Nail Diseases & Infection

Our bodies host 1000's of micro organisms, some of which are good for us, heavily promoted in yoghurt drink adverts. These micro organisms include bacteria and fungi.

What is a fungal infection?

Fungal infections are caused by microscopic plants that live on our skin and on the dead tissue of our hair and nails. Below we have listed some of the common diseases and disorders associated with nails.

Always remember "Nail Technicians" are only qualified (make sure your nail technician is qualified) in identifying a problem, and not to diagnose or treat nail diseases and disorders. If you suspect a problem ask you nail technician or seek advice from your GP and possible medical treatment.

Fungal or Yeast Infection

A fungal or yeast infection which results in Onychomycosis, can invade through a tear in the proximal and lateral nail folds as well as the Eponychium. This type of infection is characterized by Onycholysis (nail plate separation) with evident debris under the nail plate. It normally appears white or yellowish in colour, and may also change the texture and shape of the nail. The fungus digests the keratin protein of which the nail plate is comprised. As the infection progresses, organic debris accumulates under the nail plate often discolouring it. Other infectious organisms may be involved, and if left untreated, the nail plate may separate from the nail bed and crumble off.

Paronychia (Nail Infection)

Paronychia disease is an infection of the inflammation skin and soft tissue infections that surrounds a toenail or fingernail. It can start suddenly (acute Paronychia) or gradually (chronic Paronychia).

The etiology, infectious agent, and treatment are usually different for each form, and the 2 forms are often considered separate entities. Acute Paronychia develops over a few hours when a nail fold becomes painful, red and swollen. It is one of the most common hand infections.

Symptoms of Paronychia

A small collection of pus forms under the skin next to the nail, or underneath the nail itself. The area around the nail is tender, red and mildly swollen the cuticle is missing; and the skin around the nail feels moist or "boggy." Often, only one nail is affected. Acute Paronychia starts as a red, warm, painful swelling of the skin around the nail. In chronic Paronychia, the redness and tenderness are less noticeable than the acute infection. The nail may have a green discoloration due to Pseudomonas infection. It mainly occurs in people who have constantly wet hands, such as hairdressers, nurses, and bartender's e.t.c.

Pseudomonas (The Greenies)

Pseudomonas bacterial infection can occur between the natural nail plate and the nail bed, and/or between an artificial nail coating and the natural nail plate. Many people have been led to believe that the classic 'green' discoloration of this type of infection is some type of mold. In actuality, mold is not a human pathogen. The discoloration is simply a by-product of the infection and is caused primarily by iron compounds. Pseudomonas thrives in moist places; it feeds off the dead tissue and bacteria in the nail plate, while the moisture levels allow it to grow.

The after effects of this infection will cause the nail plate to darken and soften underneath an artificial coating. The darker the discoloration, the deeper into the nail plate layers the bacteria has travelled. If the bacteria have entered between the nail plate and the nail bed, it will cause the same discolorations and may also cause the nail plate to lift from the nail bed.

Tinea Unguis

Symptoms
The symptoms of Tinea include itchiness and foot odour. Sweat and water make the epidermis white and soggy, resulting in Tinea. There often is scaling, maceration and fissuring of the skin between the third and fourth toes.

Causes
Tinea or ringworm is caused mainly by Trichophyton rubum and is the commonest type of fungal infection.

Cure
Tea Tree Ointment is an antiseptic and soothing ointment which contains tea tree and lavender essential oils blended with infused calendula oil. It is ideal for the healing of Tinea wounds, cuts rashes and for soothing insect bites. May also be used to alleviate Tinea and fungal infections.

Prevention of Tinea
1. Keep feet as clean and dry as possible. 2. Carefully dry feet, especially between the toes. 3. Remove flaky skin from beneath the toes each day with dry tissue paper or gauze. 4. Wearing light socks made of absorbent fibres, such as cotton and wool, to allow better circulation of air and to reduce sweating. 5. Avoid socks made with synthetic fibres. 6. Wearing open sandals or shoes with porous soles and uppers 7. Going barefoot whenever possible.

Onychatrophia

Onychatrophia is an atrophy or wasting away of the nail plate which causes it to lose its lustre, become smaller and sometimes shed entirely. Injury or disease may account for this irregularity.
Nail Atrophy

Hematoma

A Haematoma is the result of trauma (injury) to the nail plate. It can happen from simply trapping your finger or toe in the door, banging it and even from improperly fitting or 'too-tight' shoes.

The nail bed will bleed due to this trauma, and the blood is trapped between the nail bed and the nail plate. Sometime a haematoma may also indicate a fractured bone. It is common for sports men and women to experience haematoma because of the constant friction from the shoes against the toenails.

Haematoma may result in nail plate separation and infection because the blood can attract fungi and bacteria. If several days have passed and the blood clot becomes painful, the nail plate may require removal so the nail bed can be cleansed.

