Nail Disorders: Diagnosis, Causes, and Modern Dermatological Treatment
What Are Nail Disorders, and Why Do They Require a Dermatological Evaluation?
Fingernails and toenails do not merely serve an aesthetic purpose; they also protect the tips of the fingers and toes and are a strong indicator of overall health. Nail disorders are extremely common and can range from simple changes caused by injury to serious infections or systemic diseases.
Many people tend to ignore changes in the color, shape, or texture of their nails, or try to cover them up with cosmetic products. However, a timely examination by a specialized dermatologist is essential for an accurate diagnosis, as different nail conditions present similar symptoms but require completely different treatment approaches.
Nail Fungus (Onychomycosis)
Onychomycosis is the most common nail condition, primarily affecting the toenails. It is caused by dermatophytes, yeasts (such as Candida), or other fungi that invade the nail plate or nail bed.
The main symptoms include:
- Color change: The nail takes on a yellowish, brown, white, or grayish tint.
- Thickening and deformation: The nail plate becomes hard, thick, and difficult to cut.
- Brittle nails: The nail breaks easily at the tips or peels.
- Onycholysis: Separation of the nail from its nail bed.
The treatment of fungal infections requires patience and medical guidance. Depending on the extent of the infection, topical antifungal nail polishes, oral medications, or a combination of both may be used, while a nail culture performed in the doctor’s office helps accurately identify the fungus.
Ingrown Toenail (Onychocryptosis)
An ingrown toenail occurs when the edge of the nail (usually on the big toe) grows into the surrounding skin, causing inflammation, severe pain, redness, and swelling. In advanced stages, granulation tissue and purulent discharge may develop due to bacterial infection.
The main predisposing factors include:
- Incorrect way to trim nails (cutting them too deep or rounding the corners).
- Tight or ill-fitting shoes that put pressure on the toes.
- Anatomical structure of the nail or injuries.
At our clinic, we use both conservative and surgical methods (such as partial onychectomy with chemical cauterization of the nail bed), ensuring a permanent solution to the problem without pain and with a rapid recovery.
Nail Psoriasis & Other Inflammatory Conditions
Nails are often affected by skin conditions that also affect the rest of the body:
- Nail Psoriasis: It presents with small pits (pits resembling “thimbles”), oil spots (yellowish lesions under the nail), hyperkeratosis, and onycholysis.
- Lichen Planus: It can cause thinning, ridging, or even permanent damage to the nail bed if not treated promptly.
- Eczematous Onychia: Inflammation of the area around the nail (paronychia) caused by allergies or frequent contact with water and chemicals.
Other Common Nail Disorders and Abnormalities
- Paronychia (Acute or Chronic): Bacterial or fungal inflammation of the tissues surrounding the nail, accompanied by pain, redness, and pus.
- Subungual Hematoma: A collection of blood under the nail following an injury, causing dark discoloration.
- Linear Melanonychia: The appearance of a brown or black vertical line on the nail. It requires a careful dermatoscopic evaluation by a dermatologist to rule out subungual melanoma.
How Are Nail Disorders Diagnosed and Treated?
The diagnosis is based on a detailed clinical examination, nail dermatoscopy (onychoscopy), and, when deemed necessary, a mycological test (culture) or skin biopsy.
The treatment approach is tailored to the specific cause and includes:
- Targeted local or systemic medication.
- Invasive dermatosurgical techniques for the painless removal or correction of pathological lesions.
- Tips for prevention and proper foot care.
Take Care of Your Nails at Dermtherapy
If you’ve noticed any changes in the color, shape, or texture of your nails, don’t delay in seeing a dermatologist. At the Dermtherapy dermatology clinic in Galatsi, dermatologist and venereologist Alexandros Soumalevris provides accurate diagnoses and modern treatments for all nail conditions.