Nails

Nails: How to keep your fingernails healthy and strong

Your nails may be small but they play an important role, serving to help protect your fingers and improve dexterity. They also may reveal clues to your general health.

Take a close look at your nails. Are they strong and healthy looking? Or do you see ridges, dents or areas of unusual color or shape? Many less than desirable nail conditions can be avoided through proper care, but some actually indicate an illness that requires attention.

Anatomy of a healthy fingernail

Your nails are composed of laminated layers of a protein called keratin, which is also found in your hair and skin. Each nail comprises several parts, including:

• Nail plate. The nail plate is the part of your nail that’s most visible – the hard portion you see when you look at your fingernail.
• Nail folds. This is skin that frames each of your nail plates on three sides.
• Nail bed. Your nail bed is the skin beneath the nail plate. Cells at the base of your nail bed produce the fingernail or toenail plate.
• Cuticle. Your cuticle is the tissue that overlaps your nail plate at the base of your nail. It protects the new keratin cells that slowly emerge from the nail bed.
• Lunula. The lunula is the whitish, half-moon shape at the base of your nail underneath the plate.

Your nails grow from the area under your cuticle (matrix). As new cells grow, older cells become hard and compacted and are eventually pushed out toward your fingertips. Nails grow about 0.1 millimeter a day, which means that it takes a fingernail about four to six months to fully regenerate. Healthy nails are smooth, without ridges or grooves. They’re uniform in color and consistency and free of spots or discoloration.

Common nail conditions: Reading the signs

Your fingernails hold clues to your health. Learn to recognize the signs that might indicate a health issue. Some nail conditions are harmless. These include vertical ridges, which may become more pronounced as you age, and white lines or spots. Spots usually result from injury to the nail plate or nail bed. In time the white spots will grow out.

Other nail conditions can indicate disease. For example, yellow or green discoloration in your nails may result from a respiratory condition, such as chronic bronchitis, or from swelling of your hands (lymphedema). Indentations that run across your nails, called Beau’s lines, appear when growth at the area under your cuticle is interrupted. This might occur because of an injury or severe illness, such as a heart attack.

If you have a nail problem that persists or is associated with other signs and symptoms, make an appointment with your doctor to get it checked out. The doctor’s visit typically includes an examination of your nails along with other observations and tests to make a diagnosis.

Caring for your nails

No nail care product alone can give you healthy nails. But following these simple guidelines can help you keep your nails looking their best:

• Don’t abuse your nails. To prevent nail damage, don’t use your fingernails as tools to pick, poke or pry things.
• Don’t bite your nails or pick at your cuticles. These habits can damage the nail bed. Even a minor cut alongside your nail can allow bacteria or fungi to enter and cause an infection (paronychia). Because your nails grow slowly, an injured nail retains signs of an injury for several months.
• Protect your nails. Wear cotton-lined rubber gloves when using soap and water for prolonged periods or when using harsh chemicals.
• Perform routine nail maintenance. Trim fingernails and clean under the nails regularly. Use a sharp manicure scissors or clippers and an emery board to smooth nail edges. Never pull off hangnails – doing so almost always results in ripping living tissue. Instead clip hangnails off, leaving a slight angle outward.
• Moisturize your nails frequently. Nails need moisture just like your skin does. Rub lotion into your nails when moisturizing your hands. Be sure to apply a moisturizer each time you wash your hands.

Special considerations: Manicures and weak nails

If you rely on manicures to make your nails look good, keep a few things in mind. Don’t have your cuticles removed – it can lead to nail infection. Also, check to be sure that your nail technician properly sterilizes all tools used during your manicure. Using unsterilized tools may transmit viral infections, such as hepatitis B or warts.

Weak or brittle fingernails can be a challenge to toughen up. The following tips can help you protect them, making your nails less likely to split or break.

• Keep your nails short, square shaped and slightly rounded on top. Trim brittle nails after a bath or a 15-minute hand-soak in bath oil. Then apply a moisturizer.
• Moisturize your nails and cuticles at bedtime and cover them with cotton gloves.
• Apply a nail hardener, but avoid products containing toluene sulfonamide or formaldehyde. These chemicals can cause redness or irritate the skin.
• Don’t use nail polish remover more than twice a month. Instead, touch up the polish. When you do need a remover, avoid those that use acetone, which dries nails.
• Repair splits or tears with nail glue or clear polish.

Dietary changes that supposedly strengthen nails don’t work. Unless you’re deficient in protein – rare among people in the United States – adding protein to your diet won’t strengthen your nails. Similarly, soaking your nails in gelatin won’t help either.

It’s easy to neglect your nails. But a little basic nail care can go a long way.

