Noah Sinclair
The skin under your fingernail is called the hyponychium and it acts as a barrier to protect you from germs and debris. However, sometimes the hyponychium can overgrow, leading to thickened nails. This can be caused by various factors, such as gel manicures, acrylic nails, or nail biting. In addition to hyponychium overgrowth, there are several other conditions that can affect the appearance of the area beneath your fingernails. For example, pitted nails can indicate an underlying disease, while spoon-shaped nails can be a sign of iron deficiency. Discoloured nails can also signal various health issues, with yellow nails potentially indicating lung disease or rheumatoid arthritis, and bluish nails suggesting insufficient oxygen intake. One of the most serious nail conditions is subungual melanoma, a rare form of skin cancer that usually presents as a dark vertical streak on the nail. As changes in nail appearance can indicate underlying health issues, it is important to consult a dermatologist if you notice any unusual symptoms.
| Characteristics | Values |
|---|---|
| Skin colour | Reddish-brown |
| Skin function | Acts as a barrier from germs and debris |
| Skin composition | Contains white blood cells |
| Skin disorders | Overgrowth, thickening, psoriasis, fungal infections, onychomycosis, PIU, alopecia areata, paronychia, koilonychia, onychotillomania, clubbing, onycholysis, subungual melanoma |
| Nail colour | Yellow, Blue, White, Black, Brown |
| Nail disorders | Pitting, spoon-shaped, washboard, clubbing, curving, lifting, nail melanoma, nail psoriasis, nail infections, ridges, grooves, dents, divots, cracking, splitting, bleeding |
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What You'll Learn
- The hyponychium, the skin just under the free edge of your nail, can thicken and overgrow
- Subungual melanoma, a rare and aggressive form of skin cancer, can cause discolouration
- Spoon-shaped nails can indicate an iron deficiency
- Pitting or dents in nails can be a sign of a disease affecting the entire body
- Gel manicures, acrylic nails, nail biting and psoriasis can cause skin overgrowth
The hyponychium, the skin just under the free edge of your nail, can thicken and overgrow
The hyponychium is the skin just under the free edge of the nail plate at the distal edge of the finger. It is located just beyond the distal end of the nail bed, near the fingertip. The hyponychium forms a tight seal that acts as a protective barrier, preventing the entry of harmful bacteria, germs, allergens, and pathogens into the delicate areas of the nail, such as the nail bed and matrix. This protective mechanism is one of the four Guardian Seals of the nail unit.
The hyponychium contains numerous nerve endings that serve as an alert system. When the protective seal is compromised, these nerve endings signal discomfort or pain, indicating potential damage or infection. In some cases, the hyponychium may thicken or become discoloured, which could be a sign of infection. This thickening of the hyponychium can occur due to various factors and can lead to discomfort and aesthetic concerns.
One possible cause of hyponychium thickening is Pterygium Inversum Unguis (PIU), an uncommon condition where the hyponychium attaches to the underside of the nail as it grows. This condition can be influenced by certain manicure procedures, such as gel manicures or acrylic nails. The chemicals in gel manicures and the practice of wearing long nails with gel or acrylic coatings have been associated with PIU. Avoiding these types of manicures and maintaining shorter nails can help address the overgrowth.
Nail psoriasis and fungal infections, known as onychomycosis, can also contribute to hyponychium thickening. Onychomycosis occurs when a fungus infects the fingernail, leading to thickening of the nail and the underlying skin tissue. In the case of nail psoriasis, excessive skin cell growth and scaling can occur in the hyponychium and nail bed, resulting in subungual hyperkeratosis. Treatment options for these conditions may include topical corticosteroids or antifungal medications, respectively.
Additionally, hyponychium thickening could be related to trauma, exposure to chemicals, underlying systemic conditions, or allergic reactions. Good nail hygiene is crucial for maintaining the integrity of the hyponychium. Regular cleaning of the nail area and avoiding activities that may cause trauma to the hyponychium are important preventive measures. If you experience hyponychium overgrowth, it is recommended to consult a dermatologist for evaluation and appropriate treatment.
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Subungual melanoma, a rare and aggressive form of skin cancer, can cause discolouration
The area underneath the fingernail is called the hyponychium. It acts as a barrier to protect the body from germs and debris. However, the hyponychium can sometimes overgrow, leading to thickened nails. This can be caused by gel manicures, acrylic nails, or nail biting. In other cases, nail psoriasis and fungal infections can also cause skin cells to accumulate under the fingernails.
One rare and severe condition that can affect the area under the fingernail is subungual melanoma, a form of skin cancer. Subungual melanoma is characterised by discolouration and usually appears as a dark, vertical streak on the nail. It may start as a small brown or black line, resembling a marker pen stroke, but can eventually cover the entire nail and extend to the cuticle. In some cases, subungual melanoma may not present with pigmented streaks, but instead manifest as changes to the nail, bleeding, and pain at the nail bed.
Subungual melanoma is an aggressive form of melanoma, a type of skin cancer that begins in the melanocytes, the cells responsible for skin pigment. Unlike other skin cancers, subungual melanoma is not linked to sun exposure. It is most likely to develop in the big toe, thumb, or index finger. The exact cause of subungual melanoma is unknown, but certain factors can increase the risk, including having darker skin, a personal or family history of melanoma, and being over the age of 50.
Due to its rarity and subtle early signs, subungual melanoma is often discovered later than other cancers. However, learning to recognise the warning signs can help with early detection and increase the chances of successful treatment. When detected early, the survival rate for subungual melanoma is about 95%. If left untreated, the cancer can spread to other organs, and the survival rate drops to approximately 15%. Therefore, it is crucial to be vigilant and consult a dermatologist if any unusual changes or discolouration are noticed in the nails or surrounding skin.
