Saturday, January 1, 2011

How to Keep Strong Healthy Nails

Are Your Nails Fit?
Take a good look at them – how strong and healthy are your nails? Are there ridges, dents, or areas of unusual color or shape? Many nail disorders can be avoided through proper care, but some indicate an illness that may require medical attention.

Healthy nails are smooth, without ridges or grooves. They're uniform in color and consistency and free of spots or discoloration. Distorted, discoloured or otherwise unsightly 'abnormal' fingernails and toenails are very common problems experienced by people of all ages in the community. Damage to the nail may be caused by an injury, fungal disease, or other skin conditions such as psoriasis or eczema. Nails with white lines or spots due to an injury, will eventually grow out with the nail.

As there are many potential conditions which cause nail abnormalities it is important to seek medical advice for correct diagnosis and the most effective treatment.

W H A T   T O   L O O K   F O R

1  Ridging of the nail
Ridging in nails can be either along (longitudinal) or across (transverse) the nail. Longitudinal ridging is harmless and normally becomes more prominent with age, but it can also be associated with medical conditions such as rheumatoid arthritis, lichen planus and injury to the nail.

Transverse depressions often appear some weeks after an illness or fever and grow out with the nail. Alternatively they may be caused by longstanding or severe eczema around the nail fold and also trauma from pushing back the cuticle.

Transverse layering or nail splitting is a frequent abnormality which involves splitting of the free end of the nail into layers. It is commonly seen in people who frequently immerse their hands in water as part of their work or home duties.

2  Thickening of the nail
Thickening of the nail can occur as a result of dermatological or general medical disease, and is most frequently seen in the toenails of the elderly. It often results from the long term use of ill-fitting footwear and neglect of the nails.

When psoriasis and other skin conditions affect the nail, they often lead to thickening of the nail (refer skin diseases and nail disorders below). If a fungal infection is suspected to have caused the nail thickening a sample of the thickened nail can be collected and analysed by a laboratory. If this confirms a fungal infection specific treatments are available. 

3 Lifting of the nail plate
A normal nail is translucent and its pink colour is provided by the nail bed. The end of the nail appears white because of the air beneath it and if the nail becomes separated from the bed, the white colour will extend down the nail. This condition is often a result of repeated minor injury to the underside of the nail, (for example, excessive cleaning under the free edge of the nail).

4  Discolouration
Medications, chemicals from hair dyes, some nail lacquers, nicotine and creams such as Dithranol can all cause discolouration of the nail.

Antibiotics can cause nail lifting and brownish discolouration of the nail plate. Agents used in chemotherapy may also cause discolouration. Bleeding beneath the nail plate can cause dark discolouration.

Melanoma is another important cause of nail discolouration and may involve the nail bed, nail and/or cuticle. You should see your doctor if new or changing pigmentation of the nail or around the nail occurs.

5 Inflammation of the nail fold
Bacterial infection of the nail fold causes redness, swelling, tenderness and pain usually around the proximal nail fold (see diagram above), sometimes with pus formation. The most common cause is bacterial infection with Staphyloccus aureus. This condition is often seen in nurses, hospitality workers and anyone involved in activities where nails are immersed in water for periods of time. Damage to the cuticle, through immersion in water or over-zealous manicuring, also predisposes to this form of inflammation.

Keep your nails dry and clean. This prevents bacteria, fungi or other organisms from growing under the nail. Clean under the nails regularly and thoroughly dry your hands and feet after bathing. Wear rubber gloves when using soap and water for prolonged periods.

6  Nail biting
Nail biting is associated with infection around the nail folds and can cause deformity of the nail plate. Don't bite your nails or pick at your cuticles. These habits can damage the nail bed. Even a minor cut alongside your nail can allow bacteria or fungi to enter and cause an infection (paronychia). There are many different reasons for habitual nail biting, and as just as many remedies to solve it! You might apply a foul tasting bite prevention cream to your nails (available from any pharmacy), or seek advice from your doctor on the most appropriate treatment.

7  Hangnails
A hangnail or agnail is a small, torn piece of skin near a fingernail or toenail. Hangnails are usually caused by dry skin or (in the case of fingernails) nail biting, and may be prevented with proper moisturization of the skin. Never pull off hangnails — doing so almost always results in ripping living tissue. Instead clip off hangnails, leaving a slight angle outward.

8  Skin diseases and nail disorders
Many nail abnormalities stem from skin diseases which need to be treated to enable the nails to return to normal. Some common examples are:

Psoriasis causes scaly red skin patches and visible abnormalities of the nail including pitting of the nails, with individual pits about the size of a pinhead. Psoriasis can also lead to onycholysis (lifting of the nail plate) and thickening of the nails.

Eczema / Dermatitis
This superficial inflammation of the skin causes itching, a red rash which may blister, weep and become crusted leaving the skin scaling, thickened or discoloured. Often the fingertips and surrounding skin can be affected by eczema with swelling (and possibly infection) of the nail fold tissues. This is often seen in infants who suck their thumbs.

Fungal skin and nail infections
Fungal infections of the skin ('tinea','ringworm') are contagious and may appear as itchy and occasionally painful rashes of the skin. Once the skin is infected the problem moves to nails which can be identified by thickening, a change in colour and sometimes crumbling of the nail.

'Jock itch' and 'athletes foot' are common fungal infections which can spread to other areas of the body and nails. Diagnosis is usually confirmed by taking a sample (scraping or clipping of the nail or a sample of the debris under the nail). This sample is then examined and tested for fungal infection.

Several topical and oral treatments are available from your doctor to treat fungal nail infection. Fungal infections can be caught in many situations, but taking a few simple precautions will help avoid them. Some of these precautions are:

Wear jandals/sandals in communal showers
Dry feet and body thoroughly
Do not share towels and clothing
Wear loose fitting clothing, cotton underwear and socks
Wear cotton gloves under rubber gloves if hands are often in water
Avoid harsh or irritating soaps/detergents
Change shoes regularly. 'Air' them in the sun

Lumps and bumps
Viral warts may occur in, around, or under the nail plate and may result in nail deformity. Cysts can occur towards the end of the finger and this can lead to a longitudinal depression in the nail. Uncommonly, skin cancers (including melanoma and squamous cell carcinoma) can occur in the nail plate area and any non-healing, growing bleeding or discoloured area should be shown to your doctor.

I N   S U M M A R Y

No Nail care products can give you healthy nails. 
It's easy to neglect them, but a little basic nail care can go a long way toward keeping your nails in a healthy condition.

Wear shoes that fit properly. 

Shoes that place excessive pressure on your toes or pinch your toes may cause your nails to grow into surrounding tissue.

Special considerations: Manicures and weak nails.

If you rely on manicures to make your nails look good, keep a few things in mind. Don't have your cuticles removed — it can lead to nail infection. Also, check to be sure that your nail technician properly sterilizes all tools used during your manicure. Using unsterilized tools may transmit yeast or bacterial infections.

Watch for problems.
If you have a nail problem that doesn't seem to go away on its own or is associated with other signs and symptoms, make an appointment with your doctor to get it checked out.


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