Liam Carter
Fingernails grow about 2 to 3 millimeters each month, while toenails grow at a slower rate of 1 millimeter per month. Nail growth in children is similar to the values observed in young adults, with the fastest nail growth rate of 1.5 mm per day occurring between the ages of 10 and 14. If your child's nails are not growing, it could be due to various factors such as injury, illness, or underlying health conditions. In some cases, slow nail growth can be an indicator of more serious issues such as liver disease or sickle cell anemia. Additionally, certain nail disorders, such as onychomycosis, a fungal infection, or koilonychia, caused by iron deficiency, can affect nail growth and require medical attention.
| Characteristics | Values |
|---|---|
| Nail growth rate | 1.5 mm per day between the ages of 10 and 14 years |
| Nail colour | White nails may indicate liver disease or sickle cell anemia |
| Nail colour | Yellow nails may indicate a fungal infection |
| Nail colour | Dark spots or streaks may be normal in darker-skinned people |
| Nail shape | Warts can change the shape of the nail |
| Nail shape | Pitting or small divots may be caused by skin conditions such as psoriasis or alopecia areata |
| Nail texture | Leukonychia causes a milky white discolouration on the nail plate |
| Nail texture | Onychomycosis causes the nail to become thick, coarse, or brittle |
| Nail texture | Koilonychia causes the nail to become thin and soft |
| Nail texture | Beau lines cause transverse groove formation |
| Nail condition | Ingrown toenails are a common nail condition |
| Nail condition | Hangnails are loose strips of dead skin that hang from the edge of a fingernail |
| Nail care | Nails should be trimmed straight across and slightly rounded at the top |
| Nail care | Nails should be kept clean, dry, and moisturized |
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Nail injury
Nail injuries are a common occurrence, especially in children, and can be caused by various factors such as trauma or accidents. For example, dropping something on your toe or catching your finger in a drawer can result in a nail injury. In some cases, a bruise may appear under the nail, and the nail may even fall off. However, a new nail will grow in its place over time. Minor nail injuries, such as a bruise or a hangnail, can usually be treated at home with proper care.
It is important to keep your child's nails clean and dry to prevent infections and other problems. Nails should be trimmed straight across and rounded slightly at the tips for maximum strength and to prevent ingrown nails. Ingrown nails can be a common problem, especially on the big toe, and can result from improper nail trimming or ill-fitting shoes. Soaking the affected toe in warm water can help treat this condition.
In some cases, nail injuries can lead to more serious infections, especially if there is redness, swelling, or pus present. These signs may indicate a bacterial or fungal infection, which requires medical attention. Fungal infections, such as onychomycosis, can cause the nail to become thickened, yellowed, coarse, or brittle. Bacterial infections can cause redness, pain, swelling, and drainage at the site of infection.
It is important to be mindful of your child's nail health and to seek medical attention if you notice any concerning symptoms. While nail disorders in children are uncommon, they can sometimes be associated with underlying systemic conditions or cosmetic or psychological problems. A thorough examination by a healthcare professional is necessary to rule out any serious issues and determine the appropriate course of treatment.
Additionally, certain nail conditions can indicate underlying health issues. For example, koilonychia, or spoon nails, can be a sign of iron deficiency anemia, autoimmune diseases such as lupus, or poor blood flow to the hands or feet. In some cases, nail changes such as leukonychia, which causes milky white discolouration, can result from trauma to the nail, such as repeatedly sucking the thumb or wearing ill-fitting shoes. Therefore, it is important to pay attention to your child's nail health and seek professional advice if you have any concerns.
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Fungal infections
A fungal nail infection can cause your child's nails to thicken, discolour, and become fragile and easy to break. The nails may turn yellow, white, or brown, and the nail bed may emit an unpleasant smell. In some cases, the whole nail may crumble or break off.
Fungal nail infections are contagious and can be passed from person to person. Children can be exposed to fungal infections in various ways, including walking barefoot in places like pools, playgrounds, and locker rooms, or by sharing personal items such as nail clippers, socks, or towels. Additionally, wearing tight or non-breathable shoes can trap moisture, creating an ideal environment for fungal growth. Poor foot hygiene, such as not washing or drying feet properly, can also encourage fungi to thrive.
To prevent and treat fungal nail infections, it is important to practice good foot hygiene. This includes washing and drying the feet daily, especially between the toes, and using a separate towel for the feet to prevent the spread of germs. Choosing breathable shoes and moisture-wicking socks can help keep the feet dry. It is also recommended to cut nails straight across, not too short, and to smooth any rough edges. Using clean nail clippers and avoiding sharing them with others is crucial.
If your child has a fungal nail infection, it is important to seek treatment. Topical antifungal medications, such as creams, lotions, or medicated nail polish, are usually the first choice for mild cases. These treatments are most effective when the infection is caught early, before the nail thickens. In more severe cases, oral antifungal agents may be prescribed by a healthcare provider. It is important to identify the specific type of nail fungus before starting treatment.
While rare, several conditions can mimic nail fungus in children. For example, alopecia areata can cause tiny pits on the nail surface, giving it a sandpaper-like texture and a dull appearance. Therefore, it is important to consult a healthcare professional to obtain an accurate diagnosis and rule out other conditions before starting any treatment.
