Nail disorders are conditions that affect the health, appearance, and structure of the nails. They may involve your fingernails, toenails, or both. A number of factors can affect nail health.
What causes nail disorders?
- Fungal infections: one of the most common causes of discoloured and thickened nails.
- Bacterial infections: these may cause swelling, pain, and the formation of pus.
- Trauma or injury: repeated pressure or damage to the nails can cause abnormalities.
- Nutritional deficiencies: a lack of biotin, zinc, iron, or other nutrients may lead to nail disorders.
- Underlying health conditions: an underlying illness can sometimes be the cause of poor nail health.
- Excessive chemical exposure: exposing nails to detergents or harsh products may also affect nail health.
Types of nail disorders
Brittle or crumbly nails
Brittle nails are often a sign of ageing or long-term exposure to chemicals or water; the dermatologist may recommend wearing gloves to protect the nails when working in water. They can also result from fungal infection, a skin condition called lichen planus, nail psoriasis, and an underactive or overactive thyroid.
Discoloured nails
This is a common condition in which the nails appear discoloured, especially yellow. The most common cause is a fungal nail infection. Nail psoriasis can also make the nails look yellow. Other causes include sinusitis, lymphoedema, frequent application of nail varnish, or inflammation of the thyroid gland.
Nail psoriasis
Nail psoriasis is characterised by pitting, or small dents, in the nails, which may also become thick or discoloured. It is usually associated with psoriasis, an autoimmune condition, and requires long-term treatment.
Ingrown toenail
In this condition the nail starts growing into the skin, causing pain, redness, and swelling. It often results from improper trimming of the nails or wearing tight footwear. It can be treated with medication, while severe cases require removal of the toenail.
White nails
Very white nails can be a sign of fungal nail infection or a decreased blood supply to the nail bed, a condition called Terry's nails. Such nails are typically white with dark or reddened tips and may indicate various health conditions, including diabetes, liver cirrhosis, malnutrition, an overactive thyroid, or anaemia.
Thickened and overgrown nails
A fungal infection can thicken the nails and may also make them discoloured or crumbly. Other possible causes include nail psoriasis, long-term pressure from shoes, and reactive arthritis.
Acute paronychia
This condition starts after a minor injury to the nail fold. The affected area becomes red, warm, tender, and swollen, and may produce pus around the nail. It can develop into an infection requiring antibiotic creams or tablets; surgical draining of the pus also relieves acute paronychia.
Chronic paronychia
If acute paronychia does not improve with medication and draining, it may become chronic. The infection can spread to other fingers, making them swollen and red, and the nail plate thickens. Chronic paronychia may take months to clear.
When should I see a dermatologist?
Visit a dermatologist if you notice any change in the appearance of your nails. They will find the root cause of the condition and prescribe the right treatment. At Derma Essence, treatment is led by Dr. Reena Sharma (MD Dermatology). For related concerns, see ingrown toenail or fungal infection.
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