Nail Disease
Onychoschizia (splitting of the
finger nails)
I. Definition:
Onychoschizia or splitting of the fingernails is one
of the most common problems that the dermatologist sees. The term onychoschizia
includes splitting, frail, soft or thin nails and nails with ridges. Onychoschizia
is more common in women.
II. Causes:
-
Repetitive and prolonged wetting and drying of the fingernails
is the single most common cause of splitting and ridging of the nails.
-
Splitting of the nails is rarely caused by internal disease
or vitamin deficiency.
-
Nail polish remover causes onychoschizia.
-
Trauma to the fingers contributes to onychoschizia.
III. Treatment:
-
The best treatment is to avoid repeated wetting and drying
of the nails. Try to wear cotton lined rubber gloves when performing household
chores that involve getting the hands wet.
-
Rub lotions containing alpha-hydroxy acids such as Neostrata
or lanolin containing lotions such as Elon into the nails both before and
after getting the hands wet.
-
Watch people who have beautiful nails. Notice how they use
their hands or finger pads to do simple chores rather than use their nails.
Never dial a phone with the nail tips; use a pencil. Nails should never
be used as tools. Get in the habit of using your fingers as if they have
wet polish on them.
-
If you can’t avoid trauma to the nail tips, keep the nails
cut short.
-
Always wear gloves during cold weather and when you do chores
which may traumatize the nail tips.
-
Never peel or scrape off nail polish.
-
Shape and file the nails with a very fine file and round
the tips in a gentle curve. Daily filing of snags or irregularities helps
to prevent further breakage or splitting. Never use metal instruments on
the nail surface to push back the cuticle because this scrapes away the
microscopic protective cells of the nail surface.
-
When (and if) the nails are "buffed," do this in the same
direction as the nail grows and not in a "back and forth" motion because
this can cause nail splitting.
-
Nail polish can protect the nail surface. The almost daily
application of a "top coat" will keep the nail tips protected. Nail polishes
with nylon fibers in them may add strength and protection to fragile nails.
Use nail polish remover as infrequently as possible because it dries out
the nails.
-
One study has shown that biotin (a vitamin) 2.5 mg a day
taken by mouth is beneficial. Do not do this if you are pregnant.
-
Some patients are convinced that one pack of Knox Gelatin
mixed with orange juice and taken by mouth each day will restore nails
to a youthful state. There is no scientific data that supports the use
of unflavored gelatin to strengthen nails.
-
Taking colloidal minerals and a multivitamin each day has
been shown to increase the speed of nail growth which in turn leads to
healthier nails.
Onychomycosis (fungal infection of
the finger/toe nails)
I. Definition:
Onychomycosis is a fungal infection of the finger or
toe nails which is very difficult to cure.
II. Causes:
-
Onychomycosis is caused by a fungus. Often a person has had
athlete's foot for a long time prior to the development of onychomycosis.
-
Sometimes trauma or damage to a nail predisposes to the development
of onychomycosis.
III. Treatment:
-
Once fungus gets into the nails, it is very difficult to
treat.
-
Onychomycosis of the finger nails can be treated by taking
pills called griseofulvin. The pills must be taken for six months to one
year and have side effects. These include headaches, nausea, and rare reversible
liver damage. You can not drink alcohol if you are taking griseofulvin.
A course of treatment costs approximately $350 and has a 50-70% chance
of curing the condition.
-
A new medication, terbinafine, is now available for the treatment
of toe and finger nail fungal infections. Terbinafine is taken once a day
for 6 to 12 weeks. This medication has less side effects than griseofulvin.
A 12 week course of treatment costs $500 and has a 50-70% chance of curing
the condition.
-
If you do not want to try to cure the condition you can control
onychomycosis by rubbing Lotrimin cream into the nail every day. This is
available without a prescription at your local drug store.
-
Removal of the nail will not get rid of onychomycosis. When
the new nail grows in, it almost always becomes reinfected.
Call or email us to set up
an appointment today.
