Sophia Delgado
If you are experiencing issues with your finger nails, it is recommended that you see a dermatologist. A dermatologist is a doctor who specialises in treating nail and skin disorders. They can help with a wide range of nail concerns, from cosmetic issues to more serious problems that may be linked to underlying diseases, such as joint disease or cancer. Concerns of the nails should not be taken lightly as they could indicate a serious health problem. If you are unsure, it is always best to talk to your regular doctor about your nail health, and they may refer you to a dermatologist.
| Characteristics | Values |
|---|---|
| Doctor to see | Dermatologist, GP/PCP |
| Type of appointment | In-person, online |
| Symptoms requiring attention | Pus or drainage, bleeding, indentation or ridges in the nails, breaking, cracking, or splitting, brown, black, or red lines, pain, new growth, or a new pigmented band |
| Conditions treated | Fungal infections, bacterial nail infections, cysts, tumours, warts, nail psoriasis, nail lichen planus, onycholysis, brittle nails, allergic reactions, melanoma, joint disease, cancer |
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What You'll Learn
- See a dermatologist for issues like nail fungus, discolouration, or brittleness
- Visit a general practitioner for a referral to a specialist
- Dark streaks under the nail could be melanoma and should be checked immediately
- Nail issues could be linked to inflammatory diseases or even cancer
- A podiatrist may be able to help with toenail issues
See a dermatologist for issues like nail fungus, discolouration, or brittleness
If you are experiencing issues with your finger nails, it is advisable to see a dermatologist. Dermatologists are medical doctors who specialise in treating the skin, hair, and nails. They can help identify the root cause of your nail concerns and provide appropriate treatments.
Nail issues can sometimes be indicative of a more serious underlying health problem. For instance, discolouration of the nails, such as a new or changing dark streak, could be a sign of melanoma, the most serious type of skin cancer. Other issues like nail fungus, brittleness, or breakage can also cause discomfort and inhibit daily activities. Therefore, it is important to seek prompt evaluation from a board-certified dermatologist who has experience in diagnosing and treating nail disorders.
A dermatologist can perform a thorough examination of your nails and may take samples or perform microbiological tests to identify the specific cause of your nail issues. They can then recommend appropriate treatments, which may include topical treatments, oral medications, or in-office procedures. Topical treatments can include specialized creams, lotions, or prescribed steroids and antifungals. Oral medications, such as fluconazole or terbinafine, can help eliminate nail infections. In more severe cases, a damaged nail may need to be surgically removed to facilitate the growth of a new, healthy nail.
It is always beneficial to seek early treatment for any nail concerns. By doing so, dermatologists can intervene promptly and provide tailored treatments to correct nail issues effectively. Additionally, they can offer guidance on nail care and provide tips to promote healthy nail growth.
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Visit a general practitioner for a referral to a specialist
If you are experiencing any issues with your fingernails, it is recommended that you visit a general practitioner first. They will be able to assess your condition and refer you to a specialist if needed.
A general practitioner is a good first step as they can provide an initial evaluation and guidance on the next steps. They may also be able to offer some basic treatments or remedies for common nail issues. For example, if you are experiencing brittle nails, your GP may recommend a nail care routine to keep your hands hydrated and protected. They might also suggest some over-the-counter treatments for issues such as fungal infections.
However, if your condition is more complex or they are unsure of the exact cause, they will refer you to a specialist. This could be a dermatologist or a nail disorder expert, who will have more specific knowledge and experience in treating nail disorders. Dermatologists are doctors who specialize in treating skin and nail disorders and are often the first port of call for nail issues. They can help diagnose and treat a wide range of nail conditions, from fungal infections to more serious issues such as skin cancer.
In some cases, your general practitioner may refer you to a specific nail center or clinic, such as the Nail Center at Weill Cornell Medicine, which has a team of board-certified dermatologists and nail disorder experts. These centers often have advanced treatments, including surgery, for all types of nail concerns. They can also collaborate with other specialists, such as podiatrists, to ensure you receive the best possible care.
Therefore, while you may initially visit a general practitioner for nail issues, they will ensure you receive the appropriate referral to a specialist if needed, so you can get back to feeling and looking your best.
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Dark streaks under the nail could be melanoma and should be checked immediately
Dark streaks under the nail can be indicative of melanoma and should be checked by a doctor immediately. Melanoma is a deadly form of skin cancer that can develop under and around the fingernails and toenails. While melanoma of the nails is rare, it is more common in older individuals and people with skin of colour. A personal or family history of melanoma or previous nail trauma may also be risk factors.
Known as subungual melanoma, this type of cancer can develop underneath the nail plate, or it can originate in the skin next to the nail plate, known as periungual melanoma. Subungual melanoma symptoms can be easy to miss as they occur underneath the nails, and people typically receive a late-stage diagnosis compared to other forms of melanoma. Early-stage subungual melanoma can cause brown or black streaks or discoloration that resemble a bruise. The affected nail may also start to separate from the nail bed.
One of the key indicators of subungual melanoma is "Hutchinson's sign", where pigmentation extends onto the skin surrounding the nail. The melanoma may also present as a wide and irregular band of colour or a dark and narrow band. A black stripe from subungual melanoma will typically darken or widen over time, and the nail may become painful or start to bleed.
