Nail diseases include a range of diseases or disorders that affect the nails on the fingers or toes. The nails, although often considered purely cosmetic, are actually specialized structures of the skin and can be a reflection of the body's overall health. Changes, discoloration, or abnormalities in the nails may indicate systemic, local, or infectious diseases. “The nail plate is the hard and transparent end that we recognize as the actual “nail.” Below the nail plate is the nail bed, and the nail matrix lies at the base of the nail - this is where the nail is produced. Disturbances in any of these areas can lead to nail diseases or abnormalities,” explains our nail designer Nini.
What causes nail diseases?
Symptoms or signs of nail diseases may include redness, swelling, pain, discoloration, thickening, deformation, or separation of the nail from the nail bed. Visible changes in the color, shape, texture, or thickness of the nail may also occur. Nail diseases can be caused by a variety of factors including:
Infections: These can be bacterial, fungal or viral infections. A common example is nail fungus (onychomycosis), in which the nail becomes discolored, thickened, and brittle.
Traumatic injuries: Impacts, cuts, or pinching of the nail can cause bruising, separation, or other changes.
Systemic diseases: Some diseases that affect the entire body, such as psoriasis, eczema or rheumatoid arthritis, can also cause nail changes.
Environmental factors: Chemical exposure, such as that caused by nail polish removers or cleaning products, or repeated exposure to moisture can affect the nails.
Genetic factors: Some nail diseases can run in families.
“It is important to note that not all changes in the nails indicate disease. Sometimes they are harmless or due to temporary factors. However, nail changes can often be an early sign of a more serious illness, which is why it is advisable to consult a dermatologist or a doctor who specializes in unusual symptoms,” says our nail expert.
The 6 most common nail diseases
If you notice changes in your nails, it may be a sign of an underlying nail disease. Here are some of the most common nail diseases and their symptoms and causes:
1. Nail fungus (onychomycosis)
Nail fungus, also known as onychomycosis, is a common infection that affects one or more fingernails or toenails. The infection often begins as a yellow or white spot under the tip of the nail and can continue to spread, causing thickening, decay, and even loss of the nail.
Causes of nail fungus
Nail fungus is primarily caused by dermatophytes, a type of fungus. However, yeast and mold can also cause these nail infections. These organisms thrive in warm, moist environments, such as those found in swimming pools, showers, or sweaty shoes. Since toenails are often kept in such a climate and also have less blood flow than fingernails, they are more susceptible to infections.
Risk factors for nail fungus
- Older age, associated with reduced blood circulation and more years of potential exposure to fungi
- Heavily stressed feet, especially in shared showers, gyms or swimming pools
- A weakened immune system
- Skin diseases such as psoriasis
- Diabetes or other circulatory disorders
Symptoms of nail fungus
Signs and symptoms of nail fungus can vary, but some of the most common include:
- Thickening of the nail
- Discoloration, usually yellowish, white or even black
- Brittle, crumbling, or flaky nails
- Deformation of the nail
- A slightly unpleasant smell
Transmission of nail fungus
Nail fungus can spread from one nail to the next or to other areas of the body. It is also possible for someone to become infected in environments with high levels of fungus, such as communal showers or swimming pools.
Prevent nail fungus
There are various measures that can help prevent nail fungus:
- Keep your nails short, dry and clean
- Avoid walking barefoot in common areas
- Change shoes and socks regularly to keep your feet dry
- Use antifungal sprays or powders if necessary
Nail fungus can be stubborn and is often difficult to treat. If you notice signs of a fungal nail infection, it is advisable to visit a dermatologist or podiatrist for professional evaluation and treatment instructions.
