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Nails can cause, help diagnose health problems

Healthy nails are an important part of overall health. Keeping finger and toe nails in good physical shape not only makes for a neater appearance but also makes it easier to perform everyday tasks and can help prevent infection.

Because nails are always “out there” — greeting a friend, digging a garden or cleaning the sink — they are subject to a lot of abuse. Smashing a nail, getting it stuck in a door, and frequent exposure to water and chemicals are the most common causes of bacterial infections. These infections can cause redness, swelling and pain of the skin folds of the nails.

Nail disorders account for about 10 percent of all skin conditions, according to the American Academy of Dermatology. Although most minor nail infections heal on their own, nails can look raunchy for a long time because of the nails’ slow rate of growth.

White spots on the nails are very common and are caused by injury to the base of the nail. These spots will eventually grow out; although they often recur. Splinter hemorrhages also tend to resolve on their own. They appear as splinter-like vertical lines under the nail plate when the blood vessels in the nail bed are disrupted, usually by injury, sometimes by diseases and drugs.

More Serious Nail Problems May Require Medical Treatment

For more serious nail conditions, it is best to see your doctor, who may refer you to a dermatologist, a physician who specializes in skin and nail conditions. Treatments may include a cream or lotion to apply directly to the nails, or an oral medication.

Taking things into your own hands (or feet) could make matters worse. For example, even though ingrown toenails can be painful, attempts to cut away the nail could result in infection. You can, however, help to prevent ingrown nails by not wearing tight shoes and by trimming nails properly (see section below, “What to Do and Not Do”).

Being confined in shoes, even proper-fitting ones, can create the moist, warm environment where fungal infections thrive. Fungal infections are responsible for about 50 percent of all nail disorders. These infections can cause the end of the nail to separate from the skin beneath it, and debris to accumulate under the nail and discolor it. To reduce the risk of coming in contact with a fungus, wear shower shoes in public pools and other facilities.

What Nails Can Tell About Other Health Problems

Nails can act as windows to overall health. Changes in nails could indicate diseases and serious conditions. During a physical examination, your doctor may check nails for signs of the common conditions listed below.

Pale nail beds (the skin under the visible part of the nail) could be a symptom of anemia.

Yellowish nail beds, with a little blush at the base of the nail, could indicate diabetes.

Red nail beds could be a sign of heart disease.

Nails that are half white and half pink could indicate kidney disease.

White nails could be a sign of liver disease.

Nails that are getting thicker, turning yellow and growing more slowly could indicate lung diseases.

What to Do and Not Do

The Medical Society of the State of New York recommends following the American Academy of Dermatology instructions for proper nail care.

• Keep nails clean and dry to help prevent bacteria and other infection-causing organisms from accumulating under the nail. Cut nails straight across, only slightly rounded at the tip for optimal nail strength. Use sharp scissors and nail clippers.

• Do not remove cuticles. Breaking the seal between the nail and the skin can allow infections to develop.

• Do not bite your nails. Nail biting can allow infection-causing organisms to move back and forth between your mouth and nails and can damage the skin around the nails so infections can enter and spread.

• Do not use nail polish remover more than once a week because it dehydrates the nails.

• Moisturize your hands after washing them.

• Wear gloves when cleaning with harsh chemicals or when gardening.

• Wear shower shoes in public pools, showers, and locker rooms to reduce the risk of a fungus invading your toenails.

• Report nail changes, swelling, and pain to your doctor or dermatologist.

Additional information is available online at www.aad.org.

This information is provided by the Medical Society of the State of New York. For more health-related information and referrals to physicians in your community, contact the New York City Department of Health by calling 311.