nail disorders
Our nails serve many important roles. They protect and support the tissues in our fingers and toes. Having nails allows us to scratch an itch. A look at your nails can warn a doctor of an underlying medical condition, such as heart disease or diabetes. At Aspire Dermatology & Aesthetics in Orange City, Florida, Neil Sandhu, MD, FAAD, and the team specialize in the treatment and management of nail disorders, guided by a board-certified dermatologist and dermatology physician assistant.. Call the office or book an appointment online today to learn about nail disorders and how to keep your nails healthy.
Call Today! 386-628-DERM (3376)
common nail disorders
While uncommon in children, nail disorders affect a large number of older adults. As we age, nails thicken and become more susceptible to fungal nail infections. Circulatory problems and use of medications, which also tend to increase as we age, raise the risk of developing a nail condition. The following describes common nail conditions and the causes:
white spots
Most often caused by mild trauma, such as catching one’s finger in a door, these small spots appear when the base (matrix) of the nail is injured. Such white spots are very common, eventually grow out, and are no cause for concern. If you suddenly see a number of white spots and do not remember injuring your nail or the white spots do not seem to grow out, be sure to make an appointment to see a provider at Aspire Dermatology & Aesthetics in Orange City, Florida. White spots also can indicate an infection or other medical condition.
splinter hemorrhages
Appearing as a red to reddish-brown fine, vertical line that resembles a splinter beneath the nail, this disorder occurs when blood vessels in the nail bed are damaged. The most common cause is nail injury. Certain medications and medical conditions also can cause a splinter hemorrhage, so these should be examined by a dermatologist.
ingrown toenails
This common nail disorder occurs when the corner of the nail curves downward into the skin. The big toenails are particularly vulnerable. Improper nail trimming, tight shoes, or a poor stance can lead to this common nail problem. Ingrown nails may be painful and sometimes lead to infection. Proper treatment can avoid problems.
fungal infections (onychomycosis)
When a nail infection develops, the most common cause is a fungus. More frequent on the toenails than on the fingernails, fungal nail infections affect about 12% of all Americans. Onychomycosis tends to run in families because of an inherited tendency, but not everyone is susceptible. It is rare in children unless one or both parents are infected. The two most common types of fungi affecting the skin are dermatophytes and yeast (Candida). While both types infect nails, dermatophytes tend to be more common in toenails. Yeast infections are seen more frequently in fingernails. While some fungal nail infections may respond to topical antifungal creams, lotions, gels, and lacquers, most infections of the nail plate require oral medicines such as itraconazole, terbinafine, and fluconazole.
bacterial infections
Redness, swelling, and pain of the skin folds around the nails often indicate an infection caused by bacteria. The most common cause of a bacterial infection is injury to the nail or surrounding skin. Frequent exposure to water and chemicals is a common cause of these bacterial infections. Sometimes a green discoloration of the nail occurs. A bacterium called pseudomonas causes this discoloration.
tumors and warts
These may be found in any portion of the nail and can cause the nail plate to change shape. When a growing tumor or wart interferes with nail growth, it can destroy the nail.
Warts are viral infections that affect the skin surrounding or underneath the nail. They can be painful and sometimes limit use of the affected finger or toe. Treatment usually involves destroying the wart with freezing or chemicals. If a wart or tumor extends into the nail folds or is located under the nail plate, surgery may be necessary to remove it.
mucinous cysts
Appearing as clear, jelly-filled papules at the base of the nail, these cysts can become painful and may damage or deform the nail. Treatment involves removing the cyst.
dark spots or cysts
If a dark spot or streak appears on any nail, and is not the result of an injury, it must be examined by a dermatologist or dermatology physician assistant at Aspire Dermatology & Aesthetics. This could be melanoma, the most lethal form of skin cancer. Your provider may recommend a biopsy to determine if a dark spot on the nail is a skin cancer.
psoriatic nails
Psoriasis is a chronic skin condition that causes red, scaly patches. Approximately 10% to 50% of people with psoriasis, and 80% of people who suffer from psoriatic arthritis have nail problems, especially with their fingernails. The most common signs include pitting, rippling, and discoloration of the nail. With psoriatic nails, it is common for the skin beneath the nail to develop a reddish-brown discoloration. Splinter hemorrhages can form. The nail may separate from the nail bed, crumble, and/or split. Swelling and redness of the skin surrounding the base of the nail also are common.
nail biting: a hard habit to break
If you develop a nail disorder or find yourself susceptible to nail conditions, it is especially important to break the nail-biting habit. Not only does nail biting ruin the look of the nails, it can damage the skin surrounding the fingers, allowing infections to enter and spread. Nail biting also is an easy way to transfer infectious organisms from the fingers to the mouth and vice versa. Applying bad tasting nail polishes or liquids to the nail may help some to break the habit. If nail biting is constant and severe, it may be a sign of anxiety or a compulsive disorder. In such cases, behavioral therapy may be appropriate.
treating nail disorders
While most minor nail injuries heal without treatment, severe nail disorders require medical care. The following nail problems should be reported to a dermatologist:
- Change in the color or shape of a nail
- Swollen skin or pain around a nail
- White or black line visible in a nail
- Dents or ridges in a nail
If treatment is prescribed, it is important to know that therapy can be a challenge. Nails grow slowly, so they respond slowly to treatment. Due to their thickness, nails do not absorb topical medications very well. Oral medication is often necessary. Surgical treatment is common to remove tumors and correct structural abnormalities.
a window on health
The nails can reveal much about a person’s overall health. Many diseases and serious conditions can be detected by changes in the nails. This is why doctors often check the nails carefully during a physical examination. The most common health conditions that the nails may be revealing are:
Condition/Nail Appearance
- Liver Diseases: White nails
- Kidney Diseases: Half of nail is pink, half is white
- Heart Conditions: Nail bed is red
- Lung Diseases: Yellowing and thickening of the nail, slowed growth rate
- Anemia: Pale nail beds
- Diabetes: Yellowish nails, with a slight blush at the base
Aspire Dermatology & Aesthetics provides patients with a treatment plan for various nail conditions. Schedule an appointment at Aspire Dermatology & Aesthetics today. Book a consultation online or call the office and speak with a friendly staff member.
