Ava Monroe
Dermatitis around the fingernails can be caused by various factors, including nail cosmetics, nail biting, and underlying skin conditions such as eczema and psoriasis. Treatment options depend on the specific cause and can range from lifestyle changes to medical interventions. For example, in the case of contact dermatitis caused by nail products, identifying and avoiding allergens is crucial, whereas eczema may be managed through a combination of lifestyle changes and medications such as topical steroids. In more severe cases, such as nail infections or psoriasis, medical attention is necessary, and treatments may include antibiotics, corticosteroids, or other prescribed medications.
How to treat dermatitis around finger nails
| Characteristics | Values |
|---|---|
| Diagnosis | See a dermatologist for a proper diagnosis. Patch testing can be done to identify specific allergens. |
| Treatment | Topical steroids, cool compresses, moisturisers, emollients, corticosteroid creams, antibiotics, sedatives, and systemic corticosteroid therapy. |
| Prevention | Identify and avoid allergens, wear gloves when doing activities that may damage nails, regularly clean, trim and moisturize nails. |
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What You'll Learn
- Identify the cause: Eczema, psoriasis, or an allergic reaction to nail products
- See a dermatologist for a proper diagnosis and treatment plan
- Treat with topical steroids, corticosteroids, or antibiotics
- Keep the area clean, dry, and moisturized
- Avoid triggers and irritants, such as nail biting and harsh chemicals
Identify the cause: Eczema, psoriasis, or an allergic reaction to nail products
Dermatitis around the fingernails can be caused by a variety of issues, including eczema, psoriasis, or an allergic reaction to nail products.
Eczema
Eczema is a common skin disease affecting around 5.5% of American adults. It is characterised by red, itchy skin and can appear anywhere on the body. When eczema affects the hands and feet, it is called pompholyx eczema. This type of eczema can affect the nail folds and skin around the nails (cuticles), resulting in swelling. It can also cause pitting in the nails, which looks like dents made by a sharp object, as well as grooved and thin nails. If you have eczema elsewhere on your body, you may be more likely to develop nail eczema.
Psoriasis
Nail psoriasis is an autoimmune disease that causes skin cells to reproduce quickly, leading to discolouration, pitting, and changes in the structure of your nails. It usually appears in older adults and is often accompanied by a psoriatic rash on other parts of the body. It can also cause lifting and white discolouration of the nails. If you have psoriasis or a family history of psoriasis, you may be more likely to develop nail psoriasis.
Allergic Reaction to Nail Products
Allergic contact dermatitis can be caused by exposure to certain substances, such as topical anaesthetics or acrylic nails. It is important to note that dermatitis can also be caused by irritants and allergens in the environment, such as detergents and other chemicals. Wearing protective gloves can help prevent dermatitis caused by these types of exposures.
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See a dermatologist for a proper diagnosis and treatment plan
Dermatitis around the fingernails can be uncomfortable and unsightly. It is important to see a dermatologist for a proper diagnosis and treatment plan. Dermatologists are specialists in diagnosing and treating skin, hair, and nail conditions. They can help identify the root cause of your nail concerns and provide tailored advice and treatments to address the issue.
When you visit a dermatologist, they will examine your nails and ask about your symptoms and medical history. They may take a sample of the affected nail or perform a nail clipping to send for microbiological testing, especially if they suspect a fungal infection. In some cases, they may also recommend an X-ray or a biopsy to rule out other underlying conditions.
Based on the diagnosis, your dermatologist will create a treatment plan specific to your needs. Treatment options can vary depending on the underlying cause of your dermatitis. For example, if you have a bacterial infection, such as paronychia, your dermatologist may prescribe antibiotics to clear the infection. They may also recommend soaks to help treat the infection and relieve any associated pain and tenderness.
In cases of nail eczema or psoriasis, your dermatologist may recommend topical treatments, such as corticosteroid creams or ointments, to reduce inflammation and improve the condition of your nails. They may also suggest lifestyle changes, such as avoiding triggering products, keeping your hands dry, and wearing gloves during household chores or activities that may damage your nails.
For more severe cases of nail psoriasis, your dermatologist may suggest medicine injections or oral medications. They can also provide guidance on nail care routines to keep your hands and nails hydrated and protected. It is important to follow their instructions and attend any recommended follow-up appointments to monitor your progress and ensure the treatment's effectiveness.
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Treat with topical steroids, corticosteroids, or antibiotics
Topical steroids and corticosteroids are medicines applied directly to the skin to reduce inflammation and irritation. They are available in various formulations, including ointments, creams, lotions, gels, foams, oils, solutions, and shampoos. The quantity of topical steroid or corticosteroid prescribed depends on the duration of treatment, the frequency of application, the skin location, and the total surface area treated. For example, when treating dermatitis around the fingernails, a lower potency and shorter duration of treatment are recommended to reduce the risk of adverse effects.
When using topical corticosteroids, it is important to follow the recommended dosage and application instructions. For adults, the dosage is typically given in fingertip units (FTUs), which is the amount of medication dispensed from the tip of the index finger to the crease of the distal interphalangeal joint, covering approximately 2% of the body's surface area. Topical corticosteroids are typically applied once or twice daily for a few weeks, depending on their potency. It is important to note that the skin around the fingernails is thinner and more sensitive to the effects of corticosteroids, so extra caution should be exercised when applying the medication in this area.