Nail biting: Does it cause long-term damage?

Although unsanitary, nail biting typically causes no long-term damage to your nails.

Your nails are formed near where your U-shaped cuticles begin (nail bed). As long as nail biting doesn’t damage this area, your nails will continue to grow even if they’re bitten off on a regular basis. Nail biting can worsen some existing conditions of the nail bed, such as infection of the skin around the nail bed (paronychia) or warts around the nail bed. In addition, you can pass bacteria or viruses from your nails and fingers to your mouth by biting your nails, making it more likely you’ll catch a cold or other infection.

Most nail biting is merely a bad habit that most people eventually break. But constant, severe nail biting can be a sign of anxiety or compulsive behavior. In such cases, you may consider consulting your doctor or a mental health professional for further evaluation. Treatment may include behavioral therapy to help you stop biting your nails.

Ingrown toenail

Introduction

An ingrown toenail is a common condition in which the corner or side of one of your toenails grows into the soft flesh of that toe. The result is pain, redness, swelling and, sometimes, an infection. An ingrown toenail usually affects your big toe.

Often, you can take care of ingrown toenails on your own. If the pain is severe or spreading, however, your doctor can take steps to relieve your discomfort and help you avoid complications of an ingrown toenail.

If you have diabetes or another condition that causes poor circulation to your feet, you’re at greater risk of complications from an ingrown toenail

Causes
Ingrown toenails result when the nail grows into the flesh of your toe, often the big toe. Common causes include:

• Wearing shoes that crowd your toenails
• Cutting your toenails too short or not straight across
• Injury to your toenail
• Unusually curved toenails
• Thickening of your toenails

Treatment

If steps you take at home don’t help, your doctor can treat an ingrown toenail by trimming or removing the ingrown portion of your nail to help relieve pain. Before this procedure, your doctor numbs your toe by injecting it with an anesthetic. After the procedure, you may need to rest your foot and soak it in warm water. Your doctor may also recommend using topical or oral antibiotics for ingrown toenail treatment, especially if the toe is infected or at risk of becoming infected.

For a recurrent ingrown toenail, your primary doctor or foot doctor may suggest removing a portion of your toenail along with the underlying tissue (nail bed) to prevent that part of your nail from growing back. This procedure can be done with a chemical, a laser or other methods.

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Doctor dos & don’ts

DON’T SHARE YOUR NAIL FILE

Resist the urge to let anyone–even a relative–use your emery board. This tool is a porous germ-trapper. Keep yours to yourself, and replace it often.

DO WEAR THE RIGHT SHOE SIZE

Are you cramming your feet into too-small or too-pointy shoes? If so, your toenails may grow into the surrounding skin–causing the dreaded ingrown nail, which can lead to pain, swelling, and infection. When nails are too long, tight shoes can cause even more damage, says Mitchel P. Goldman, M.D., an associate clinical professor of dermatology at the University of California, San Diego. “If your toes hit the front of your shoe, nails can crack or turn black-and-blue. Or nails may lift, which can lead to infection.”

DO MOISTURIZE DAILY

Nails need to be hydrated, since most problems crop up when they’re parched. “Dry nails can crack, peel, and become brittle. Plus, dehydrated cuticles not only look ragged but also can turn into painful and infected hangnails,” says Audrey Kunin, M.D., a Kansas City, Missouri, dermatologist. The best moisturizers are thick–even greasy. Try Elizabeth Arden Eight Hour Hand Cream.

DON’T GO BAREFOOT

Keep your shoes on while at public places (swimming pools, locker rooms, shoe stores)–if you don’t, we won’t be responsible for your toenail health. Why worry? “Warm, damp environments are a breeding ground for fungi and viruses,” explains Phoebe Rich, M.D., a nail disorders expert and a clinical associate professor of dermatology at Oregon Health & Science University in Portland. Tip: If hose isn’t offered when you’re shoe shopping, ask for it.

TLC to help nails grow

“Everyone has an individual rate at which her nails increase in length, and that can’t be changed,” says Paul Kechijian, M.D., a nail specialist and a former clinical associate professor of dermatology at New York University. On average, nails gain about one eighth of an inch per month. Their growth can be influenced by hormones (which is why pregnant women’s nails grow like crazy) and temperature (more growth in summer than in winter). While most experts agree that there’s no single food or pill that will speed nail growth, it’s well-known that poor nutrition, infections, and aging can all slow it. “To keep nails healthy, hydrate them and minimize the use of harsh chemicals and tools,” says Marsha Gordon, M.D., associate clinical professor of dermatology and vice chairman of the dermatology department at Mount Sinai School of Medicine. Help prevent breakage with a hardener like OPI Nail Envy.