Consultant dermatologists are experts in the treatment of nails. Having normal nails is something most of us take for granted. When nails are abnormal, they can have an impact on the quality of life both from a mechanical point of view and a cosmetic point of view.
Common diseases affecting the nails include psoriasis and eczema. There is often confusion with nails, but they are specialised parts of the skin and are included in the disease process along with the skin itself.
Other causes of nail abnormalities include congenital conditions (ones you have inherited from your parents), although these are generally rare; and other acquired conditions like lichen planus, alopecia areata and fungal nail infections.
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What does this treatment do?
Before any therapy, a diagnosis is needed and then an appropriate treatment course can be planned. This may be treatment with antibiotics or anti-fungal agents to combat infection; therapy aimed at the eczema or psoriasis; or surgery to a lesion of some sort.
Topical therapies can be useful in some circumstances, but systemic treatment is typically needed to cure the disease. There are potential side effects from the oral drugs that are usually used and so alternative forms of treatment are available. Laser therapy has become increasingly popular as this can kill the fungi allowing the nail to recover, but without risk of systemic side effects at all.
Proof of nail infection is required before embarking on any treatment. Some GPs will carry out this test for you. Alternatively, this test can be carried out in the clinic with us at the same time as your initial consultation. The test results can take up to 3 weeks to come back.
Frequently asked questions
There are five common abnormalities, but you can also suffer ridging, washboard nails, thickening, scarring and loss of nails, all with a variety of causes.
Brittleness: increases with age and can be associated with iron deficiency in some people.
Roughness: common and usually of little significance.
Pits: classical feature of psoriasis, but also found in eczema and in alopecia areata.
Onycholysis: Lifting of the nail from the underlying nail bed, which can be found in psoriasis, fungal infections, overactive thyroid, lesions under the nail, associated with some medications, but sometimes without cause.
Discoloration: white marks are common and normal. However, coloured nails can often suggest other issues:
- white nails can be found in liver disease
- pale nails in anaemia
- yellow nails in fungal infections
- green-blue ones in pseudomonas infection
- black-brown with bruising, moles or melanoma.