What your nails say about your health

Fungal nail infections

Fungal infections - whether it's athlete's foot, vaginal thrush or that sore, itchy rash in your groin or under your breasts - very commonly affects your skin.

Thrush is caused by a fungal infection, from yeasts which normally live harmlessly on all our skins. But if a fungus gets into your nails, it can be difficult to get rid of. The main symptoms are thickened, flaky, discoloured nails - often your toenails.

If your doctor thinks a fungus may be to blame, they will probably send a clipping from your nail to the laboratory. Over the counter medications containing amorolfine 5% can work on nails but can take months. If the infection is on multiple nails, you may need to take a tablet a day for three to six months to get rid of the infection. Fortunately, it may be unsightly but it's harmless.

Patient picks for Nail problems

Skin, nail and hair health

Why do we have nails?

Strictly speaking, unless your survival depends on the ability to pick fruit from the lower branches of trees, you don't actually need nails. Sure, fingernails are useful things to have when you want to pop open a tube of Pringles or find out whether you've won the lottery without hunting around for a coin. But they are not essential for life in the same way as, say, the lungs are. Fingernails can be looked on as a little gift from evolution that you can spray with sparkle or simply chew on when you are anxious, but they are not vital for human existence. Similarly, toenails have their uses, but if you didn't have them, you'd get by.

by Dr Laurence Knott

Skin, nail and hair health

Paronychia

Paronychia is a common infection of the skin just next to fingernails or toes. It may be acute or chronic and treatment usually involves antibiotic medicines for germ (bacterial) infections. Occasionally antifungal medicines for infection caused by a yeast (candida) or a fungus are used. In some cases steroid creams may be needed for the skin around the nail. Occasionally a small operation is needed to drain out any pus which has collected.

by Dr Colin Tidy, MRCGP

Psoriasis

Little pits in your nails are common. Very occasionally, they can be a sign of a condition called psoriasis. We usually think of psoriasis as a skin condition which causes red patches - but in a few people, the main symptom is joint pain. It's worth talking to your GP if you have persistent or unsightly pits in your nails.

Clubbing

No, not partying late into the night, but swelling of the end portion of the fingers, along with curving over of the fingernails. It's sometimes described as 'drumstick fingers' because of the swelling.

Usually linked to lung or heart conditions, along with inflammatory bowel diseases like Crohn's and ulcerative colitis, or primary biliary cirrhosis, it definitely needs checking out.

White spots

I've lost count of the number of patients who've told me they're short of calcium because they have white spots or lines on their nails. In fact, it's nothing to do with this. It's probably simple bashes and bangs to your nails.

The best thing you can do is to stop worrying - and maybe protect your nails to prevent it happening again. It's very common in gardeners and DIY enthusiasts. The spots or lines will gradually grow out to the ends of your nails and then disappear.

Ingrowing toenails - you can prevent them

Ingrowing toenails usually affect the side of your big toe. The nail starts to grow into the flesh at the side of your nail, and can cause a nasty infection.

This can often be treated with antibiotic creams or tablets. Occasionally, it keeps coming back, and you may need a minor operation to remove part or your entire toenail.

A few simple steps can keep ingrowing toenails at bay:

• Don't ever cut your toenails down at the sides - always cut them straight across, leaving them longer at the sides.

• Make sure your shoes have plenty of room at the front, so your toes aren't squashed.

• Wear open-toed sandals or comfy slippers at home, to avoid pressure on your toes.

These measures will also cut your risk of bunions too. Finally, if you find it hard to cut your own toenails, talk to your GP about a referral to the local chiropody or toenail cutting service.