Not ‘only’ a nail infection

Nails can be a mirror of internal disease. Nail problems can range from discolouration in the form of yellowish, greenish, or whitish nails along with discharge to pus formation, or the sudden onset of longitudinal dark bands. Nails can be affected by many conditions, both infectious and non-infectious.

Common causes

Infections are a common cause of nail problems. Bacterial nail infections, if not treated at the right time, can become chronic and recurrent. In individuals who are immune-suppressed or in cases where the infection is severe, it can even spread to the bone.

Fungal infections are also very common, especially since many of us work without gloves in the kitchen and our hands are in water frequently. Because of this, both fungal and bacterial nail infections are commonly seen. If fungal infections are not treated, they can spread, which makes timely treatment essential. Fungal infections are also frequently seen in the feet, particularly in people doing household work. This occurs because of moist environments, so it is important to clean between the toes, keep them dry, and use over-the-counter antifungal dusting powders if your hands or feet are often wet.

Viral infections such as warts are also commonly seen around the nails. Warts are contagious growths that can occur in anyone and may increase in size and number if not treated. They can spread through contact, through the use of public spaces. While using gyms for instance, the equipment is used by multiple people, and since people sweat during workouts, the chance of getting infections increases. To prevent this, you should always wear your own gloves, sanitise equipment before and after use, and maintain good hand hygiene.

Other issues

Nails can also serve as an early marker for autoimmune conditions such as lichen planus, psoriasis, and eczema. In these cases, you may see nail pitting or longitudinal ridges, which can be early markers of skin disease. Sometimes nails may change shape, becoming spoon-shaped, inverted spoon-shaped, or may develop other deformities, which may be related to heart or lung conditions or even nutritional deficiencies. Sudden discolouration or the appearance of longitudinal bands can also be a marker of early melanoma, a type of skin cancer. Certain medications may cause nail changes as well, ranging from discolouration to painful nail beds or painful skin around the nail, all of which should be treated before they worsen.

Precautions and treatment

If your hands are frequently in water for work, it is advisable to wear kitchen gloves (not regular gloves). When getting a manicure or pedicure, ensure that the salon maintains strict hygiene and sanitises instruments before and after every use. Keep your nails short and trimmed regularly. Ingrown toenails are increasingly common due to narrow footwear styles, even though Indians typically have broader feet. Wearing broad shoes, avoiding tight footwear, and allowing your feet to breathe can help prevent this.

Any sudden nail discoloration should be examined by a dermatologist. Pain in the nails, surrounding skin, or nail bed should be treated with antibiotics or antifungals if an infection is present. Finally, if you notice sudden changes in shape, pitting, or bluish discoloration of the nails, it is essential to consult a physician.

(Dr. Reshma T. Vishnani is consultant dermatologist, trichologist and aesthetic dermatologist, Kokilaben Dhirubhai Ambani Hospital, Mumbai. reshma.vishnani@kokilabenhospitals.com)