’t looked normal for years. This toe that doesn’t feel like it’s part of the whole. Like someone swapped her toe for an alien’s in the night.

She told me how she searched on the internet for someone who could help. She knew it wouldn’t be a beauty therapist (that part would probably come later). She needed a podiatrist who could strip the thick, unsightly formation back and form a gel nail to make a toe look normal again. Even if it was temporary.

We talk about how the “toe” happened. It was an injury. The nail was badly bruised and it never recovered. She spent years living in hope that one day it would heal up and a normal nail would grow in and finally, she gave in to this thick disfigured nail that is here to stay.

Can we fix it? Yes, we can.

After a few questions about medical history and general health, we were ready to go. The nail was very thick, yellow and shaped more like a horn than a nail. It looked like it would have been uncomfortable in shoes. I could understand why she was so anxious to do something about it.

I reduced the thickness of the nail down to a minimum thickness so that the gel nail to be attached wouldn’t be too bulky. This part of the process requires skill and clinical experience. If the nail reduction isn’t done properly there could be problems when shoes press on the area and cause pressure lesions or secondary problems as the nail grows in underneath. If the reduction goes too far or dirty instruments are used, sepsis can be an even bigger problem.

The gel is applied in 2-3 layers, each time cured under UV light. Then the gel is sculpted gently into a nail shape and sealed with a final layer to protect from dye from socks, shoes, and polishes. The nails can be painted with nail varnish or shellac. Pretty much treated like a normal nail, although a little TLC is advised to prolong the life of the nail.

My patient seems a little quiet and I’m not sure if she’s happy with the result. I feel quite pleased with the new gel “nail” and wonder if it has met her expectations. She pays and leaves with assurances that she looks forward to going on holiday and trying out her sandals.

I don’t hear anything until a few months later when she comes in for another gel nail appointment. The remnants of the original gel nail are still attached and have only started to lift and look thicker because her own nail has started to thicken up again underneath. I take away the old gel, buff down the nail plate and apply a fresh gel nail as we had done before. While I do this my patient tells me how she hadn’t enjoyed a holiday like that in years. The gel nail behaved like a normal nail the whole time she was away and she could wear whatever shoes she liked or none! It was wonderful, she said!

We agree that the new nail looks fine and as I show her out, she stops with tears in her eyes and gives me a hug, thanking me because “you have no idea how much this means!” Wow! Did I make that much of a difference in someone’s life just by applying some gel resin? Apparently, I did.

Now, this lady feels good about her feet and she’s looking after her feet. This one new skill that I have acquired since graduating in 1999 has surprised me the most. It was a gamble. Many podiatrists still think that it’s not for them to dabble in the beauty industry but when you can get someone to engage with their feet, to feel good and want to look after them, to make healthy choices about them, then it is well worth the effort.

Besides, it’s good fun doing it.

If you can relate to this article and would like to discuss gel nail reconstruction with Clare, feel free to call Five Little Piggies on 0141 613 1113.

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