Why should I care about nail health?

Nail problems are very common and troubling. Nails often reflect our general state of health and can often be the first sign of serious general health issues.

Nail facts

Fingernails grow out in four to six months. Toenails grow out in nine to 12 months. Individual rates depend on age, time of the year, activity levels and heredity.

Nails grow faster on fingers, especially on your dominant hands, more so than toes.

Women’s nails grow more slowly than men’s except possibly during pregnancy.

Nails grow more rapidly in the summer than in the winter.

Nail growth is affected by disease, nutrition, medications from a chronic illness, fevers, and the aging process.

What causes nail problems?

Changes in the nail, such as discoloration or thickening, can signal health problems including liver and kidney diseases, heart and lung conditions, inflammatory disorders, anemia, diabetes, and fungal infections.

Improper nail care, ill-fitting shoes, and trauma can also cause nail problems.

Symptoms that could signal nail problems include changes in color or shape, swelling of the skin around the nails, thinning or thickening of the nails, bleeding, discharge around the nails, and/or pain.

Fungal infections cause about one half of all nail disorders. They are more common in toenails because the toes are confined in a warm, moist, weight-bearing environment.

Although rare, melanomas can grow under the nail. Such melanomas may be mistaken for an injury, so a dermatologist should be consulted if a dark-colored streak appears on the nail. If the nail discoloration does not gradually improve or if the size of the dark spot increases over time, a dermatologist should be consulted.

Other common nail problems 

White spots after an injury to the nail.

Vertical lines, (known as splinter hemorrhages), under the nails can be caused by a nail injury or certain drugs.

Fungal and bacterial infections are most often due to injury, poor skin hygiene, nail biting, finger sucking, or frequent exposure to water.

Ingrown toenails can be caused by improper nail trimming, poor stance, digestive problems, or tight shoes

How common are nail problems?

Nail problems make up about 10 percent of all dermatology visits, and 99 percent of people will experience some type of nail problem in their lifetime.

Nail problems usually increase along the road of life and affect a high number of senior citizens.

How are nail problems diagnosed?

By a dermatologist, podiatrist, or primary care physician.

Can nail problems be prevented?

Yes, and here are some tips for keeping the nails healthy:

Keep nails clean and dry to prevent fungus and bacteria from collecting under the nail.

Wear proper-fitting shoes and alternate shoes on a regular basis. Tight shoes can cause ingrown toenails.

Do not try to treat ingrown toenails, especially if they are infected. See a dermatologist or podiatrist.

Use an antifungal foot powder daily. Do not bite your fingernails. You can transfer infectious organisms between your fingers to your mouth. Also, nail biting can damage the skin around your fingers and infections may enter. Be sure to cleanse your feet daily and thoroughly dry them.

Nail salon safety tips

Report any nail changes to your dermatologist. Redness, swelling and pain can signal an infection or other serious health problems.

While most nail salons follow strict sanitation guidelines, consumers should check to make sure that their salon, manicure stations, and the instruments are clean and that the technicians wash their hands between clients.

Consumers who get frequent manicures and pedicures should bring their own tools to the salon.

Do not let a nail technician aggressively push back your cuticle as it may allow an infection to develop.

If you are itching, burning, or have any type of allergic reaction to a nail, see a dermatologist. Good foot health also includes washing the feet thoroughly — including between the toes.

How are nail problems treated?

Treatment depends on the exact cause or diagnosis. Many nail problems can look similar, so it is important to make sure a dermatologist makes the diagnosis so that the appropriate treatment program can be started. Treatments can include lifestyle modifications, topical nail strengtheners, vitamins, topical medications, systemic medications, and/or lasers.

Action steps

The most important thing to do in preventing nail problems is to use the suggestions above. Secondly, if you have a nail problem, don’t wait — see a dermatologist, podiatrist, or your primary care physician for the appropriate diagnosis. When you have the correct diagnosis, you can then start the correct treatment.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.

Nail problems are very common and troubling. Nails often reflect…