Nail Diseases and Nail Health: American Academy of Dermatology

Your nails can tell you a lot about your health. Nail diseases and warning signs of other health problems appear on the nails. Your nails also reveal whether you are taking good care of them. Good nail care is important because it can help prevent many common many common nail problems.

The following explains what your nails could be telling you. To help you keep your nails healthy, you also will find dermatologists tips for taking good care of your nails.

Nail Diseases:

The skin around our nails and the tissue beneath them are susceptible to many diseases. If you see any of the following promptly see a dermatologist. Early diagnosis and proper treatment offer the best outcome. If allowed to progress, nail disease can be challenging to treat.

*Dark Spot or Streak:

Melanoma (skin cancer): Nail streaks are common in people of color. While many nail streaks are harmless, it is important to know that about 30% to 40% of melanomas that occur in people of color develop under a nail.

While melanoma under the nail is more common in people of color, anyone can get melanoma under a nail. If your nail has a dark streak or spot and you do not remember injuring the nail, promptly see a dermatologist. When caught early, melanoma can be cured.

Growth:

*Skin Cancer: Many different types of skin cancer, including melanoma and squamous cell carcinoma, can form under or around a nail. If you see a growth under or around you nail, promptly see a dermatologist. Your dermatologist can tell you whether the growth should be removed.

*Wart: A growth on the skin surrounding a nail is often a wart. Warts are common on the hands and feet. When warts develop near a nail or grow under the nail, they should be treated. Treatment can prevent the wart from restricting  a person’s ability to use a finger or toe. Dermatologist offer a variety of treatments for warts.

*Pits, Ridges & Discoloration

Psoritatic nails: Psoriasis is a skin condition that can affect the nails. When psoriasis affects the nails, common signs are pits, ridges and nail discoloration. The skin beneath the nail can turn reddish brown. Reddish lines may appear. The nails can separate from the nail bed, crumble and split.

These nail changes can occur in people with all types of psoriasis. Sometimes, nail changes are the first sign of psoriatic arthritis, a type of arthritis that some people who have psoriasis develop. Nail psoriasis can affect one or several nails and be painful. Treatment can help manage nail psoriasis.

*Jelly-Like Cyst:

Mucinous cyst: Appearing on the skin above the cuticle, these cysts can be painful and should be treated. Allowed to grow, this cyst can damage or deform the nail. A dermatologist can remove this type of cyst.

*Nail Thickens, Lifts:

Fungal nail infection: When a nail thickens, discolors, splits and lift from the nail bed it often indicates a nail infection caused by a fungus. When caught early, a fungal nail infection may clean with an antifungal cream, lotion, gel or lacquer. Many fungal nail infections, however, require medicine that works throughout the body. Your dermatologist may prescribe an antifungal medicine that comes in pill or liquid from. Laser treatments also may be used.

*Redness, Swelling and Pain:

Bacterial nail infection: When these signs appear on the skin around the nail, it often signals a nail infection caused by bacteria. Sometimes the nail develops a greenish color. Pus can accumulate in the skin around the nail. A bacterial nail infection most commonly forms after the nail or surrounding skin is injured. Treatment is important. A dermatologist often will drain the pus and prescribe an antibiotic.

*Nail curves into skin:

Ingrown nail: When the corner of a nail curves downward into the skin, it causes an ingrown nail. Ingrown nails are most common on the big toe. An ingrown nail may be caused by not cutting the nail straight across., tight shoes, poor hygiene, injury and even a genetic predisposition. An ingrown toenail can be painful and sometimes causes an infection. Treatment can avoid these problems.

*Reddish Line:

Splinter hemorrhage: If you see a fine red to reddish-brown vertical line that looks like a splinter under your nail, it often means that you injured a blood vessel beneath your nail. Some medicines and medical conditions also cause this, so be sure to see your dermatologist if one of your nails has a reddish line.

*White Spots:

Injured Nail:  Small white spots often mean a nail injury. These white spots are very common and do not require treatment. You should, however, see your dermatologist if you suddenly see many white spots and do not remember injuring your nail or the white spots do not grow out. You could have an infection or another medical condition.

Nails can reveal health problems: Have you ever noticed that a doctor checks your nails during a physical exam? The reason doctors look at our nails is that changes to our nails often help doctors find diseases. The following table shows what changes in nail color might mean.

Liver Disease: White nails

Kidney Disease: Half pink/half white nails

Heart Disease: Red nail bed

Lung Disease: Nails yellowing, thickening growing slowly

Anemia: Pale nail bed

Diabetes: Yellowish nails with slight blush at base

When to see a dermatologist: if you are concerned about a nail change, see your dermatologist. A dermatologist’s trained eyes can tell whether the change requires treatment or is harmless.

Good Nail Care:

Poor nail care can cause problems with your nails. To keep your nails healthy, dermatologists recommend the following:

*Keep you nails clean and dry: this helps prevent nail infections.

*Cut your toenails and fingernails straight across, rounding slightly in the center. This keeps your nails strong and helps avoid ingrown toenails.

*Keep toenails short. This minimizes the risk of nail injuries and other problems.

*If your toenails are thick and difficult to cut, soak your feet in warm salt water (one teaspoon of salt per pint of water) for five to ten minutes. After drying your feet, apply a cream that contains urea or lactic acid to soften the skin and nails.

*Smooth rough edges with an emery board. This helps prevent nails from snagging and reduces your risk of injuring a nail. To avoid an infection, do not share emery boards.

*Avoid biting your nails. Nail biting can ruin the look of your nails. It also can damage the skin around your nails, increasing your risk of a nail infection. Avoiding the temptation to bit your nails is especially important if you have a nail disease or you often get a nail disease.

To help patients stop nail biting, dermatologists often recommend applying a bad tasting nail polish or product that can help end nail biting. If this does not help, behavioral therapy may help break this habit.

*Protect your cuticles. Cuticles prevent bacteria and other germs from entering our bodies. To protect your cuticles, never cut or forcefully push back your cuticles. If you must push back your cuticles, only do so after a shower or bath and do so gently.

Ask you dermatologist to  treat an ingrown toenail. If you try to dig out an ingrown toenail. If you try to dig out an ingrown toenail, you can cause an infection or worsen an existing infection.

*Wear shoes that fit and alternate your shoes.

*If you have diabetes or poor circulation, pay close attention to your feet and nails. At the first sign of a problem, see your dermatologist.

Disclaimer: This information was taken directly from American Academy of Dermatology pamphlet on nail diseases and nail health. If you need additional information, please feel free to contact that at the above number or email.