2. Inflammation of the nail bed (paronychia)
Nail bed inflammation, also known as paronychia, refers to inflammation of the nail bed and is one of the most common diseases of the hand. It can be acute or chronic and affects both fingernails and toenails. Here is a detailed look at this condition:
Causes of nail bed inflammation
- Infection: Bacteria, especially staphylococci, are common causes. Fungi and viruses can also play a role, especially in the chronic form
- Injuries: Smallest injuries, such as those that can occur when cutting nails or tearing cuticles, often provide entry points for pathogens
- Chemical irritation: Frequent contact with cleaning agents or solvents can irritate the nail bed and promote inflammation
- Pre-existing conditions: Illnesses such as diabetes or a weakened immune system increase the risk of nail bed inflammation
Symptoms of nail bed inflammation
The typical signs of nail bed inflammation include:
- Redness and swelling of the affected area
- Pain and tenderness
- Pus formation under or around the nail
- Change in nail growth or color
- In chronic paronychia, the nail may become thickened or deformed
Risk factors for nail bed inflammation
Certain factors increase the risk of developing nail bed inflammation:
- Frequent contact with water, e.g. B. for professions such as chefs, hairdressers,
- Nursing staff or cleaning staff
- Nail biting or improper nail cutting
- Existing skin diseases such as eczema or psoriasis
- Weakened immune system or underlying medical conditions
Prevent nail bed inflammation
To protect against nail bed inflammation you should:
- Keep your hands dry regularly and wear gloves when working with water or chemicals
- Avoid injury to nails or cuticles
- Trim your nails regularly but carefully, being careful not to cut them too short or damage the cuticles
- At the first signs of inflammation, keep the affected area clean and dry and, if necessary, consult a doctor
Our nail designer Nini warns: “Nail bed inflammation can be very painful and, if not treated properly, can lead to permanent damage to the nail or further infections. It is therefore important to pay attention to the first symptoms and seek medical advice if necessary!”
3. Nail debris (onycholysis)
Onycholysis refers to the separation of the nail from its nail bed. This condition can affect both the fingernails and toenails and can vary in extent, from small detached areas to complete detachment of the entire nail.
Causes of Nail Debris
- Trauma or injury: Often the direct cause is repeated trauma, such as constantly hitting the nail or wearing shoes that are too tight and crush the toenail
- Infections: Fungal infections can cause the nail to detach from the nail bed. Bacterial or viral infections can also promote onycholysis
- Diseases: Certain skin diseases, such as psoriasis, eczema or dermatitis, can lead to onycholysis. Systemic diseases such as thyroid disease or iron deficiency anemia can also play a role
- Chemicals: Frequent contact with harsh chemicals, such as nail polish removers or cleaners, can contribute to nail peeling
- Medications: Some medications, especially chemotherapy drugs, can cause nail changes including onycholysis
Typical signs of onycholysis
- The nail that separates from the tip or sides of the nail bed
- A changed, often whitish or yellowish, color of the detached nail area
- The affected area is painless but may be sensitive to pressure or shock
Risk factors for nail debris
Factors that may increase the risk of onycholysis include:
- Washing your hands frequently or soaking your nails in water for a long time
- Occupations that subject the hands or feet to constant injury or exposure to chemicals
- Nail biting or aggressive manicure practices
- Prevention of nail debris
- Wear gloves when working with water or chemicals
- Avoid impacts and trauma to the nails
- Avoid wearing shoes that are too tight
- Keep nails clean and dry and avoid aggressive manicure practices
Onycholysis is more than just a cosmetic problem. Because the detached nail area creates a barrier to protect the underlying nail bed, onycholysis can lead to further infections and complications. It is therefore important to identify the cause early and, if necessary, consult a dermatologist or specialist.
4. Brittle nails (onychoschisis)
Onychoschisis refers to the layered splitting or detachment of the outer layers of the nail, especially the free end of the nail. This condition often affects the fingernails and is characterized by thin, brittle, and peeling nails. You can find a detailed explanation of onychoschisis here.
Causes of brittle nails
Onychoschisis can be caused by a variety of factors:
• External factors: Frequent soaking of hands in water (e.g. from washing dishes or long baths) and subsequent exposure to dry air can dry out the nails and promote their separation in layers
• Chemicals: Repeated use of nail polish, nail polish remover, and other chemicals can damage the nail and lead to onychoschisis
• Trauma: Constant microtrauma, such as scratching or rubbing nails, can also contribute
• Nutritional deficiencies: Deficiencies in certain vitamins and minerals can affect nail health
Symptoms of brittle nails
The main feature of onychoschisis is the peeling or splitting of the nail layers at the free end of the nail. This can look like this:
- Thin, brittle nails that flake easily.
- Horizontal cracks or splits at the end of the nail.
- Possible discoloration or clouding of the affected nail area.
Risk factors for brittle nails
Some people are more susceptible to onychoschisis than others. Risk factors include:
- Female gender: Women are affected more often than men, possibly due to cosmetics or manicure practices
- Older age: As we age, nails can lose moisture and become more prone to splitting
- Occupations or hobbies that require frequent hand contact with water or chemicals
Prevention of brittle nails
To prevent onychoschisis or minimize its progression, some simple precautions are helpful:
- Soak your hands and nails in water as little as possible and then always dry them well
- Wear gloves when coming into contact with water or chemicals
- Avoid using aggressive nail polish removers and only apply nail polish occasionally
- Use moisturizers or special nail oils to keep nails hydrated
- Keep nails short and clean and gently file sharp edges to minimize peeling
“If you notice signs of onychoschisis and they progress or worsen despite prevention, it is advisable to see a dermatologist or other specialist to determine the exact cause and receive appropriate treatment,” says our nail expert Nini.
