Nail Care & Maintenance

Discover the best practices for keeping your nails strong and beautiful

What They Are:

Nails are composed of keratin, a type of hardened protein that is also found in hair and skin. They serve an important protective function, shielding the delicate tissues at the tips of our fingers and toes. Nails grow from the nail matrix, located just beneath the cuticle at the base of the nail. The part of the nail that you can see is called the nail plate, which extends over the nail bed. The appearance and health of nails can be influenced by various factors, including nutrition, general health, and environmental exposure.

Growth and Structure:

Nail Matrix: This is where nail growth starts. Cells in the matrix divide and form new nail cells, which are then pushed forward. The matrix is essential for the overall health and appearance of the nail.

Cuticle: The cuticle is a protective layer of skin where the nail plate and the surrounding skin meet. It helps to guard the nail matrix against infections.

Nail Plate: The hard, visible part of the nail. The oldest part of the nail is found at the tips, as the plate grows from the base towards the edge.

Nail Bed: The skin beneath the nail plate. A healthy nail bed gives nails their pinkish color due to the presence of tiny blood vessels.

On average, fingernails grow about 1/10th of an inch (2.5 mm) per month, though this rate can vary. Toenails grow more slowly.

Factors That Influence Nail Health:

Nutrition: Adequate intake of vitamins and minerals such as biotin, iron, and zinc is crucial for strong and healthy nails. Deficiencies can lead to brittle, weak nails or abnormalities such as ridges or discoloration.

Health Conditions: Changes in nail appearance, texture, or growth can sometimes indicate underlying health issues. For example, pale nails may indicate anemia, while yellow or thickened nails might suggest a fungal infection. Chronic illnesses such as diabetes or thyroid disorders can also affect nail health.

Environmental Exposure: Frequent exposure to water, soaps, chemicals, or detergents can dry out nails and cuticles, making them brittle or causing them to crack and peel. Nail damage can also occur from overuse of harsh nail products like nail polish removers, acrylic nails, or gels.

Nail Care Tips for Healthier Nails

Keep Nails Clean and Dry:

Moisture can promote the growth of bacteria and fungi. Ensure that nails are properly dried after washing hands or exposure to water.

Clean nails regularly to avoid dirt and germs from accumulating beneath them.

Trim Nails Regularly:

Use sharp nail scissors or clippers to trim nails straight across. This helps prevent breakage and ingrown nails.

Filing your nails in one direction with a fine file can smooth rough edges and prevent snagging.

Moisturize Cuticles:

Cuticles play an important role in protecting the nail matrix, so avoid cutting them. Instead, moisturize them with cuticle oil or cream to keep them hydrated and healthy.

Push back cuticles gently after soaking nails in warm water to soften them.

Avoid Biting Nails or Picking at Cuticles:

Nail-biting can cause damage to the nail bed and result in infections. It's important to keep nails short and practice good hygiene to avoid the habit.

Picking at cuticles can lead to infections or unsightly ridges and splits.

Limit the Use of Harsh Chemicals:

Excessive use of nail polish removers containing acetone can dry out nails, making them more prone to splitting and cracking. Opt for acetone-free formulas where possible.

Use protective gloves when handling cleaning agents or harsh chemicals to prevent nails from becoming dry and brittle.

Maintain a Healthy Diet:

Eating foods rich in protein, omega-3 fatty acids, and vitamins like biotin and B-complex vitamins can strengthen nails. Incorporate foods such as eggs, nuts, and leafy greens into your diet for optimal nail health.

Use a Nail Hardener:

For those with particularly weak nails, applying a nail hardener can help strengthen the nail plate. However, use these sparingly, as overuse can lead to brittle nails.

Don’t Ignore Nail Problems:

If you notice persistent changes in the texture, color, or growth of your nails, or if you experience pain or swelling around the nails, consult a healthcare professional. These symptoms may signal an underlying health condition or infection.

Healthy nails not only look good but are also indicative of good overall health. Proper care and maintenance, coupled with a balanced diet, can help you keep your nails in their best condition. While nails serve as a protective barrier, they are susceptible to damage from poor habits, exposure to harsh chemicals, and health conditions. By incorporating a regular nail care routine and making mindful lifestyle choices, you can promote strong, healthy nails that reflect your body’s overall well-being.

Are Your Nails Healthy?

You can often determine the health of your nails just by examining them. Healthy nails are typically smooth, strong, and free of any unusual spots, discoloration, or shapes. They have a consistent texture and color, with no ridges, cracks, or irregularities. The appearance of your nails can give important clues about your overall health, and any significant changes could signal underlying problems.

