Sometimes, like in the picture, the skin on the top of the proximal nail fold gets a bit damaged and ‘frayed’. It can be painful and inflamed – but not always.
Some people have very thin and delicate skin either naturally or due to invasive treatments like chemotherapy or the application of topical medication such as cortisone. Diving into a handbag or using cleaning products without gloves can cause this on delicate skin.
But there is another cause. Abrading or cutting the skin of the PNF can create this situation even on stronger skin.
Imagine a piece of woven material folded once. This is what the skin of the PNF does. The edge of this fold is where there is a frame of clear skin. This is the epidermis folded under. The epidermis is the upper layer of skin where there are no blood vessels nor nerve endings but there is continual creation of new epidermal skin cells. When fully keratinised they are shed by the eponychium under the PNF (which makes the very sticky) and we see this as the cuticle on the nail plate.
Let us go back to our folded fabric and picture the edge of the fold. Now imagine rubbing the edge with some sand paper. The threads in the fabric will fray, correct? What will happen if the extreme edge is cut off, just a few threads and not all the way through? Some threads will come loose and also fray.
This is what can happen if the edge of the PNF is abraded or cut. The epidermis can become disconnected and peel away causing the effect as seen in the picture.
To conclude, don’t be too aggressive with this area of living skin. Keep it moisturised and supple and advise your clients to regularly use a good nail oil and protective hand cream.