5. Spoon nails (koilonychia)
Koilonychia, often referred to as "spoon nails," describes a nail disorder in which the nails become thin and take on a concave, spoon-like shape. The condition can be either congenital or acquired and usually occurs in the fingernails, but can also affect the toenails.
Causes of spoon nails
The exact cause of koilonychia can vary, some of the most common factors include:
- Iron deficiency: One of the most well-known causes of koilonychia is iron deficiency, which can lead to anemia
- Genetics: In some cases, koilonychia may be due to genetic factors and may occur as a congenital condition
- Environmental factors: Frequent contact with water or chemicals, trauma, or injury can also contribute to the development of spoon nails
- Other medical conditions: Certain medical conditions such as Raynaud's syndrome, systemic lupus erythematosus, or psoriasis may also be associated with koilonychia.
Symptoms of spoon nails
The main feature of koilonychia is the visible change in the structure of the nail:
- The nail becomes thin and takes on a concave shape, similar to the appearance of a spoon
- The nail may be softer or more brittle
- In some cases, the nails may have an unusual color or spots.
Risk factors for spoon nails
Some people are more susceptible to koilonychia due to certain risk factors:
- Age: Children may be more susceptible to spoon nails, although the condition often improves on its own as they get older
- Dietary habits: People who do not get enough iron from their diet are at higher risk
- Occupational exposure: People whose hands come into frequent contact with water or chemicals, such as cleaners, may be more susceptible to koilonychia
Prevention and diagnosis of spoon nails
It is important to identify the underlying cause of koilonychia to determine the best prevention or management strategies:
- A balanced diet that contains enough iron can help reduce the risk of spoon nails
- Protect hands from excessive contact with water and chemicals by wearing gloves
- A doctor may do a blood test to diagnose iron deficiency or other underlying conditions
Our nail designer Nini warns: “If you notice signs of koilonychia, especially if they appear suddenly or are accompanied by other symptoms, it is advisable to see a dermatologist or other specialist. They can make an accurate diagnosis and give recommendations for treatment!”
6. Dimple in the nail (pitting)
Nail pits, often referred to as "nail pitting" or simply "pitting," are small, pinpoint-like depressions or dents on the surface of the nail. This phenomenon can occur on both the fingernails and toenails and is often a sign of an underlying medical condition.
Causes of nail pitting
- Psoriasis: One of the most well-known causes of nail pitting is psoriasis, a chronic skin disease. Many people with psoriasis experience specific nail changes, including pitting
- Alopecia Areata: This is an autoimmune disease that causes hair loss and can also lead to nail pitting
- Eczema: Nail pitting can also occur in people who suffer from eczema
- Other Skin Conditions: Certain other skin conditions can also cause nail pitting
Symptoms of nail pitting
In addition to the small dents or depressions on the nail surface that are characteristic of pitting, people with this nail condition may also notice other symptoms on their nails:
- Discoloration or stains
- Thickening or splitting of the nail
- Lifting the nail off the nail bed
Risk factors for nail pitting
Some people are at higher risk of nail pitting due to certain conditions or medical conditions:
- People with a family history of psoriasis or other skin diseases
- People suffering from certain autoimmune diseases
- People with frequent nail injuries or infections
Diagnosis and further information about nail pitting
If you notice signs of nail pitting, it is important to see a dermatologist or other specialist. This can not only assess the pitting itself, but also look for other signs of an underlying disease. In some cases, tests or examinations may be necessary to determine the exact cause of pitting. “Identifying and treating the underlying cause of nail pitting can not only help improve the appearance of the nails, but also manage other possible symptoms or complications associated with the condition,” says our nail designer Nini.
Pay attention to your nails
Each part of the nail has a specific function, and together they form a structure that is both protective and functional. Healthy nail care , protection and attention to changes or abnormalities in the nail area are important to ensure the overall health of the nails and to detect potential nail diseases early. Please remember that if you have any abnormalities or problems with your nails, it is important to consult a dermatologist or a doctor who specializes in this area. This overview is intended to serve as a guide only and does not replace the professional advice of a doctor.