If you notice any of these symptoms, it is important to seek medical advice as soon as possible. A board-certified dermatologist with experience in diagnosing and treating nail disorders will be able to evaluate your nails and determine the severity of the melanoma. Treatment may involve surgically removing the affected area, including the entire nail or a portion of the digit. If the melanoma has spread to the bone, finger amputation may be necessary to prevent further spread.
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Nail issues could be linked to inflammatory diseases or even cancer
Changes in the colour or texture of your nails may indicate an underlying inflammatory disease or, in rare cases, cancer. If you are concerned about the appearance of your nails, you should see your doctor or a dermatologist.
Nail Issues and Inflammatory Diseases
Inflammatory diseases that can be detected through nail issues include:
- Pulmonary disease or inflammatory bowel disease, indicated by clubbing of the nails (thickening of the soft tissue beneath the proximal nail plate, resulting in sponginess and thickening of the proximal plate area).
- Hemochromatosis or anemia, indicated by koilonychia or "spoon-shaped" nails.
- Hyperthyroidism, indicated by onycholysis (separation of the nail from the nail bed) in the absence of trauma or psoriasis.
- Previous severe illness, trauma, or exposure to cold temperatures in patients with Raynaud's disease, indicated by Beau's lines (horizontal ridges on the nails).
- Low albumin levels, indicated by Muehrcke's lines, which may herald endocarditis in patients with heart murmur and unexplained fever.
- Connective tissue disorders, indicated by telangiectasia, koilonychia, or pitting of the nails.
- Psoriasis or inflammatory arthritis, indicated by a rippled or pitted nail surface.
- Chronic paronychia, a condition causing inflammation, redness, tenderness, and swelling of the skin folds and tissues surrounding the nails, often resulting from irritants, allergens, or infections.
Nail Issues and Cancer
In rare cases, nail issues can be linked to cancer or an increased risk of developing cancer. For example:
- Nail melanoma or skin cancer can occur under the nail, indicated by increased pigmentation in the nail plate.
- A benign nail abnormality may lead to the diagnosis of BAP1 tumour predisposition syndrome, a rare inherited disorder that increases the risk of developing cancerous tumours in the skin, eyes, kidneys, and the tissue that lines the chest and abdomen. This syndrome is characterised by onychopapillomas, which cause a coloured band (usually white or red) along the nail's length, thickening of the nail, and thickening at the nail's end.
It is important to note that nail changes are rarely the first sign of these diseases and abnormalities, and many nail issues are harmless. However, if you notice any changes or abnormalities in your nails, it is always best to consult with a medical professional for proper diagnosis and treatment.
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A podiatrist may be able to help with toenail issues
A podiatrist may be able to help with a variety of toenail issues. Podiatrists are foot doctors who can provide comprehensive care for foot and ankle conditions. They can treat a full range of podiatric issues, from trauma and fractures to diabetic foot conditions.
One of the most common toenail problems that podiatrists treat is ingrown toenails. An ingrown toenail occurs when the toenail grows into the skin around it, causing pain, redness, and swelling. In severe cases, the toenail may break the skin, creating an open wound that can become infected. Podiatrists can also treat toenail fungus infections, which are caused by tiny fungal organisms that get under the nail, feed on the skin and keratin, and begin to grow. Toenail fungus can cause the nail to thicken, discolour, or become brittle, and may result in an unpleasant odour or even the loss of the nail. It is important to seek treatment for toenail fungus as soon as possible, as it can spread to other toenails and cause further issues.
Additionally, podiatrists can help with more complex toenail issues. For example, if the toenail is very infected or infections are recurring, a podiatrist may recommend removing the toenail. While this is not an ideal option, it can permanently resolve the issue. Podiatrists can also provide care for individuals with diabetes, who may be more prone to toenail fungus and infections due to poor blood circulation. By working closely with a podiatrist, people with diabetes can effectively manage their toenail and foot health.
In conclusion, podiatrists are well-equipped to handle a range of toenail issues, from common problems like ingrown toenails and fungus infections to more complex infections and diabetic foot care. If you are experiencing any pain, discomfort, or abnormalities with your toenails, seeking the help of a podiatrist can be an effective way to diagnose, treat, and resolve these issues.
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Frequently asked questions
A dermatologist is a doctor that specializes in treating nail and skin disorders. You can see your regular doctor about your nail health concerns, and they may refer you to a dermatologist.
Dermatologists can help with a range of fingernail and toenail conditions, including:
- Fungal infections
- Discoloration
- Brittleness
- Breakage
- Nail psoriasis
- Allergic reactions from nail cosmetics
- Tumors
- Warts
- Pus or drainage
- Indentation or ridges in the nails
- Pain
If you are experiencing any of the following symptoms, it is important to have your nails evaluated by a doctor:
- Brown or black lines in the nail (could indicate melanoma)
- Red lines in the nail (erythronychia)
- Pus or drainage
- Pain or sensitivity
- Breaking, cracking, or splitting of the nails
- Indentation or ridges in the nails
- Thickening or crumbling of the nails
- New growth or a new pigmented band
During a dermatologist appointment for nail issues, the doctor will examine your nails and may perform nail clippings, X-rays, or a biopsy to diagnose the issue. They may also recommend a nail care routine or prescribe medication to treat the condition.
You can find a dermatologist by searching online directories, such as the one provided by the American Academy of Dermatology (AAD), or by asking your regular doctor for a referral to a specialist.
