Liam Carter
If you have concerns about your fingernails, you should see a dermatologist. A dermatologist is a doctor who specializes in treating nail and skin disorders. They can help with a wide range of nail conditions, including fungal infections, discoloration, brittleness, and breakage. Many nail conditions can be treated with over-the-counter or prescription medications, and in some cases, surgery may be required. It is important to take nail concerns seriously as they can be a sign of a more serious health problem, such as inflammatory disease or even skin cancer.
| Characteristics | Values |
|---|---|
| Doctor Speciality | Dermatologist |
| Other Names | Onychologist |
| Symptoms | Pus or drainage, bleeding, indentation or ridges in the nails, breaking, cracking, or splitting of the nails, brown, black, or red lines, thickening, crumbling, discoloration, brittleness, new growth, new pigmented band |
| Treatment | Oral or topical medications, surgery, laser treatments, injections, biopsy |
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What You'll Learn
Dermatologists treat nail disorders
Dermatologists are doctors who specialise in treating skin and nail disorders. They can help diagnose and treat a wide range of nail conditions, including those that are painful or disabling and those linked to other diseases, such as joint disease or cancer.
If you are experiencing nail symptoms such as an abnormal appearance, pus or drainage, bleeding, indentation or ridges in the nails, or breaking, cracking, or splitting of the nails, it is important to have your nails evaluated by a dermatologist as soon as possible.
Dermatologists can offer advanced treatments for nail disorders, including oral or topical medications such as antifungal, antibiotic, or anti-inflammatory drugs, as well as state-of-the-art diagnostic and therapeutic surgeries. They may also recommend devices or injections for conditions like psoriasis and laser treatments. In some cases, they may perform a biopsy to help determine the underlying cause of the nail problem.
For example, if you have thick or discoloured nails, a dermatologist can help diagnose and treat a potential nail disorder. They can also treat subungual haematoma, where blood gets trapped under the nail, causing discolouration. In addition, dermatologists can help manage autoimmune conditions that can cause nail problems, such as vitiligo, lupus, alopecia, and autoimmune arthritis.
Dermatologists are equipped with the knowledge and expertise to identify the root cause of your nail concerns and provide appropriate treatments, so it is always best to consult with them if you have any concerns about your nail health.
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Over-the-counter medication can be used
Fingernail and toenail disorders can be treated by a dermatologist or onychologist. These specialists can diagnose and treat a wide range of nail issues, including abnormal appearance, pus or drainage, bleeding, indentation or ridges in the nails, and breaking, cracking, or splitting of the nails.
If you are experiencing any nail symptoms, it is important to consult a board-certified dermatologist as soon as possible. They can recommend the best course of treatment, which may include over-the-counter (OTC) or prescription medications.
For those with mild cases of toenail fungus or who cannot take oral antifungals, prescription nail polishes are an option. While they take longer to work and may not be effective for severe cases, they can still help improve the nail's appearance. Additionally, OTC treatments for athlete's foot, such as effective antifungal creams or sprays, can be used to prevent and treat fungal infections that can spread to the nails.
While OTC medications can be a convenient first step in treating nail fungus, they may not be sufficient for more severe or persistent infections. In such cases, it is advisable to consult a dermatologist or podiatrist to discuss prescription oral or topical medications, laser therapy, or other treatment options.
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Biopsies may be required
A doctor who specializes in treating nail and skin disorders is called a dermatologist. You can consult your regular doctor about your nail health concerns, and they may refer you to a dermatologist.
Nail biopsies are performed to diagnose and treat a wide range of pathologies, some of which can be fatal. It is a safe surgical procedure that helps determine the underlying cause of a nail problem. The procedure involves removing a small sample of the affected fingernail or toenail for closer analysis in a laboratory.
There are several types of nail biopsies, including:
- Excision biopsy: This is applicable to tumorous growths arising from the nail bed or matrix, such as glomus tumors. It requires partial or complete nail plate removal to expose the underlying tissue, followed by the localization and excision of the growth.
