Nail Disease

Nail Disease

What Kinds of Disorders Affect the Nails?

There are a large number of disorders that can affect the nails; some are genetically inherited and some are acquired.

Abnormalities involving nail plate growth (too much or too little) and some involving nail plate composition, as well as several nail disorders that are the result of infection or systemic diseases are examples of nail disorders.

Common Nail Disorders

Ingrown Nails

Ingrown nails are the result of nail plates growing into the surrounding skin tissue. They usually result from either trauma or bony deformity of the underlying digit. They are most effectively treated with surgical removal (either temporarily or permanently) of the damaged nail plate that has become ingrown. Permanent removal of a chronically problematic nail plate (or more commonly partial nail removal) can be safely achieved with a Co2 laser.


Paronychia is an inflammation of the nail fold (the skin on the sides of the nail plate or cuticle). It can be acute or chronic. Acute paronychia develops rapidly, over a few hours. The nail fold becomes tender or painful, red and swollen. Sometimes yellow pus appears under the cuticle. It may be accompanied by fever. It is usually due to staphylococcus aureus, a bacterial infection. This may be treated with topical or oral antibiotics. It can also be due to the cold sore virus, herpes simplex. Acute paronychia usually clears completely in a few days, and rarely recurs.

Chronic Paronychia

Chronic paronychia has a more gradual onset and is much more difficult to get rid of. It may start in one nail fold but often spreads to several nearby digits. Each affected nail fold becomes swollen and is lifted off the nail plate. It may be red and tender and there may be pus under the cuticle. The nail plate becomes distorted and rigid as it grows. It may become discoloured and brittle. Once the problem is cleared, it can take up to a year for the nails to grow back to normal. Chronic paronychia may be due to several different microorganisms and/or a form of dermatitis or bony abnormality. One subset of this condition occurs in patients who have constantly wet hands. Recurrent ingrown nails (see above) can also cause chronic paronychia. Treatment depends on effective determination of the underlying cause of the paronychia.

Nail Fungus

Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, nail fungus may cause your nail to discolor, thicken and crumble at the edge. It can affect several nails at once. If the condition is mild, you may not need treatment, at least not initially. However, if your nail fungus becomes severe, becomes painful and has caused thickened nails, medications are often indicated. Moderate or severe fungus, left untreated, can cause significant nail deformity, be the source of more severe infections later in life, can become very difficult to treat, and even result in gait abnormalities as patients have difficulties with finding comfortable footwear with the deformed nails. Fortunately, there are several treatment options available for nail fungus, including topical and oral medicines and laser therapy.

Nail Thickening

Your nails can thicken for many reasons. These include:

  • Psoriasis
  • Injury
  • Fungal infections – a common cause of thickened toenails

Systemic Disease

Nail changes may also be caused by lichen planus[S6] , or other systemic diseases, such as diabetes, thyroid disease, and lung, liver or kidney disease

Nail Plate Psoriasis

In some cases, psoriasis[S7] can cause pitted and deformed nails that are thickened and discolored. Nails may also separate from the nail bed and be prone to trauma and infection.

Dr. Lubitz is a skilled and accredited dermatologist who is specially trained to diagnose and treat nail disorders.

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