Signs of Healthy Nails:

Smooth Surface: Healthy nails have a uniform surface with no pits, grooves, or indentations. They should not feel rough or uneven.

Consistent Color: Fingernails should be a pale pink or flesh-toned color, depending on your skin tone, while the tips may appear white as they grow beyond the nail bed.

Lack of Spots or Streaks: There should be no visible spots, streaks, or lines in healthy nails, except in people with skin of color where brown longitudinal bands of pigment, known as physiologic melanonychia, are completely normal and harmless.

Signs of Nail Problems and Diseases:

Pitting: Small depressions or pits in the surface of the nails can be a sign of underlying conditions like psoriasis or alopecia areata.

Ridges: Vertical ridges (running from the cuticle to the tip) can be common with aging, but deep or horizontal ridges (across the nail) can signal an underlying issue, such as nutritional deficiencies or trauma.

Streaks or Lines: Dark or unusual streaks can be a sign of subungual melanoma (a type of skin cancer affecting the nail bed), especially if they are new, change in size, or only affect one nail.

Yellowing: Nails that turn yellow may indicate a fungal infection, psoriasis, or chronic respiratory diseases, including chronic bronchitis. It can also result from the excessive use of nail polish without proper care.

Discoloration: Any unusual discoloration, such as nails turning blue or purple, may suggest a lack of oxygen in the blood (cyanosis) or a circulatory issue.

Systemic Diseases Linked to Nail Changes

The appearance of nails can often reflect what's happening inside the body. Changes in the texture, color, or growth of nails may indicate the presence of systemic diseases or disorders:

Diabetes: Individuals with diabetes often experience slower nail growth and are at risk of developing fungal infections (onychomycosis). Discolored or thickened nails can also be a sign of poor circulation, which is a common complication in diabetes.

Anemia: Brittle or spoon-shaped nails (koilonychia) may be a sign of iron deficiency anemia. Nails may also become pale due to a lack of red blood cells and reduced oxygen circulation.

Thyroid Disease: Both hypothyroidism and hyperthyroidism can affect nail health. Thyroid dysfunction can lead to brittle, slow-growing nails. Severe hypothyroidism may cause onycholysis, where the nail separates from the nail bed.

Hand-Foot-Mouth Disease (HFMD): This viral infection, more common in children, can cause nail shedding (onychomadesis), where the nails detach from the nail bed and eventually fall off.

Nail Conditions Linked to Skin Diseases

Some skin conditions not only affect the skin but also cause changes in the nails and cuticles:

Psoriasis: About 50% of people with psoriasis will experience nail issues. Nail psoriasis can lead to pitting, discoloration, thickening, or crumbling nails, and may cause nails to detach from the nail bed (onycholysis).

Lupus: People with lupus may notice that their nails become brittle and that the surrounding skin appears reddish or swollen. Lupus can also cause ridging or thickening of the nails.

Hand Eczema: Chronic hand eczema may cause the nails to become rough, pitted, or ridged. The cuticles may also appear inflamed or cracked.

Medications and Nail Health

Certain medications used to treat diseases can lead to nail changes as a side effect:

Antibiotics: Long-term use of certain antibiotics can cause discoloration or changes in nail texture. Tetracycline, for instance, may cause the nails to develop yellow or brown tints.

Chemotherapy: Chemotherapy drugs used to treat cancer can lead to nail loss, dark lines on the nails (melanonychia), or complete separation of the nail from the bed (onycholysis).

Other Drugs: Medications such as retinoids, used to treat acne or psoriasis, can cause nail thinning and fragility, leading to easy breakage.

Nail Growths: Benign and Cancerous

Nails can also develop growths, some of which are benign while others can be more serious:

Benign Growths: Non-cancerous growths such as glomus tumors or pyogenic granulomas can appear under or around the nails, causing pain, redness, and swelling. These may require removal if they interfere with nail function or cause discomfort.

Subungual Melanoma: This rare but serious form of skin cancer affects the nail matrix and causes dark streaks or pigmentation changes in one nail. Unlike benign conditions, subungual melanoma often grows and changes over time, requiring immediate medical attention.

When to See a Doctor

While some nail changes may simply be a cosmetic issue or a sign of minor injury, it's important to recognize when changes could indicate a more serious health concern. If you notice any of the following, consult your doctor or dermatologist:

• New or changing dark streaks under the nails

• Separation of the nail from the nail bed

• Persistent nail pitting, ridging, or discoloration

• Pain, swelling, or inflammation around the nail or cuticle

• Signs of infection, such as redness, warmth, or pus

By paying attention to your nails, you can catch early signs of both nail diseases and broader health issues. Regular nail care and monitoring are essential steps toward maintaining not just nail health, but overall well-being.

