Nail health: symptoms and diagnoses

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Nail health: symptoms and diagnoses
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The nails, especially the toenails, can often suffer from unsightly or painful problems: fungal infections, streaks, thickening, yellow or black marks, etc. So how can you tell whether these problems are benign or serious? Here are the main symptoms and their diagnoses.

Ingrown toenails

When the edges of the nail start to become embedded in the skin, generally on the big toe, this is an ingrown toenail, often caused by wearing shoes that are too tight or because of a deformation of the toes, notably in older people or people with diabetes. The way in which you cut your nails can also cause an ingrown toenail, which is why  it is recommended that you cut them in a square shape, leaving some of the nail protruding over the skin.

It is recommended that you consult a chiropodist to treat the problem as soon as it begins, especially if the skin around the nail becomes red, swollen and painful. While you are awaiting an appointment, apply an antiseptic solution and cover it with a plaster.

If it has already progressed too far, you will need to use products to break down the nail, or resort to surgery.

Horizontal lines

The cuticle is the skin that protects the base of the nail, and when it is damaged, bacteria can penetrate the bed of the nail and cause the appearance of horizontal lines on the surface, which are due to an infection in the cuticle.

To reduce the risk of infection, don’t cut or tear the cuticles, but push them back gently. Consult a dermatologist who can run tests to identify the germ(s) responsible for the infection and prescribe an antibiotic cream or a course of oral antibiotics.

White marks

When small white marks appear on the nails, they are not due to a lack of calcium, but to repeated micro-traumas that cause the nail to lift off slightly, but they are nothing to worry about.

More rarely, these white marks can indicate a fungal infection of the nail, alopecia areata or intoxication (lead or arsenic poisoning), but generally these form extensive marks, stripes or white lines.

Thick, yellow nails

If one part of the nail becomes white or yellow and the nail starts to thicken, it could be a fungal infection, like in the photo shown above. A fungal infection, although painless, can be contracted at the swimming pool, at a hammam, via perspiration, shoes that are too tight, etc. The trigger factors are numerous, and the infection can rapidly spread to other nails.

It is often sufficient to apply a local treatment (a cream or an anti-fungal varnish). But if the bed of the nail is infected, it is best to consult a chiropodist or a dermatologist in order to get tests done, as an oral treatment may be necessary.

Vertical stripes

When thick stripes appear going lengthways along the nails, it is simply a sign of ageing or of an iron deficiency. Sometimes, such streaks can transform into a small crack which weakens the nail.

Redness and swelling around the edge of the nails

When the skin around the nail becomes red, swollen and painful, it is generally due to paronychia, a bacterial or fungal infection at the base or sides of the nails. Avoid getting cuts or tears around your nails in order to prevent infection, because a cut or simply biting your nails can cause paronychia.

Disinfect the infected area with iodine several times a day and cover it with a plaster. If the inflammation persists after several days, especially in the case of pain and fever, consult your doctor. A medical intervention will probably be necessary to remove the pus, as well as taking anti-inflammatories and antibiotics.

Dark marks on the nails

If a dark coloured or black mark or streak moves with the nail as it grows, it is simply a heamotoma, usually after the nail has suffered a strong impact or shock. But if the mark forms a brown or black stripe, which stays in the same place around the edge of the nail, the mark is on the skin. You should consult a dermatologist immediately, who will carry out tests to determine whether it could be a melanoma (skin cancer). In this case, medical intervention will be necessary.

If there is pain radiating under the nail, an x-ray may be necessary in order to ensure there is no fracture.


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