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Iron deficiency
In addition to spoon nails, iron deficiency can also lead to brittle nails that break easily. This can be a result of the decreased oxygen supply to the nails, causing them to become dry and fragile. Iron deficiency may also manifest as horizontal or vertical ridges in the nails, which can indicate a lack of nutrients required for healthy nail growth.
Treating iron deficiency often involves addressing the underlying cause, such as dietary changes or medical conditions like celiac disease or cancer. Increasing iron intake through diet or supplements can help improve nail health. Iron-rich foods include beans, lentils, dark chocolate, fortified bread and cereals, leafy greens like spinach, meat, seafood, nuts, and seeds. It is important to consult a healthcare professional to determine the appropriate course of action and rule out any other underlying conditions.
While nail disorders in children are uncommon, they can be an important indicator of underlying systemic conditions. Therefore, it is essential to monitor any persistent or unusual nail changes and seek medical advice if needed. In the case of iron deficiency, addressing the nutrient deficiency can help promote nail growth and improve the overall health of the nails.
If you suspect that your child's nail issues are related to iron deficiency, it is important to consult a healthcare professional for proper diagnosis and treatment. They may recommend dietary changes, supplements, or other interventions to address the iron deficiency and promote healthy nail growth.
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Melanin pigmentation
Melanonychia can be due to both local and systemic causes. Local causes include trauma, infection, inflammation, or a nail infection. Systemic causes can include nutritional deficiencies, such as a lack of vitamin B12, vitamin D, or protein, as well as medication, endocrine disease, connective tissue disease, inflammatory skin disease, or a local tumour. In children, the principal cause of longitudinal melanonychia is nail matrix nevi, which may be present at birth or develop between the ages of 2 and 4. It is important to note that benign melanocytic nevi are responsible for 75% of cases of longitudinal melanonychia in children, while 25% are due to melanocytic activation.
The diagnosis of melanonychia involves a series of examinations by a healthcare professional. They will review the patient's medical history and perform a physical examination of the fingernails and toenails. A dermatoscopic examination using a specific type of microscope may also be conducted to closely examine the discoloured areas. In some cases, a biopsy of the nail may be necessary to establish a definitive diagnosis.
The treatment of melanonychia depends on the underlying cause. In cases where the pigmentation is due to a nutritional deficiency, correcting the deficiency may lead to regression of the pigmentation. For benign causes of melanonychia, treatment may not be necessary, and regular follow-ups may be sufficient. However, if the melanonychia is due to a malignant tumour, removal of the tumour and, in some cases, amputation of the affected finger or toe may be required.
It is important to note that while melanonychia can occur in individuals of all races, it is more prevalent in people with skin of colour, especially those with Fitzpatrick skin type V and VI. The prevalence is significantly lower in White-skinned individuals, affecting only about 1% of the population.
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Leukonychia
White spots on the nails can also indicate a mild deficiency of certain minerals, such as zinc, or low iron, magnesium, and calcium levels. In rare cases, leukonychia can be a side effect of certain medications or treatments, such as chemotherapy.
There are several types of leukonychia:
- True leukonychia: discolouration due to abnormal nail plate keratinisation. The white nail will not fade when pressure is applied to the nail plate.
- Apparent leukonychia: secondary to disease of the nail bed. This discolouration disappears with pressure applied to the nail.
- Pseudo-leukonychia: whiteness of the superficial nail plate, typically caused by external factors such as artificial nails and frequent use of nail polish removers.
- Leukonychia striata: horizontal white streaks that appear parallel to the base of the nail (lunula). This is also known as Mees' Lines or Transverse Leukonychia.
- Leukonychia punctata: tiny white spots become visible on the nail. It is the most common form of leukonychia and is considered \"true\" leukonychia.
- Longitudinal leukonychia: longitudinal white lines emerge beneath the nail plate. This type is quite rare.
If your child is experiencing leukonychia, it is recommended to consult a doctor or dermatologist, especially if there is concern about potential injuries, infections, or underlying medical conditions.
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Frequently asked questions
There could be several reasons for this. It could be a fungal infection, which is more common in children with Down syndrome and immunodeficiencies. It could also be leukonychia, which is a milky white discolouration of the nail plate. Alternatively, it could be due to an injury, inflammatory dermatosis, or iron deficiency anaemia. If you are concerned, it is best to consult a doctor.
Yes, nail disorders in children can be associated with underlying systemic conditions, such as trichothiodystrophy, Darier disease, and LEOPARD syndrome.
Signs of a nail infection include pain, redness, swelling, and pus. If the nail is thickened and yellow, it could be a fungal infection.
Ingrown toenails are a common condition in children. If it does not resolve on its own, you should take your child to see a dermatologist or podiatrist.
Yes, there are several treatments available depending on the cause. For fungal infections, systemic antifungal medicines or topical antifungal drugs can be used. For leukonychia, there is no specific treatment, but it can be managed by treating any underlying conditions. For koilonychia, the treatment depends on managing the underlying cause, such as including iron-rich foods in the diet.