Nail Care: Keeping Nails Healthy

Proper nail care is essential for maintaining the health and appearance of your nails, as well as preventing common issues like hangnails and infections. Simple daily habits can go a long way in promoting strong and smooth nails.

Moisturize Regularly

Keeping your hands, nails, and cuticles well-moisturized is one of the easiest and most effective ways to maintain nail health. Moisturizing helps prevent hangnails, which are small, dry bits of skin that can form along the sides of your nails. Hangnails can be painful and, if left untreated, may lead to infection if they are pulled or bitten off.

How to Moisturize Properly:

Apply a nourishing hand cream, cuticle oil, or lotion after washing your hands and before bed.

Focus on the cuticles and nail beds to prevent dryness and cracking.

Use products with ingredients like vitamin E, shea butter, or jojoba oil for added moisture.

Dealing with Hangnails Safely

It’s tempting to bite or pull off hangnails, but this can easily cause more damage. By pulling or biting, you might remove more than just the hangnail, injuring the surrounding skin. This can result in redness, swelling, pain, and potentially lead to infection.

Safest Way to Remove Hangnails:

Carefully trim them using clean, sterilized nail scissors or clippers.

Avoid cutting too close to the skin.

After removal, apply a soothing ointment or cream to the area to prevent infection and promote healing.

Leave Your Cuticles Alone

Cuticles act as a natural barrier that protects your nails from infection and damage. It’s important to avoid cutting or pushing back cuticles, as this can expose the nail matrix to bacteria, fungi, and irritants.

Cuticle Care Tips:

Instead of cutting, gently push back your cuticles using a cuticle pusher after a shower when they are soft.

Regularly apply cuticle oil to keep them moisturized and soft.

If your cuticles are overgrown, consult a professional for safe care rather than attempting to trim them yourself.

Other Nail Care Practices

In addition to moisturizing and caring for your cuticles, here are other important practices for maintaining healthy nails:

Keep Nails Clean and Dry: Moisture trapped under the nails can foster the growth of bacteria and fungi. Keep your nails clean and dry, especially after washing your hands or working in damp environments.

Trim Nails Regularly: Trim your nails regularly to prevent them from breaking or splitting. Use sharp, clean scissors or nail clippers, and trim nails straight across to avoid ingrown nails.

Avoid Overuse of Nail Products: Constant use of nail polish, acetone-based removers, and artificial nails can weaken nails over time. Allow your nails to “breathe” between applications of nail polish and consider switching to acetone-free removers.

Wear Gloves for Protection: When performing household chores, gardening, or working with chemicals, wear gloves to protect your nails and hands from harsh substances.

Strengthen Nails with Biotin Supplements: If you experience brittle or weak nails, biotin supplements may help improve nail strength and reduce breakage. Always consult a doctor before starting any supplement.

By adopting these practices, you can help ensure that your nails stay strong, smooth, and free of problems like hangnails and infections. Regular care and attention to your nails also contribute to overall hand health, helping you avoid common issues and keeping your nails looking their best.

There are several environmental exposures that can damage your nails:

Environmental Exposures That Can Damage Your Nails

Your nails are susceptible to damage from a variety of environmental factors that can weaken, dry out, or otherwise affect their health and appearance. Here are some of the common environmental exposures that can negatively impact your nails:

Frequent Hand Washing

While keeping your hands clean is important, frequent hand washing can strip your nails and skin of their natural oils, leading to dryness, brittleness, and cracking. Harsh soaps can further exacerbate the problem, leaving your nails vulnerable to breakage.

Tip: Use a mild, moisturizing hand soap and apply hand cream after each wash to replenish lost moisture.

Harsh Chemicals

Exposure to harsh chemicals, whether through household cleaners, detergents, or industrial substances, can weaken the nails and cause them to become dry, brittle, and prone to splitting. Certain chemicals can also cause irritation to the skin around the nails, leading to peeling or redness.

Tip: Always wear gloves when cleaning, doing laundry, or handling any chemicals to protect your nails and hands from damage.

Nail Products and Over-Processing

Frequent use of nail polish, nail polish remover, especially those with acetone, can dry out your nails. Nail hardeners and artificial nails may also weaken the natural nail over time if used excessively.

Tip: Give your nails a break from polish periodically to allow them to recover, and opt for acetone-free nail polish removers whenever possible.

