Ava Monroe
The area under your fingernails is called the hyponychium, a thickened portion of epithelium that forms a seal to protect the nail bed from germs and debris. The hyponychium contains white blood cells to prevent infection. However, it can become overgrown, leading to thickened skin under the nails. This can be caused by nail-biting, gel manicures, or underlying conditions such as nail psoriasis and fungal infections. Infections under the nails, known as paronychia, can be bacterial or fungal and may require treatment with antibiotics or antifungal medications. Maintaining good nail hygiene, such as regularly cleaning under the nails and avoiding biting them, is essential to prevent infections and maintain healthy nails.
| Characteristics | Values |
|---|---|
| What is under your fingernails | The hyponychium, or the thick skin under your nail tip |
| How it functions | It acts as a barrier from germs and debris, and contains white blood cells to prevent infection |
| Overgrowth | Can be caused by gel manicures, acrylic nails, nail biting, nail psoriasis, or fungal infections |
| Treatment | Avoid picking at the skin and visit a dermatologist if bleeding, discolored, or swollen |
| Nail infections | Caused by bacteria and fungi getting under the skin around the nail; can be treated with antibiotics |
| Prevention | Keep hands clean, focusing on the bottom of the nails; use a soapy nail brush or a higher-grade sanitizer |
| Growth rate | Fingernails grow at an average rate of 3.5 mm per month, while toenails grow at approximately half that rate |
| Composition | Made of a tough, rigid protein called alpha-keratin |
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What You'll Learn
- The hyponychium, or the 'quick', is the thick skin under your nail tip
- Pterygium inversum unguis (PIU) is an uncommon condition that causes skin overgrowth under the fingernail
- Paronychia is a bacterial nail infection
- The nail plate is the hard nail area made of translucent keratin protein
- The nail matrix is the active tissue that generates cells
The hyponychium, or the 'quick', is the thick skin under your nail tip
The hyponychium is the thick skin under your nail tip. It acts as a protective seal to prevent harmful bacteria, allergens, and pathogens from entering the finger. This barrier stops external substances, germs, and debris from getting under your nails. The skin in this region contains white blood cells to help prevent infection.
The hyponychium is located near the fingertip, at the distal end of the finger, just beyond the distal end of the nail bed. It is sometimes called the "quick", and it seals the nail plate to the tip of the finger.
The hyponychium can overgrow and become thicker, which can make trimming nails painful. This overgrowth can be caused by gel manicures, acrylic nails, nail biting, nail psoriasis, or fungal infections. It can also be present from birth or acquired later, with the acquired form associated with autoimmune conditions such as lupus. In some cases, the hyponychium may thicken or become discolored, indicating a potential infection.
If you are experiencing issues with your hyponychium, it is recommended to see a dermatologist, especially if the skin is discolored, painful, bleeding, or swollen. At-home treatments include softening the thickened skin with cuticle oil or cuticle remover, but it is important to avoid cutting the skin in this area as it can increase sensitivity and cause pain.
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Pterygium inversum unguis (PIU) is an uncommon condition that causes skin overgrowth under the fingernail
The skin under your fingernails is called the hyponychium. It acts as a barrier to prevent germs and debris from getting under your nails. This skin contains white blood cells to help prevent infection. However, the hyponychium can sometimes overgrow, becoming thicker and making it painful to trim your nails. This condition is known as Pterygium Inversum Unguis (PIU) and is an uncommon cause of skin overgrowth under the fingernail.
PIU occurs when the hyponychium attaches to the underside of the nail as it grows. It is a rare nail disorder characterised by the adherence of the distal portion of the nail bed to the ventral surface of the nail plate, resulting in a subungual extension of the hyponychium and the loss of the nail grooves. This condition can be congenital, present from birth, or acquired later in life. The exact cause of PIU is not well understood, but it is believed to be associated with certain autoimmune conditions, such as lupus, and external factors such as nail psoriasis and fungal infections.
The acquired form of PIU is most commonly associated with autoimmune conditions, particularly lupus, but it can also be triggered by other factors. For example, nail psoriasis, a skin condition where skin cells grow rapidly, can affect the hyponychium and nail bed, leading to scaling and buildup, known as subungual hyperkeratosis. Additionally, certain habits and behaviours can increase the likelihood of hyponychium overgrowth, such as getting gel manicures, wearing acrylic nails, or biting your nails.
