Sophia Delgado
The American Academy of Dermatology is a professional organization for dermatologists, who are medical doctors specializing in treating the skin, hair, and nails. They offer expert advice on nail care, including how to trim your nails properly. Nails are a reflection of your overall health, and any changes in colour, texture, or shape can indicate an underlying disease or infection. For instance, a new or changing dark streak on a fingernail or toenail could indicate melanoma, the most serious type of skin cancer. Other issues like nail biting, fungal infections, and ingrown nails can also be addressed by dermatologists. They can provide guidance on when to treat nail issues at home and when to seek medical attention. With their expertise, dermatologists help people maintain healthy nails and address any concerns related to nail health.
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What You'll Learn
Fingernail lifting up (onycholysis)
Fingernail lifting, or onycholysis, is a common nail disorder where the nail plate separates from the nail bed. It can affect both fingernails and toenails, and usually only affects one nail. It is most frequently seen in adult women, but it can affect both sexes, all ages, and races.
The condition typically presents as a well-defined area of white opaque nail, with the detached nail appearing white and opaque compared to the normal nail, which is transparent and pink. The nail surface may also be pitted, indented, or crumbly. Onycholysis is usually painless, but it can be painful if acute or inflammatory.
Onycholysis is often caused by some sort of injury or trauma to the nail or the area where the nails start to grow (nail matrix). This can include bumping or hitting your nails, wearing ill-fitting shoes, keeping your nails in water for too long, or even regular manicures. It can also be caused by fungal infections, reactions to chemicals in nail products, certain medications, or underlying medical conditions.
If you suspect that onycholysis may be caused by an underlying medical condition or medication, it is important to see a medical professional for diagnosis and treatment. Treatment for onycholysis may involve cutting away the separated nail as it grows out, taking antifungal medications, or discontinuing the use of certain nail products. It is recommended to keep the nail bed dry and avoid harsh products that may be causing the nail lifting.
The regrowth process for fingernails typically takes 4 to 6 months, while toenails can take twice as long. The longer onycholysis persists, the less likely new nail growth will reattach due to permanent damage to the underlying nail bed.
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Infection around the fingernail (paronychia)
Paronychia is a bacterial or fungal skin infection that develops around the nail. It is characterised by inflammation, redness, swelling, pain, and discomfort. It can be acute (lasting fewer than six weeks) or chronic (persisting longer than six weeks). Acute paronychia usually results from bacterial infections, whereas the causes of chronic paronychia are less understood.
Acute paronychia is typically caused by bacterial pathogens such as Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas. It can also be caused by viral pathogens like the cold sore virus, Herpes simplex (herpetic whitlow), or the yeast Candida albicans. Acute paronychia develops rapidly, usually affecting a single nail fold within a few hours.
Chronic paronychia is primarily associated with hand dermatitis or constantly cold and wet hands. It is more common in people with underlying skin conditions or those exposed to irritants like detergents and other chemicals. Nail biting or cuticle picking can also create tiny cracks in the nails or cuts in the skin, increasing the risk of infection.
Mild cases of paronychia can be treated at home by soaking the infected area in warm water several times a day and keeping the area clean and dry. Topical antiseptics may be used for minor infections. However, if symptoms persist or worsen, it is important to seek medical advice. Oral antibiotics are often prescribed for severe or prolonged bacterial infections, and surgical drainage may be required if an abscess forms.
Paronychia is a common nail condition, and early diagnosis and treatment can prevent more extensive complications.
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Yellow nail syndrome
Nail Changes
The nails may grow slower or stop growing. They usually become thick, yellow, or green and may detach from the nail bed and fall off. Nail changes may affect one or all nails.
Swelling
Fluid buildup and swelling (lymphedema) affect about 8 in 10 people with YNS. The legs are especially affected, and the onset of lymphedema may occur around puberty. The skin on areas affected by lymphedema may become hardened or thickened.
