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4 Nail Signs It’s Time to See the Dermatologist

Your nails can tell a lot about your general health. Changes in your nail’s appearance may just be an anomaly or result from an injury, but changes to your nails may also be indicative of disease or an underlying medical condition. Here are four nail change signs that warrant seeing the dermatologist. 

1. Paronychia

If the tissue surrounding a fingernail or toenail is red, swollen, and painful, you likely have paronychia. This is an infection that commonly occurs where the nail and the skin meet. The infection may be bacterial or fungal.

People who bite their nails or damage their cuticles by cutting them are most at risk. Improper hand-washing is another cause. Bartenders and diabetics are sometimes susceptible to this condition as well. Additionally, paronychia that accompanies a scaly rash may appear with a type of cancer of the larynx. 

Dermatologists prescribe an anti-fungal ointment when they think the paronychia is fungal. They will prescribe topical and/or oral antibiotics for bacterial causes. Doctors may also recommend children and adults who bite their nails use an over the counter, bitter-tasting nail paint to discourage the habit.

2. Koilonychia

Are your fingernails concave, or resemble the bowl of a spoon? Are they brittle? Do they break easily? If so, you may have koilonychia. This nail condition is usually indicative of anemia, especially iron-deficiency anemia. 

Dermatologists may also see koilonychia in other medical conditions, such as autoimmune diseases like lupus. The condition is often seen in people with intestinal cancers or celiac disease, which can cause internal bleeding that leads to anemia or a malabsorption problem.

To treat koilonychia, a doctor must first determine the underlying cause. The usual treatment recommendation is to increase dietary iron. People can do this by improving their diet and taking supplements if necessary. Adding Vitamin C to the diet will help absorption issues.

3. Onycholysis

When you nail detaches from the nail bed, the condition is called onycholysis. The affected nail(s) will begin pulling away and may change color as they do so. While this can happen as the result of a nail bed injury, it may be a sign of an underlying medical condition.

According to Medical News Today, onycholysis is common in people with toenail fungus. This condition can also result from chemicals, including household cleaners, nail polish, and nail polish remover. Yeast infections, medication reactions, psoriasis, thyroid disease, and nutritional deficiencies are other common causes of onycholysis.

Like koilonychia, your physician must first determine the underlying cause of onycholysis. The doctor may order lab tests to determine the cause. For example, a technician may draw your blood to check thyroid function. If the thyroid is not working properly, you will have to take medication. By treating the underlying condition, your nails will correct themselves as they grow out.

4. Acral Lentiginous Melanoma

If you see a black streak running through your fingernail or toenail, it is imperative you see a dermatologist immediately. This is often a sign of melanoma, which is the most dangerous form of skin cancer.

According to the Aim at Melanoma Foundation, the most common location of this black streak is on the thumb or big toe. Sometimes, it will be a clearly defined dark streak, but acral lentiginous melanoma can also resemble a small, dark bruise or an orange-colored mark. A mole on the palm or hand may also indicate acral lentiginous melanoma.

Acral lentiginous melanoma is more common in people of Asian descent and those with darker skin, but it can occur in anyone. Acral lentiginous melanoma also tends to be aggressive so do not ignore any signs suggestive of this condition. 

Are you concerned about the health of your nails or worried the appearance of your nails may indicate a more serious problem? Contact us today to schedule an appointment.

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