Leuconychia

Leuconychia is evident as white lines or spots in the nail plate and may be caused by tiny bubbles of air that are trapped in the nail plate layers due to trauma. This condition may be hereditary and no treatment is required as the spots will grow out with the nail plate.

Vertical Ridges

These can also be characteristic of aging, this does not men it is only limited to the aged or elderly. The nail plate grows forward on the nail bed in a 'rail and groove' effect, much like a train rides on its' tracks.

What can we do, well actually you can correct it but it is possible to reduce the appearance. As we age, the natural oil and moisture levels drop in the nail plate, and this rail and groove effect becomes apparent. Ridged nails can improve through re-hydration of the nail plate with once or twice daily applications of good quality nail and cuticle oil containing Jojoba and Vitamin E.

Melanonychia

Is a vertical pigmented band or bands, also known as "nail moles", which usually form in the nail matrix? If you suddenly notice these or see a change in the nail plate then you should see a GP or dermatologist immediately. Not always but it sometimes can be a malignant melanoma (cancer) or lesion. Dark streaks may be a normal occurrence in dark-skinned people.

Other Nails Disorders & Infections

Onychogryposis are claw-type nails that are characterized by a thickened nail plate and are often the result of trauma. This type of nail plate will curve inward, pinching the nail bed and sometimes require surgical intervention to relieve the pain.

Onychorrhexis are brittle nails which often split vertically, peel and/or have vertical ridges. This irregularity can be the result of heredity, the use of strong solvents in the workplace or the home, including household cleaning solutions. Although oil or paraffin treatments will re-hydrate the nail plate, one may wish to confer with a physician to rule out disease.

Onychauxis is evidenced by over-thickening of the nail plate and may be the result of internal disorders -- seek medical advice.

Beau's Lines are nails that are characterized by horizontal lines of darkened cells and linear depressions. This disorder may be caused by trauma, illness, malnutrition or any major metabolic condition, chemotherapy or other damaging event, and is the result of any interruption in the protein formation of the nail plate. Seek a physician's diagnosis.

Koilonychias is usually caused through iron deficiency anaemia. These nails show raised ridges and are thin and concave. Seek a physician's advice and treatment.

Melanonychia are vertical pigmented bands, often described as nail 'moles', which usually form in the nail matrix. Seek a physician's care should you suddenly see this change in the nail plate. It could signify a malignant melanoma or lesion. Dark streaks may be a normal occurrence in dark-skinned individuals, and are fairly common.

Pterygium is the inward advance of skin over the nail plate, usually the result of trauma to the matrix due to a surgical procedure or by a deep cut to the nail plate. Pterygium results in the loss of the nail plate due to the development of scar tissue. Cortisone is used to prevent the advancement of scar tissue. Never attempt to remove Pterygium -instead, consult a physician for advice and treatment.

NOTE: The 'true cuticle' is often referred to as Pterygium. If you have Pterygium, it can only be treated by a physician and should never be removed by a nail technician.

Pterygium Inversum Unguis is an acquired condition characterized by a forward growth of the hyponychium characterized by live tissue firmly attached to the underside of the nail plate, which contains a blood supply and nerves. Possible causes are systemic, hereditary, or from an allergic reaction to acrylics or solvents. Never use force to 'push back' the advancing hyponychium -- it is an extremely painful approach, and will result in a blood flow. Consult a physician for diagnosis and treatment.

Psoriasis of the nails is characterized by raw, scaly skin and is sometimes confused with eczema. When it attacks the nail plate, it will leave it pitted, dry, and it will often crumble. The plate may separate from the nail bed and may also appear red, orange or brown, with red spots in the lunula. Do not attempt salon treatments on a client with Nail Psoriasis. Consult with a dermatologist for diagnosis and treatment.

Brittle Nails are characterized by a vertical splitting or separation of the nail plate layers at the distal (free) edge of the nail plate. In most cases, nail splitting and vertical ridges are characteristic of the natural aging process. This nail problem is also the result of overexposure to water and chemical solvents such as household cleaning solutions. As we age, the nail bed's natural flow of oils and moisture is greatly reduced. This oil and moisture is the cement that holds the nail plate layers together and gives the plate its inherent flexibility. At the first signs of splitting or peeling, re-hydrate the nail plate layers with a good quality cuticle and nail oil that contains Jojoba and Vitamin E as two of the botanical oils. Jojoba oil has a very tiny molecule which can penetrate the nail plate surface, open up the layers and draw the Vitamin E in after it. The molecular structure of Vitamin E is too large to penetrate the nail plate layers or the surface layer of the skin without the benefits of Jojoba oil. Oil the nail plate and surrounding cuticle at least twice daily; more if you have your hands in water a lot. Wear gloves whenever working with household cleaning solutions, and remember: water is considered the 'universal solvent', and is indeed a 'chemical'.