How I spotted a sign of skin cancer on my salon client’s nail

Session nail stylist, salon owner & educator, Marie-Louise Coster, reveals how undertaking skin cancer awareness training benefitted a client…

As nail techs, we provide a very personal service. The level of touch brings responsibility, because clients often share deeply personal things. We need to listen, and if asked, support clients to find help for their concerns. I strongly recommend every professional has a directory of organisations they can direct clients to. There are things that we can be a supportive ear for, and other things that require expert help, so having a list of details for counselling services, domestic violence charities, suicide prevention helplines and so on is invaluable.

When we see clients regularly, we are in a prime position to notice things that they may not be aware of themselves. There are parts of our clients’ bodies that they don’t see but we do, particularly if you offer massages or back treatments for example.

We aren’t doctors and must never behave as such or diagnose. However, we must be equipped with knowledge that allows us pick up on things and recommend to our clients when they should seek medical advice.

Every year, I update my MASCED (Melanoma And Skin Cancer Early Detection) training, which is a nationally accredited programme offered by Skcin, a UK charity dedicated to the prevention and early detection of skin cancer. Not that long ago, my MASCED training became one of the most important things I have ever done.

A regular massage client had come in and as I was massaging her hands and arms, I saw a dark brown/black vertical line in her nail plate. She paints her fingernails so I hadn’t noticed it before, but I remembered from my training that a dark vertical line in the nail can be a sign of skin cancer. I casually pointed the mark out and quizzed the client a little. I didn’t want to alarm her, but asked if she’d had the mark for long, to which she said she hadn’t noticed. I also asked questions like ‘does it hurt when I touch it?‘ and ‘do you remember trapping the nail?‘ and after the treatment, I brought it up again, much like I would give aftercare advice. I suggested she mention the line to her doctor.

I saw this client a month later and she had nail polish on, meaning I couldn’t see the nail. I asked if she had seen a doctor and if the line was still there. She said it was there but she had forgotten to see a doctor, therefore I urged her to make an appointment. She called me one day and told me she had emailed pictures of her nail to a doctor, who said it was bruised. I was not convinced by this, so asked if the diagnosis had come from her usual doctor. It was a doctor she didn’t know and I recommended she speak to her regular doctor.

About two weeks later, the client came in for a treatment. The first thing she said was ‘did you know that was skin cancer in my nail?’ I told her that I didn’t know for certain that it was skin cancer, and I am not a doctor so would never diagnose, but I have undertaken advanced training in skin cancer awareness and knew that she was displaying a potential sign.

After I had urged her to get a second opinion before, she had asked to have at least a telephone consultation with her designated doctor. She spoke with them, sent more pictures and was asked to visit the practice immediately. Her doctor referred her to hospital for an emergency appointment and said ‘your masseuse may well have just saved your life.’ Fortunately, the client is absolutely fine, but things could have been very different.

Our jobs are so much more than painting nails: we are in a valuable position to help our clients. Maybe I did save my client’s life, but I was just doing my job the very best I could.

Find out more about MASCED training here.

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