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Spoon-shaped nails can indicate an iron deficiency
Spoon-shaped nails, or koilonychia, are a condition where the nail is thin and soft, and the centre is scooped out, resembling a spoon. This condition can affect both finger and toenails, and it can occur in both adults and infants. Spoon-shaped nails are often a sign of iron deficiency anaemia, which causes a person's red blood cell count to be lower than normal. Iron deficiency can be caused by various factors, including high altitude, an autoimmune disease, malnutrition, and heavy menstruation.
If you suspect you have spoon-shaped nails due to iron deficiency, it is important to consult a doctor or healthcare provider. They will be able to examine your nails, review your medical history, and perform blood tests to determine the underlying cause. Treatment options may include dietary changes, such as increasing your intake of iron-rich foods or taking iron supplements, and addressing any underlying medical conditions.
In addition to iron deficiency, spoon-shaped nails can also be caused by other factors. For example, they may be hereditary or genetic, with some people being born with this nail shape. Environmental factors can also play a role, as people living at high altitudes or those who perform manual labour have an increased risk of developing spoon-shaped nails. Certain medical conditions, such as lupus, heart disease, or celiac disease, can also contribute to this condition.
While spoon-shaped nails can indicate an iron deficiency, it is important to consult a healthcare professional for a proper diagnosis and treatment plan. They can help determine the underlying cause and provide guidance on improving nail health and addressing any associated medical conditions.
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Pitting or dents in nails can be a sign of a disease affecting the entire body
The appearance of our nails can tell us a lot about our health. While some nail changes are harmless, others can indicate an underlying condition. One such change is nail pitting, which is characterised by small dents or depressions in the nails that can vary in depth and number. In some cases, these pits may resemble white spots or marks.
Nail pitting is often associated with skin conditions, particularly psoriasis, a common inflammatory skin disorder. Psoriasis causes skin cells to build up rapidly, leading to red, scaly patches on the skin. It can affect any part of the body, including the nails, where it can result in pitting, discolouration, abnormal growth, and nail separation from the nail bed (onycholysis). Psoriatic arthritis, a type of arthritis associated with psoriasis, is also linked to nail pitting and can cause joint stiffness, swelling, and pain.
In addition to psoriasis, nail pitting has been associated with various other conditions, including eczema, joint inflammation, alopecia areata, and autoimmune disorders such as Bloch-Sulzberger syndrome and incontinentia pigmenti. These autoimmune conditions can cause hair loss, nail brittleness, and mucous membrane irritation, in addition to nail pitting.
While nail pitting may be a harmless trait that runs in families, it can also indicate a disease affecting the entire body. Therefore, it is advisable to consult a dermatologist or a doctor if you notice pitting or other persistent changes in your nails. They can assess your nails, medical history, and perform a physical examination to determine the underlying cause and provide appropriate treatment or referrals.
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Gel manicures, acrylic nails, nail biting and psoriasis can cause skin overgrowth
The skin under the nail is called the hyponychium. Sometimes, this skin can overgrow and thicken, making nail trimming painful and causing cosmetic concerns. This condition is known as subungual hyperkeratosis, which is often caused by nail psoriasis.
Gel manicures, acrylic nails, nail biting, and psoriasis can all contribute to skin overgrowth under the nails. Here's how:
Gel Manicures and Acrylic Nails
Gel manicures and acrylic nails can cause nail brittleness, peeling, and cracking. They can also increase the risk of skin cancer and premature skin aging on the hands due to exposure to ultraviolet radiation during the sealing process. This radiation is used to cure or harden the gel polish onto the nail. To protect the skin, it is recommended to apply sunscreen with an SPF of 30 or higher or wear dark, opaque gloves with the fingertips cut off before the procedure.
Additionally, gel manicures and acrylic nails have been linked to subungual hyperkeratosis, a condition where the skin under the nail thickens and grows excessively. This may be due to the acquired form of Pterygium Inversum Unguis (PIU), triggered by external factors. If PIU is the cause, avoiding gel manicures and acrylic nails can usually reverse the condition.
Nail Biting
Nail biting, or onychophagia, is a common habit, with up to 30% of the population engaging in it. While it may not always lead to long-term damage, chronic nail biting can cause harm to the nails and the surrounding skin. It can also introduce bacteria into the body, potentially leading to stomach or intestinal infections. Nail biting is often associated with other body-focused repetitive behaviors, such as skin picking, and it can be challenging to break the habit once it forms.
Psoriasis
Nail psoriasis is an autoimmune skin condition that affects about half of all people with psoriasis. It causes the rapid overgrowth of skin cells, leading to thick, scaly plaques on the skin. This overgrowth of skin cells can occur under the nails, resulting in subungual hyperkeratosis. People with nail psoriasis may notice a white, chalky substance under the nail, and it can be painful if it occurs in the toenails due to shoe pressure.
In summary, while gel manicures, acrylic nails, nail biting, and psoriasis can all contribute to skin overgrowth under the nails, there are measures to prevent and address these issues. These include wearing sunscreen or protective gloves before gel manicures, seeking help to stop nail biting, and understanding the symptoms and treatment options for nail psoriasis.
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Frequently asked questions
The skin underneath your fingernail is called the hyponychium. It acts as a barrier to protect your nail from germs and debris.
Skin overgrowth under the fingernail, also known as Hyponychium thickening, can be caused by various factors such as fungal nail infections, nail psoriasis, or even gel manicures.
Nail melanoma, or subungual melanoma, usually appears as a small, dark band or vertical streak under your nail that grows over time. It may be black, brown, or greenish-black in colour.
Pitted nails, or nails with dents, can indicate a disease that affects your entire body. It could be a sign of alopecia areata, inflammatory arthritis, or even liver trouble.
