What changes look like
The manifestations are varied, and the doctor often determines the cause from them. The nail may split at the ends, become thinner and bend, crumble, or, conversely, thicken. There are longitudinal grooves, often age-related, and transverse grooves that appear after a serious illness, high temperature or severe stress. Pinpoint impressions similar to needle marks are typical of psoriasis. Changes in color - white spots and stripes, yellowness, darkening - also have a diagnostic value and are always assessed together with the condition of the skin and hair.
- Delamination and fragility of the free edge
- Longitudinal grooves
- Transverse depressions after illness or stress
- Point impressions for psoriasis
- Thickening and discoloration
- Spoon-shaped concavity due to iron deficiency
Reasons
The most common group is external influences: constant contact with water, detergents and solvents, working without gloves, aggressive manicure with filing of the plate and removal of the cuticle, frequent extensions and removal of coatings, injuries and tight shoes. The second group is skin diseases: psoriasis, eczema, lichen planus, in which the nails are affected along with the skin. The third is systemic conditions: iron deficiency, thyroid disease, nutritional disorders, chronic lung and heart diseases, taking certain medications, including chemotherapy. Separately, a fungal infection is always excluded.
- Water, household chemicals, work without gloves
- Aggressive manicure and extensions
- Injuries and tight shoes
- Psoriasis, eczema, lichen planus
- Iron deficiency and nutritional disorders
- Thyroid diseases
- Side effects of drugs
- Fungal infection
When is it a fungus?
It is difficult to distinguish onychodystrophy from onychomycosis by eye, and the treatment is fundamentally different, therefore, if the nail is thickened, yellowish in color and crumbling, the doctor takes the material for examination. The fungus is indicated by the infection of one or two toenails first, the change begins from the free edge and spreads to the base, there is peeling between the toes. Against fungus - identical changes in all nails, symmetry, damage only to the hands of a person with wet work, accompanying rashes on the skin. A laboratory test puts an end to it.
- Microscopy and culture of scrapings
- The fungus often starts on the feet
- Identical changes in all nails - against fungus
- Peeling between fingers - due to fungus
- Antifungal drugs are not prescribed without confirmation
Survey
The doctor examines all fingernails, toenails, nail folds, skin and scalp, which are often where signs of psoriasis or eczema are found. Specifies profession, care habits, illnesses suffered over the past six months and medications taken. The laboratory most often checks a complete blood count, ferritin and serum iron, TSH, and if a malnutrition is suspected, zinc and other indicators. Scraping for mushrooms is almost always taken. In unclear cases, a nail bed biopsy is possible.
- Inspection of all nails, skin and hair
- Collecting medical history for the last 6–12 months
- Scraping for mushrooms
- Complete blood count, ferritin, iron
- TSH
- Zinc and nutritional indicators according to indications
Treatment and care
If the reason is external, the main work is the regime: household chores with gloves, refusal of aggressive manicure and frequent removal of coatings, short, neat cutting of nails, daily application of moisturizers and oils to the plate and rollers. In case of iron deficiency, it is replenished under the control of tests; in case of thyroid disease, it is treated; in case of psoriasis and eczema, external therapy is prescribed, sometimes with the introduction of drugs into the area of the nail fold. Biotin and other supplements help only with a confirmed deficiency, and not for everyone. The result is assessed after 3–6 months.
- Gloves when working with water and chemicals
- Refusal of filing the plate and deep processing of the cuticle
- Daily moisturizing of nails and rollers
- Correction of iron deficiency under test control
- Treatment of psoriasis, eczema, thyroid diseases
- Antifungal therapy for confirmed fungus
- Patience: noticeable results after 3–6 months