Respiratory Symptoms
Almost 2 in 5 people with YNS experience fluid buildup in the lung tissue (pleural effusions). Respiratory symptoms include a chronic cough, repeat sinus infections (sinusitis), pneumonia, and shortness of breath.
The exact cause of YNS is unknown, but it may be linked to improper circulation, issues with lymphatic drainage, or fluid buildup around the lungs. Some researchers believe that it is a genetic disorder, with some cases running in families. YNS is often misdiagnosed as onychomycosis, but histopathological analysis of nail samples is negative for fungus. There is no specific treatment for YNS, so early identification of symptoms is crucial for effective management.
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Deep grooves in nails (Beau lines)
Deep horizontal grooves in the nails, known as Beau's lines, are often harmless and may be caused by injury to the nail, such as slamming your finger in a door or dropping something heavy on your finger. They can also be caused by manicures, artificial nails, or harsh nail products. In some cases, Beau's lines can indicate a more serious underlying condition, such as a chronic illness, nutritional deficiencies, or even acute kidney disease. People with chronic conditions like diabetes and peripheral artery disease should be particularly vigilant about any nail changes.
Beau's lines are typically diagnosed by a dermatologist or healthcare provider who will examine the nails and take a health history. The thickness and number of Beau's lines can provide clues about the underlying cause. For example, a single Beau's line on one nail may indicate an injury to a single finger or toe, while Beau's lines on all nails can suggest illness or stress. Repeated Beau's lines could be a sign of an underlying condition that is interrupting nail growth.
While there is no specific treatment for Beau's lines themselves, addressing the underlying cause will allow new, smooth nails to grow. This process can take about six months. In the meantime, you can temporarily hide the ridges with a nail ridge filler and nail polish, but use these products with caution as they can weaken or damage nails. If you notice Beau's lines and are unsure of the cause, it is important to see a healthcare provider to rule out any possible health conditions.
To prevent Beau's lines, it is recommended to avoid manicures, artificial nails, and harsh nail products. Maintaining proper nutrition is also important, as severe zinc deficiency or inadequate protein intake can contribute to their formation. Managing blood sugar levels in individuals with diabetes may help reduce the appearance of Beau's lines. Overall, any changes in nail appearance should be monitored and discussed with a healthcare provider, as nails can provide important insights into overall health.
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How to trim your nails
Well-maintained nails are not only aesthetically pleasing but also help prevent infections. Here is a guide on how to trim your nails:
Tools and Timing
First, ensure you have the right tools. For fingernails, use a nail clipper or nail scissors, and for toenails, use a toenail clipper. Remember to disinfect your tools regularly. The best time to trim your nails is immediately after taking a bath or shower, as the nails are softer and less likely to snap.
Trimming Technique
When cutting your fingernails, trim almost straight across the nail. Use a nail file or emery board to round the corners slightly, which will help keep them strong and prevent them from catching on things. For toenails, cut straight across to reduce the chances of getting an ingrown toenail. Toenails grow more slowly than fingernails, so they may not need to be trimmed as often.
Leave Cuticles Alone
Avoid cutting or pushing back your cuticles, as they protect the nail root. Cutting or pushing them back makes it easier for bacteria and other germs to enter your body and cause infections.
Moisturise and File
Moisturising after trimming is important, especially in dry conditions, as it helps keep your nails flexible and prevents them from splitting. Additionally, filing your nails can help guide their shape as they grow out and eliminate any scratchy spots.
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Frequently asked questions
You should see a board-certified dermatologist if you notice any changes to your nails, such as a new or changing dark streak, redness and swelling, dents that look like they were made by an icepick, thickening, and yellowing. These could be signs of something more serious, such as melanoma, infection, or another disease.
The American Academy of Dermatology has a search tool for the public to help patients find board-certified dermatologists.
Nails reflect your overall health, so proper nail care is important. To trim your fingernails, cut straight across the nail and use a nail file to round the corners, which will help keep them strong. Toenails grow more slowly, so you won't need to trim them as often. Cuticles protect the nail root, so it's important to leave them alone.
