It’s a safe bet that most people take the health of their nails for granted. However, Dr. Jeffery Ross Gunter of SummitMD Dermatology recommends keeping a close watch on them. “Your body is always talking to you and letting you know when something is wrong. That includes our nails. If we pay attention to their color, shape, and texture, they will tell us when there’s a problem.”
Nail fungal infections are very common, says Dr. Gunter, and are highly contagious. “Anyone who walks barefoot around a warm, wet place like a locker room or pool is vulnerable to them. These areas are the perfect breeding ground for a fungus that spreads quickly. All that has to happen is for one person with a nail infection to walk there. When you walk in that same area, you can pick it up.”
Another risk, he states, comes from having wet nails for a prolonged period of time. “People who get their hands wet often because of a job or a hobby or athletes who put on the same sweaty shoes each day can develop a nail fungus, too.”
What the nails look like will depend on what caused the infection. “It is common for them to become discolored,” says Dr. Gunter. “They usually turn green, yellow, or brown and may have a white spot. As the infection progresses, you’ll see more symptoms, including crumbling, lifting up from the finger, or thickening. Conversely, the nails might become thinner. It’s important to pay attention to any changes in them.”
Treatment is normally very effective. “Although you will probably lose the nail, you will regrow it if the infection is caught early enough,” states Dr. Gunter. “Treatment also can localize the infection. It is very easy for a nail fungus to spread to another nail or to someone else.”
Dr. Gunter always emphasizes the importance of quickly treating a nail fungus infection to his patients who have a weakened immune system or diabetes. “Diabetics, in particular, must avoid developing sores or infections. These pose a serious health risk, so I counsel these patients to come in immediately if they suspect a nail infection.”
Dr. Gunter has suggestions for preventing nail fungus infections. “Protect your feet by wearing flip flops around pools, showers, and locker rooms. Doing so will help you avoid athlete’s foot and nail fungus. Remember, too, that once you are done treating the infection, you should throw away anything you wore prior to the treatment. This is worth the cost because a fungus can live for a long time in your shoes, and that could cause a new infection.”
The best defense, he says, includes putting on a clean pair of socks each day and alternating the shoes that you wear so that they have time to dry out. To keep your feet dry, make sure your shoes fit properly. “Shoes that are made of leather or canvas are particularly good to wear. Remember to put antifungal powder in them and to keep your nails short.”
Nail psoriasis is another ailment that Dr. Gunter is experienced in treating. “I typically see nails that are pitted or crumbling and that have blood under them. They also are discolored and are brown, yellow, or white. It’s vital to see a dermatologist for this because without treatment, the pain will increase, and you might develop ‘disappearing’ nails, limiting your ability to walk or use your hands.”
When Dr. Gunter diagnoses nail psoriasis, the treatment he prescribes can last for several months. “This is because nails grow so slowly. It takes time for the treatment to really penetrate them and be effective. I normally give the patient a strong corticosteroid that is applied to the nail several times a day. For stronger treatments, I consider giving my patients a different psoriasis medicine.”
The key to the successful treatment of nail fungus infections and nail psoriasis, Dr. Gunter says, is consistency. “With some cases, it can take a few months to see results. By staying with the treatment plan and being patient, you should see the infection clear up.”
Jeffrey Ross Gunter, MD, FAAD is a board-certified dermatologist at SummitMD Dermatology. He is a graduate of the Keck School of Medicine at the University of Southern California where he was previously a Clinical Professor of Dermatology and Chief Resident of Dermatology at the LAC/USC Medical Center in Los Angeles, CA.
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