Overexposure to Water

Constant contact with water can soften the nails, making them more likely to break or split. Activities such as doing dishes without gloves, swimming, or even long showers can lead to overexposure to moisture.

Tip: Protect your nails by wearing gloves when doing dishes or other water-related tasks. After swimming or bathing, be sure to dry your nails thoroughly and apply moisturizer to prevent water damage.

Extreme Temperatures

Both extreme cold and heat can affect nail health. Cold weather can dry out your nails and the surrounding skin, while excessive heat can cause dehydration of the nails, making them brittle and prone to peeling.

Tip: During winter months, wear gloves to protect your hands from the cold, and during hot weather, make sure to stay hydrated and use hand moisturizers regularly.

UV Exposure

Excessive sun exposure can damage the nails much like it can harm your skin. Prolonged UV exposure can dry out your nails, causing them to become weak, discolored, and prone to breakage. UV exposure from tanning beds or frequent use of UV lamps for gel manicures can also contribute to nail thinning.

Tip: Use sunscreen on your hands and nails when outside, and limit the use of UV lamps for gel nails, opting for LED lights when possible.

Trauma and Mechanical Damage

Repeated trauma from tapping, hitting, or biting your nails can cause splitting, peeling, or ridges. Constant pressure from typing, playing certain musical instruments, or manual labor can also cause physical damage to the nails over time.

Tip: Be mindful of how you treat your nails during daily activities, and avoid biting or using your nails as tools.

By being aware of these environmental factors and taking protective measures, you can help prevent damage to your nails, keeping them healthy and strong. Regular care, hydration, and protection are key to maintaining your nail health in the face of everyday exposures.

Manicures, Pedicures, and Nail Health

Manicures and pedicures, especially those involving acrylic and gel nails, can offer a polished appearance but can also lead to several types of traumatic nail injuries. It's important to be aware of these potential issues and take precautions to protect your nails during these treatments.

Potential Nail Injuries from Acrylic and Gel Nails

Brittleness: The application of acrylics or gels can weaken the natural nail, making them brittle and prone to breaking.

Impact: Brittle nails may chip easily and can cause discomfort when performing daily tasks.

Ridges: Ridges can develop as a result of trauma to the nail matrix during the application or removal of artificial nails.

Impact: Ridges can affect the smoothness and appearance of the nails, leading to uneven surfaces.

Pitting: Small indentations may form on the surface of the nails, often due to underlying health issues or trauma during nail treatments.

Impact: Pitted nails can look unsightly and may be indicative of a more serious underlying condition.

Nail Detachment (Onycholysis): This occurs when the nail separates from the nail bed, which can happen due to trauma from filing or improper application.

Impact: Detachment can lead to pain and increase the risk of infection.

Infection Around the Cuticle (Paronychia): Bacteria or fungi can enter through breaks in the skin around the cuticle, leading to inflammation, redness, and swelling.

Impact: Infections can be painful and may require medical treatment to resolve.

Irritant and Allergic Contact Dermatitis: Chemicals used in nail products, such as solvents and adhesives, can cause skin irritation or allergic reactions.

Impact: Symptoms may include redness, itching, and peeling skin around the nails, which can be uncomfortable and may take time to heal.

Preventing Nail Damage During Manual or Wet Work

To minimize the risk of nail damage during household chores or manual tasks, consider the following protective measures:

Wear Gloves:

Use vinyl or nitrile gloves when performing tasks that may expose your hands and nails to water, chemicals, or physical trauma. Gloves can act as a barrier to protect against irritants and mechanical damage.

Choose Quality Products:

When getting manicures or pedicures, opt for reputable salons that prioritize hygiene and use high-quality products to minimize the risk of adverse reactions.

Communicate with Technicians:

Inform your nail technician about any sensitivities or allergies you may have, and ask them to use products that are less likely to cause irritation.

Take Breaks from Artificial Nails:

Allow your natural nails to breathe by taking breaks between applications of acrylic or gel nails. This can help restore their strength and health.

Maintain Nail Hygiene:

Regularly clean your nails and cuticles, and moisturize them to prevent dryness and brittleness.

By being proactive and mindful of your nail care, you can enjoy the benefits of manicures and pedicures while minimizing the risks associated with acrylic and gel nails. Remember to always prioritize the health of your nails to maintain their strength and appearance.

Did You Know?

Here are some interesting facts about nails that highlight their unique characteristics and growth patterns:

Growth Rate:

Fingers vs. Toes: Nails grow at an average rate of 2.5 mm per month on fingers and 1 mm per month on toes. This difference is primarily due to less blood circulation and fewer nutrients reaching the toenails.

