Society’s views on how individuals care for their nails is associated with a person’s importance of self care, with the assumption that lack of proper nail care determines lack of proper hygiene. However, while nail care plays an important role in overall hygiene, it doesn’t necessarily mean the person is unhygienic. There are a number of diseases and conditions that account for what can appear to be bad nail care and “nail changes may be a clue to an underlying systemic disease or infection.” There are an abundance of nail disorders that are often seen such as “Brittle nail syndrome, onychomycosis, paronychia and nail psoriasis.” All of these conditions can be the result of another disease, infection or trauma. Because these nail disorders present in different ways depending on the stage it is in and the patient’s personal description of certain aspects (such as pain and irritation levels), there are many occurrences where the nail disorder is misdiagnosed, which is why it is so important to gather all the details possible and provide nail care information to prevent this from happening in the first place. Caring for nails properly can be thought of as being too expensive and out of the budget for some, but this isn’t true at all. Basic manicures cost anywhere from $10 to $20 if needed, whereas others prefer to do at-home manicures. It is important that nails are properly cared for in order to prevent those disorders listed above.
Brittle nail syndrome is when there is “increased fragility of the nail plate resulting in splitting, peeling and friability.” There are many causes of this, some being unavoidable like aging, along with infections and other inflammatory diseases. Secondary brittle nail syndrome is typically associated with dermatological diseases (such as psoriasis), nutritional deficiencies (Vitamins A-E, iron, selenium and zinc deficiencies), and certain medications (retinoids, antiretrovirals and chemotherapeutic agents). In order to treat brittle nail syndrome, the underlying cause must first be discovered and treated accordingly, which should help to resolve the nail symptoms. While the studies have yet to show great evidence, biotin is usually recommended for patients with brittle nails as an oral supplement.
For fungal nail infections (such as onychomycosis) the treatment consists of antifungals to treat the nail and get it back to its normal state as soon as possible. This can be done with oral antibiotics (such as itraconazole) and topical antifungals (such as ciclopirox). For fungal nail infections, be sure the patient is aware of how contagious the infection is and any preventative measures (such as wearing shower slippers). Nail disorders associated with inflammation and infection (such as paronychia and nail psoriasis) have several ways of being treated. Paronychia is the inflammation or infection of the nail skin folds. Mild cases can be treated with warm soaks of a mixture of water and vinegar or antiseptic solutions (such as Burow solution) to help promote spontaneous draining. Topical antibiotics can be given and if the infection persists, systemic antibiotics will be needed. Nail psoriasis is most common in patients that have already been diagnosed with skin psoriasis. Treatment consists of maintaining top notch nail care and stressing the importance of no mechanical trauma to the nails, as this will aggravate the condition even more. For patients with no skin psoriasis, there are intralesional steroid injections that can be used, along with other pharmaceutical options.
Nail disorders, prevention and treatments
Society’s views on how individuals care for their nails is associated with a person’s importance of self care, with the assumption that lack of proper nail care determines lack of proper hygiene. However, while nail care plays an important role in overall hygiene, it doesn’t necessarily mean the person is unhygienic. There are a number of diseases and conditions that account for what can appear to be bad nail care and “nail changes may be a clue to an underlying systemic disease or infection.” There are an abundance of nail disorders that are often seen such as “Brittle nail syndrome, onychomycosis, paronychia and nail psoriasis.” All of these conditions can be the result of another disease, infection or trauma. Because these nail disorders present in different ways depending on the stage it is in and the patient’s personal description of certain aspects (such as pain and irritation levels), there are many occurrences where the nail disorder is misdiagnosed, which is why it is so important to gather all the details possible and provide nail care information to prevent this from happening in the first place. Caring for nails properly can be thought of as being too expensive and out of the budget for some, but this isn’t true at all. Basic manicures cost anywhere from $10 to $20 if needed, whereas others prefer to do at-home manicures. It is important that nails are properly cared for in order to prevent those disorders listed above.
Brittle nail syndrome is when there is “increased fragility of the nail plate resulting in splitting, peeling and friability.” There are many causes of this, some being unavoidable like aging, along with infections and other inflammatory diseases. Secondary brittle nail syndrome is typically associated with dermatological diseases (such as psoriasis), nutritional deficiencies (Vitamins A-E, iron, selenium and zinc deficiencies), and certain medications (retinoids, antiretrovirals and chemotherapeutic agents). In order to treat brittle nail syndrome, the underlying cause must first be discovered and treated accordingly, which should help to resolve the nail symptoms. While the studies have yet to show great evidence, biotin is usually recommended for patients with brittle nails as an oral supplement.
For fungal nail infections (such as onychomycosis) the treatment consists of antifungals to treat the nail and get it back to its normal state as soon as possible. This can be done with oral antibiotics (such as itraconazole) and topical antifungals (such as ciclopirox). For fungal nail infections, be sure the patient is aware of how contagious the infection is and any preventative measures (such as wearing shower slippers). Nail disorders associated with inflammation and infection (such as paronychia and nail psoriasis) have several ways of being treated. Paronychia is the inflammation or infection of the nail skin folds. Mild cases can be treated with warm soaks of a mixture of water and vinegar or antiseptic solutions (such as Burow solution) to help promote spontaneous draining. Topical antibiotics can be given and if the infection persists, systemic antibiotics will be needed. Nail psoriasis is most common in patients that have already been diagnosed with skin psoriasis. Treatment consists of maintaining top notch nail care and stressing the importance of no mechanical trauma to the nails, as this will aggravate the condition even more. For patients with no skin psoriasis, there are intralesional steroid injections that can be used, along with other pharmaceutical options.
Resources:
Lee, Debra, and Shari Lipner. “Optimal Diagnosis and Management of Common Nail Disorders.” Shibboleth Authentication Request, 3 Mar. 2022, www-ncbi-nlm-nih-gov.jerome.stjohns.edu/pmc/articles/PMC8896184/.
Moossavi, Meena, and Richard Scher. “Nail Care Products.” Shibboleth Authentication Request, 2001, www-sciencedirect-com.jerome.stjohns.edu/science/article/abs/pii/S0738081X01002036?via%3Dihub.
Center for Food Safety and Applied Nutrition. “Nail Care Products.” U.S. Food and Drug Administration, FDA, www.fda.gov/cosmetics/cosmetic-products/nail-care-products. Accessed 17 Aug. 2023.