The nails on our fingers and toes serve both a health and utilitarian function in our lives. But the impulse to file, buff, polish and paint them, even bedeck them with jewels, dates back to the dawn of Greek civilization. Think Cleopatra! To this day, for young girls in many countries and cultures, their first manicure and/or pedicure still stands out as one of the presumed rights of passage from childhood to adulthood.
Regardless of age, it seems an almost genetic imperative for females of all ages, races, creeds and religions to fixate on their nails, all 20 of them. The more vibrant and jelly bean-like the colors applied to her little fingers and toes by her mother, the bigger the smile on my granddaughter’s face. And, she’s only 4.
But I am obliged for the purpose of this article to point out that these oddly shaped, hard and very durable parts of our body are not just there to be lavishly decorated and fussed over. Nails actually assist we humans in ways that without them would make certain daily chores, well, a bigger chore. If you’re not quite sure what I’m talking about, wrap a piece of masking or electrical tape around the tips of your fingers and try picking up a penny.
The condition of the nails also helps doctors perform an important diagnostic function. For those physicians trained to notice, the condition and appearance of the nails can serve as an indication of a potential medical problem. And, on a purely practical note, just try scratching a mosquito bite if you’ve clipped, or worse, bitten off too much of those natural, built-in scratching tools.
What Our Nails Tell Us
Our fingernails grow on average about an eighth of an inch a month. Toenails about a tenth of an inch. The older we get the slower our nails grow. Age can also turn supple nails brittle.
My dermatologist told me that more serious skin problems elsewhere in the body could show up in the nails. In fact, as many as fifty percent of all people with psoriasis “present” (her term) with small pits and depressions on their nails. Though much more uncommon, brown stripes can signal the presence of a melanoma growing under the nail.
Dark lines on the nail – “or any pigmented streak,” she cautioned – should be looked at immediately by a doctor. And, she emphasized that any very dark, or pigmented single line wider than a quarter of an inch, should be biopsied.
Changes in the appearance of the nails also can result from blood leaching out of the small blood vessels that weave through the nail bed. This condition is called, Splinter Hemorrhage. If a splinter hemorrhage is closer to the white, semicircular part of the nail that abuts the cuticle, it may be a sign of endocarditis, a bacterial infection of the heart.
DISEASES OF THE NAILS
Paronychia
Paronychia, a yeast infection usually caused by a small cut, or nick, in the skin, could happen if a manicurist is careless or clumsy when trimming the nails. It can get worse if the manicurist’s tools hadn’t been properly sterilized before use. That little nick, or cut, could cause a serious staph, or strep infection.
In these cases, if pus accumulates near the nail the area may need to be drained, which is not as bad as it sounds when compared with the pain of living with an infected digit.
When yeast infections like paronychia are present it is important to keep the area dry, especially if candida, a yeast-like parasitic fungus, was the cause. The good news is sometimes candida clears up on its own.
Fungal Infections
Onychomycosis, characterized by a thickening of the nail, is the most common fungal infection of the nail. Onychomycosis usually affects toenails. But on occasion fingernails can also fall prey to the infection. The drug itraconazole (brand: Sporanox) is usually prescribed by doctors to treat this persistent fungus. It might be necessary to keep up the treatment for as long as two-to-three months. A newer antifungal drug called terbinafine (brand: Lamisil) may take as long as it’s cousin Sporanox to work, but Lamisil has a slightly higher cure rate: 80% vs. 70% for Sporanox. Once cured, your doctor will usually prescribe an over-the-counter antifungal cream to prevent a recurrence of the infection.
Hangnails
Hangnails are tears, or splits in the edge of the nail itself. Hangnails can be painful and can become infected. In fact, paronychia infections (See: Paronychia) can begin with hangnails.
Ingrown Toenails
Cutting the nail too short most often causes an ingrown toenail, which typically afflicts the big toe. An ingrown toenail is a painful condition where the nail bends or curls into and then eventually pierces the skin, sometimes causing an infection. To prevent most ingrown toenails, the old adage “an ounce of prevention is worth of pound of cure” is worth applying. Try and catch it early. Look at your big toes, no matter how ugly you find them. If you notice the corner, or edge of the nail digging into the surrounding skin, it’s best to soak the toe in warm water. In the early stages with the problem just beginning, you might try placing a tiny piece of cotton under the edge of the advancing nail to try and coax it into taking an about face.
If nothing seems to work, see your doctor before an infection sets in. Again, the treatment is not as bad as you think. Yes, it might involve some minor surgery. But anesthetic creams like lidocaine numbs the area so the doctor can correct the problem painlessly with a scalpel, or laser, or even with a chemical called phenol (carbolic acid) that dissolves the errant part of the nail that’s causing the problem.
