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Nailing It!

"See what your nail color says about your health"
By: Risa Caldoza-De Leon MD, FPAPSHPINailing It!

Nails are made up of layers of a hardened protein called keratin, also found in your hair and skin. Under a good light, healthy unpolished nails are smooth, without ridges or dents. The area under the nail should be a uniform light pink without spots or discoloration.

Right handed? Your fingernails will grow faster than your toenails, especially on your dominant hand. Fingernails usually grow one’s dominant hand. On a monthly average, fingernails grow 3.5 mm (1/8th of an inch) while toenails grow about 1.6 mm. Factors such as age, health status, time of year, activity level and heredity play a part, though. Men’s nails grow faster than women’s except when she’s pregnant. Nails grow quickly during summer.

Alerting hue!

One of 10 patients that we, skin care physicians, see complains of a nail problem, mostly senior citizens. Symptoms vary from changes in color, shape, thickness, swelling of the skin around the nails, bleeding, or discharge.

Nail problems are more common in those with diabetes or poor circulation. Nail diseases in people who have compromised the immune system, such as those with leukemia, AIDS, diabetes, or had an organ transplant can become a serious matter.

  • Red, gray or black nails may result from a hematoma (a collection of blood) due to trauma.
  • In rare cases, a dark-colored streak within the nail plate can point to melanoma, the deadliest form of skin cancer.
  • Dirty, gray nails are often caused by enterobacteria.
  • Thin red or brown lines under the nail plate or splinter hemorrhages occur due to a clotting phenomenon in the capillaries below the nail bed. When accompanied by fever and chills, these leaks become classic signs of endocarditis, an inflammation of the inner layer of the heart.
  • Slow-growing yellow nails or yellow nail syndrome (YNS) is an inherited condition linked to swelling of tissues (lymphedema) and lung ailments.
  • In onycholysis, where the nail is separated from the nail bed, nails become whitish-yellow.
  • A translucent yellow-red colored nail under the nail plate that looks like a drop of oil (Oil Drop Sign) is a hallmark of psoriasis.
  • Green nail syndrome (GNS) or chloronychia is an infection where the nail color changes to blue-green, dark green or bluish-grey, and all shades in between. If your hands are repeatedly sunk in water – calling housewives, dishwashers and health care personnel – you are more prone to have GNS. Likewise, those who wear tight shoes for long periods of time especially when exercising, like military personnel and soccer players. Good thing GNS can be addressed by topical antibiotics, but treatment takes one to four months. Studies show that chlorine bleach diluted with water, applied topically to affected nails, as well as vinegar (acetic acid) may both be useful. In some cases, nails may have to pull out and oral antibiotics will be given.

Step on my shoes, or not!

Trauma to the nails, such as when a friend accidentally (or purposely) steps on your toes can cause white nails. White lines may be seen when a medical illness or trauma elsewhere in the body, causes the protein to be deposited within the nail bed. See a white mark shaped like a moon on your nail close to the nail fold? That’s a lanula, and its normal so no worries. Scared you there for a while, didn’t I?

Toeing the line

The cuticle, yes, the one that nippers target, is there for a reason, to protect your nails from infection, so leave them be. Clean, dry and trimmed nails do not mean no cuticles!

  • If cutting your toenails is difficult, you may soak your feet in warm salty water for 10 minutes, then slather urea or lactic acid cream to soften the nails before cutting.
  • Wearing tight shoes can cause ingrown toenails, so wear proper-fitting shoes all the time.
  • Don’t go barefoot at the pool or public showers to cut the risk of toenails and foot infections.
  • Biting your fingernails will not only make you appear harassed and scared but this can transfer infectious organisms between your fingers and mouth.
  • When visiting a nail salon, check if the salon sterilizes all its instruments after each use, or, you can bring your own.
  • For yellowing nails caused by dark polishes or frequent use of acrylic nails, mix a paste of 1 tablespoon 3% hydrogen peroxide (yes, agua oxigenada) and 2 ½ tablespoons of baking soda, let sit on your nails for a few minutes, then brush with a nail brush.
  • Rub lemon juice daily on the affected nails for about two weeks. Tada, pinkish nails again. And lay off the dark colors for a while!

See your skin care physician if you’re suffering from nail problems. Please do not call your manicurist to deal with that ingrown nail.

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