While the management of PIU is not well-defined, it is believed that treating the underlying cause is the most effective strategy. Patients with PIU require long-term follow-up examinations to monitor for the development of connective tissue diseases, such as scleroderma. In some cases, individuals with PIU may experience pain, discomfort, and bleeding when attempting to clip their nails, leading to relatively long fingernails. However, it is important to note that cutting the hyponychium is not recommended as it can introduce an infection. Instead, individuals concerned about overgrowth should consult a dermatologist for evaluation and treatment.
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Paronychia is a bacterial nail infection
Bacterial paronychia usually appears suddenly, and symptoms usually develop over several hours or days. Sometimes they take longer to develop. The infection can cause the nail to become yellow or green and dry and brittle. The nail can even detach from the nail bed and fall off.
Healthcare providers treat paronychia with antibiotics to kill the infection. Providers may also drain pus (a thick, infectious fluid that builds up around a wound). They may also culture the fluid to determine the specific bacteria causing the infection. Soaking the infected nail in warm water for 15-20 minutes a few times a day can help the infection heal on its own in a few days.
In rare cases, part of the nail may need to be removed. Chronic paronychia is more commonly caused by irritation from occupational or environmental exposures. It can also be caused by a chronic bacterial or fungal infection.
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The nail plate is the hard nail area made of translucent keratin protein
The nail plate, also known as the corpus unguis or nail body, is the hard nail area made of translucent keratin protein. It is the visible part of the nail, from the nail root to the free edge. The nail plate is made up of several layers of dead, compacted cells, which give the nail its strength and flexibility. The transverse shape of the nail plate is determined by the form of the underlying bone.
The word "nail" often refers specifically to the nail plate in common usage. The nail plate is strongly attached to the nail bed and does not contain any nerves or blood vessels. The nail bed, located beneath the nail plate, contains nerves and blood vessels that supply nourishment to the entire nail unit. The nail bed is made up of two types of tissues: the dermis and the epidermis.
The nail plate is formed by the constant production of new keratin by the nail matrix, which is the active tissue or germinal matrix that generates cells. As new nail plate cells are produced, they push older cells forward, causing the nail to grow. The older cells become compressed, flat, and translucent, allowing the capillaries in the nail bed below to be visible, resulting in a pink colour.
The nail plate is composed of approximately 10-20% soft epithelial keratins, with the remainder being hard α-keratin. The proteins in the nail plate exhibit extensive folding, which, along with the different geometries of disulfide bonds, results in a different degree of hydration compared to the proteins in the skin. The nail plate contains a significant proportion of amino acids such as glutamic acid, arginine, aspartic acid, serine, and leucine.
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The nail matrix is the active tissue that generates cells
The nail matrix is a vital structure for nail growth, as it is the active tissue that generates new cells that form our fingernails and toenails. It is located at the base of the nail, and while most of it is hidden, the lunula, or the white crescent shape at the bottom of the nail, is part of the nail matrix and is usually visible. The nail matrix consists of two parts: the germinal matrix and the sterile matrix.
The germinal matrix is the most active area of the nail matrix, producing an estimated 90% of nail cells. It is located below the lunula, closest to the knuckle, and gives the nail its natural curvature. The sterile matrix, on the other hand, is responsible for the remaining 10% of nail cells and is more important for keeping the nail attached to the underlying skin. It is found above the lunula, and the nail changes colour in this region as the cells no longer have nuclei, making the nail appear more transparent.
The nail matrix is susceptible to various injuries and conditions that can impact nail growth. For example, trauma to the nail matrix can cause nail cell production to stop temporarily, and in severe cases, the nail may never grow back. Additionally, conditions such as subungual melanoma can cause cancerous cells to grow in the nail matrix, leading to pigment changes and striped discolouration in the nail.
The health of the nail matrix is crucial for maintaining healthy nails. Proper care is essential, as several factors, including fungal infections, injuries, and certain medications, can damage the nail matrix and affect nail growth. In many cases, with the right attention, the nail matrix can heal, and nail growth will resume.
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Frequently asked questions
The hyponychium is the thick skin under your nail tip. It acts as a barrier from germs and debris, preventing them from getting under your nails.
The space under your fingernails can be a breeding ground for bacteria, which can lead to the spread of diseases. Washing your hands properly, including under your fingernails, can help prevent the spread of such diseases.
Keeping your nails short and clean is important. You can also use a soapy nail brush or a toothbrush to gently scrub the nail area for two minutes.
