Fingertips can provide window to health
Fingernails can tell us if we’re sick. Abnormalities or changes in color or texture may indicate a larger problem, from anemia to heart disease.
Dr. Philip Fleckman, a dermatologist at the University of Washington, examines the nails as one tool in diagnosing possible diseases inside or outside the body: “People don’t think to consider nail changes as mirrors of internal disease. Those funny looking nails might reflect internal disease. They may reflect other skin diseases or injury. Or, they may just be a normal variance.”
Nail color, usually a healthy pink reflecting the tissues beneath the nail, is an indicator of health. Pale or whitish nails may be a sign of iron deficiency, often seen in the chronically ill. Darkening on the outside of the nail might indicate kidney disease.
Bluish discoloration called Cyanosis can indicate that hemoglobin, which carries oxygen in the blood, lacks sufficient oxygen. Lung, heart, or pulmonary disease can prevent adequate oxygen uptake and distribution. By the time someone has blue nails, says Dr. Fleckman, s/he is normally extremely sick, and immediate diagnosis and treatment are necessary.
Yellow nails are usually reactions to chemicals or cigarette smoke. “Yellow nail syndrome,” indicated by thick and slow growing nails combined with a cough or sinus problem, can mean lung disease.
Pitting, spooning (an upward curving nail), and white spots under the nail can indicate a range of illnesses from anemia and hypothyroid to psoriasis. Psoriasis is indicated when arthritis and skin scaling at the elbow accompany pitting. A large spot under the nail is caused by the nail separating from the nail bed and may reflect a number of illnesses. White lines can signal low protein; keratin, a protein, makes your nails hard.
But not all nail color changes reflect disease. Some whitening and thickening is normal with aging, beginning around age 20. Vertical lines called longitudinal ridges and tiny white spots are usually regarded as normal.
Race is a factor as well. Pigmentation bands in the nail of a Caucasian person could indicate cancer, while in a non-Caucasian, pigmentation bands are more likely to be normal. It’s a question of degree and how rapidly the condition has arisen. Know what your nails look like when you’re healthy, so you have a baseline for comparison. A major stroke, surgery, or medications like tetracycline can change the growth rate or color of nails. A horizontal furrow or bowline will eventually grow out.
When a nail is rounder than normal on top and spongy, this is called “clubbing.” It often signals pulmonary, lung or intestinal disease, iron deficiency, or a metabolic disease. Like most nail irregularities, clubbing does not indicate an exact problem but points to the need for further examination.
Brittle nails may indicate thyroid disease, but normally they’re due to low humidity or overexposure to water from frequent hand washing. Doctors recommend wearing plastic gloves when washing dishes, cleaning the bathroom or car, and applying moisturizer. Harsh chemicals such as gasoline, turpentine, nail polish remover, paint, and photographic chemicals can also crack the natural glue that makes nails hard.
Infection is common in toenails and among those sporting artificial nails. New anti-fungal medications are being heavily marketed to consumers. This has occasionally motivated patients and doctors without nail disease expertise to turn to inappropriate and expensive quick fixes.
Older treatments for nail fungus, in pill and cream forms, generally prevent fungal infection from spreading, while newer drugs are orally administered and penetrate the nail to destroy the fungus. The nail needs to grow out so results take eight months to a year. Re-infection is a problem in half of all cases.
Fingernail fashion can cause a variety of health problems. Most salon professionals are competent in advising clients about nail care. Instruments should always be sterilized between clients. It’s also important to avoid using the nail glue methacrolate, which is illegal in many states and can cause serious reactions.
Manicures and nail polish may cover up problem areas, hiding symptoms of illness. Back and forth nail filing can cause splintering; file in one direction only. Chemicals like acetone solvent can weaken the nail. Rubbing alcohol is a better choice to remove polish.
Beauticians should take great care when manipulating the cuticle. Cut cuticles can lead to yeast or bacterial infections. Says Dr. Fleckman, “Your cuticles are there for a reason. It’s there to seal the skin on this nail fold down onto the nail plate. When you push the cuticle back mechanically, you disrupt that seal and can get into problems.” He recommends not touching the cuticle at all or with a wet cloth in the shower. Loose cuticle or hangnails should be carefully trimmed near the skin with cuticle scissors to avoid bleeding.
Dr. Fleckman says it’s a common myth that taking gelatin or calcium strengthens your nails, but it doesn’t. The best maintenance is to use hand creams. In fact, doctors say that nothing is necessary to strengthen a healthy nail. Nature has taken care of that.
By » kyle on 2009-04-27 11:23:04