Dermatology

Nailing It

  • November 1, 2019
  • 1 minute read

It is common to experience some form of nail problem at any point in life, learn about prevalent ones and what you need to look out for.

Nail problems afflict people of all ages. Common causes include trauma, fungal or bacterial infection, weathering, chemical damage, and skin diseases such as eczema and psoriasis.

Changes in the nails may reflect underlying medical problems. A rare but serious cause is melanoma, an aggressive skin cancer that may present as a black band in the nail.

Fungal Nail Infections

A condition seen more often in toenails than fingernails. If the infection spreads further, nail fungus may cause the nail to discolour, thicken, disintegrate at the edge and affect other nails consecutively. It may be a sign of nail fungus if one or more nails are:

  • Thickened and/or darkened
  • Whitish to yellow-brown spot under the tip of the nail
  • Easily broken, crumbly or uneven
  • Distorted in shape
  • Smelling slightly foul

Treatment is aimed to prevent spread to other nails, and to clear up any fungal skin infection. Proper nail care and oral medications may help a painful nail fungus that has caused thickened nails.

Nail Ridges

Fingernails can reveal a lot about your health. One common change in the nails is the appearance of horizontal ridges, which may signal eczema, inflammation of the nail fold, or vitamin and mineral deficiencies. Iron deficiency anaemia is another trigger for horizontal ridges in association with concaved or spoon-shaped nails.

Deep horizontal ridges affecting all nails, also called Beau’s lines, can indicate a serious systemic condition such as acute kidney disease that causes nail growth to stop temporarily, as well as mumps, thyroid disease, diabetes or syphilis. Chemotherapy can also cause Beau’s lines. Older adults often develop slight vertical ridges due to a slower rate of cell turnover.

Ingrown Nails or Weathering of Nails

Ingrown nails — where the nail grows into the flesh instead of over it — can result from an injury, ill-fitting shoes, or improper grooming of the nails. People with curved or thick nails are most susceptible. The big toenails are most commonly affected, and may become painful and swollen.

Diabetics and people with vascular trouble or numbness in the toes need to be proactive in treating and preventing ingrown toenails, as infection from ingrown nails can lead to serious complications, including losing a limb.

Pigmented Nails

Nails are usually translucent. Brown or black pigmentation of the nail can be caused by factors such as pregnancy, trauma, infection, moles and birthmarks.

Any persistent abnormal changes to your nails should be investigated by a dermatologist. A nail biopsy may be needed to exclude melanoma. If the nail pigmentation is from a benign cause and non-cancerous, treatment is often not required.

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