There are times when nail care requires a dermatologist. Fingernails and toenails are extremely vulnerable to infection and damage. If you have been diligent about leaving your cuticles alone and avoiding all the don’ts and performing most of the do’s in the list above and you are still having nail problems, make an appointment with your dermatologist. Nails that are brittle, discolored, dull, abnormally thick, distorted, crumbling, loose, or subject to unusual debris under the nail are a medical problem, not a cosmetic one.
It is quite normal for the skin to host a variety of microorganisms, including bacteria and fungi. Some are useful to the body, but others can multiply rapidly, leading to infections. Specifically, fungal infections are caused by microscopic plants (fungi) that thrive on the dead tissue of the nails and outer skin layers, particularly the cuticle.
Fungal nail infections are most often seen in adults, can be difficult to treat, and often recur. Toenails are affected more often than fingernails. People who frequent public swimming pools, gyms, or shower rooms; people who perspire a great deal; and people who wear tight, occlusive shoes are most likely to develop toenail infections because the fungi flourish in warm, moist areas. Prolonged exposure to moistness on the skin, minor nail injuries, and damage to the cuticle area can also increase susceptibility to fungal infection. Please be aware that fungal and bacterial infections are extremely contagious and can be spread through direct contact with another person who has the problem, and even through contact with contaminated towels, shower and pool surfaces, and nail implements such as cuticle clippers, nail clippers, orange sticks, and cuticle pushers.
Nail infections can be cleared with the persistent use of a prescription antifungal or antibacterial cream or lotion. Because nails grow slowly, treatment must be continued for 3 to 6 months for fingernails and 6 to 12 months for toenails (the time it takes to grow a new nail). There are oral medications for these problems, but they are best discussed with your doctor.
In terms of preventing problems for the feet, it is essential to keep them clean and dry. Change shoes and socks frequently. Dry the feet and hands thoroughly after bathing. Powders such as baby powder with corn starch or talcum may help keep the feet dry. Of course, avoiding any damage to toenails and fingernails is of utmost importance.
To minimize the risk of damage to the nails, keep them smooth and properly trimmed. Trim the fingernails weekly. The toenails grow more slowly and may be trimmed as needed, about once a month. Nail-polish remover of any kind can weaken and dry the nails. Nail polish may coat and protect the nails slightly, but if you choose to use it remember that all polishes are basically identical, despite advertising claims to the contrary. Nail strengtheners can discolor or break the nails and damage the nail, too. Artificial nails may produce allergic reactions under the nail and can create a perfect environment for bacterial or fungal growth.