Nail Conditions

Tinea unguium

Tinea unguium means a fungal infection in the nail. This occurs most commonly in toenails, but can also be seen in fingernails. To diagnose this, we commonly send a nail clipping to a skin pathologist who can test the nail for the presence of fungus. If fungus is detected, then the most effective medication, oral anti-fungal pills, can be prescribed. Topical medications can also be applied to the nail but have a lower success rate.


Paronychia is a bacterial or yeast infection in the skin folds surrounding the nail. Paronychia is most commonly seen in people who have their hands in water a lot, usually working in the kitchen or washing dishes. Oral or topical prescription antibiotics or anti-yeast medications need to be prescribed.

Thin, brittle nails

As we age, our nails can naturally become thinner or weaker. More commonly though, nails become brittle or break and split because of what we do to them. When nails are repeatedly exposed to soap and water, nail polish remover, nail glues or other chemicals, our nails show the effects. Remember, conditions that cause dry, irritated skin will also produce dry nails. Be sure to keep your hands moisturized, especially the skin around your nails. Cuticle oil may be used as well, particularly during the dry winter months. Lastly, the supplement Biotin can sometimes help grow stronger nails.


Psoriasis can cause the nails to become thick and discolored or to even lift off the nail bed. People with psoriasis also tend to have red, scaly patches on their skin, particularly on knees, elbows, scalp, and lower back. Psoriasis is related to the immune system, and patients are often genetically predisposed. Treatment includes topical medications and if severe enough, potent systemic medications such as Enbrel, Humira, or Stelara.

Black nail

A black nail can be caused by bleeding under the nail (such as hitting a fingernail with a hammer) or a bacterial infection. The serious skin cancer, melanoma, can also grow under the nail to give it a black or dark appearance. So, if your nail turns black and there was no obvious trauma, please get it evaluated by a dermatologist.