All Kinds of Problems Beset Your Nails

Paronychia. Onychomycosis. Surely, these are the names of six-armed Greek monsters that might attack Jason and the Argonauts.

In fact, they're microscopic monsters that will gladly attack your nails -- and may cause damage if you don't do something about them.

Rarely do people hold forth about the condition of their nails while co-workers are gathered around the office coffeepot. But nail problems do cause considerable pain and embarrassment.

As many as 10 percent of all dermatology problems involve nail disorders, reports the American Academy of Dermatology (AAD).

According to the AAD, about half of people with nail problems have fungal infections. For some of these people, new anti-fungal medications may help. The medications may have side effects, however, and they are not appropriate for everyone.

Before considering any treatment for your nails, it's important to confirm that the nail problem is, in fact, caused by a fungal infection. People with any doubt about their nails should consult with a dermatologist. Sometimes nail problems are signs of serious illnesses in other parts of the body.

Common problems

Acute paronychia

Acute paronychial is a swelling and redness of skin around the nail, seen more often in fingernails than toenails. It may be caused by an injury to the skin around the nail, or by pulling on or chewing the cuticle. It can also be caused by hangnails. Paronychia's underlying cause is bacteria, so your doctor may suggest an antibacterial ointment or prescribe an antibiotic by mouth. Chronic paronychia is a more gradual development of redness and swelling around the nails and is usually caused by a fungus. People with diabetes or who work with their hands in water or chemical solvents daily have a higher risk for developing chronic paronychia and may have more than one finger affected. Treatment is usually with a topical antifungal cream. You can avoid paronychia by wearing waterproof gloves over cotton gloves while doing housework, or when you are exposed to chemicals. Also, avoid pulling at or chewing on the cuticles or skin around your nails. Don't pick or chew hangnails; trim them with nail clippers.

Onycholysis

This is a condition in which the nail plate separates from the tissue beneath it, usually at the tip of the nail. It's more commonly seen in fingernails than toenails. You'll notice the normal white tip of the nail begins to extend toward the cuticle. The separation between nail plate and nail bed gives dirt a nice place to hide, and provides a fertile home for fungus and bacteria. The most common causes of onycholysis are trauma, when someone, perhaps playing a sport, accidentally tears the nail plate from the bed or when someone cleans too aggressively beneath the free edge of the nail. Continuous exposure to water and contact with chemicals can also lead to onycholysis. In some cases, it may reflect systemic or skin disease (hyperthyroidism or psoriasis). One tip to avoid problems: Clip your nails short to reduce the chance of tearing.

Onychomycosis

In this condition, fungus attacks your nails. It usually occurs with athlete's foot. The nail plate and bed separate. In many cases, the nail plate thickens. The border of the nail may crumble. The nail's color may vary from yellow to brown. Among the causes of onychomycosis: injury to the nails, repeated stress on nails because of athletic activities, mechanical stresses created by bone changes in the feet as they age, and nerve and circulatory changes caused by aging. People with diabetes are at increased risk for fungal nail infections.

To prevent a toenail infection, dry between your toes after bathing. Don't walk barefoot around public pools, showers or locker rooms. Change your socks frequently, perhaps even several times a day, if you sweat a lot.