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Have You Noticed Recent Changes to Your Nails?

December 16, 2019


If so, it is time to visit your dermatologist for a checkup. People sometimes forget that a dermatologist is a doctor that specializes in diagnosing and treating more than 3,000 adult and pediatric disorders of the skin, hair, nail, and mucous membranes. They receive specialized training to perform skin grafts, excision of lesions, laser treatments, skin cancer removal, and more. Moreover, our Central Florida dermatologists provide professional care for cosmetic issues, helping patients revitalize the appearance of damaged or diseased skin, hair and nails. Most procedures can be performed in an outpatient setting at the doctor's office or clinic. Although some practitioners in beauty spas call themselves skin and nail specialists, they do not have the correct accreditation to address or treat underlying health conditions.

The nail is a small organ that covers and protects the dorsal aspect of distal fingers and toes. A change in color, shape, or texture of your nails can be harmless but it can also be a sign of hormonal imbalances or the onset of disease. Since a dermatologist is a medical specialist, who can diagnose and treat these conditions, seeing one for an immediate diagnosis is essential for your health and well-being. Abnormalities of fingernails and toenails can develop as a side effect of certain medications, autoimmune disorders, fungal infections or trauma. Early treatment cannot only help prevent the disease from worsening it can give you peace of mind. Most often, once our dermatology providers identify and eliminate the cause of the abnormal condition, your nails will return to healthy growth.

Your Nails Reflect Your Dermatologic Health

Nails play an important role in evaluating an individual's overall health condition. Although a nail technician may be the first to notice changes to your nail health, the onset of disease can be very subtle and requires the attention of a doctor trained in this area medicine for an accurate diagnosis and treatment plan. Moreover, nail conditions that show signs of infection or inflammation may require immediate medical attention. Listed below are common nail disorders as well as subtle changes that should be evaluated by a dermatologist:

  • INGROWN NAILS - Although ingrown nails (onychocryptosis) can affect the fingers or toes, the most common occurrence is an ingrown toenail of the big toe. When the round nail bed curves down into the inside or outside of the digit, it can cut into the skin causing discomfort that can lead to infection unless it is treated properly.
  • FUNGAL INFECTION - Unless the condition is properly addressed, cases of toenail fungus (onychomycosis) can last for decades. Fungal infections of the nails can cause a thickening that becomes brittle allowing the edges to crumble or flake. Discoloration, yellow streaks or white patches appearing on the nails are often a sign of a fungal infection.
  • RAM'S HORN NAILS - Ram's horn nails (onychogryphosis) is a nail disease that can develop at any age but is common in older adults. Regardless of cause, the condition causes one side to grow faster and it is most often accompanied by a thickening and yellowing of the nails. A dermatologist can determine whether the excessive growth is related to trauma, infection, autoimmunity or other diseases, and provide the most appropriate treatments.
  • BEAU LINES - Lines that run the direction that the nail grows are common and typically not a worry. However, deep grooves that run the width of your nail can indicate that something happened during recent nail growth. Fevers, injuries, chemotherapy and stress are common causes that might result in gaps as well as deep grooves. Contact a dermatology practice near you for an accurate diagnosis and treatment options.
  • TUMORS & WARTS - Both benign tumors and warts can interfere with the growth of an affected nail and may even cause it to become lose or displaced. These can become painful and are best removed before the growth affects the use of the fingers or toes.
  • NAIL PSORIASIS - About half of the people with psoriasis exhibit signs of nail psoriasis where plaque psoriasis forms on the nail matrix and disrupts normal growth. Red to yellow discoloration with oil spots can usually be seen below the nail plate. Pinhead size pitting, grooved indentations, or ram's horn nails may also be present.
  • WHITE SPOTS - For some, white spots (leukonychia) may appear as tiny dots while others have white spots that stretch across the entire nail. These are likely not a sign of a serious medical condition and are usually related to injuries to the nail bed from manicures or pedicures. White spots may affect one nail or several.
  • DARK STREAK DISCOLORATION - If a fingernail or toenail develops a new or changing dark streak running in the direction of nail growth, it could be a sign of melanoma, which is a serious form of skin cancer. Not every dark streak is a melanoma, but it is important to contact our dermatology practice specializing in diagnosis and treatment of skin cancer and melanoma. Treatment should be sought in a timely manner.
  • SPLINTER HEMORRHAGES - Thin reddish-brown to black lines that form vertically under the nail, or a crack within the nail, are common to nail injuries. Direct trauma to the nail may result in the collection of blood causing a hematoma or black spot under the nail. Splinter hemorrhages can become painful and require medical attention.
  • DIGITAL MUCINOUS PSEUDOCYST - A small, benign lump that occurs on a finger or toe near the nail is called a mucous pseudocyst. These lesions may appear bluish in color and most commonly occur after middle age and effect women twice as often as men. Cortisone injections or surgical removals are common treatment protocols.
  • BACTERIAL INFECTION - Redness and swelling around a nail may indicate a bacterial infection. When bacteria cause a nail infection, the nail itself may turn greenish black. Without proper treatment, the infection may worsen. Frequent exposure to water and/or chemicals are common culprits that can damage tissue around and below the nails.
  • CLUBBING OR CURVING - Clubbing can cause nails to curve down and may be a genetic trait that runs in your family. However, when you first notice your nails start to turn downward, or if the nails feel spongy when pressed on, it is time to be seen in one of our 16 convenient locations, since clubbing can be a sign of other disease processes.
  • SPOON-SHAPED NAILS - Thin spoon-shaped nails, especially fingernails, that dip in the middle forming a spoon shape can be indicative of a lack of nutrition, sensitivity to gluten, or other health problems. Getting a proper diagnosis and treatment is important to correct an iron deficiency, identify celiac disease, or determine another cause.
  • INFLAMMATION OF THE NAIL FOLD - The tissue surrounding the nail plate can become inflamed by microscopic pathogens through small wounds in the skin. If left untreated, pus can form under the nail causing it to shed. Any inflammation of the nail fold should be treated by a qualified medical professional as soon as possible to prevent further complications.

Nail Changes Can Occur at Any Age

Your nails play an important role in protecting the tip of your digits. Proper diagnosis and treatment of nail diseases require an in-depth knowledge of the anatomy, physiology, and pathology of the nail. Our experienced team of dermatology providers will examine the growth characteristics as well as the variance between different fingernails and toenails to identify peculiarities resulting from dermatologic or systemic diseases as well as injuries to the nail and bed. Although nail disorders are commonly seen in older adults (due to the regular use of medications, poor blood circulation, and the natural thickening that comes with the aging process), significant changes to the condition of the nails as well as trauma to fingernails and toenails should be brought to the attention of a licensed medical provider.

For expert dermatologic care, contact one of our convenient Central Florida locations to determine the extent of damage and the medical conditions involved that may require medications, injections, and possibly surgical removal.

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