fingernails and toenails

Nailed it

YOUR HEATH DR GITA MATHAI

When you are young, fingernails and toenails give no trouble at all. (They may just be a bit dirty). With advancing age, however, they become brittle, hard, fall off or develop infections and become painful. Suddenly, you are forced to notice your nails! Healthy nails are usually smooth and light pink in colour. Blue nails occur when there is a lack of oxygen in the blood (heart and lung disease). Nails can turn black in vitamin B12 deficiency. A horizontal depression or discoloration can develop across the nail due to illness, antibiotics or chemotherapy. The line becomes prominent as the nail grows out and then gradually disappears. Nails may grow brittle if there is anaemia and can also become spoon shaped. The opposite, a bulged out, parrot-beak like club-shaped nail is seen in chronic obstructive airways disease. Splitting and fraying are associated with hypothyroidism and psoriasis. When trimming your toenails: Briefly soak your foot in warm water to soften the nail. Use a clean, sharp nail trimmer. Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not pick or tear at the nails. Fingernails grow faster than toenails. The rate of growth depends on health, heredity and sex. Growth slows during illness and with increasing age, but at the same time, the nails become tougher. They are then more difficult to trim. In prehistoric times people had to bite their nails to trim them but today it is a social no-no. Biting in itself is harmless but it can cause secondary bacterial infection of the skin around the nail. It can cause and perpetuate worm infestation. It can transmit flu viruses acquired from contaminated surfaces directly to the mouth. Bitten down nails may work against you in job interviews. It is a habit that is arises out of lack of impulse control, and is perpetuated by stress. Most important, a close examination of the nails can reveal other disease processes such as iron deficiency (anaemia), vitamin B12 deficiency, diabetes, kidney and liver disease and even infection of the heart valves (endocarditis). In older people (particularly those who have high blood sugar) an infected ingrown toenail (usually the big toe) is a common problem. This occurs when toenails are trimmed too short, blades or knives are used instead of nail cutters or if the edges of the nails are picked and torn. If there is no diabetes, an ingrown toenail can be treated at home by soaking it in warm salted water for 10 minutes and placing a cotton ball soaked in antibiotic ointment under it. Nails are also prone to fungal infections. This destroys the nails and gives it an “eaten away” appearance. Topical ointments are not very effective. Medicines have to be taken orally until the infection resolves and a healthy nail grows out. This takes anywhere from three to six months. Medical conditions like psoariasis may mimic fungal infection. A proper diagnosis is essential before embarking on treatment. In our climate, slippers or open-toed sandals are better than shoes. If shoes have to be worn, they should fit properly. Shoes that you wear every day should have plenty of room around the toes so that nails do not hit the end of the shoe. They should also not be too loose as your feet will slide forward while walking or running and hit the end damaging the nails. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in