Nail Problems

The nails of a healthy person appear to be smooth with a consistent color. It is possible to develop vertical ridges on your nails or to have brittle nails with the growing age. There are several reasons why diseases, such as spots, discoloration, and nail separation, can appear on the nails, including injuries to the fingers and hands, warts (periungual warts), and infections (onychomycosis). People are very much conscious about protecting the tips of fingers from harmful bacteria.As our fingernails assist us in picking up objects, scratching an itch, or untying knots. People of all ages suffer from nail problems. Generally, abnormal nail changes are not caused by diet, except in cases of severe malnutrition, when the individual eats a lot or less than they need. The treatment of some nail conditions requires the help of a doctor or a dermatologist, while other conditions can be treated with simple self-help techniques and slight lifestyle changes.Toenail complications can also affect individuals of all ages, but they tend to be more usual among the elderly. Injuries, infections, and skin disorders such as eczema and psoriasis are a few causes of fingernail problems. The most common reasons for toenail complications are trauma, ill-fitting shoes, poor blood circulation, poor nerve supply, and infection. Toenail problems can be treated successfully with the help of a podiatrist.

Anatomy of Nail

A protein called keratin is the building block of nails, and this is the identical protein known to make up the skin and hair. An individual’s nails build from cells that multiply within the base of the nail, then layer onto one another and harden at the top. The process is known as keratinization.We inherit our parents’ characteristics of nails, such as strength, thickness, and growth rate. The nail is composed of the following components:

• Nail matrix: The nail matrix is the place behind the nail’s skin responsible for nail growth.
• Nail plate: It is the component of the nail that is evident.
• Nail Bed: The nail bed is the structure upon which the nail plate rests.
• Lunula: Lunula is the crescent-moon form you might see at the base of a nail plate.
• Nail folds: A nail fold is a delicate skin groove that holds the nail in place.
• Cuticles: A cuticle is a thin flap of tissue covering the base of the nail plate.

Types of Nail problems

Usually, nail problems are not due to anything serious; as we age, our nails tend to grow thicker or brittle (which can break easily). During pregnancy, you may notice a change in shape or size of your nails (as well as softening or brittleness of your nails within the first six months of having a baby).A damaged nail may change its color, become loose and ultimately fall off due to an injury. The fingernails that fall down due to an injury should grow within six months, and toenails can take up to 18 months to grow back.Some of the common problems are mentioned below:

• Damaged nails
• Brittle nails
• White bands
• Psoriasis
• Onycholysis
• Ridges
• Beau’s lines
• Fungus

1. Damaged Nails

Nail bed injuries can occur for several reasons. In most cases, it occurs when your nail gets caught between two objects or if it’s hit by something heavy, such as being slammed into a door, having something dropped onto it, or being hit with a hammer. They may also be caused by cuts, such as those caused by knives or saws. In most cases, nail bed injuries can be treated; however, in rare instances, deformities can occur.

2. Brittle Nails

Brittle nails are a common condition among the elderly. There are many possible causes of brittle nails, such as; drugs, trauma to the nail, several diseases, or nutrient deficiencies. The condition that causes nails to split horizontally is known as onychoschizia. However, when the nail separates along the direction it grows, the condition is referred to as onychorrhexis.Brittle nails can be treated through supplements and a proper diet. Some of these supplements may be vitamins (especially biotin), amino acids, or specific minerals, such as zinc.

3. White bands (Muehrcke’s Lines)

Muehrcke’s lines appear as pale or white bands crossing your nails from side to side. Muehrcke’s lines usually do not appear on the thumbnail. These disorders are caused by the fact that your blood does not contain enough albumins (hypoalbuminemia). The amino acid albumin develops most of the protein in your blood, and its absence could have serious health repercussions. The development of these lines may be caused by several medical conditions, including liver cirrhosis, nephrotic syndrome, chemotherapy side effects, or malnutrition. If you observe these bands, please consult your doctor to get an accurate diagnosis and required treatment.

4. Beau’s lines

Does your nail have a depressed band or a gap that extends horizontally around it? Several nail problems are commonly associated with systemic disease, one of which is Beau’s lines. Sadly, it is impossible to tell which disease caused it by looking at the nail. These unsightly lines may appear to respond to extreme cold, nail trauma, heart attack, and many other severe stressors such as the flu, syphilis, and mumps. So consult with your doctor for proper diagnosis.

5. Psoriasis

In addition, psoriasis is an inflammatory skin disease characterized by red, irritating, scaly patches, most usually found on the knees, elbows, trunk, and scalp. Psoriasis is a chronic (long-term) skin disease with no treatment and is extremely common in children. Generally, it happens in remission or flares, where it flares for a few weeks or months, then subsides for some time or goes into remission.

6. Onycholysis

There is a condition called Nail lifting (onycholysis), in which the fingernail or toenail spontaneously separates (detaches) from the nail bed at the end of the nail (distal) and on the edges of the nail (lateral). If the nail lifts, it might appear to be a half-moon shape, or the nail’s free side may rise like a hood. The nail lifting creates a space below the nail that collects dirt and debris.The accumulation of water under the nail can also cause bacteria and yeast to grow and lead to infection. The phenomenon of nail lifting may also be associated with underlying medical conditions, such as thyroid disease, pregnancy, infection, and barely with certain kinds of cancer. There are some other responsible factors for nail lifting, such as nail injury, nail cosmetics, and combative manicures.Moreover, it has also been observed that certain medications, such as chemotherapy and drugs made from vitamin A, can cause nail lifting. When tetracycline (commonly used for acne relief) interacts with sunlight, it may also cause the nails to lift.

7. Ridged Nails

Your fingernails are made by living skin cells. A skin condition such as eczema may result in fingernail ridges. There is also the possibility of dry skin causing ridges in the nails. If your body is deficient in protein, calcium, zinc, or vitamin A, this can sometimes be reflected in the bumps on your fingernails. There are two forms of ridges, vertical and horizontal ridges.

• Vertical Ridges: A vertical ridge is a furrow that runs from the tip of a fingernail down to the nail’s cuticle. Steep ridges are also known as longitudinal striations or bands.
• Horizontal Ridges: The presence of deep horizontal ridges, called Beau’s lines, often indicates a serious health problem. As a result, the nail may stop growing until the underlying condition is treated.

8. Onychomycosis (Fungal infection)

Onychomycosis refers to the occurrence of the nail’s fungal, yeast, and nondermatophytic mold infections. It occurs primarily in the lateral and distal portions of the toes. Onychomycosis can be classified according to the location of the nail bed affected. In general, distal fungal infection is the most common form of this disease, where dermatophytes infect the palmar and plantar skin.The intense layers of the nail plate can be affected by a proximal fungal infection, where fungal elements manifest in the intense layers of the nail plate; these conditions are more common in immunocompromised individuals.In addition, white superficial onychomycosis occurs in the toenails when fungi invade the nail plate to form colonies. A rare form of onychomycosis caused by a candida species is a sign of immunosuppression.

References:

• https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/nails-fingernail-and-toenail-problems retrieved on March 25, 2022.
• https://www.healthline.com/health/nail-abnormalities-2#_noHeaderPrefixedContent retrieved on March 25, 2022.
• https://www.onhealth.com/content/1/nail_health retrieved on March 25, 2022.
• https://www.aafp.org/afp/2012/0415/p779.html retrieved on March 25, 2022.