Topical corticosteroids are generally safe for most adults and children, but there are situations when they are not recommended. For example, very potent topical corticosteroids are typically not prescribed for pregnant or breastfeeding women or very young children. Additionally, it is important to be aware of potential side effects, such as skin thinning, stretch marks, and contact dermatitis. If you experience any adverse reactions, it is important to consult your healthcare provider.
Topical antibiotics, such as erythromycin, clindamycin, and metronidazole, have also been found effective in treating perioral dermatitis in small randomized trials. These antibiotics can be applied directly to the affected area to help reduce inflammation and treat the underlying bacterial infection. Similar to topical steroids and corticosteroids, it is important to follow the instructions provided by your healthcare provider when using topical antibiotics and be mindful of any potential side effects or interactions with other medications.
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Keep the area clean, dry, and moisturized
To treat dermatitis around your fingernails, it is important to keep the affected area clean, dry, and moisturized. Here are some detailed tips on how to do this:
Keep the Area Clean
- Wash your hands with a gentle, fragrance-free soap and lukewarm water. Avoid hot water as it can irritate the skin and worsen dermatitis symptoms.
- Use a soft, clean cloth to pat the area dry after washing. Avoid rubbing the skin, as this can further irritate the affected area.
- Avoid harsh chemicals and scented soaps or hand washes, as these can trigger or worsen dermatitis. Opt for mild, unscented, and hypoallergenic products instead.
Keep the Area Dry
- After washing your hands, ensure they are completely dry, especially around the nails and in the folds of the skin. Gently pat the area with a soft, absorbent towel.
- Use a hairdryer on a cool setting to thoroughly dry the hands and nails, if needed.
- Avoid wearing gloves or covering the affected area, as this can trap moisture and create a favourable environment for bacteria to thrive.
Keep the Area Moisturized
- Apply a generous amount of fragrance-free, hypoallergenic moisturizer to the affected area several times a day. Look for products with natural ingredients and avoid any known triggers.
- Choose a thick, ointment-based moisturizer to create a protective barrier on the skin, which helps to lock in moisture and prevent dryness.
- Consider using a moisturizer with soothing ingredients such as aloe vera or chamomile, which can help calm irritated skin.
It is important to consult a dermatologist or healthcare provider for a proper diagnosis and treatment plan. They may recommend specific products or medications, such as topical steroids, to treat dermatitis around the fingernails effectively.
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Avoid triggers and irritants, such as nail biting and harsh chemicals
Dermatitis around the fingernails can be uncomfortable and unsightly, and it's important to address it to prevent it from worsening or becoming infected. One of the key ways to manage dermatitis is to avoid triggers and irritants, such as nail biting and harsh chemicals.
Nail biting is a common habit, but it can damage the skin around your nails and leave you vulnerable to infection. Bacteria and viruses from your mouth can be transferred to your fingers and face, and the physical act of nail biting can create tiny cracks in the nails or cuts in the skin. To stop biting your nails, try keeping them short and well-maintained. You can also apply bitter-tasting nail polish, which discourages biting and helps break the habit. Keeping your nails painted can also help, as you'll be less likely to want to damage your manicure. If you have hangnails or cuticles that tempt you to bite, carry a cuticle cutter or nail file with you to address them instead.
Harsh chemicals can also irritate the skin and lead to a nail bed infection. If you work with chemicals, be sure to wear protective gloves to create a barrier between your skin and the irritant. This is especially important when doing activities that may damage or dry out your nails, such as washing dishes, playing sports, or working outdoors. Keep your hands dry when possible, as moisture can worsen dermatitis.
By avoiding triggers and irritants, you can help manage dermatitis around your fingernails and prevent further inflammation or infection. It's also important to consult a dermatologist or healthcare provider for proper diagnosis and treatment recommendations specific to your needs.
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Frequently asked questions
Dermatitis around the fingernails can be caused by an allergy to nail cosmetics, such as nail enamels, nail enamel removers, cuticle removers, and artificial nails. It can also be caused by an allergy to the chemicals in acrylic nail products. This is known as contact dermatitis, an allergic reaction that occurs when the skin comes into contact with an irritating substance.
Symptoms of dermatitis around the fingernails include redness and swelling of the fingertips, as well as intense swelling and redness of the area within a few hours. A rash may also appear a day or two after contact with the allergen.
The treatment for dermatitis around the fingernails depends on the underlying cause. If it is caused by an allergy to nail products, the first step is to identify and avoid further contact with the allergen. Patch testing by a certified dermatologist can help identify specific allergens. Treatment options include topical steroid creams, cool compresses, moisturisers, and emollients.
Yes, nail infections such as paronychia (nail infection caused by bacteria) can be a secondary infection resulting from dermatitis around the fingernails. Paronychia is treated with antibiotics to kill the infection and, in some cases, drainage of pus and culture of the fluid to identify the specific bacteria causing the infection.
Yes, eczema and psoriasis are both chronic skin conditions that can affect the nails and cause similar symptoms to dermatitis. Eczema is characterised by red, itchy skin and can cause pitting, grooves, and thinning of the nails. Psoriasis is an autoimmune disease that causes nail discolouration, pitting, and changes in nail structure. Both conditions can be treated with corticosteroids, although the treatment for psoriasis may also include medicine injections or oral medications in more serious cases.