Seasonal Growth Variation:

Faster Growth in Summer: Nails tend to grow faster in the summer compared to winter. This is likely due to increased blood flow and circulation as a result of warmer temperatures.

Regrowth Time:

Recovery Period: If you lose a fingernail, it typically takes about six months for it to fully regrow. Toenails, on the other hand, take about one year to regenerate completely.

Water Absorption:

Hydration Differences: Nails can absorb more water than skin. This means that they can swell and change shape slightly when exposed to moisture, which is important to consider during nail care and manicures.

Gelatin Myths:

No Acceleration from Gelatin: Contrary to popular belief, consuming or applying gelatin does not make your nails grow faster. Nail growth is primarily determined by genetics and overall health rather than dietary supplements.

These facts underscore the fascinating nature of nails and the importance of proper care to maintain their health and appearance. Understanding these aspects can help you make informed decisions about nail care and maintenance!

Prevention of Fungal Infections

Maintaining healthy nails and preventing fungal infections requires consistent care and attention. Here are some effective practices to help keep fungal infections at bay:

Keep Skin Clean and Dry:

Ensure that your hands and feet are thoroughly washed and dried, especially in areas prone to moisture, such as between the toes and under the nails. Fungi thrive in damp environments, so keeping skin dry is crucial.

Avoid Sharing Tools:

Never share nail care tools, such as nail files, clippers, or brushes, with others. This helps prevent the transmission of fungi and bacteria that can lead to infections.

Trim Nails Straight Across:

Regularly trim your nails straight across to prevent ingrown nails, which can provide an entry point for infections. Avoid rounding the edges, as this can also contribute to ingrown nails.

Use Antifungal Sprays or Powders:

Consider using antifungal sprays or powders daily, especially if you are prone to fungal infections or have been in environments where fungi are likely to thrive (e.g., gyms, swimming pools).

Give Feet a Break from Shoes:

Allow your feet to breathe by going shoeless at home whenever possible. If wearing shoes, choose breathable options that promote airflow, helping to keep feet dry.

Avoid Going Barefoot in Public Areas:

Protect your feet in public spaces such as locker rooms and showers by wearing flip-flops or water shoes. This reduces the risk of exposure to fungal spores that can be present on floors.

Examine Toenails Regularly:

Regularly inspect your toenails for any signs of infection, such as discoloration, thickening, or unusual growth patterns. Early detection can help address potential issues before they become more serious.

By following these preventive measures, you can significantly reduce the risk of developing fungal infections and maintain healthier nails. Regular nail care and attention to hygiene are essential components of overall nail health.

Treatment of Fungal Infections

Identifying and treating fungal infections effectively is crucial for maintaining nail health. Here’s a comprehensive overview of the treatment process:

Diagnosis:

The first step in treatment is an accurate diagnosis. Your doctor will typically take a sample by clipping or scraping beneath the nail. This sample is then sent to a laboratory for examination under a microscope and culture (grown in a Petri dish) to confirm the presence of a fungal infection.

Treatment Options:

Treatment generally involves prescription-strength topical and/or oral medications. The choice of treatment depends on various factors, including the severity of the infection and how many nails are affected.

Topical Treatments:

Topical Antifungal Lacquers: These are applied directly to the infected nails and require consistent use over an extended period, often close to one year. However, the complete cure rate for topical treatments is relatively low, at about 20%. Topical medications are typically recommended when only a few nails are involved and are preferred due to their lower risk of side effects compared to oral medications.

Oral Medications:

Oral Antifungals: These medications are pills taken daily for approximately three months and can provide a higher success rate, with about 40% achieving a complete cure. Oral medications are generally used when multiple nails are involved or when topical treatments have failed.

Recurrence Risk:

Even after successful treatment, there is a significant chance of recurrence, estimated at around 25%. This highlights the importance of ongoing care and preventive measures to avoid reinfection.

Consultation with Your Doctor:

Not all nail infections require treatment. It's essential to discuss with your doctor whether treatment is necessary and what options are best suited for your situation. This consultation can help determine whether a topical lacquer or oral medication is more appropriate based on the extent of the infection and your overall health.

Considerations for Treatment:

While topical medications generally have fewer side effects, oral medications may be necessary for more severe cases. Your healthcare provider will consider various factors, including your medical history, the specific type of fungus, and any potential interactions with other medications you may be taking.

By working closely with your healthcare provider and following the prescribed treatment regimen, you can effectively manage fungal infections and promote healthier nails. Regular monitoring and adherence to preventive practices are essential for reducing the risk of future infections.

Contact a Dermatologist