NAILS

Healthy Nails at Your Fingertips…and on Your Toes

Nails in good condition can be very attractive. They also reflect an individual's personal habits - good or bad.

Aside from their cosmetic appeal, nails serve many important functions.

They help us pick up and manipulate objects and support the tissues of the fingers and toes. Most importantly, nails often reflect our general state of health.

They are composed primarily of keratin, a hardened protein also found in skin and hair. The nail itself consists of several different parts, including the nail plate, nail bed, matrix, lunula, cuticle and nail folds.

Nails, like hair, grow from the matrix.

As older cells grow out and are replaced by newer ones, they are compacted and take on a hardened form.

The average growth rate for nails is 0.1 mm each day; individual rates depend on age, time of year, activity level, and heredity.

  Keeping Your Manicured Nails Healthy

for healthier manicures

Used properly, nail cosmetics rarely cause problems. But if you've taken a shine to them, dermatologists recommend that you:

• Keep nail extensions short. Acrylics won't bend or break like natural nails, and snagging them on any surface can cause problems that are unsightly and serious.

• Make sure your manicurist uses sterile instruments. If in doubt, bring your own grooming implements or buy new ones at the salon.

• Don't camouflage an undiagnosed abnormality.

See your dermatologist if the skin around your nails swells, feels sore or becomes discolored or the nail crumbles, splits, becomes stained, or develops lines, spots, streaks, pitting or ridges. A nail abnormality can be a sign of illness.

So check it out, don't cover it up!

Common Nail Disorders

Nail disorders comprise  about 10 percent of all skin conditions. Due to their location, nails take a lot of abuse. 

Most of us have closed fingers in doors, suffered from ingrown toenails, or endured minor nail or nail fold infections. Sometimes, toenail injuries result from poor fitting shoes or athletic activity.  Although they might be unsightly for a while due to the nail's slow growth rate, most minor nail injuries heal on their own.  More serious injuries or disorders  require professional treatment.

Symptoms that could signal nail problems include color or shape changes, swelling of the skin around the nails, pain, the persistence of white or black lines, dents or ridges in the nail, and should be reported to a dermatologist.

White Spots are small, semi-circular spots that result from injury to the base (matrix) of the nail where nail cells are produced.  They are not a cause for concern and will eventually grow out.  White spots are very common and usually recur.

Splinter Hemorrhages  are a disruption of blood vessels in the nail bed can cause fine, splinter-like vertical lines to appear under the nail plate. They are caused by trauma to the nail, by certain drugs and diseases.

Ingrown nails can be very uncomfortable until treated

Fungal Infections  often cause the end of the nail plate to separate from the nail bed. Debris (white, green, yellow, or black) may build up under the nail plate and discolor the nail bed. The top of the nail or the skin at the base of the nail can also be affected. Toenails are more susceptible to fungal infections because they are confined in a warm, moist environment. These make up approximately 50 percent of all  nail disorders and can be difficult to treat.  Candida or yeast infections are common in fingernails, especially if the hands are always in water or if the person has diabetes.

Fungal infections of the nail can cause discoloration and abnormal growth.	Physical activity in poor fitting shoes can cause joggers nails .

Bacterial Infections  cause redness, swelling, and pain of the nail skin folds.  The most common cause is trauma to the nail or surrounding skin, as well as frequent exposure to water and chamicals.  A green discoloration of the nail is due to infectin by a bacterium called pseudomonas. 

Tumors and Warts  can be found in any portion of the nail.  The nail plate could change shape or be destroyed due to interference of a growing tumor or wart.
Warts are viral infections that affect the skin surrounding or underneath the nail.  They can be painful and sometimes cause limited use of the affected finger or toe.  Treatment usually involves freezing or chemicals that destroy the wart.  If the wart or tumor extends into the nail folds or is located under the nail plate itself, surgery may be necessary to remove it.  Sometimes during the treatment of a tumor or wart, the nail can be further damaged.

Warts can be on the skin surrounding the nail and underneath the nails.

Mucinous cysts are clear, jelly-filled papules that can appear at the base of the nail.  They can become painful, may damage or deform the nail, and should be removed.

Dark spots in the nail must be examined by a dermatologist to be certain they are not cancerous.

Psoriasis is a chronic skin disease characterized by red, scaly patches. Approximately 10 to 50 percent of people with psoriasis, and 80 percent of people who suffer from inflammation associated with psoriasis, have nail problems, especially affecting the fingernails.  The most common signs include pitting, rippling, or discoloration of the nail, reddish-brown discoloration of the skin under the nail, separation of the nail from the nail bed, splinter hemorrhages, crumbling and/or splitting of the nail, as well as swelling and redness of the skin surrounding the base of the nail.

Psoriasis can also affect the nails

A Hard Habit To Break
Nail biting is a common problem, especially among young children. While the habit is typically outgrown, it has been linked to anxiety or boredom in older children and adults. Not only does nail biting ruin the look of the nails, it is also a good way to transfer infectious organisms from the fingers to the mouth and vice versa. A tic habit deforms the nails by repeated picking at the cuticle.  Applying bad tasting nail polishes or liquids to the nail as well as other therapies may help break the habit .

Repeated picking at the cuticle can lead to an abnormal appearing nail.

Treatment
Nail disorders are difficult to treat and respond very slowly to therapy due to the slow growth rate of the nail and its inability to absorb medications very well. Surgical treatment is common to remove tumors or correct structural abnormalities. Non-surgical treatments include the use of topical or oral medications.

A Window On Health
The nails can reveal much about a person's overall health. Many diseases and serious conditions can be detected by changes in the nails. Most doctors will check the nails carefully during a physical examination. The most common health conditions and their effect on the nails are: 

  Preventive Nail Care

Since many nail disorders result from poor nail care, developing good nail habits early will help keep them healthy. Remember the following tips:

• Keep nails clean and dry . This helps keep bacteria and other infectious organisms from collecting under the nail.
• If toenails are thick and difficult to cut , soak them in warm salt water (one tsp. of salt to a pint of water) for five to ten minutes.  Apply urea cream, which will soften the nails and make them easier to trim.
• Nails should be cut straight across and rounded slightly at the tip for maximum strength . Use sharp nail scissors or clippers. Filing the nails into points will weaken them.
• Avoid biting fingernails, and do not remove your cuticle.  
• Use a "fine" textured file to keep nails shaped and free of snags.
• Avoid "digging-out" ingrown toenails, especially if they are already infected and sore.   Seek treatment from a dermatologist.
• Report any nail irregularities to your dermatologist.  Nail changes, swelling, and pain could signal a serious problem.