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Nail Issues: Causes, Treatment, and Tips

May 23, 2024 • read

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Nail Issues: Causes, Treatment, and Tips

Nails are not just a cosmetic feature; they are an integral part of our body that can reflect overall health.

Many people experience nail problems at some point in their lives. While some issues are minor and cosmetic, others can be signs of underlying health problems. Dermatologists play a crucial role in diagnosing and treating various nail conditions.  

In this blog, we’ll explore common nail issues, how dermatologists can help, and tips for maintaining healthy nails.

Common causes of nail issues

Fungal infections (onychomycosis): One of the most frequent nail problems is fungal infections, which can make nails discolored, thick, and more likely to crack and break. These infections are caused by various fungal organisms, with the most common being dermatophyte.

Psoriasis: Nail psoriasis often appears as pitting, abnormal nail growth, and discoloration. It may also cause the nail to separate from the nail bed.

Ingrown toenails: This painful condition occurs when the nail grows into the toe skin. It can cause pain, redness, and swelling, often due to improper nail trimming or tight footwear.

Brittle nails: Brittle nails break or split easily. This can be due to aging, long-term use of nail polish, or exposure to moist conditions.

Onycholysis: This refers to the separation of the nail from the nail bed. It can be caused by injury, infection, or systemic conditions like thyroid disease.

When to see a dermatologist for nail issues

In general, anytime a nail changes colour, shape or becomes thicker or thinner, it’s a good idea to seek treatment. While these symptoms might not indicate something serious, they can sometimes be signs of a more urgent issue, such as an infection or melanoma. 

Below is a list of symptoms to look out for: 

Persistent Changes in Nail Color

If you notice significant changes in the color of your nails, such as dark streaks, white streaks, or changes in nail bed color, it’s essential to consult a dermatologist. These changes could be signs of melanoma or other serious conditions.

Changes in Nail Shape or Thickness

If your nails become unusually thick, distorted, or change shape, it might indicate a fungal infection or another underlying condition that requires professional attention. Fungal infections left untreated can spread to other toes or other people. 

Pain and Swelling

Any pain, swelling, or redness around the nails should be evaluated by a dermatologist, especially if it doesn’t improve or worsens. These symptoms could be signs of infection or ingrown nails that might need medical treatment.

Nails Separating from the Nail Bed

Known as onycholysis, this condition can occur due to trauma, infection, or systemic issues like thyroid disease. A dermatologist can determine the cause and recommend appropriate treatment.

Signs of infection: Symptoms like pus, significant pain, swelling, the area feeling hot, or red streaks coming from the nail area are urgent signs of infection. These require immediate medical intervention to prevent the spread of infection.

Nail problems accompanied by other symptoms: If nail issues are accompanied by other symptoms like joint pain, skin rashes, or hair loss, this could indicate a systemic or autoimmune disease. A dermatologist can conduct a thorough evaluation to diagnose any related conditions.

Brittle or cracked nails that don’t improve: If your nails are persistently brittle or cracked and do not improve despite home care, this could indicate an underlying health issue. A dermatologist can help identify the cause and recommend treatments to strengthen your nails.

Seeing a dermatologist for these issues ensures that you receive a proper diagnosis and appropriate treatment. Early intervention can prevent complications, making it crucial to seek help when these signs appear.

How dermatologists can help with nail issues

Conditions like psoriasis can affect your nails, causing them to discolour, develop pits or dents, and even separate from the nail bed. In some circumstances, this can result in intense discomfort, making walking or using your hands as usual hard.

Fungal infections in your nails may also require care from a dermatologist if they don’t improve with over-the-counter (OTC) treatments or if your nail has become brittle, soft, or crumbly.

If you find yourself experiencing any of these symptoms, a dermatologist can diagnose your nail issue and provide the appropriate treatment to address it. For nail infections, this may include an oral antifungal prescription such as terbinafine or itraconazole, while nail psoriasis may be addressed with corticosteroids, lasers, or prescription topicals such as tazarotene or calcipotriol. 

Tips for healthy nails

Maintaining healthy nails is not just about aesthetics; it’s about hygiene and overall health. Here are some tips recommended by dermatologists:

Keep nails clean and dry: This prevents bacteria from growing under your nails. Prolonged exposure to water can contribute to split nails.

Trim nails regularly: Proper nail trimming is essential in preventing issues such as hangnails and ingrown toenails. Trim nails straight across and smooth the edges with a file.

Use moisturizer: When you use hand lotion, rub the lotion into your fingernails and cuticles, too. Moisturizers are essential for keeping nails from becoming brittle.

Limit nail polish use: Frequent use of nail polish can make nails brittle. It’s healthy to give your nails a break from polish periodically.

Wear protective gloves: When doing chores that involve harsh chemicals or prolonged exposure to water, wearing gloves can protect your nails from damage.

You can keep your nails healthy by understanding common nail problems and knowing how to treat and prevent them. Consulting a dermatologist is the best course of action if you encounter persistent nail issues. They can provide specialized care and treatments tailored to your specific needs, helping you maintain both the health and beauty of your nails.

Connecting with a dermatologist

Getting an appointment with a dermatologist in person can take a while. Appointments require a referral from your healthcare provider, and if you’re among the one in five Canadians without a family doctor, this could result in long wait times at the walk-in clinic. On top of that, getting a referral doesn’t guarantee a timely appointment. The average wait time to see a dermatologist for a non-urgent skin concern in Canada is between six to 18 months, depending on where you live and what your reason for referral is.

With Maple, Canada’s leading virtual care platform, you can get a diagnosis and personalized treatment plan from a Canadian-licensed dermatologist without a referral. Dermatologists on Maple are the same specialists you’d see in person, but they also practice outside of their own clinic hours to see patients virtually. 


Information presented here is for educational purposes, and not to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.

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