Health Encyclopedia

All Kinds of Problems Can Beset Your Nails

Paronychia. Onychomycosis. Surely, these are the names of six-armed Greek monsters that might attack Jason and the Argonauts.

In fact, they're microscopic monsters that will gladly attack your nails -- and may cause damage if you don't do something about them.

Nail problems can cause considerable pain and embarrassment. According to the American Academy of Dermatology (AAD), as many as 10 percent of all dermatology problems involve nail disorders and about half of people with nail problems have fungal infections. For some of these people, new anti-fungal medications may help. The medications may have side effects, however, and they are not appropriate for everyone.

Before considering any treatment for your nails, it's important to confirm what the nail problem is. People with any doubt about their nails should consult with a dermatologist. Sometimes nail problems are signs of serious illnesses in other parts of the body.

Common problems

Acute and chronic paronychia

Acute paronychial is an infection of the tissue surrounding the nail that leads to swelling and redness of the skin. It is seen more often in fingernails than toenails. It may be caused by an injury to the skin around the nail, or by pulling on or chewing the cuticle. It can also be caused by hangnails. Paronychia's underlying cause is bacteria. Your doctor may suggest using warm compresses along with an antibacterial ointment or a prescribed oral antibiotic. A topical corticosteroid may also be advised. In severe cases, incision and draining may be required. Chronic paronychia is a more gradual development of redness and swelling around the nails and its causes can be multifactorial including irritants, allergens, and fungus. People with diabetes or who work with their hands in water or chemical solvents daily have a higher risk for developing chronic paronychia and may have more than one finger that is affected. Treatment begins with avoiding exposure to possible irritants and use of a broad spectrum topical antifungal cream and a topical steroid. For cases that do not respond to initial treatment, an injectable or oral corticosteroid may be used. Acetaminophen or nonsteroidal anti-inflammatory drugs may be help relieve symptoms. 

You can avoid paronychia by wearing waterproof gloves over cotton gloves while doing housework, or when you are exposed to chemicals. Also, avoid pulling at or chewing on the cuticles or skin around your nails. Don't pick or chew hangnails; trim them with nail clippers.

Onycholysis

This is a condition in which the nail plate separates from the tissue beneath it, usually at the tip of the nail. It's more commonly seen in fingernails than toenails. You'll notice the normal white tip of the nail begins to extend toward the cuticle. The separation between nail plate and nail bed increases risk for infection as it provides a fertile home for fungus and bacteria. A common cause of onycholysis is injury, such as when you clean too aggressively beneath the free edge of the nail. Continuous exposure to water and contact with chemicals can also lead to onycholysis. In some cases, it may be a sign of an underlying condition or skin disease (including hyperthyroidism, lichen planus, or psoriasis). It can also be associated with contact dermatitis. Keeping nails trimmed short, avoiding nail polish, injury, irritants or wet work can help manage this problem.

Onychomycosis

In this condition, an infection of the nail is caused by fungus including yeasts and certain types of mold. It commonly occurs with athlete's foot (tinea pedis). The nail plate and bed separate. In many cases, the nail plate thickens. The border of the nail may crumble. The nail's color may vary from yellow to brown. Among the causes of onychomycosis: injury or repeated stress on the nails such as from athletic activities, and nerve, circulatory and bone changes caused by aging. People with diabetes are at increased risk for fungal nail infections. Treatment after the diagnosis has been confirmed usually includes oral and sometimes topical antifungal agents.

To prevent a toenail infection, be sure to dry between your toes after bathing. Don't walk barefoot around public pools, showers or locker rooms. Change your socks frequently, perhaps even several times a day, if you sweat a lot.