Nails are small and serve a purpose, but they also can tell us a lot about your health. When something changes in your nails, it is essential to see a dermatologist.
Changes to a nail color, shape, or texture can be a warning sign of a severe health condition. A dermatologist is uniquely qualified to examine the nails and skin around them.
Onychoschizia
Nails that look brittle, discolored, or split apart may have an underlying cause. Your doctor will examine your nails and nail beds for any signs of a medical condition. They may clip a piece of nail and culture it to see if you have a fungal infection or use a polymerase chain reaction (PCR) test to produce many copies of the gene from the fungus causing your onychomycosis.
A wavy line of white or yellow striations in the nails is a sign of longitudinal ridging of the nail plate (laminar onycholysis). It occurs in psoriasis, fungal nail infection, and lichen planus. Dermoscopically, this pattern resembles longitudinal bands of fading colors in the aurora borealis pattern.
Ingrown nails
If your nails become brittle and distorted, it’s time to see a dermatologist. They can help you find the proper treatment of nail conditions.
Ingrown toenails are a painful condition usually caused by improper nail growth, especially in the toes. They also tend to worsen due to external pressure over the toenails, such as when wearing tight shoes.
A dermatologist can treat your ingrown toenails by numbing the area and lifting the edge of the nail to expose the skin underneath. They can then trim the edge of the nail and put in a gutter splint to prevent further nail growth into the skin. If an infection forms, the dermatologist may lance and drain the abscess. This will usually cure the infection.
Paronychia
This is a painful condition characterized by an infection of the area around the fingernail or toenail. The area is usually red, swollen, and full of pus.
People who work with chemicals or detergents are at high risk for paronychia, as are those who lick their fingers, pick at hangnails, or bite their nails. These habits can create tiny cracks in the skin and cuticles and allow bacteria to enter.
Splinter Hemorrhage
The nails and their surrounding skin and nail beds speak volumes about the health of your body. They often reveal clues to underlying medical conditions such as splinter hemorrhage. This occurs when blood vessels under the nail surface burst, causing reddish-brown spots that look like thin wooden splinters beneath your fingernails.
These tiny blood splinters usually result from minor nail trauma, such as stubbing your toe or biting your nails. They don’t hurt, and they grow out as the nail grows. However, if they happen frequently without any apparent cause and appear in the center of your nails or on many nails at once, you should seek a dermatologist’s help. They may be signs of systemic diseases such as psoriasis and lichen planus or a side effect of your medications.
Infections
The nails are a reservoir of infections, especially fungi. Fungal nail disease can be very disfiguring and significantly impact the quality of life. A dermatologist should be consulted early to optimize treatment outcomes and prevent recurrence and dissemination.
Nails reveal a lot about our health. Whether it is a dark streak that may indicate melanoma or white nails that point to diabetes or anemia, the dermatologist can interpret these signs and refer patients to the appropriate specialist for further evaluation.
Dermatologists spend four years in college earning their bachelor’s degree and another four years in medical school to become board-certified. Their practice is light on emergencies, but it’s high in volume.
