Nailproblems

Nail Problems affect people of all ages. Common causes of nail problems include trauma, fungal or bacterial infection, weathering, chemical damage and skin diseases such as eczema and psoriasis. Nail changes may sometimes reflect internal medical problems, such as kidney or thyroid disease, anaemia or low albumin. Diet is generally not responsible for abnormal nail changes, unless the person is suffering from severe malnutrition. A rare but serious cause of nail changes is melanoma, an aggressive form of skin cancer that may present as a black band in the nail.

Some of the more common nail changes include:

Discolouration (yellow, brown, black, greenish-black)

Thickening

Textural changes such as ridges, grooves and pits

Splitting / brittle nails

Lifted nail plate ('hollowed nail')

Painful ingrown toenail

Skin diseases of nail fold or nail bed affecting nail growth, e.g. rash, swelling, nodule, warts

Haematoma (blood/bruise) under nail

Treatment

Fingernail infections usually respond faster to treatment than toenail infections. Depending on the cause, treatment options may include:

Antibiotics for bacterial infections

Topical &/or oral anti-fungal preparations, for fungal infection of the nails

Removal of part of or the whole nail together with targeted treatment of the underlying cause. Partial nail avulsion with segmental matrix horn cauterization is an effective but minimally- invasive treatment for painful ingrown toenails, with faster recovery time than traditional surgical methods. Destroying the nail-producing matrix at the targeted site prevents re-formation of the part of the nail that keeps becoming ingrown, while preserving the rest of the nail. This is done under nerve block anaesthesia which makes the procedure painless.

Treatment for any contributing skin disease e.g. steroid lotion or injections, oral medication or biologic injections for nail psoriasis

Laser excision of warts around or under the nails

Advice on appropriate nail care