Nail Disorders: Causes, Symptoms, and Treatment Options
Nail disorders affect the appearance, structure, and health of fingernails and toenails. They can result from infections, genetic factors, immune system disorders, or trauma. Healthy nails are smooth, evenly colored, and strong, but certain conditions can lead to changes in nail texture, color, or shape. This article provides a detailed look at common nail disorders, their causes, symptoms, and treatment options.
1. Onychomycosis (Fungal Nail Infections)
What Is Onychomycosis?
Onychomycosis is a common fungal infection that affects the nails, leading to discoloration, thickening, and brittleness. It is more prevalent in toenails than fingernails and is often caused by dermatophytes, yeast, or mold.
Causes:
✔️ Fungal overgrowth due to warm, moist environments
✔️ Poor foot hygiene and prolonged exposure to damp conditions
✔️ Walking barefoot in public showers or pools
✔️ Weakened immune system or diabetes
Symptoms:
Thickened, brittle nails
Yellow, brown, or white discoloration
Nail detachment from the nail bed
Foul odor in severe cases
Treatment Options:
Topical antifungal treatments – Medicated nail lacquers (e.g., ciclopirox)
Oral antifungal medications – Terbinafine, itraconazole (long-term treatment)
Laser therapy – Helps kill fungus without damaging the nail
Preventive measures – Keeping feet dry, wearing breathable shoes, and trimming nails properly
2. Nail Psoriasis
What Is Nail Psoriasis?
Nail psoriasis is an autoimmune condition that affects the nails, causing pitting, discoloration, and nail thickening. It often occurs alongside psoriasis affecting the skin but can sometimes appear independently.
Causes:
✔️ Autoimmune response triggering inflammation in the nail matrix
✔️ Genetic predisposition to psoriasis
✔️ Environmental triggers such as stress and infections
Symptoms:
Pitting or small dents in the nails
Yellow-brown discoloration (oil drop sign)
Thickened, crumbly nails
Separation of the nail from the nail bed (onycholysis)
Treatment Options:
Topical corticosteroids – Applied directly to the nails to reduce inflammation
Intralesional steroid injections – Helps control severe cases
Vitamin D analogs (calcipotriol) – Slows down cell turnover
Biologic drugs (etanercept, infliximab) – Used in severe cases affecting both skin and nails
3. Ingrown Toenails
What Is an Ingrown Toenail?
An ingrown toenail occurs when the nail grows into the surrounding skin, causing pain, swelling, and potential infection. It most commonly affects the big toe.
Causes:
✔️ Improper nail trimming (cutting nails too short or rounded)
✔️ Wearing tight or ill-fitting shoes
✔️ Injury to the toenail
✔️ Genetic predisposition
Symptoms:
Pain and tenderness along the nail edges
Redness, swelling, and inflammation
Pus or infection in severe cases
Treatment Options:
At-home remedies – Soaking feet in warm saltwater, gently lifting the nail edge
Proper nail trimming – Cutting nails straight across instead of rounding them
Medical intervention – Partial or total nail removal in severe cases
Preventive measures – Wearing comfortable shoes and avoiding trauma to the toes
4. Nail Dystrophy
What Is Nail Dystrophy?
Nail dystrophy refers to abnormalities in nail growth, leading to thickening, splitting, ridging, or discoloration. It is often a symptom of an underlying condition rather than a standalone disorder.
Causes:
✔️ Trauma to the nail matrix
✔️ Chronic illnesses (e.g., thyroid disease, eczema)
✔️ Malnutrition or vitamin deficiencies (iron, biotin, zinc)
✔️ Repeated exposure to harsh chemicals or nail treatments
Symptoms:
Brittle, weak nails that break easily
Horizontal or vertical ridges on the nail surface
Uneven nail growth or deformities
Thickened, discolored nails
Treatment Options:
Nutritional support – Biotin supplements, iron-rich foods
Addressing underlying conditions – Managing eczema, thyroid imbalances
Avoiding harsh chemicals – Limiting use of nail polish removers with acetone
Strengthening treatments – Applying nail hardeners or hydrating oils
5. Paronychia (Nail Fold Infection)
What Is Paronychia?
Paronychia is an infection of the nail folds caused by bacteria or fungi, leading to pain, swelling, and pus formation. It can be acute (develops quickly) or chronic (persists for weeks or months).
Causes:
✔️ Bacterial infections (often Staphylococcus aureus)
✔️ Fungal infections (Candida overgrowth)
✔️ Nail biting or picking at cuticles
✔️ Frequent exposure to water and chemicals
Symptoms:
Red, swollen nail folds
Tenderness or throbbing pain around the nail
Pus-filled abscess in severe cases
Nail deformation if left untreated
Treatment Options:
Warm water soaks – Helps reduce swelling and pain
Topical or oral antibiotics – For bacterial infections
Antifungal creams – For chronic fungal paronychia
Surgical drainage – If abscess formation occurs
How to Maintain Healthy Nails?
Moisturize your nails and cuticles to prevent brittleness.
✂️ Trim nails properly – Cut them straight across to avoid ingrown nails.
Keep nails clean and dry to prevent fungal infections.
Limit nail polish and harsh chemicals that can weaken nails.
Maintain a balanced diet rich in biotin, zinc, and iron for strong nails.
Conclusion
Nail disorders can impact both appearance and comfort, but early diagnosis and proper treatment can help maintain nail health. If you notice persistent nail changes, consult a dermatologist for appropriate care. Healthy lifestyle habits and good nail hygiene can prevent many common nail problems.
Frequently Asked Questions (FAQs)
Are fungal nail infections contagious?
Yes, they can spread through direct contact or shared items like towels and nail clippers.
Can nail psoriasis be cured?
There is no permanent cure, but treatments can help manage symptoms and improve nail appearance.
What is the best way to prevent ingrown toenails?
Trim nails straight across, avoid tight shoes, and keep feet clean and dry.