- Punch biopsy: This technique retrieves a small cylinder of tissue from the suspected area. It is often used as a diagnostic tool and can be taken directly through the nail plate.
- Shave biopsy: Also known as a tangential excision biopsy, this technique is recommended for the nail matrix origin of longitudinal melanonychia. It helps minimize scarring.
- Longitudinal nail biopsy: This technique is used for large, laterally located lesions or when a sample of the entire nail unit is required. It provides the most diagnostic information as it samples the nail matrix, bed, fold, and hyponychium simultaneously.
The choice of biopsy technique depends on the specific case and the area to be examined. It is important to select the appropriate area for biopsy to ensure accurate diagnosis and effective treatment.
Nail biopsies are an essential tool for dermatologists to establish the diagnosis of various skin and nail conditions. However, they are not commonly performed due to the special setup and preparation required. Additionally, the procedure can be painful and inconvenient for the patient, and it may not always lead to a definitive diagnosis. Nevertheless, in certain cases, a biopsy is necessary, especially if other treatments have been ineffective.
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Imaging and photography technology can aid diagnosis
Imaging and photography technology can aid in the diagnosis of fingernail issues. A doctor who specializes in treating nail and skin disorders is called a dermatologist. They may refer you to an onychologist, a specialist in nail disorders and treatments.
Nail disorders can be difficult to live with and are frequently misdiagnosed, which can be dangerous and frustrating. It is important to seek an evaluation from a board-certified dermatologist with experience in diagnosing and treating nail disorders.
State-of-the-art imaging and photography technology, including dermoscopy, can ensure accurate photos and measurements for diagnosis, monitoring, and treatment. For example, ultrasound imaging (USG) can help visualize the defect under the proximal nail fold to confirm the diagnosis of onychomadesis and retronychia. It may also help rule out conditions like subungual tumours or reveal abscesses. USG can also assess the intensity of local inflammation, enthesopathy, and the early development of psoriatic arthritis.
Digital radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are other radiological techniques that can aid in the diagnosis of nail disorders. MRI, for example, can help evaluate soft tissue components, while CT scans and radiographs are better for assessing bony lesions.
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Surgery may be necessary
Nail surgery requires a comprehensive understanding of nail anatomy and physiology, as well as the associated vascular and neural pathways. The surgical techniques used can vary depending on the specific condition being treated. For example, excisional matricectomy involves using cold steel surgery, cutting electrosurgery, or a cutting laser to remove the nail matrix. In contrast, ablative matricectomy uses chemocautery, electrocautery, or a laser to destroy the nail matrix.
Before performing nail surgery, a preoperative evaluation is essential to ensure the patient's safety and rule out any contraindications. This evaluation includes a medical history and physical examination to identify any underlying conditions that may affect healing, such as small or large vessel occlusive disease. It is crucial to exclude patients with conditions like atherosclerosis, diabetes mellitus, or collagen vascular disease, as they may experience delayed healing.
The type of anesthesia used during nail surgery can vary depending on the specific procedure and the patient's needs. The surgeon's knowledge of anesthesia techniques is essential to ensure patient comfort and safety.
After surgery, proper wound care and healing are crucial to ensure optimal patient satisfaction and minimize discomfort. The nail surgeon should have a good understanding of wound care protocols, including dressing changes and soakings, to promote healing and maintain the cosmetic appearance of the nail.
Overall, while surgery may be necessary in certain cases, it is just one aspect of nail treatment. A comprehensive approach to nail disorders may also include oral or topical medications, laser treatments, injectables, and collaborative care with other specialists.
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Frequently asked questions
A doctor that specialises in treating fingernail conditions is called a dermatologist.
Some common fingernail conditions include fungal infections, discoloration, brittleness, and breakage.
Dermatologists may use oral or topical medications, surgery, laser treatments, or injectables of anti-inflammatory medicine placed directly into the nail growth centre.
